Moderation of Physical Activity between Cardiometabolic Risk and Adiponectin in Adolescents.

The aims of the study were to examine the moderating role of physical activity in the relationship between cardiometabolic risk factors and adiponectin concentration in adolescents. This is a cross-sectional study conducted with 96 adolescents of both sexes, between 11 and 17 years old. Body mass, height, fat mass (FM), fat-free mass, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein (LDL-c), triglycerides, insulin, adiponectin, C-reactive protein, and level of physical activity (energy expenditure questionnaire) were measured. Body mass index (BMI), triponderal mass index (TMI), homeostasis model to assessment insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Macro-PROCESS for SPSS was used for moderation analyses. Direct interactions were found for BMI, TMI, FM, insulin, and HOMA-IR and inverse for LDL-c, and QUICKI. Protection against cardiometabolic risk was found when the PA-coeff was completed above 1.57 coeff (BMI), 1.62 coeff (TMI), 1.55 coeff (FM), 1.41 coeff (LDL-c)1.60 coeff (insulin), 1.59 coeff (HOMA-IR) and 1.35 coeff (QUICKI). We conclude that physical activity was a moderator in the relationship with adiposity, insulin resistance and sensitivity, LDL-c, and adiponectin. In this context, we evidenced a relevant clinical impact on the health of adolescents, demonstrating the interaction between anthropometrics variables and physical activity.

Effects and individual response of continuous and interval training on adiponectin concentration, cardiometabolic risk factors, and physical fitness in overweight adolescents.

This study aimed to evaluate the effect and individual responsiveness after 12 weeks of high-intensity interval training (HIIT) and moderate-intensity of continuous training (MICT) on adiponectin, cardiometabolic risk factors and physical fitness in overweight adolescents. This study was participated by 52 adolescents, both sexes, 11 and 16 years old, separated into HIIT (n = 13), MICT (n = 15), and control group (CG, n = 24). Body mass, height, waist circumference (WC), fat mass (FM), fat-free mass (FFM), blood pressure, high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides, glucose, insulin, adiponectin, and C-reactive protein (CRP) were evaluated. Body mass index z-score (BMI-z), waist-to-height ratio (WHtR), insulin resistance, and insulin sensitivity were calculated. Resting heart rate (HRrest), peak oxygen consumption (VO2peak), right handgrip strength (HGS-right), left handgrip strength (HGS-left), and abdominal resistance (ABD) was evaluated. HIIT session lasted around 35 min and MICT of 60 min of exercises on stationary bicycle, three times a weekday for 12 weeks. ANOVA, effect size, and prevalence of responders were used for statistical analysis. HIIT reduced BMI-z, WHtR, LDL-c, and CRP, while increased of physical fitness. MICT reduced HDL-c, while increased of physical fitness. CG reduced FM, HDL-c, and CRP, while increased FFM and HRrest. Frequencies of respondents in HIIT were observed for CRP, VO2peak, HGS-right, and HGS-left. Frequencies of respondents in MICT were observed for CRP and HGS-right. Frequencies of no-respondents in CG were observed for WC, WHtR, CRP, HRrest, and ABD.  Conclusion: Interventions with exercises were effective to adiposity, metabolic health, and physical fitness improvements. Individual responses were observed in inflammatory process and physical fitness, important changes in overweight adolescent's therapy.  Trial registration number and date of registration: This study was registered with the Brazilian Registry of Clinical Trials (REBEC), the number RBR-6343y7, date of registration May 3, 2017. What is Known: • Effect of regular physical exercise positively affects overweight, comorbidities, and metabolic diseases, recommended mainly for children and adolescents. What is New: • Due to the great inter-individual variability, the same stimulus can provide different responses; adolescents who benefit from the stimulus are considered responsive. • Intervention of HIIT and MICT did not alter the concentrations of adiponectin; however, the adolescents presented responsiveness to the inflammatory process and physical fitness.

Prediction equations for maximal heart rate in obese and nonobese children and adolescents: a systematic review and meta-analysis.

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

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

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

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

Effects of resistance training on the glycemic control of people with type 1 diabetes: a systematic review and meta-analysis

ABSTRACT Resistance training has shown the potential to contribute to better glycemic control in people with Type 1 Diabetes (T1D), however, there are contradictory results in this regard and a need to clarify the effects of isolated resistance training on glycemic control in T1D. The aim was to verify the effects of resistance training on the glycemic control of people with T1D. Original articles were selected, randomized and non-randomized clinical trials that aimed to verify chronic responses, through the concentrations of glycated hemoglobin (HbA1c), to a structured program of resistance exercise in the glycemia of patients with T1D. The following databases were searched; MEDLINE, PubMed, Web of Science, Scopus, ScienceDirect, LILACS, and SciELO. Five studies were included in the review. A reduction in HbA1c was observed (SMD = -0.568 ± 0.165 [95% CI = -0.891 to -0.246]; p = 0.001; I² = 82%) in patients undergoing resistance training, when compared to the control group (SMD = 1.006 ± 0.181 [95% CI = 0.653 to 1.360]; p <0.001). Two studies, with children and adolescents and longer interventions, demonstrated a significant reduction in HbA1c, increased strength, and an improved lipid profile. Resistance training was efficient for assisting in glycemic control in people with T1D and should be incorporated in treatment plans.

Family History of Hypertension: Impact on Blood Pressure, Anthropometric Measurements and Physical Activity Level in Schoolchildren

Abstract Background: A family history of arterial hypertension (AH), combined with environmental risk factors, is directly related to the development of AH. Objectives: To evaluate the frequency of AH, anthropometric indicators and level of physical activity and their association with a family history (FH) of AH in school children. Methods: Cross-sectional study with 118 students, aged between 11 and 17 years, of both sexes. Waist circumference (WC), weight, height, level of physical activity and FH of HA were collected. Body mass index z score (BMI-z) and waist-to-height ratio (WHtR) were calculated. Binary logistic regression model was used to verify the chance risk, with significance p <0.05. Results: Of the 118 parents who answered the questionnaire, 34.7% had a positive FH of AH. Girls with a positive FH had higher means of WC (p= 0,004), BMI (p=0,020), and systolic blood pressure (SBP) (p=0,006) than boys, and a higher risk of being overweight (OR=4,48; 95%CI:1,55-12,94), and having elevated WHtR (OR=5.98; 95%CI:1.66- 21.47) and SBP (OR=3,07; 95%CI:1,03-9,13) than girls without a FH, but they practice more vigorours moderate physical activity (MVPA) (p=0,039). On the other hand, no differences in these parameters were observed between boys with and without a FM of AH. Conclusion: Overweight and a FH of hypertension were associated with an increased risk for AH in girls. This was not observed among boys, perhaps due to more active lifestyle.

Instruments For Assessment Of Excessive Daytime Sleepiness In Brazilian Children And Adolescents: Systematic Review.

OBJECTIVE: To systematically review the literature on the instruments used to assess excessive daytime sleepiness (EDS) in Brazilian children and adolescents. DATA SOURCE: A systematic review of the literature was performed in the databases MEDLINE PubMed, Scopus, Web of Science, LILACS, Scielo and SPORTDiscus, with no time limit for searches. The eligibility criteria were studies published in English and Portuguese, original articles that used questionnaires to assess EDS and whose sample consisted of Brazilian children and/or adolescents. As search strategy, the following terms were combined with Boolean operators "OR" and/or "AND": drowsiness, disorders of excessive somnolence, excessive daytime sleepiness, day sleepiness, midday sleepiness, daytime sleepiness, adolescents, Brazil, Brazilian adolescents, and children. DATA SYNTHESIS: Sixteen articles were selected, in which nine different instruments were applied to 8.240 children and adolescents from the South, Southeast, Midwest and Northeast regions of Brazil. The mean of methodological quality of studies was 16.1±1.9 points. The instruments most frequently used were the Pediatric Daytime Sleepiness Scale (PDSS) and Karolinska Sleepiness Scale (KSS), but only PDSS was shown reliable to assess EDS in Brazilian children and adolescents. CONCLUSIONS: The PDSS was the only instrument considered reliable to assess EDS in Brazilian children and adolescents. Further research on EDS in children and adolescents are suggested to perform the validation of other instruments for Brazil and present internal consistency values.

Comparison between girls and boys lifestyle profile and physical activity / Comparação do perfil de estilo de vida e a prática de atividade física entre meninas e meninos

The aim of this study was to compare lifestyle profile and physical activity between girls and boys. A total of 336 students 11 to 17 years old participated in the study (51.5% female). Height, body mass, sexual maturation and z-score body mass index (BMI-z) were assessed. The level of physical activity (PA) was determined through the International Physical Activity Questionnaire (IPAQ). Lifestyle was assessed using the Individual Lifestyle Profile questionnaire (PEVI), computing the total scores from five components and considering the following cutoff points: >30 points = favorable PEVI; and ≤30 points = unfavorable PEVI. Results showed 35.1% of the students were considered overweight, 74.78% did not comply with the recommendations for physical activity and 31.5% presented unfa-vorable PEVI. There was a difference between boys and girls in moderate to vigorous physical activity (MVPA) (p = 0.048). Boys presented better lifestyle (p = 0.06) and had, on average, more light PA (p < 0.01), moderate PA (p < 0.01), vigorous PA (p < 0.01) and MVPA (p < 0.01) than girls. Girls with favorable PEVI had higher average levels of light PA than those with unfavorable PEVI (p < 0.001). It was concluded that boys are more active during the week when compared to girls. However, they also present fewer concerns with preventive behaviors and relationships. Light PA was higher in girls with a favorable lifestyle profile

O objetivo deste estudo foi comparar o perfil de estilo de vida e a prática de atividade física entre meninas e meninos. Participaram do estudo 336 escolares, de 11 a 17 anos de de idade (51,5% sexo feminino). Foram avaliados a estatura, massa corporal, maturação sexual e índice de massa corporal escore z (IMC-z). O nível de atividade física (AF) foi analisado pelo International Physical Activity Questionnaire (IPAQ). O estilo de vida foi avaliado por meio do questionário Perfil do Estilo de Vida Individual (PEVI), analisando o total de escores dos cinco componentes, considerando-se como pontos de corte: >30 pontos = PEVI favorável e ≤30 pontos = PEVI desfavorável. Observou-se que 35,1% dos escolares foram considerados acima do peso, 74,78% não cumprem as recomendações de atividade física e 31,5% apresentaram PEVI desfavorável. Existiu diferença entre meninos e meninas para a prática de atividade física moderada e vigorosa (AFMV ) (p = 0,048). Os meninos apresentaram melhor estilo de vida (p = 0,06) e praticam em média mais AF leve (p < 0,01), AF moderada (p < 0,01), AF vigorosa (p < 0,01) e AFMV (p < 0,01) do que meninas. Enquanto as meninas com PEVI favorável praticam em média mais AF leve do que aquelas com PEVI desfavorável (p < 0,001). Concluiu-se que meninos praticam mais AF na semana em relação às meninas, entretanto possuem menor preocupação com comportamentos preventivos e relacionamentos. A prática de AF leve foi maior em meninas com perfil de estilo de vida favorável

Hypertensive Measures In Schoolchildren: Risk Of Central Obesity And Protective Effect Of Moderate-To-Vigorous Physical Activity. / Medidas Hipertensivas em Escolares: Risco da Obesidade Central e Efeito Protetor da Atividade Física Moderada-Vigorosa.

Background The proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities. Objective To verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren. Methods 336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95thpercentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05. Results It was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬-14.42) and overweight (OR = 2.91; 95% CI: 1.76-4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15-0.72). Conclusion Central obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49).

Validation of equations to estimate the peak oxygen uptake in adolescents from 20 metres shuttle run test.

This study aimed to develop new prediction models from directly determined peak of oxygen uptake (VO2peak) in adolescents using 20-metre shuttle run test (20 m-SR) and to compare the new models with previously published equations. This study included 148 adolescents (43% girls), aged 13.37 ± 1.84 years old. Adolescents were randomly assigned to validation (n = 91) and cross-validation (n = 57) groups. VO2peak was measured using a gas analyser in both maximal exercise tests in the laboratory as well as by 20 m-SR. The multiple linear regression method was applied to develop the models using BMI, BMI-z score and body fat percentage (%FM). The proposed models presented better predictive performance (R2 = 75.6% to 78.9%) and a lower absolute percentage error (%error = 10.51 to 11.78%) than the previously published equations (R2 = 38.8% to 69.1%; %error = 13.13% to 21.54%). The Model with BMI-z was the best fit equation in girls, and the model with BMI-z and %FM in boys. Therefore, it is recommended that the equations developed in the present study be used in future research and projects in the school environment to estimate VO2peak in adolescents by the 20 m-SR test.

Medidas Hipertensivas em Escolares: Risco da Obesidade Central e Efeito Protetor da Atividade Física Moderada-Vigorosa / Hypertensive Measures In Schoolchildren: Risk Of Central Obesity And Protective Effect Of Moderate-To-Vigorous Physical Activity

Resumo Fundamento Aumento da prevalência de hipertensão arterial (HA) em crianças e adolescentes e sua associação com diversas comorbidades. Objetivo Verificar a associação de HA, obesidade central e obesidade geral, e nível de atividade física em escolares. Métodos Participaram do estudo 336 crianças e adolescentes, de 11 a 17 anos de idade. Aferiram-se estatura, peso corporal, circunferência da cintura (CC) e pressão arterial (PA). Foi calculado o índice de massa corporal escore z (IMC-z). O nível de atividade física foi avaliado pela versão curta do International Physical Activity Questionnaire (IPAQ), conforme a prática em atividades físicas moderadas-vigorosas (AF-mv). Consideraram-se hipertensos os escolares que apresentaram pressão arterial sistólica (PAS) e/ou diastólica (PAD) superiores ao percentil 95, de acordo com sexo, faixa etária e estatura, ou ≥120×80mmHg. Utilizaram-se os testes estatísticos de t-Student , Qui-quadrado, Mann-Whitney e modelo de regressão logistica binária, considerando-se o nível de significância de p<0,05. Resultados Foram observados que 40,5% dos escolares apresentaram HA, 35,11% excesso de peso (12,5% obesos), 13,39% CC elevada e 40,2% foram considerados insuficientemente ativos em AF-mv. As chances de HA foram relacionadas à CC elevada (OR=6,11; IC95%:2,59 a 14,42) e ao excesso de peso (OR=2,91; IC95%:1,76 a 4,79). Além disso, os adolescentes que praticavam AF-mv apresentaram menor risco de PAD elevada (OR=0,33; IC95%:0,15 a 0,72). Conclusão Concluiu-se que a obesidade central, a obesidade geral e o sexo masculino foram os melhores preditores de HA em crianças e adolescentes. A prática de AF-mv demonstrou efeito protetor na PAD elevada em escolares. (Arq Bras Cardiol. 2020; 115(1):42-49)

Abstract Background The proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities. Objective To verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren. Methods 336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95thpercentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05. Results It was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬-14.42) and overweight (OR = 2.91; 95% CI: 1.76-4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15-0.72). Conclusion Central obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49)

Effect of combined interval training on the cardiorespiratory fitness in heart failure patients: a systematic review and meta-analysis.

BACKGROUND: The combination of interval training and resistance training has showed interesting results in chronic heart failure patients, corroborating the benefits of physiological adaptations of both protocols. OBJECTIVE: To evaluate the effect of the combination of interval training and resistance training program when compared to interval training alone and/or without intervention group on cardiorespiratory fitness in patients with chronic heart failure. METHODS: We search MEDLINE via PubMed, ScienceDirect, Sportdiscus, BIREME and Scielo, from their inception to December 2018. Were included both randomized and non-randomized controlled trials comparing the effect of combined training, interval training alone and/or WI group on VO2peak (expressed in ml/kg/min), in people with chronic heart failure patients. The meta-analysis was conducted via Review Manager v 5.3 software, using random effect model. RESULTS: Ten articles were selected (nine randomized controlled trial), involving 401 participants. Six studies compared combined training with interval training and six studies compared combined training with the without intervention group. Eighty percent of the trials presented moderate risk of bias and twenty percent low risk of bias. Data showed significant difference and major increase in VO2peak in favor to combined training group compared to interval training group (SMD=0.25; CI=0.04-0.46) and without intervention group (SMD=0.46; CI=0.29-0.64), respectively. CONCLUSION: The combination of interval training and resistance training showed more effective in increasing cardiorespiratory fitness in patients with heart failure than interval training alone and non-exercise therapy. However, further studies should be conducted to increase the understanding of this combined training method.

Effect of different interval training protocols on adiposity indicators in overweight-obese children and adolescents: a systematic review and meta-analysis / Efeito de diferentes protocolos de treinamento intervalado sobre indicadores de adiposidade em crianças e adolescentes com sobrepeso e obesidade: uma revisão sistemática e metanálise

ABSTRACT The present meta-analysis verified the impact of different protocols of high-intensity interval training (HIIT) on indicators of adiposity in overweight and obese children and adolescents. Searches were performed in the databases: PubMed, ScienceDirect, SPORTDiscus, LILACS and SciELO. Were included studies without caloric restriction that aimed to verify the effect of HIIT interventions on the adiposity indicators in overweight children and adolescents published until December 2018. The PEDro scale was used to assess the risk of bias. The meta-analysis was conducted in the Revman software using standardized mean difference (SMD) data and 95% confidence intervals (CI). Seventeen studies were selected, which involved 289 children and adolescents with overweight and obesity. HIIT interventions (mean=11.7±5.9 weeks) produced significant decreases in body fat percentage (SMD=-0.65; CI=-1.07, -0.23) and waist circumference (SMD=-0.34; CI=-0.49, -0.18). Also, major relative risk of decrease in body fat percentage were observed in favour to protocols with work/recovery interval ratios of 1:1 and 2:1. HIIT protocols with ratios (work/recovery intervals) 1:1 and 2:1 promote significant reductions in fat percentage and waist circumference in overweight and obese children, independently of the total work time.

RESUMO A presente meta-análise verificou o impacto de diferentes protocolos de treinamento intervalado de alta intensidade (HIIT) sobre indicadores de adiposidade em crianças e adolescentes com sobrepeso e obesidade. As buscas foram realizadas nas bases de dados: PubMed, ScienceDirect, SPORTDiscus, LILACS e SciELO. Foram incluídos estudos sem restrição calórica, que objetivaram verificar o efeito das intervenções do HIIT nos indicadores de adiposidade em crianças e adolescentes acima do peso publicados até dezembro de 2018. A escala PEDro foi utilizada para avaliar o risco de viés. A meta-análise foi conduzida no software Revman a partir dos dados de diferença média padronizada (SMD) e intervalos de confiança de 95% (IC). Foram selecionados 17 estudos, envolvendo 289 crianças e adolescentes com sobrepeso e obesidade. As intervenções de HIIT (duração=11,7±5,9 semanas) produziram reduções significativas no percentual de gordura corporal (SMD=-0,65; IC=-1,07,-0,23) e circunferência da cintura (SMD=-0,34; IC=-0,49-0.18). Também foi observado um risco relativo maior de diminuição do percentual de gordura corporal a favor de protocolos com proporção de intervalos de trabalho/recuperação de 1:1 e 2:1. Protocolos HIIT com proporções 1:1 e 2:1 promovem reduções significativas no percentual de gordura e circunferência da cintura em crianças com sobrepeso e obesidade, independentemente do tempo total de trabalho.

Predictive equations of maximum oxygen consumption by shuttle run test in children and adolescents: a systematic review / Equações preditivas do consumo máximo de oxigênio por meio do teste shuttle run em crianças e adolescentes: uma revisão sistemática

ABSTRACT Objective: To systematically review the literature as for the level of evidence of predictive equations of VO2peak through the 20-meter shuttle run test (20m-SRT) in children and adolescents. Data sources: Searches were conducted independently by two researchers, according to the procedures adopted by PRISMA, in the electronic databases MEDLINE via PubMed, ScienceDirect, Web of Science, LILACS and SciELO, for articles published until September 2017 in English and Portuguese. The inclusion criteria were: original studies, abstract available, using predictive equations of VO2peak through 20m-SRT, conducted with adolescents and/or children, non-athletes, and mentioning correlation analysis between predicted and measured VO2peak. The level of evidence of equations was based on the risk of bias of the studies using the following criteria: sample number, sample characteristics, and statistical analysis. Data synthesis: Eighteen studies were selected, in which fifteen equations were found and analyzed. The studies had been conducted with samples composed of subjects of both sexes, aged 8 to 19 years. Equations of Léger and Matsuzaka had their level of evidence classified as high, and estimation ranged between r=0.54-0.90 and r=0.65-0.90. Equations by Ruiz, Barnett and Matsuzaka had their level of evidence classified as moderate, and estimation ranged between r=0.75-0.96, r=0.66-0.84 and r=0.66-0.89, respectively. Conclusions: Matsuzaka's equation presented satisfactory parameters for estimates of VO2peak in children and adolescents. Although not explored in equations, body adiposity and pubertal stage are significantly associated with cardiorespiratory fitness in children and adolescents.

RESUMO Objetivo: Revisar sistematicamente na literatura o nível de evidência das equações preditivas do pico de consumo de oxigênio (VO2pico) por meio do teste de shuttle run de 20 metros (SR-20m) em crianças e adolescentes. Fonte de dados: As buscas foram conduzidas nas bases de dados eletrônicas Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, ScienceDirect, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO), de agosto a setembro de 2017, nos idiomas inglês e português. Os critérios de inclusão utilizados foram: estudos originais, com resumo disponível, com equações para predição do VO2pico por meio do SR-20m, adolescentes e/ou crianças, não atletas e com análise correlacional do VO2pico predito e mensurado. O nível de evidência das equações foi caracterizado com base no risco de viés dos estudos, no qual se adotou os seguintes critérios: número da amostra, características da amostra e análise estatística. Síntese dos dados: Dezoito estudos foram selecionados, nos quais 12 equações foram encontradas e analisadas. Os estudos foram conduzidos com amostras de ambos os sexos com idades de oito a 19 anos. As equações de Léger e Matsuzaka foram classificadas com forte nível de evidência, com variação de amplitude de estimativa entre r=0,54-0,90 e r=0,65-0,90. Enquanto as equações Ruiz, Barnett e Matsuzaka foram consideradas de evidência moderada, com variação de amplitude de estimativa entre r=0,75-0,96, r=0,66-0,84 e r=0,66-0,89, respectivamente. Conclusões: A equação de Matsuzaka apresentou parâmetros satisfatórios para estimar o VO2pico em crianças e adolescentes. Embora não explorados em equações, a adiposidade corporal e o estágio puberal demonstram associações relevantes com a aptidão cardiorrespiratória em crianças e adolescentes.

PREDICTIVE EQUATIONS OF MAXIMUM OXYGEN CONSUMPTION BY SHUTTLE RUN TEST IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW.

OBJECTIVE: To systematically review the literature as for the level of evidence of predictive equations of VO2peak through the 20-meter shuttle run test (20m-SRT) in children and adolescents. DATA SOURCES: Searches were conducted independently by two researchers, according to the procedures adopted by PRISMA, in the electronic databases MEDLINE via PubMed, ScienceDirect, Web of Science, LILACS and SciELO, for articles published until September 2017 in English and Portuguese. The inclusion criteria were: original studies, abstract available, using predictive equations of VO2peak through 20m-SRT, conducted with adolescents and/or children, non-athletes, and mentioning correlation analysis between predicted and measured VO2peak. The level of evidence of equations was based on the risk of bias of the studies using the following criteria: sample number, sample characteristics, and statistical analysis. DATA SYNTHESIS: Eighteen studies were selected, in which fifteen equations were found and analyzed. The studies had been conducted with samples composed of subjects of both sexes, aged 8 to 19 years. Equations of Léger and Matsuzaka had their level of evidence classified as high, and estimation ranged between r=0.54-0.90 and r=0.65-0.90. Equations by Ruiz, Barnett and Matsuzaka had their level of evidence classified as moderate, and estimation ranged between r=0.75-0.96, r=0.66-0.84 and r=0.66-0.89, respectively. CONCLUSIONS: Matsuzaka's equation presented satisfactory parameters for estimates of VO2peak in children and adolescents. Although not explored in equations, body adiposity and pubertal stage are significantly associated with cardiorespiratory fitness in children and adolescents.

Is the combination of interval and resistance training more effective on physical fitness? A systematic review and Meta-analysis / Será a combinação dos treinamentos intervalado e resistido mais efetiva sobre a aptidão física em adultos? Uma revisão sistemática e meta-análise

Abstract Interval training (HIIT / SIT) combined with resistance training (RT) has been highlighted as a strategy for the improvement of health-related physical fitness markers (HRPF) in adults. Thus, the aim of this meta-analysis was to compare the efficacy of combined training (HIIT / SIT + RT) with other exercise protocols on HRPF markers in adults. A systematic search was performed in MEDLINE via PebMed, Cochrane-CENTRAL, SPORTDiscus, LILACS, SCIELO and Scopus databases between January and March 2017, using the following keywords in English and Portuguese: physical fitness, high-intensity interval training, sprint interval training, resistance training and adults. The quality of studies was evaluated using the PEDro scale. After applying both inclusion and exclusion criteria, nine articles were selected (n = 231). The extraction of means and standard deviations from studies was performed independently by two authors and the RevMan software was used to perform the meta-analysis. Combined training interventions lasted from 6 to 12 weeks and generated greater increase in maximal oxygen uptake than other forms of exercise. The combination of interval training and strength training may be considered more effective to improve aerobic capacity levels in adults.

Resumo O treinamento intervalado (HIIT/SIT) combinado com o treinamento de resistência (TR) tem se destacado como estratégia para a melhora de indicadores de aptidão física relacionados à saúde (AFRS) em adultos. Assim, o objetivo desta meta-análise foi comparar a efetividade do treinamento combinado (HIIT/SIT + TR) com outros protocolos de exercício sobre os indicadores de AFRS em adultos. Foi realizado a busca sistemática nas bases de dados eletrônicas MEDLINE via PubMed, Cochrane-CENTRAL, SPORTDiscus, LILACS, SCIELO e Scopus, entre janeiro e março de 2017, com a utilização dos seguintes descritores, em inglês e português: physical fitness, hight-intensity interval training, sprint interval training, resistance training e adults. A qualidade dos estudos foi avaliada por meio da escala PEDro. Após a aplicação dos critérios de inclusão e exclusão, nove artigos foram selecionados (n= 231). A extração das médias e desvios padrões dos estudos foi realizada de forma independente por dois autores e utilizou-se o programa RevMan na condução da meta-análise. As intervenções com treinamento combinado (HIIT/SIT + TR) tiveram duração de 6 a 12 semanas e produziram maiores aumentos de absorção máxima de oxigênio que outras formas de exercício. A combinação do treinamento intervalado e treinamento de força pode ser considerada mais eficaz para a melhora dos níveis de capacidade aeróbica em adultos.