Protocolos de rehabilitación cardiaca mediante realidad virtual: revisión sistemática / Virtual reality protocols in cardiac rehabilitation: systematic review

Resumen Introducción El desarrollo de protocolos de rehabilitación cardiaca tradicional proporciona grandes beneficios para la salud a pesar de las limitaciones espaciales y funcionales que generan. Los sistemas de realidad virtual han sido objeto de gran interés en la rehabilitación cardiaca debido a los beneficios que aportan, a la motivación de los pacientes y a la reducción de los plazos. Objetivo Evaluar la eficacia de los sistemas de realidad virtual en la aplicación de programas de rehabilitación cardiaca. Método: Se realizó una revisión sistemática sobre el uso de los sistemas de realidad virtual en rehabilitación cardiaca y su efecto. En la búsqueda se incluyeron las bases de datos Scopus, Sport-Discus, PubMed-Medline, Web of Science y Dialnet. Resultados De 280 artículos identificados, ocho fueron escogidos de acuerdo con los criterios de inclusión. Un total de 872 pacientes fueron analizados. Los resultados mostraron diferencias significativas a favor de las terapias con realidad virtual, en la adherencia y en mejores niveles de los indicadores de capacidad y de potencia aeróbica. Conclusiones Se confirma que la aplicación de sistemas de realidad virtual en programas de rehabilitación cardiaca favorece la adherencia al programa y genera mejoras en los indicadores físicos.

Abstract Introduction The development of traditional cardiac rehabilitation protocols provides great health benefits despite the spatial and functional limitations that they generate. Virtual reality systems have been the object of great interest in cardiac rehabilitation due to the benefits they provide, the motivation of patients and the reduction of time limits. Objective To evaluate the effectiveness of virtual reality systems in the application of cardiac rehabilitation programs. Method A systematic review was carried out to evaluate the use of virtual reality systems in cardiac rehabilitation programs. The search included databases such as Scopus, Sport-Discus, PubMed-Medline, Web of Science, and Dialnet. Results Of 280 identified articles, eight were chosen based on the inclusion criteria. A total of 872 patients were analyzed. The results changed differences in favor of virtual reality therapies, in the motivation to develop the program, reduction in hospitalization time, better levels of capacity and aerobic power markers. Conclusions We can confirm the evidence of the application of virtual reality technologies in cardiac rehabilitation programs causing improvements in aerobic capacity, vital capacity or in the level of effort that patients with cardiac pathology endure.

Hematological detraining-related changes among elderly individuals with high blood pressure.

AIM: The aim of the present study was to compare the effects of detraining on physical performance, blood pressure, biologic and anthropometric variables of hypertensive elderly individuals, grouped by two levels of previous physical activity. METHODS: A total of 87 elderly individuals (70 to 93 years old) with systolic/diastolic blood pressure levels above 120/80 mmHg who participated during 18 non-consecutive months in 2 years in physical exercise programs offered in northern Portugal communities were included in the study. Tests were performed before and after three months of no exercise. Attendance to the exercise sessions, hematological markers, cardiorespiratory function, and anthropometric variables were assessed. The results were analyzed according to the fulfillment of the WHO recommendations on moderate physical activity (at least 150 minutes/week). RESULTS: Weight, total cholesterol, and glucose were influenced by the amount of physical activity performed previously to the detraining period. After the detraining period, the total cholesterol, glucose, insulin, and weight had significant differences influenced by the amount of physical activity previously performed (p<0.05). CONCLUSIONS: The number of minutes per week of aerobic and resistance exercise training over 18 non-consecutive months was not a significant determinant factor in the development of hypertension during the three months of detraining.

Hematological detraining-related changes among elderly individuals with high blood pressure

SUMMARY AIM The aim of the present study was to compare the effects of detraining on physical performance, blood pressure, biologic and anthropometric variables of hypertensive elderly individuals, grouped by two levels of previous physical activity. METHODS A total of 87 elderly individuals (70 to 93 years old) with systolic/diastolic blood pressure levels above 120/80 mmHg who participated during 18 non-consecutive months in 2 years in physical exercise programs offered in northern Portugal communities were included in the study. Tests were performed before and after three months of no exercise. Attendance to the exercise sessions, hematological markers, cardiorespiratory function, and anthropometric variables were assessed. The results were analyzed according to the fulfillment of the WHO recommendations on moderate physical activity (at least 150 minutes/week). RESULTS Weight, total cholesterol, and glucose were influenced by the amount of physical activity performed previously to the detraining period. After the detraining period, the total cholesterol, glucose, insulin, and weight had significant differences influenced by the amount of physical activity previously performed (p<0.05). CONCLUSIONS The number of minutes per week of aerobic and resistance exercise training over 18 non-consecutive months was not a significant determinant factor in the development of hypertension during the three months of detraining.

RESUMO OBJETIVO O objetivo do presente estudo foi comparar os efeitos da desvalorização do desempenho físico, da pressão arterial e das variáveis bioquímicas e antropométricas dos idosos hipertensivos, dependendo de duas categorias de atividade física prévia. MÉTODOS Foram incluídos no estudo 87 idosos (70 a 93 anos) com níveis de pressão arterial sistólica/diastólica superiores a 120/80 mmHg que participaram durante 18 meses não consecutivos em dois anos em programas de exercício físico. Os testes foram realizados antes e depois de três meses sem programas de exercícios. Foram avaliados a frequência das sessões de exercício, marcadores hematológicos, função cardiorrespiratória e parâmetros antropométricos. Os resultados foram analisados de acordo com o cumprimento das recomendações da OMS sobre atividade física moderada (pelo menos 150 minutos/semana). RESULTADOS O peso, o colesterol total e a glicose foram influenciados pela quantidade de atividade física realizada previamente ao período de destreinamento. Posteriormente, o colesterol total, a glicose, a insulina e o peso apresentaram diferenças significativas influenciadas pela quantidade de atividade física previamente realizada (p<0,05). CONCLUSÕES O número de minutos por semana de treinamento aeróbico e de exercícios resistidos durante 18 meses não consecutivos não foi um fator determinante significativo na evolução da hipertensão durante os três meses de destreinamento.

Construct Validity of the Spanish Version of the CHAMPS Questionnaire for institutionalized patients over 65 years old

Abstract This study investigates the construct validity of the Spanish version of the CHAMPS questionnaire with institutionalized older adults between the ages of 74 and 90. Seven days of accelerometer data were collected from 52 participants (mean age 82.40 ± 8.26 years), followed by the administration of CHAMPS. The Barthel Index and the Chair Stand Test were used to assess functional independence and fitness levels. The four scores yielded by CHAMPS showed a low-to-moderate agreement with the data derived from the accelerometer (r=0.253-0.385) and with the Barthel Index (r=0.313-0.519), but no association was established with fitness levels. Additionally, no significant correlations were observed between CHAMPS and the accelerometer when cognitive impairment was considered. The results imply that the Spanish version of CHAMPS shows construct validity to estimate the amount of physical activity performed by institutionalized older adults without cognitive impairment.(AU)

Anthropometric analysis and performance characteristics to predict selection in young male and female handball players

Abstract The aim of this study was two-fold. The first aim was to determine if there were any anthropometric and physical performance differences (controlling for maturation) between male and female handball players selected in training categories as well asthe relation of these differences with the performance level achieved. The second aim was to identify the discriminatory variables between the performance levels achieved. A total of 216 young handball players (125 men and 91 women) participated in the study. The data were classified by selection level (regional n=154; national n=62), gender (men; women) and age category (under-15; under-17). The use of MANCOVA analyses, controllingfor maturation, identified how gender could determine variables related to handball players' future competitive levels. The results revealed that anthropometric variables such as height, arm span, trochanter height, thigh girth, and leg girth were more influential in men than in women. In addition, the physical performance tests of vertical jump (squat jump and counter movement jump with/without arm) and 10x5m shuttle run were determinants in both sexes. Discriminatory analysis predicted that a combination of five variables (counter movement jump with arm, body mass, 10x5m shuttle run, dominant hand length and trochanter height) would successfully distinguish between regional and national players, with a predictive accuracy of 81.9% for all players.

Physical exercise in MCI elderly promotes reduction of pro-inflammatory cytokines and improvements on cognition and BDNF peripheral levels.

The benefits of physical exercise to reduce low-grade inflammation and improve Brain-Derived Neurotrophic Factor (BDNF) levels and cognitive function became a growing field of interest. Low-grade inflammation is common during aging and seems to be linked to neurodegenerative process. Regular physical exercises can help to reduce pro-inflammatory cytokines levels and to improve BDNF peripheral concentrations. The main goal of this research was to analyze the effects of a 16-week multimodal physical exercise program on peripheral BDNF levels and on Tumor Necrosis-α (TNF-α) and Interleukin- 6 (IL-6) as pro-inflammatory markers in cognitive healthy elderly individuals and in elderly with mild cognitive impairment (MCI). Cognitive functions were assessed by the Montreal Cognitive Assessment (MoCA) prior to and after the intervention. Thirty cognitively healthy participants and thirty-seven MCI participants were assigned to the control (CG) and trained (TG) groups. The TG participated in a multimodal physical training program for a 16-week period. The results showed a significant between-subjects interaction, which indicates the beneficial contribution of training on the reduction of TNF-α (p=0.001) and IL-6 (p<0.001) and on the improvement of BDNF (p<0.001) peripheral concentrations. Cognitive functions also presented significant improvements for MCI trained group (p=0.03). In conclusion, physical exercise was effective to reduce pro-inflammatory cytokines and to improve BDNF peripheral levels, with positive reflexes on cognition. To the best of our knowledge, this is the first study that evaluated longitudinally the effects of a multimodal physical exercises protocol on peripheral concentrations of pro-inflammatory cytokines and cognition performance in elderly MCI individuals.

Exercícios físicos generalizados capacidade funcional e sintomas depressivos em idosos brasileiros / Physical exercises, functional capacity and depressive symptoms in Brazilian elderly

O objetivo deste estudo foi verificar os efeitos de 16 semanas de exercícios físicos generalizados sobre componentes da capacidade funcional, aptidão funcional geral e sintomas depressivos em idosos. Cinquenta e cinco idosos (67,3±5,8 anos) participaram do estudo. Os grupos foram distribuídos de acordo com a participação no protocolo proposto: a) grupo treinado (GT), composto de 27 participantes que atenderam pelo menos 75% do total de sessões de exercícios físicos generalizados por 16 semanas e; b) grupo controle (GC), participantes que não estiveram participando de nenhum tipo de programa regular de atividades físicas. A capacidade funcional foi avaliada por meio da bateria de testes para idosos da AAHPERD que é composta por cinco testes: coordenação, flexibilidade, resistência de força, agilidade e equilíbrio dinâmico e resistência aeróbia geral. Os sintomas depressivos foram medidos por meio da Escala de Depressão e Geriatria- versão curta (GDS-15). Os resultados demonstraram que os idosos do GT apresentaram melhor desempenho nos testes motores. Os sintomas depressivos não sofreram alterações em ambos os grupos. Desta maneira, nossos resultados indicam que 16 semanas são suficientes para promover benefícios na aptidão funcional geral de idosos, enquanto que idosos que permanecem sedentários tendem a apresentar decréscimo em sua aptidão física geral. O programa proposto não foi capaz de provocar alterações significativas em idosos com baixos valores relatados de sintomas depressivos para esta variável. As evidências do presente estudo possibilitam predizer que um programa generalizado pode auxiliar na prevenção de doenças crônicas, evitar declínios funcionais e produzir efeitos positivos na qualidade de vida.

The objective of our study was to investigate the effects of 16 weeks of multimodal exercise on functional capacity components, general functional fitness and depressive symptoms in the elderly. Fifty-five elderly (67.3 ± 5.8 years) participated in the study. The groups were distributed according to the participation on the proposed protocol: a) trained group (TG) composed of 27 participants who attended at least 75% of the total generalized physical exercise sessions for 16 weeks; and b) control group (CG), participants who did not attend any regular physical activity program. Functional capacity was assessed using the AAHPERD battery of motor tests for elderly, which consists of five tests: coordination, flexibility, muscular resistance, agility/dynamic balance, and overall aerobic endurance. Depressive symptoms were measured using the short version of the Geriatric Depression Scale (GDS-15). The results showed that elderly on TG had better performance on motor tests. Depressive symptoms did not change for both groups. Thus, our results indicate that 16 weeks is sufficient to improve general functional fitness in elderly, while those who remain sedentary tend to decrease their overall physical fitness. The proposed program could not induce significant changes in the elderly with low levels of depressive symptoms reported for this variable. The evidence of this study allows the prediction that a generalized program can help prevent chronic diseases, reduce functional decline and produce positive effects on quality of life.