Deaths in Open Water Swimming Races in Brazil from 2009 to 2019.

Since the inclusion in the Olympic Games (2008), open swimming races have attracted greater media attention and, therefore, have a greater number of practitioners, especially in Brazil, an extremely favorable country for this sport. However, increasing reports of fatal incidents in open water races brought the medical and scientific community to attention. The aim of this study was to review the characteristics of deaths in open waters events in Brazil from 2009 to 2019. The survey was divided into 3 steps: 1) contacting sports-related federations and companies, including swimming and triathlon federations, master associations and event organizing companies; 2) internet search; and 3) personal communication with athletes, coaches, organizers, and health personnel. A total of 12 deaths were observed in open water swimming races, including triathlon swimming segment races in Brazil from 2009 to 2019. The average was 1.1 deaths per year, whereas in the last 3 years (2017-2019) the average was 3 deaths per year. The male participants accounted for 11 deaths (91.7%), the average age was 47 years old, experienced athletes were more affected (80%), and incidents occurred mainly in ocean waters (75%). The increase of deaths in the last 3 years draws attention, and the best way to reduce the deaths by drowning in open waters in Brazil, is to understand the profile and causes, to propose solutions.

The Effect of Physical Activity on Motor Skills of Children with Autism Spectrum Disorder: A Meta-Analysis.

OBJECTIVE: The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD. METHODS: On 28 June 2021, a systematic review with meta-analysis was performed using the following databases: MEDLINE, SciELO, LILACS, PEDro, SPORTDiscus, CINAHL, SCOPUS, Web of Science, Cochrane, and Science Direct. We analyzed the methodological quality and risk of bias using the Jadad scale and Cochrane tool, respectively. Motor coordination results were meta-analyzed using the RevMan program. Two independent researchers used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool to assess the level of evidence from the meta-analysis. RESULTS: We found four studies in the listed databases and five randomized clinical trials were included in the meta-analysis that included 109 children with ASD. Children with ASD who performed physical activity did not present significantly better motor coordination than control children (p = 0.12). CONCLUSIONS: Considering the clinical importance of physical activity for children with ASD, this systematic review with meta-analysis showed that physical activity had no statistically significant effects on coordination in individuals with ASD.

Entrenamiento de restricción del flujo de sangre en sujetos hipertensivos: revisión sistemática / Blood flow restriction training on hypertesive subjects: a systematic review

Introduction: Systemic arterial hypertension has been growing worldwide, causing thousands of deaths and large expenses in this condition treatment. Currently, resistance training (RT) is widely prescribed as a non-pharmacological option for blood pressure control, but there are some individuals with intolerance to high load of RT. Hence, blood flow restriction is a method created to stimulate high level of physiological adaptations with low resistive load. However, there are uncertainties about safety and efficacy of this method. Objective: The present study aimed to investigate the safety and efficacy of blood flow restriction training in hypertensive individuals. Material and method: The research was carried out through a systematic review within the criteria established by the PRISMA statement. Only studies about blood flow restriction in subjects with arterial hypertension were selected in the following databases: MEDLINE/PUBMED, Web of Science, SCOPUS and SPORTDiscus. Results: Five studies (4 acute and 1 chronic effects ) met the requirements for the present review, with 77 hypertensive individuals. Only one study presented levels of blood pressure above to the recommended for hypertensive subjects. Conclusion: Even though the number of studies is still insufficient to conclude about the efficacy, the results allow concluding that resistance training with blood flow restriction is a safe alternative of exercise method to hypertensive subjects, especially for those with intolerance to high training loads.(AU)

Introducción: La hipertensión arterial sistémica ha ido creciendo a nivel mundial, provocando miles de muertes y grandes gastos en el tratamiento de esta afección. Actualmente, el entrenamiento de fuerza se prescribe ampliamente como una opción no farmacológica para el control de la presión arterial, pero hay algunas personas con intolerancia al entrenamiento de alta intensidad. Por ello, el entrenamiento de restricción del flujo sanguíneo es un método creado para estimular los altos niveles de adaptación fisiológica con cargas de baja intensidad. Sin embargo, existen incertidumbres sobre la seguridad y eficacia de este método y no hay consenso al respecto. Objetivo: El presente estudio tuvo como objetivo investigar la seguridad y eficacia del entrenamiento de restricción del flujo sanguíneo en individuos hipertensos. Material y método: La investigación se realizó mediante una revisión sistemática, dentro de los criterios establecidos por la declaración PRISMA y se utilizaron las siguientes bases de datos: MEDLINE/PUBMED, Web of Science, SCOPUS y SPORTDiscus, incluyendo solo estudios con individuos con hipertensión arterial en los que se utilizó el método. Resultados: Cinco estudios (4 efectos agudos y 1 efectos crónicos) cumplieron con los requisitos de la presente revisión, con 77 individuos hipertensos. 4 estudios evaluaron efectos agudos y 1 estudio evaluó efectos crónicos. Solo un estudio incluido presenta niveles aumentados de presión arterial por encima de los niveles recomendados en sujetos hipertensos y los otros 4 estudios demostraron la seguridad del entrenamiento de oclusión. Conclusión: A pesar de que el número de estudios aún es insuficiente para concluir sobre su eficacia, los resultados muestran una seguridad de este método como ejercicio alternativo para sujetos hipertensos, especialmente aquellos con intolerancia al entrenamiento de cargas de alta intensidad.(AU)

Effects of 12 Months of Vitamin D Supplementation on Physical Fitness Levels in Postmenopausal Women with Type 2 Diabetes.

INTRODUCTION: It is common for postmenopausal women to receive a vitamin D supplementation prescription to assist in preventing future falls and to maintain bone health. However, the association between vitamin D supplementation and physical fitness components has not been studied in older women with diabetes. OBJECTIVE: We examined the influence of 12 months of vitamin D supplementation on the components of physical fitness in postmenopausal women with type 2 diabetes mellitus (T2DM). METHODS: Thirty-five postmenopausal women (62.48 ± 7.67 years; 154.6 ± 5.11 cm; 73.93 ± 15.43 kg; 31.13 ± 5.82 BMI) with a diagnosis of T2DM participated in this longitudinal study where participants were supplemented with 1000 IU/day of vitamin D over 12 months. Subjects performed fasting blood samples, anthropometric assessments, body composition, clinical exams, and physical tests at 6-month intervals (P0, P6, and P12). RESULTS AND CONCLUSION: Vitamin D supplementation alone was effective in postmenopausal women in increasing serum vitamin D levels, altering muscle strength levels, promoting improvements in muscle function, as well as preventing and controlling fragility caused by T2DM and aging.

Reliability of bioimpedance and indirect calorimetry to evaluate resting metabolic rate in Brazilian women with metabolic syndrome.

BACKGROUND AND AIMS: Precise evaluation of resting metabolic rate (RMR) is critical, especially for seniors in syndromes conditions. The study aimed to compare different methods and devices to evaluate the resting metabolic rate and assess them' reliability in Brazilian women with metabolic syndrome. METHODS: A single-center prospective study with forty elderly postmenopausal women was performed to verify the reliability of indirect calorimetry (IC) versus Bioimpedance (BIA) on RMR fluctuations for an interval length of six months. RESULTS: Measurements showed a high correlation between devices at baseline [BIA vs IC, intraclass correlation coefficient (ICC) = 0.906 (0.822-0.950)]. Surprisingly, a high correlation was kept between BIA and IC after six months [BIA vs. IC, ICC = 0.909 (0.829-0.952)]. The results suggest that both BIA and IC are excellent strategies to measure RMR in elderly postmenopausal women and with metabolic syndrome. CONCLUSIONS: However, the BIA method presents greater convenience, optimizes patients' time, and does not require prolonged fasting to obtain good reliable results compared to IC.

Lymphocyte CD4+ cell count, strength improvements, heart rate and body composition of HIV-positive patients during a 3-month strength training program.

BACKGROUND: There is a lack of information regarding the positive effects of different types of physical training on HIV-positive patient immune function, body composition and physical fitness. The goal of this study was two-fold: 1) to determine the effects of a three-month progressive strength training program on lymphocyte CD4+ cell counts in HIV-positive patients; and 2) to measure strength improvements, body composition and cardiovascular alterations in HIV-positive patients after a strength training program. METHODS: Sixteen HIV-positive male subjects participated in a strength-training program. CD4+ cell count, heart rate body composition and strength measurements were acquired at rest two days before and two days after the program. RESULTS: The average CD4+ cell count was increased (%=23%, P=0.0005), and all strength tests also showed improvement (%=95%, P=0,0001). Patient resting heart rate decreased (%=9%, P=0.0042), as did the skinfold sum (%=16%, P=0.002). Limb circumference sum and body weight did not change. CONCLUSIONS: Considering that a decrease in CD4+ cell count, muscle mass and overall physical fitness are expected results of HIV infection, the strength training protocol described here is an effective and safe way to improve immune function, body composition and cardiovascular fitness in HIV-positive patients. The results provided an important evidence for the effectiveness of a 3-month progressive resistance exercise training program at increasing immune function and physical fitness, strongly recommending its inclusion in the standardized treatment plan of HIV-positive patients.

Low intensity static stretching does not modulate heart rate variability in trained men / Alongamento estático de baixa intensidade não modula a variabilidade da frequência cardíaca em homens treinados

OBJECTIVE: To investigate the acute effect of static stretching on heart rate variability in trained men. METHODS: Eight subjects were randomly submitted to two situations, as follows: a static stretch protocol and 20 minutes at rest. The stretch protocol consisted of two sets of 30 seconds of static stretch of the chest muscles with a 40 second of interval between them. After 48 hours, the procedures were reversed so that all the subjects should were submitted to the two situations. The values of heart rate variability were measured before and after the experimental and control situation (stretch vs. rest). We registered the following cardiac variables: root mean square of standard deviation (rMSSD), the number of pairs of successive beats that differ by more than 50 ms (pNN50), low frequency (LF) and high frequency (HF). The Shapiro-Wilk and the paired Student's test were used for statistical analysis; a critical level of significance of p < 0.05 was adopted. RESULTS: No significant differences (p > 0.05) were found (stretching vs. control) to the RMSSD, pNN50, LF and HF indices. However, although no statistical differences were observed, the figures show large changes on mean values, suggesting an unclear effect on the sympathetic-vagal modulation. CONCLUSION: The present results suggest that a low intensity (motion range until discomfort point) and volume (1 minute) of static stretching does not significantly affect the acute sympathetic-vagal control in trained men. Because the protocol did not show differences regarding the studied variables, we suggest that there is not a sufficient level of physiological basis to perform this type of exercise in a traditional pre-exercise setting, if the purpose is obtain gains in physical performance.

OBJETIVO: Nosso objetivo foi verificar o efeito agudo do alongamento estático sobre a variabilidade da frequência cardíaca (VFC) em homens treinados. MÉTODOS: Oito voluntários (n = 8) foram randomicamente submetidos a duas situações, a saber: alongamento estático (AE) ou 20 minutos em repouso (CTRL). O protocolo de alongamento consistiu em duas séries de 30 segundos para musculatura do peitoral (40 segundos de intervalo). Após 48 horas, os procedimentos foram realizados de maneira reversa, de forma que todos os participantes realizaram as duas situações (ALONGAMENTO e CRTL) ao final do estudo. Os valores de VFC foram medidos antes e imediatamente depois das situações experimental e controle (alongamento vs. repouso). Para registro das variáveis cardíacas coletadas (rMSSD, pNN50, LF e HF) no presente estudo, nós utilizamos um relógio Polar RS800CX (Polar Electro OY, Finland). As análises estatísticas realizadas foram feitas através da aplicação do teste de Shapiro-Wilk seguido pelo teste t de Student pareado, sendo adotado um nível crítico de significância de p < 0.05. RESULTADOS: Nenhuma diferença significativa (p > 0.05) foi observada (alongamento vs. controle) quando as variáveis foram analisadas. CONCLUSÃO: O presente estudo sugere que o alongamento estático com baixo volume de aplicação não altera significativamente o controle simpato-vagal em homens treinados. Na medida em que o protocolo utilizado não resultou em diferenças significativas nas variáveis estudadas, nós inferimos que não há fundamento fisiologicamente válido para a realização deste tipo de exercício em sua forma tradicional pré-exercício quando o objetivo for a obtenção de ganhos na performance física.

Functional autonomy, bone mineral density (BMD) and serum osteocalcin levels in older female participants of an aquatic exercise program (AAG).

The aim of the present study was to evaluate the effects of an AAG on BMD, osteocalcin and functional autonomy in older women. The sample consisted of eighty-two post-menopausal women with low BMD, randomly divided into two groups: the Aquatic Aerobics Group [AAG; n=42; age: 66.8±4.2years], submitted to two weekly sessions over eight months, and the Control Group (GC; n=42; age: 66.9±3.2years), which did not participate in regular exercise. BMD was measured by Dual Energy X-ray Absorptiometry [DXA] of the lumbar and femur, and serum osteocalcin was measured using electrochemiluminescence. A functional autonomy assessment protocol (GDLAM, 2004) was also applied. Statistical analyses used were repeated measures ANOVA and Tukey's post hoc tests. The results showed a significant improvement in tests following the GDLAM protocol: 10 meters walk (10mw) -p=0.003; rising from a ventral decubitus position (RVDP) - Δ%=0.78, p<0.001; rising from a chair and moving around the house (RCMH) -p<0.001 and autonomy index (AI) -p=0.007, with more favorable results observed in the AAG when compared to the CG. The AAG achieved the best results for BMD; however, no inter or intragroup statistical differences were recorded for total femur -p=0.975 and lumbar L(2)-L(4)p=0.597. For serum osteocalcin, intra and intergroup statistical differences of p=0.042 and p=0.027 were observed in the AAG, respectively. This demonstrates that an eight-month aquatic aerobic exercise program can improve functional autonomy and osteocalcin levels, although training did not improve lumbar and total femur BMD in the older women.