Pulmonary Rehabilitation Program Is an Effective Treatment Approach for Post-COVID-19 Syndrome Patients.

Background/Objectives: Patients with post-COVID-2019 syndrome may have reduced functional capacity and physical activity levels. The pulmonary rehabilitation program (PRP)-an exercise training program-is designed to restore these functions and has been shown to improve dyspnea, exercise capacity, and other measures in these patients. This study aimed to analyze the effects of the RP on post-COVID-19 syndrome patients with respect to objective and subjective functional capacity, balance, and musculoskeletal strength. Methods: A prospective interventional trial was conducted before and after this phase. Patients were referred to the hospital with a confirmed diagnosis of SARS-CoV-2 and subsequently directed to the RP. These patients underwent an 8-week pulmonary rehabilitation program (45-min sessions 3 times/week). Each session consisted of stationary cycle-ergometer and resistance musculoskeletal exercises tailored to individuals' performance. They were evaluated pre- and post-PRP using the maximal handgrip strength (HGS) test, timed up-and-go test, 6-min walk test and its derived variables, and Duke Activity Status Index questionnaire. Results: From 142 hospitalized patients admitted with a diagnosis of SARS-CoV-2 infection, 60 completed the program, with an attendance rate of 85%. Nineteen patients were categorized as severe/critical, with a significantly higher hospital stay, compared to mild/moderate patients, and there were no differences in terms of sex distribution, age, or BMI between groups. Compared to the pre-PRP evaluation, both groups showed significant (p < 0.001) improvements in TUG, HGS, DASI D6MWT, 6MWS, and DSP variables after the PRP conduction. In addition, the groups exhibited similar improvement patterns following PRP (intragroup analysis), with no intergroup differences. Conclusions: RPs promote both objective and subjective functional capacity in patients with post-COVID-19 syndrome, with no difference in improvement regardless of the severity of the initial infection.

Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials.

BACKGROUND: Physical exercise has been found to impact neurophysiological and structural aspects of the human brain. However, most research has used animal models, which yields much confusion regarding the real effects of exercise on the human brain, as well as the underlying mechanisms. OBJECTIVE: To present an update on the impact of physical exercise on brain health; and to review and analyze the evidence exclusively from human randomized controlled studies from the last six years. METHODS: A search of the literature search was conducted using the MEDLINE (via PubMed), EMBASE, Web of Science and PsycINFO databases for all randomized controlled trials published between January 2014 and January 2020. RESULTS: Twenty-four human controlled trials that observed the relationship between exercise and structural or neurochemical changes were reviewed. CONCLUSIONS: Even though this review found that physical exercise improves brain plasticity in humans, particularly through changes in brain-derived neurotrophic factor (BDNF), functional connectivity, basal ganglia and the hippocampus, many unanswered questions remain. Given the recent advances on this subject and its therapeutic potential for the general population, it is hoped that this review and future research correlating molecular, psychological and image data may help elucidate the mechanisms through which physical exercise improves brain health.

Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials / Nascidos para o movimento: uma revisão sobre o impacto do exercício físico na saúde do cérebro e as evidências de estudos controlados em humanos

Abstract Background: Physical exercise has been found to impact neurophysiological and structural aspects of the human brain. However, most research has used animal models, which yields much confusion regarding the real effects of exercise on the human brain, as well as the underlying mechanisms. Objective: To present an update on the impact of physical exercise on brain health; and to review and analyze the evidence exclusively from human randomized controlled studies from the last six years. Methods: A search of the literature search was conducted using the MEDLINE (via PubMed), EMBASE, Web of Science and PsycINFO databases for all randomized controlled trials published between January 2014 and January 2020. Results: Twenty-four human controlled trials that observed the relationship between exercise and structural or neurochemical changes were reviewed. Conclusions: Even though this review found that physical exercise improves brain plasticity in humans, particularly through changes in brain-derived neurotrophic factor (BDNF), functional connectivity, basal ganglia and the hippocampus, many unanswered questions remain. Given the recent advances on this subject and its therapeutic potential for the general population, it is hoped that this review and future research correlating molecular, psychological and image data may help elucidate the mechanisms through which physical exercise improves brain health.

RESUMO Introdução: Evidências das últimas décadas têm mostrado que o exercício físico impacta de forma significativa aspectos neurofisiológicos e estruturais do cérebro humano. No entanto, a maioria das pesquisas emprega modelos animais, o que gera confusão no que diz respeito aos efeitos reais do exercício no cérebro humano, assim como os mecanismos adjacentes. Objetivo: Apresentar uma atualização sobre o impacto do exercício no cérebro; revisar e analisar sistematicamente as evidências provenientes exclusivamente de estudos randomizados controlados em humanos, dos últimos seis anos. Métodos: Foi conduzida uma busca na literatura usando as bases de dados MEDLINE (via PubMed), EMBASE, Web of Science e PsycINFO, para todos os estudos randomizados e controlados publicados entre janeiro de 2014 e janeiro de 2020. Resultados: Foram revisados 24 estudos randomizados controlados em humanos, que observavam a relação entre exercício físico e alterações neuroquímicas e estruturais no cérebro. Conclusões: Ainda que esta revisão tenha observado que o exercício físico melhora a plasticidade cerebral em humanos, particularmente por meio de alterações no fator neurotrófico derivado do cérebro (BDNF), conectividade funcional, núcleos da base e hipocampo, muitas questões ainda precisam ser respondidas. Dados os avanços recentes nessa temática e seu potencial terapêutico para a população em geral, espera-se que este manuscrito e pesquisas futuras que correlacionem estudos moleculares e variáveis psicológicas e de imagem possam ajudar na elucidação dos mecanismos pelos quais o exercício físico melhora a saúde cerebral.

Genomic Epidemiology of 2015-2016 Zika Virus Outbreak in Cape Verde.

During 2015-2016, Cape Verde, an island nation off the coast of West Africa, experienced a Zika virus (ZIKV) outbreak involving 7,580 suspected Zika cases and 18 microcephaly cases. Analysis of the complete genomes of 3 ZIKV isolates from the outbreak indicated the strain was of the Asian (not African) lineage. The Cape Verde ZIKV sequences formed a distinct monophylogenetic group and possessed 1-2 (T659A, I756V) unique amino acid changes in the envelope protein. Phylogeographic and serologic evidence support earlier introduction of this lineage into Cape Verde, possibly from northeast Brazil, between June 2014 and August 2015, suggesting cryptic circulation of the virus before the initial wave of cases were detected in October 2015. These findings underscore the utility of genomic-scale epidemiology for outbreak investigations.

Postural balance and falls in elderly nursing home residents enrolled in a ballroom dancing program.

The aim of this study was to investigate the influence of a ballroom dancing program on the postural balance of institutionalized elderly residents. The sample consisted of 59 sedentary elderly residents of long-stay institutions who were randomly assigned to a ballroom dancing experimental group (EG, n=30) or a control group (CG, n=29). The ballroom dancing program consisted of three 50-min sessions each week on alternate days over a 12-week period. The dances included the foxtrot, waltz, rumba, swing, samba and bolero. The medical records of the subjects were reviewed to determine the number of falls they experienced in the three months prior to the intervention. Postural static balance was assessed using a Lizard (Med. EU., Italy, 2010) stabilometric and posturometric platform. Only patients in the EG lost a significant amount of weight (Δ=-2.85 kg) when comparing the pre- and post-test postural balance assessments. The intergroup comparison revealed a reduced lower limb weight distribution difference in the EG post-test compared to the CG post-test (p=0.012). In the intragroup comparison, the EG patients experienced significantly fewer falls post-test relative to pre-test (p<0.0001). This improvement was not observed for patients in the CG. In the intergroup analysis, we observed fewer falls in the EG post-test compared to the CG post-test (p<0.0001). Therefore it was conclude that sedentary elderly people living in long-term institutions can improve their balance via a ballroom dancing program. This activity improved balance and reduced the number of falls in this elderly population.

[Respiratory muscle training programs: impact on the functional autonomy of the elderly]. / Programas de treinamento muscular respiratório: impacto na autonomia funcional de idosos.

OBJECTIVE: To compare two respiratory muscle training programs for improving the functional autonomy of institutionalized elderly. METHODS: Clinical randomized trial conducted at a long stay institution with 42 elderly volunteers that were divided into three groups: Group ® Threshold (GT) with mean age (70.93 ± 8.41), Group Voldyne ® (GV) (70.54 ± 7.73) and Control Group (CG) (73.92 ± 7.28). Groups GT and GV were treated with breathing exercises and muscle training by Threshold and Voldyne, respectively while the CG did just breathing exercises. Training of groups took 10 weeks. To assess the functional autonomy, the elderly were evaluated before and after training, according to the GDLAM protocol. RESULTS: All intra-group comparison (pre x post-test) showed a significant difference in GT for all tests (C10M: Δ% = -20.57, p = 0.0001; LPS: Δ% = -13.53, p = 0.020; VTC: Δ% = -27.96, p = 0.0001; LCLC: Δ% = -18.71, p = 0.0001 and IG:% Δ = -18.43, p = 0.0001), except in LPDV. In GV there was a significant difference only (p <0.05) for the C10M (% Δ = -17.11, p = 0.004). In the comparison between (post x post), there was a statistical significance (p <0.05) for VTC test between the GT and GV (Δ = -3.62%, p = 0.017), with favorable results for the GT. Similarly, there was a statistical difference (p <0.05) in GT C10M (% Δ = -3.83, p = 0.023), LCLC (Δ = -34.02%, p = 0.012) and IG (Δ% = -13.63, p = 0.004) compared to GC. CONCLUSION: The trained groups improved functional autonomy, reaching 27.42; considered to be a weak level in both pre-and post-training.

Programas de treinamento muscular respiratório: impacto na autonomia funcional de idosos / Respiratory muscle training programs: impact on the functional autonomy of the elderly

OBJETIVO: Comparar dois programas de treinamento muscular respiratório, na melhoria da autonomia funcional de idosos institucionalizados. MÉTODOS: Ensaio clínico experimental aleatorizado, realizado numa instituição de longa permanência, com 42 idosos, divididos em grupos: Grupo Threshold® (GT; n=14; idade 70,93±8,41), Grupo Voldyne® (GV; n=14; idade 70,54±7,73) e Grupo Controle (GC; n=14; idade 73,92±7,28). Os grupos GT e GV foram tratados com exercícios respiratórios e treinamento muscular com Threshold e Voldyne, respectivamente, e o GC realizou apenas exercícios respiratórios. O treinamento teve duração de 10 semanas. Para avaliação da autonomia funcional, foi utilizado o protocolo de GDLAM. RESULTADOS: Na comparação intragrupos (pré x pós-teste) houve diferença significativa no GT para todos os testes (índice de GLDAM - IG: Δ por cento= -18,43, p=0,0001), com exceção do levantar da posição de decúbito ventral. No GV só houve diferença significativa (p<0,05) para o teste de caminhar 10 metros - C10m (Δ por cento= -17,11; p=0,004). Na comparação intergrupos (pós x pós), houve uma significância estatística (p<0,05) para o teste vestir e tirar a camiseta entre o GT e o GV (Δ por cento= -3,62; p=0,017), sendo os resultados favoráveis ao GT. Semelhantemente houve diferença estatística do GT no C10m (Δ por cento= -3,83; p=0,023), levantar-se da cadeira e locomover-se pela casa - LCLC (Δ por cento= -34,02; p=0,012) e IG (Δ por cento= -13,63; p=0,004) em relação ao GC. CONCLUSÃO: Os grupos treinados obtiveram níveis de autonomia funcional, acima de 27,42; considerado fraco tanto no pré e pós-treinamento.

OBJECTIVE: To compare two respiratory muscle training programs for improving the functional autonomy of institutionalized elderly. METHODS: Clinical randomized trial conducted at a long stay institution with 42 elderly volunteers that were divided into three groups: Group ® Threshold (GT) with mean age (70.93 ± 8.41), Group Voldyne ® (GV) (70.54 ± 7.73) and Control Group (CG) (73.92 ± 7.28). Groups GT and GV were treated with breathing exercises and muscle training by Threshold and Voldyne, respectively while the CG did just breathing exercises. Training of groups took 10 weeks. To assess the functional autonomy, the elderly were evaluated before and after training, according to the GDLAM protocol. RESULTS: All intra-group comparison (pre x post-test) showed a significant difference in GT for all tests (C10M: Δ percent = -20.57, p = 0.0001; LPS: Δ percent = -13.53, p = 0.020; VTC: Δ percent = -27.96, p = 0.0001; LCLC: Δ percent = -18.71, p = 0.0001 and IG: percent Δ = -18.43, p = 0, 0001), except in LPDV. In GV there was a significant difference only (p <0.05) for the C10M ( percent Δ = -17.11, p = 0.004). In the comparison between (post x post), there was a statistical significance (p <0.05) for VTC test between the GT and GV (Δ = -3.62 percent, p = 0.017), with favorable results for the GT. Similarly, there was a statistical difference (p <0.05) in GT C10M ( percent Δ = -3.83, p = 0.023), LCLC (Δ = -34.02 percent, p = 0.012) and IG (Δ percent = -13.63, p = 0.004) compared to GC. CONCLUSION: The trained groups improved functional autonomy, reaching 27.42; considered to be a weak level in both pre-and post-training.

Efeitos do treinamento funcional na autonomia funcional, equilíbrio e qualidade de vida de idosas / Effects of functional training on functional autonomy, balance and quality of life of elderly

O estudo foi investigar os efeitos do treinamento funcional no equilíbrio postural, funcionalautonomia e qualidade de vida de idosos ativos. A amostra foi dividida aleatoriamente em Grupo Funcional Formação (GFT) e grupo controle (GC), com idade entre 67 ± 6 e 65 ± 5 anos (de idade), respectivamente. a seguir Foram utilizados protocolos: Berg Balance Scale (EEB, o equilíbrio postural), Grupo Latino-Americano de Desenvolvimento para Maturidade (GDLAM, autonomia funcional) e da Organização Mundial da Saúde de Qualidade de Vida (WHOQOL - idade, qualidade de vida). A análise descritiva e inferencial através do teste de normalidade de Shapiro-Wilk foi realizada para avaliar os dados. Foram utilizados os testes de Kruskal-Wallis ou Two-Way Anova para a avaliação do intergroupdifference seguido teste post-hoc de Scheffe, respectivamente. Havia apenas (Δ% = 24,88%, p = 0,0001) e entre os grupos significativa diferença intragrupo (Δ% = 42,22%, p = 0,0001) para a variável grupo de treinamento funcional (GTF) na balança, a autonomia funcional em todas as variáveis ​​em que o índice geral (IG) obtidos valores de (Δ% = -37,14%, p = 0,001); e a qualidade de vida na variável áreas relacionadas com a autonomia, participação social, morte e morrer e intimidade, o índice global de qualidade de vida (QVG de idade) obtidos os seguintes resultados (Δ% = -1,41%, p = 0,001). Em conclusão, os resultados desta estudo fornecem evidência o GTF foi menos tempo na realização de testes de equilíbrio, autonomia funcional, reflectindo a melhoria da qualidade de vida de pessoas idosas.

The study was to investigate the effects of functional training on postural balance, functional autonomy and quality of life for active seniors. The sample was randomly divided into Group Functional Training (GFT) and control group (CG), aged 67±6 and 65± 5 years (old), respectively. The following protocols were used: Berg Balance Scale (EEB, postural balance), Latin American Group of Development for Maturity (GDLAM, functional autonomy) and World Health Organization of Quality of Life ( WHOQOL – old , quality of life). Descriptive and inferential analysis using Shapiro-Wilk’s normality test was performed to evaluate the data. The Kruskal-Wallis test or Two-way ANOVA test were used for the evaluation of the intergroupdifference followed Scheffe post-hoc test, respectively. There was only (∆% = 24.88%, p = 0.0001) and between groups significant intra group difference (∆% = 42.22%, p = 0.0001) for the functional training group (GTF) variable in the balance, the functional autonomy in all variables where the general index (GI) obtained values of (∆% = -37,14%, p = 0,001); and the variable quality of life in areas relating to autonomy, social participation, death and dying and intimacy, the overall index of quality of life (OQL-old) obtained the following results(∆% = -1,41%, p = 0,001). In conclusion the results of this study provide evidence the GTF was less time in the performance of balance tests, functional autonomy, reflecting the improved quality of life of elderly.