Changes in leisure physical activity, commuting and television watching in men and women users of the Brazilian National Health System in a middle-sized city: 18-months of follow-up / Mudanças na atividade física de lazer, locomoção e tempo de televisão entre homens e mulheres usuários do Sistema Único de Saúde em uma cidade de médio porte: seguimento de 18 meses

Abstract Given the importance of physical activity for health promotion and for the prevention of chronic non-communicable diseases, the Unified Health System (SUS) has changed its strategy of action in the last decades, trying to adopt preventive activities, seeking better quality of life of the Brazilian population and reduce costs with treatment of diseases. The aim of this study was to investigate changes in physical activity and sedentary behavior patterns in users of the Brazilian National Unified Health System during 18 months and the impact of sex and time on such variables. One hundred and ninety-eight participants (58 men and 140 women) were evaluated. Physical activity level was assessed using the Baecke questionnaire. Men had higher scores in all physical activity variables compared to women: walking (p-value= 0.013), cycling (p-value= 0.001) and commuting (p-value= 0.007), but not for TV watching (p-value= 0.362). After 18 months, in the overall sample, walking score increased 25.9% (95%CI= 10.6 to 41.1), but not cycling (1.5% [95%CI= -2.7 to 5.7]), commuting (14.4% [95%CI= -0.4 to 29.3]) and TV watching (1.6% [95%CI= -5.7 to 9.1]). Men were usually more active than women in active behaviors, but not in TV watching. However, differences over time were similar between sexes.

Resumo Dada a importância da atividade física para promoção da saúde, assim como para a prevenção de doenças crônicas não transmissíveis, o Sistema Único de Saúde (SUS) mudou a estratégia de atuação nas últimas décadas, procurando adotar atividades preventivas, buscando melhorar a qualidade de vida da população brasileira e diminuir gastos com tratamento de doenças. Objetivou-se investigar as mudanças na prática de atividade física e tempo de televisão em usuários do SUS durante um período de 18 meses e o impacto do sexo e tempo nessas variáveis. Foram avaliados 198 participantes (58 homens e 140 mulheres). Nível de atividade física foi mensurado através do questionário de Baecke. Homens apresentaram maiores escores em todas as variáveis de atividade física: caminhada (p-valor 0,013), ciclismo (p-valor 0,001) e locomoção (p-valor 0,007) do que mulheres, mas não para assistir televisão (p-valor= 0,362). Após 18 meses, em toda a amostra, o escore de caminhada aumentou 25,9% (IC95%= 10,6 - 41,1), mas não ciclismo (1,5% [95%CI= -2,7 - 5,7]), locomoção (14,4% [95%CI= -0,4 - 29,3]) e televisão (1,6% [95%CI= -5,7 - 9,1]). Entre usuários do SUS, homens foram usualmente mais ativos que mulheres em comportamentos ativos, mas não ao assistir televisão. Porém, diferenças ao longo do tempo foram similares entre os sexos.

Type 2 diabetes, healthcare expenditures and its correlation with anthropometric factors and physical activity: 18-month follow-up in a Brazilian city

AIMS: To compare the profile of adults attended at primary care level of the Brazilian National Health System according to occurrence of T2DM during 18 months of follow-up. METHOD: Longitudinal study carried out with 316 adults. T2DM and PA were assessed by questionnaires. Measurements of weight, height and waist circumference (WC) were also performed. Healthcare expenditures were based on the demand of services registered in medical records. Analysis of variance (ANOVA) with Tukey's post hoc test was used, as well as their similar for non-parametric variables. Spearman's correlation coefficient analyzed the relationship between variables. All analyzes were performed using the statistical software BioEstat (release 5.0) and the significance level was set at p-value <0.05. RESULTS: Patients with T2DM at baseline showed higher values of WC, BMI, nursing appointments, customer services, medication, total cost and lower values of PA when compared to patients T2DM-free. Patients who developed T2DM during the follow-up presented higher values of WC, screening, pharmacy frequency, medications and total cost when compared to individuals without T2DM. Being in the highest quartile of PA did not change the costs of health services among patients T2DM-free. Healthcare expenditures were positively correlated to BMI among participants T2DM-free and with T2DM at baseline. CONCLUSION: Participants with T2DM and participants who developed T2DM during the follow-up showed higher values of BMI, WC, healthcare expenditures and were less active when compared to participants T2DM-free. Healthcare expenditures were positively correlated with BMI among participants with T2DM at baseline and T2DM-free.(AU)

Fisioterapia respiratória e sua aplicabilidade no período pré-operatório de cirurgia cardíaca / Respiratory physiotherapy and its application in preoperative period of cardiac surgery

Procedimentos cirúrgicos torácicos podem alterar a mecânica respiratória, repercutindo na função pulmonar. A presença de profissionais fisioterapeutas é fundamental no preparo e na reabilitação dos indivíduos que são submetidos à cirurgia cardíaca, visto que dispõem de um grande arsenal de técnicas. O objetivo foi verificar a efetividade de exercícios respiratórios, com e sem a utilização de dispositivos, e o treinamento muscular respiratório pré-cirurgia cardíaca na redução das complicações pulmonares pós-operatórias. Mesmo existindo controvérsias a respeito de qual técnica utilizar, estudos demonstram a eficácia da fisioterapia respiratória pré-cirúrgica na prevenção e na redução de complicações pulmonares pós-operatórias.

Cardiac surgical procedures change respiratory mechanics, defecting in lung dysfunction. The physical therapists play an important role in the preparation and rehabilitation of individuals who are undergoing cardiac surgery, as they have a large quantity of techniques. The objective was to evaluate the effectiveness of breathing exercises with and without the use of devices, and respiratory muscle training in preoperative period of cardiac surgery in reducing postoperative pulmonary complications. Although there are controversies as to which technique to use, studies show the effectiveness of preoperative physiotherapy in the prevention and reduction of postoperative pulmonary complications.

Respiratory physiotherapy and its application in preoperative period of cardiac surgery.

Cardiac surgical procedures change respiratory mechanics, defecting in lung dysfunction. The physical therapists play an important role in the preparation and rehabilitation of individuals who are undergoing cardiac surgery, as they have a large quantity of techniques. The objective was to evaluate the effectiveness of breathing exercises with and without the use of devices, and respiratory muscle training in preoperative period of cardiac surgery in reducing postoperative pulmonary complications. Although there are controversies as to which technique to use, studies show the effectiveness of preoperative physiotherapy in the prevention and reduction of postoperative pulmonary complications.