Educational interventions for physical activity among Brazilian adults: systematic review.

OBJECTIVE: To summarize the main evidence from educational interventions designed to increase levels of physical activity (PA) among Brazilian adults. METHODS: Systematic review of intervention studies carried out in Brazil that implemented educational components aimed at promoting increased levels of PA among adult populations (18 to 65 years old). In October 2020, systematic searches were conducted in six databases, and in the reference lists of the assessed studies. RESULTS: Of the initial 2,511 studies, nine were included in the synthesis. Samples with specific characteristics (such as social vulnerability, physical inactivity, and overweight or obesity) were observed, with a greater number of women. Five interventions (55.6%) occurred in primary healthcare settings (PHC) of the Brazilian Unified Health System (SUS). Only four studies (44.4%) described the pedagogical frameworks structuring the educational approaches, among which counseling was the most used strategy, such as those carried out through face-to-face meetings, home visits, lectures, and phone calls (n = 8; 88.9%). Positive results were observed in three different indicators: increase in weekly PA volume (n = 4); increase in leisure-time PA rate (n = 1); and increase in the proportion of women classified as "very active/active" (n = 1). Given the sampling specificities, the domain "participant selection" showed a high number of interventions with high risk of bias. CONCLUSIONS: Educational approaches engendered some positive effects on different PA indicators, notably counseling as the main strategy used and approaches involving other health themes, such as nutrition and stress. However, considering the several determinants of PA in Brazil, future interventions should be conducted in different locations of Brazil in order to evaluate, in a broader way, their implementation processes and articulation with the many professionals working in PHC.

Educational interventions for physical activity among Brazilian adults: systematic review / Intervenções educativas para atividade física em adultos brasileiros: revisão sistemática

ABSTRACT OBJECTIVE To summarize the main evidence from educational interventions designed to increase levels of physical activity (PA) among Brazilian adults. METHODS Systematic review of intervention studies carried out in Brazil that implemented educational components aimed at promoting increased levels of PA among adult populations (18 to 65 years old). In October 2020, systematic searches were conducted in six databases, and in the reference lists of the assessed studies. RESULTS Of the initial 2,511 studies, nine were included in the synthesis. Samples with specific characteristics (such as social vulnerability, physical inactivity, and overweight or obesity) were observed, with a greater number of women. Five interventions (55.6%) occurred in primary healthcare settings (PHC) of the Brazilian Unified Health System (SUS). Only four studies (44.4%) described the pedagogical frameworks structuring the educational approaches, among which counseling was the most used strategy, such as those carried out through face-to-face meetings, home visits, lectures, and phone calls (n = 8; 88.9%). Positive results were observed in three different indicators: increase in weekly PA volume (n = 4); increase in leisure-time PA rate (n = 1); and increase in the proportion of women classified as "very active/active" (n = 1). Given the sampling specificities, the domain "participant selection" showed a high number of interventions with high risk of bias. CONCLUSIONS Educational approaches engendered some positive effects on different PA indicators, notably counseling as the main strategy used and approaches involving other health themes, such as nutrition and stress. However, considering the several determinants of PA in Brazil, future interventions should be conducted in different locations of Brazil in order to evaluate, in a broader way, their implementation processes and articulation with the many professionals working in PHC.

RESUMO OBJETIVO Sumarizar as principais evidências de intervenções educativas delineadas para o aumento dos níveis de atividade física (AF) em adultos brasileiros. MÉTODOS Revisão sistemática de estudos de intervenção conduzidos no Brasil, que implementaram componentes educativos com a finalidade de promover o aumento dos níveis de AF em populações de adultos (18 a 65 anos). Em outubro de 2020, buscas sistemáticas foram conduzidas em seis bases de dados e nas listas de referências dos artigos avaliados. RESULTADOS Dos 2.511 artigos iniciais, nove compuseram a síntese. Foram observadas amostras com características específicas (como vulnerabilidade social, inatividade física e sobrepeso ou obesidade), com maior número de mulheres. Cinco intervenções (55,6%) ocorreram nos cenários da atenção primária à saúde (APS) do Sistema Único de Saúde (SUS). Apenas em quatro estudos (44,4%) houve descrição dos referenciais pedagógicos estruturantes das abordagens educativas, dentro os quais o aconselhamento se configurou como a estratégia mais utilizada, como aquelas realizadas por meio de encontros presenciais, visitas domiciliares, palestras e chamadas telefônicas (n = 8; 88,9%). Resultados positivos foram observados em três distintos indicadores: aumento do volume semanal de AF (n = 4); aumento do índice de AF no lazer (n = 1); e aumento da proporção de mulheres classificadas como "muito ativas/ativas" (n = 1). Visto as especificidades amostrais, o domínio "seleção dos participantes" apresentou elevado número de intervenções com alto risco de viés. CONCLUSÕES As abordagens educativas produziram alguns efeitos positivos em distintos indicadores de AF, destacando-se o aconselhamento como principal estratégia utilizada e as abordagens que envolveram outras temáticas de saúde, como nutrição e estresse. Contudo, frente aos diversos determinantes da AF no Brasil, é importante que futuras intervenções sejam conduzidas em variadas localizações do país, de forma que avaliem, de maneira mais ampla, seus processos de implementação e articulação com os distintos profissionais que atuam na APS.

Atividade física e dor lombar em brasileiros: uma revisão sistemática / Physical activity and low back pain in Brazilians: a systematic review

O objetivo deste estudo é identificar e sumarizar os estudos observacionais conduzidos em território brasileiro que avaliaram as possíveis associações entre a prática de atividade física (AF) e a dor lombar (DL), bem como analisar seus métodos. Para isto, foram realizadas buscas em cinco bases de dados eletrônicas (Lilacs, Pubmed, Scielo, Sportdiscus e Web of Science), além de buscas manuais nas listas de referências. Foram incluídos estudos observacionais desenvolvidos em território brasileiro, sem restrições quanto à idade, que apresentaram análises de associações entre AF e DL, disponíveis até 10 de outubro de 2017. Dos 153 estudos inicialmente recuperados, 11 compuseram a síntese descritiva (sete deles envolvendo adultos). Das 14 análises de associação recuperadas, apenas uma apresentou associação de risco entre a prática excessiva de AF e DL, em adolescentes. A presente síntese aponta para a necessidade de importantes avanços metodológicos nos futuros estudos, tais como: a necessi-dade da realização de estudos longitudinais; a investigação de possíveis relações entre distintos domí-nios da AF e diferentes tipos de DL; a necessidade de padronização nos pontos de corte utilizados pelos instrumentos para determinar AF suficiente e a prevalência da DL; e a utilização de medidas objetivas, em paralelo ao questionário, para avaliação da AF

The objective of this study was to identify and summarize the available studies conduced in Brazil, which evaluated possible associations between physical activity (PA) and low back pain (LBP), as well as to an-alyse their methods. Search was performed in five electronic databases (Lilacs, Pubmed, Scielo, Sportdiscus and Web of Science) and by manual searches in reference lists. Inclusion criteria were: observational studies available until October 10, 2017; which presented association analyses between PA and LBP; sample of Brazilian individuals, with no restrictions about age Of the 153 initially studies recovered, 11 were includ-ed (seven of them involving adults). Of the 14 analyses recovered, only one association was observed between excess of PA and LBP in adolescents. Most of the included articles did not show significant associations between PA and LBP. Important methodological advances are needed in future studies on this thematic, such as: longitudinal studies; the investigation of possible relationships between LBP and the distinct domains of PA; standardization in the cut-off points used to determine the prevalence of LBP and sufficient PA; the use of objective measures, in parallel to the questionnaire, for the PA assessment