Reabilitação funcional e barreiras para atividade física na COVID-longa: um ensaio clínico randomizado / Functional rehabilitation and barriers to physical activity after COVID-19: a randomized clinical trial

O estudo teve como objetivo analisar as barreiras percebidas à prática de atividade física durante um programa de treinamento multicomponente em adultos e idosos pós infecção por COVID-19. Realizou-se um ensaio clínico randomizado com 40 participantes (19 grupo controle e 21 grupo intervenção). Foram coletadas informações sociodemográficas, de saúde e de barreiras para a prática de atividade física, antes, 12 e 24 semanas após o início da intervenção. A medida das barreiras para a prática de atividade física foi obtida por meio de uma escala válida composta por 16 itens. As diferen-ças de barreiras entre os grupos e ao longo de tempo foi analisada a partir das Equações de Estimativa Generalizada, α = 0,05. As barreiras mais citadas pelos dois grupos na linha de base foram "Preguiça, cansaço ou desânimo" (71%), "Dores, lesões ou incapacidade" (38%) e "Falta de motivação" (48%). As análises principais indicaram que ambos os grupos tiveram redução na frequência da barreira "Pre-guiça, cansaço ou desânimo" na 12ª semana (p = 0,003), porém voltando aos valores iniciais na 24ª semana (p = 0,441). Já a barreira "Por causa da epidemia de coronavírus" foi reduzida na 12ª semana (p = 0,704) e ainda mais reduzida na 24ª semana (p = 0,158), comportamento também similar entre os grupos. Como principal conclusão, barreiras para atividade física podem ser reduzidas pela parti-cipação em programas de exercício supervisionado e recomendação para a prática de atividade física

The study aimed to analyze perceived barriers to physical activity during a multicomponent training pro-gram in adults and seniors post-COVID-19 infection. A randomized clinical trial was conducted with 40 participants (19 control group and 21 intervention group). Sociodemographic, health, and barriers to physical activity information were collected before, 12 and 24 weeks after the start of the intervention. The measure of barriers to physical activity was obtained through a valid scale composed of 16 items. Differences in barriers between groups and over time were analyzed using Generalized Estimating Equations, α = 0.05. The most frequently mentioned barriers at baseline by both groups were "Laziness, fatigue, or lack of enthusiasm" (71%), "Pain, injuries, or disability" (38%), and "Lack of motivation" (48%). The main analyses indicated that both groups had a reduction in the frequency of the barrier "Laziness, fatigue, or lack of enthusiasm" at week 12 (p = 0.003), but returned to initial values at week 24 (p = 0.441). The barrier "Because of the coronavirus epidemic" was reduced in week 12 (p = 0.704) and further reduced in week 24 (p = 0.158), with a similar pattern between groups. The key conclusion is that barriers to physical activity can be reduced through participation in supervised exercise programs and recommendations for physical activity

Effects of physical training on functional, clinical, morphological, behavioural and psychosocial outcomes in post-COVID-19 infection: COVID-19 and REhabilitation study (CORE-study)-a study protocol for a randomised controlled clinical trial.

BACKGROUND: The COVID-19 pandemic remains ongoing, with a significant number of survivors who have experienced moderate to severe clinical conditions and who have suffered losses of great magnitude, especially in functional capacity, triggering limitations to daily autonomy and quality of life. Among the possibilities of intervention for disease rehabilitation, physical exercise training stands out, which can benefit several health outcomes and favours the adoption of healthier behaviours. Therefore, the aim of the study will be to analyse the effects of physical training on the functional, clinical, morphological, behavioural and psychosocial status in adults and the elderly following COVID-19 infection. METHODS: A randomised controlled clinical trial is to be conducted in parallel, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation programme, carried out at the Sports Center in partnership with the Academic Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. Participants will be adults and the elderly, of both sexes, in a post-COVID-19-infection state, who were hospitalised during the infection. The intervention will have a total duration of 24 weeks and will include a multicomponent physical training programme, which will have gradual progression in frequency, duration and intensity over time. Regarding the outcomes, before, at the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioural and psychosocial outcomes will be assessed. DISCUSSION: This study will contribute to a greater understanding of the safety, adherence and benefits of physical training in the rehabilitation of post-COVID-19 patients. The results of this study will be disseminated through presentations at congresses, workshops, peer-reviewed publications and local and international conferences, especially with a view to proposing a post-COVID-19 rehabilitation care protocol. TRIAL REGISTRATION: ReBEC, RBR-10y6jhrs . Registered on 22 February 2022. 2015.

Combined Training with Aerobic Exercise Performed Outdoors Can Promote Better Blood Pressure and Affective Responses in Individuals with Cardiovascular Risk Factors.

The purpose of the study was to compare the effects of two models of combined training (CT) (aerobic and resistance exercise realized in the same training session), with aerobic training performed in different environments (indoor or outdoor), on blood pressure (BP), heart rate (HR), and affective response in individuals with cardiovascular risk factors. Twenty-six participants were allocated, in a non-randomized design, into CT with aerobic exercise performed indoors (ICT) or outdoors (OCT). Both groups were submitted to three weekly CT sessions, with aerobic exercises performed on ergometers or an athletics track. Before and after nine weeks of training, BP and HR at rest were measured. In the last session of the training, the affective response was collected. The individuals were 65.8 ± 7.8 (ICT) and 67.3 ± 8.2 (OCT) years. Lower values of diastolic BP were observed for the OCT group at post-training (p < 0.001). Moreover, in OCT, a significant inverse correlation was identified between the affective response to training and changes in systolic BP (r = −0.60; p = 0.03) and mean BP (r = −0.62; p = 0.02). In conclusion, CT, with aerobic exercise performed outdoors, seems to be more effective in reducing BP with better affective responses to training.

Nine weeks of combined training improve functional and morphological outcomes in trained older people with cardiometabolic risk factors.

BACKGROUND: The study is characterized as a single group experiment, with the aim of verifying the responses of functional capacity and body composition, after a combined training program with undulating periodization, of low cost and easy applicability, in volunteers with cardiovascular risk factors. METHODS: Experimental study carried out with individuals of both sexes, with cardiometabolic risk factors, members of a Cardiorespiratory Rehabilitation Program (PROCOR) of the Federal University of Santa Catarina (UFSC). A combined physical training program (aerobic and strength) with load training progression was used, performed at a frequency of three weekly sessions, on alternate days, for nine weeks and using shin guards, elastic bands or just body weight. Functional capacity, anthropometric profile and body composition of individuals were evaluated before and after the intervention. The comparison of data before and after the intervention period was performed using the Student's t-test for paired samples and the Wilcoxon test. RESULTS: Improvements statistically significant were observed in the tests related to functional capacity, "Sit and Stand", "8-foot-up-and-go" at usual and maximum speeds and "March", along with a decrease in anthropometric measurements of hip circumference, body fat percentage, waist-to-hip ratio, and fat mass in the android region. In addition, the program was well-tolerated with a low rate of sample losses. CONCLUSION: The results of this study suggest that only 9 weeks of combined training at low cost and easy applicability is able to promote improvement in parameters related to functional capacity, anthropometric profile, and body composition of trained older people with cardiovascular risk factors.

Proposition of Cutoff Points for Anthropometric Indicators to Identify High Blood Pressure in Adolescents.

Aim: To propose cutoff points for anthropometric indicators for high blood pressure (HBP) screening in adolescents and to identify, among these indicators, those more accurately for boys and girls. Methods: This cross-sectional study was carried out in the city of São José, SC, Brazil with 634 adolescents aged 14 to 19 years. Blood pressure levels were measured using a digital oscillometric sphygmomanometer and adolescents were classified as having HBP or not. Anthropometric indicators were calculated based on anthropometric measurements such as body mass (BM), height, waist circumference (WC), hip circumference (HC) and triceps, subscapularis, suprailiac, and midcalf skinfold thickness (SF). The Receiver Operating Characteristic Curve (ROC) was used to analyze the predictive capacity of anthropometric indicators in the identification of HBP. Results: Higher values of Area Under the Curve (AUC) were for the anthropometric indicators BM (0.67; 95%CI: 0.62-0.72), body mass index (BMI) (0.67; 95%CI: 0.62-0.72), and WC (0.67; 95%CI: 0.62-0.71) for males. For females, no anthropometric indicator had discriminatory power for HBP screening. The cutoff points for the anthropometric indicators with discriminatory power for HBP screening in males were BM > 64.80 Kg, BMI > 21.76 Kg/m2, fat percentage (FP) > 15.75, waist height to ratio (WHtR) > 0.41, WC > 73.00 cm, and HC > 92.25 cm. Conclusion: Anthropometric indicators of body adiposity had greater discriminatory power of HBP screening in males. For females, caution is suggested because the anthropometric indicators showed AUC values (95%CI) below 0.60.

Association between mental health and sleep quality in peripheral artery disease patients: a longitudinal study / Associação entre saúde mental e qualidade do sono em pacientes com doença arterial periférica: estudo longitudinal

Objective: To analyze the longitudinal association between mental health and sleep quality in peripheral artery disease (PAD) patients in two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 PAD patients were evaluated in two years of COVID-19 pandemic (2020 and 2021). Patients were interviewed by telephone call, and information regarding mental health (anxiety, unhappiness, stress and depression) and sleep quality (sleep change, difficulty to sleep and sleep improvement) were obtained. Patients were divided into: no symptoms (patients that reported no mental health symptoms, n=31, 68.2±9.4 y.o.) and one or more symptoms (patients with at least one mental health symptom, n=68, 68.1±9.4 y.o.). Results: In 2020, mental health symptoms were associated with sleep change (OR=5.018; p=0.020), difficulty to sleep (OR=12.250; p=0.003) and sleep improvement (OR=0.104; p=0.003). In 2021, mental health was associated only with sleep change (OR=3.522; p=0.035). Conclusion: The impact of mental health symptoms on sleep quality of PAD patients was attenuated along the coronavirus pandemic.

Objetivo: Analisar a associação longitudinal entre saúde mental e qualidade do sono em pacientes com doença arterial periférica (DAP) em dois períodos da pandemia de COVID-19. Métodos: Neste estudo longitudinal, 99 pacientes com DAP foram avaliados em dois anos de pandemia de COVID-19 (2020 e 2021). Os pacientes foram entrevistados por telefone, obtendo-se informações sobre saúde mental (ansiedade, infelicidade, estresse e depressão) e qualidade do sono (alteração do sono, dificuldade para dormir e melhora do sono). Os pacientes foram divididos em: sem sintomas (pacientes que não relataram sintomas de saúde mental, n=31, 68,2±9,4 anos) e um ou mais sintomas (com pelo menos um sintoma de saúde mental, n=68, 68,1±9,4 anos). Resultados: Em 2020, os sintomas de saúde mental foram associados à alteração do sono (OR=5,018; p=0,020), dificuldade para dormir (OR=12,250; p=0,003) e melhora do sono (OR=0,104; p=0,003). Em 2021, a saúde mental esteve associada apenas à alteração do sono (OR=3,522; p=0,035). Conclusão: O impacto dos sintomas de saúde mental na qualidade do sono de pacientes com DAP foi atenuado durante a pandemia de coronavírus.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016.

This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Blood Pressure and Blood Glucose Responses to Combined Exercise Sessions of Different Intensities in Individuals with Cardiovascular Risk Factors.

OBJECTIVE: The purpose of the present study was to verify the acute effects of blood pressure and blood glucose after two sessions of combined exercise sessions performed at two levels of intensity in trained individuals with cardiovascular risk factors. METHODS: Eighteen individuals (66.22 ± 8.61 years) of both sexes (6 women/12 men) with cardiovascular risk factors performed two sessions of combined exercises at different levels of intensity: moderate (MOD) and high (HI). To control the intensity of the aerobic training, the Borg Rating of Perceived Exertion (RPE) Scale was used. For the strength training, the maximum number of repetitions was carried out within a predetermined duration of sets. Blood pressure and blood glucose measurements were collected before and 20 minutes after the sessions. The data were analyzed using Generalized Estimating Equations, α 5%. RESULTS: Reductions were observed in systolic blood pressure (MOD - Δ = -4.95 mmHg; HI - Δ = -3.31 mmHg) and blood glucose (MOD - Δ = -16.06 mg/dL; HI - Δ = -29.45 mg/dL) after the two sessions, with no difference between sessions. Diastolic blood pressure did not change (p < .05). CONCLUSION: Combined exercises sessions of moderate or high intensity can promote an acute reduction in systolic blood pressure and glycemia in individuals with cardiovascular risk factors.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016 / Deslocamento ativo entre trabalhadores da região Sul do Brasil: uma análise comparativa entre 2006 e 2016

Abstract This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Resumo O objetivo deste artigo é comparar a prevalência de deslocamento ativo para o trabalho em adultos na região Sul do Brasil entre 2006 e 2016 de acordo com características sociodemográficas e laborais. Os dados do Sistema Brasileiro de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas (VIGITEL) foram comparados em 2006 e 2016 (≥18 anos). Deslocamento ativo para o trabalho, sexo, faixa etária, escolaridade e características laborais foram coletados por inquérito telefônico e analisados nas cidades de Florianópolis, Curitiba e Porto Alegre, utilizando as frequências absolutas e relativas com seus respectivos intervalos de confiança de 95%. O deslocamento ativo aumentou significativamente em 2016 em relação a 2006. Florianópolis apresentou as maiores prevalências nos dois anos analisados. Em todas as capitais houve aumento significativo na prevalência do desfecho, principalmente para mulheres, com ensino médio e apenas em Florianópolis para homens, com baixa escolaridade. A prevalência também aumentou para características laborais em todas as capitais. O deslocamento ativo para o trabalho aumentou expressamente entre os adultos que vivem no Sul do Brasil, com destaque para Florianópolis. Ampliar intervenções nesse contexto é uma necessidade no Brasil.

Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression.

INTRODUCTION: Aerobic training of moderate intensity is the primary modality recommended in the management of hypertension. The manipulation of training variables can be an important strategy for the continuity of health benefits; however, little is known about the effects of the progression of aerobic training variables in the adaptations of blood pressure in hypertensive adults. OBJECTIVE: To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults. METHOD: The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. The results are presented as mean difference and 95% confidence interval. Statistical significance was considered with p < 0.05. RESULTS: Of the 13,028 studies found, 24 were selected and included in this review, 12 with progression of training variables and 12 without progression, with a total of 1,207 participants analyzed. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p < 0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p < 0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p < 0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). According to the results of the meta-regression analyses, only age showed an association with the reduction of SBP (ß: -0.323; CI -0.339, -0.307; p < 0.001). CONCLUSION: Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.

Dropout rates in controlled trials with exergames for blood pressure management: a systematic review and meta-analysis protocol / Taxas de abandono em estudos controlados com exergames para gerenciamento da pressão arterial: protocolo de uma revisão sistemática e metanálise

Exergame, a type of enjoyable active video game that combines physical exertion and game is a technological innovation that has generated important information for the health field. In the car-diovascular area, exergames have been used to manage blood pressure in adults with some positive results. Despite this, in primary studies, it is possible to identify that participants dropout of the exergames interventions, but no synthesis of evidence has been produced so far to explore that. The aims of this review are i) to estimate the pooled rate of dropouts in controlled trials assessing the effects of exergame-based interventions on resting blood pressure in adults and older people; ii) to compare dropout rates between exergame and controls groups, and iii) to investigate the intervention characteristics associate with dropout rates. Inclusion criteria: Randomized controlled trials (RCTs) or quasi-RCTs (≥ 4 weeks) assessing the effects of exergame-based interventions on resting blood pressure in adults aged ≥ 18 years old. Without restriction to language, date of the publication, and intervention setting. Literature searches will be conducted using PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. The quality of the RCTs will be assessed using Cochrane's risk of bias tool. A descriptive narrative synthesis and a random-effects model meta-analysis of the pooled event rate (prevalence) will be provided (p < 0.05). This protocol is registered with PROSPERO: CRD42020199547.

Exergame, um tipo de videogame ativo divertido que combina esforço físico e jogo virtual, é uma inovação tecnológica que tem gerado informações importantes para a área da saúde. Na área cardiovascular, os exer-games têm sido usados para gerenciar a pressão arterial em adultos, com alguns resultados positivos. Apesar disso, em estudos primários, é possível identificar que os participantes abandonaram (dropout) as interven-ções dos exergames, mas nenhuma síntese de evidências foi produzida até o momento para explorar isso. Os objetivos desta revisão são i) estimar a taxa combinada de dropouts em estudos controlados que avaliam os efeitos de intervenções baseadas em exergame na pressão arterial de repouso em adultos e idosos; ii) comparar as taxas de dropouts entre os grupos exergame e controles e iii) investigar as características de intervenção associadas às taxas de dropouts. Serão incluídos ensaios clínicos randomizados (ECRs) ou quase-ECRs (≥ 4 semanas) avaliando efeitos de intervenções com exergames sobre a pressão arterial em repouso em adultos (≥ 18 anos). Não haverá restrição de idioma, data de publicação e ambiente de intervenção. As buscas na lite-ratura serão conduzidas usando PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Cochrane Central Register of Controlled Trials e Scientific Electronic Library Online. O risco de viés dos ECRs será avaliado por meio da ferramenta da Cochrane. Uma síntese narrativa descritiva e uma metanálise de modelo de efeitos aleatórios da taxa de eventos combinados (pre-valência) serão fornecidas (p < 0,05). Este protocolo está registrado com PROSPERO: CRD42020199547.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial.

ABSTRACT: Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res 36(9): 2628-2634, 2022-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) in cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m -2 ) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V̇ o2 max), and ventilatory thresholds were determined before and after intervention. The generalized estimation equation was used, with the applied level of significance for the interaction of 0.10 and the isolated effect of time or group or both of 0.05. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V̇ o2 max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min -1 ; p = 0.05), while ventilatory thresholds improved in NG and CG ( p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper-body and lower-body strength, regardless of periodization. However, for improvement in V̇ o2 max, linear periodization may be superior to nonperiodization in obese adults.

Effects of different order of combined training on functional capacity, blood pressure, and body composition in women from 53 to 79 years old / Efeitos de diferentes ordens do treinamento combinado sobre a capacidade funcional, pressão arterial e composição corporal em mulheres de 53 a 79 anos

Objective: To assess the effects of order of resistance training (RT) and high-intensity interval training (HIIT) on functional capacity, blood pressure, and body composition in middle-aged and older women. Methods: Twenty-two participants were randomly assigned to one of two groups: RT followed by HIIT (RT-HIIT, n = 10, mean age 64.5 ± 7.9 years) or HIIT followed by RT (HIIT-RT, n = 10, mean age 59.32 ± 4.44 years). Both groups trained twice a week for 8 weeks. RT was composed of 7 exercises for the upper and lower body. HIIT was composed of alternate pairings of high-intensity (> 85% of maximum heart rate [MHR]) and moderate-intensity (60% MHR) running. Results: A time effect was found for upper-body muscle endurance (HIIT-RT = +9.43%; RT-HIIT = +6.16%), agility and dynamic balance (HIIT-RT = -5.96%; RT-HIIT = -8.57%), and cardiorespiratory fitness (HIIT-RT = +5.14%; RT-HIIT = +6.13%), with no difference between groups. Body composition and blood pressure did not change throughout the investigation for either group. Conclusion: Eight weeks of a combined HIIT and RT exercise program improved functional capacity of middle-aged and older women without altering blood pressure and body composition, regardless of the order of exercises.

Objetivo: Avaliar os efeitos da ordem do treinamento resistido (TR) e do treinamento intervalado de alta intensidade (HIIT) sobre a capacidade funcional, pressão arterial e composição corporal em mulheres de meia-idade e idosas. Metodologia: Vinte e duas mulheres foram aleatoriamente designadas em dois grupos: um grupo realizou TR seguido por HIIT (TR-HIIT, n = 10, 64,5 ± 7,94 anos) e outro grupo realizou HIIT seguido por TR (HIIT-TR, n = 10, 59,32 ± 4,44 anos). Ambos os grupos treinaram duas vezes por semana durante oito semanas. O TR foi composto por sete exercícios para a parte superior e inferior do corpo. O HIIT foi composto de pares alternados de corrida de alta intensidade (> 85% da frequência cardíaca máxima [FCM]) e intensidade moderada (60% FCM). Resultados: Foi encontrado um efeito dos programas de exercício para a resistência muscular de membros superiores do corpo (HIIT-TR = +9.43%; TR-HIIT = +6.16%), agilidade e equilíbrio dinâmico (HIIT-TR = -5,96%; TR-HIIT = -8.57%) e aptidão cardiorrespiratória (HIIT-TR = +5.14%; TR-HIIT = +6.13%), sem diferença entre os grupos. A composição corporal e a pressão arterial não se alteraram ao longo da investigação em nenhum dos grupos. Conclusão: Oito semanas de um programa combinado de exercícios de HIIT e de TR proporcionaram melhora na capacidade funcional de mulheres de meia-idade e idosas, sem alterar a pressão arterial e a composição corporal, independente da ordem de execução.

Effects of aerobic training with and without progression on blood pressure in patients with type 2 diabetes: A systematic review with meta-analyses and meta-regressions.

AIMS: To analyze the effects of aerobic training with and without progression on blood pressure in patients with type 2 diabetes. METHODS: The databases used for the systematic search were PubMed, Cochrane Central, SPORTDiscus and LILACS. Studies which analyzed blood pressure before and after an intervention period of eight or more weeks of aerobic training compared to a control group without training in patients with type 2 diabetes were included. RESULTS: Of the 4186 studies found, 17 clinical trials were included (912 participants). Systolic blood pressure (SBP) decreased after aerobic training with progression (-6.78 mmHg; 95% CI -8.36, -5.19; p < 0.001) and without progression (-8.07 mmHg; 95% CI -9.37, -6.77; p < 0.001). The same happened regarding diastolic blood pressure (DBP), which decreased with aerobic training with progression (-3.10 mmHg; 95% CI -4.90, -1.31; p < 0.001) and without progression (-5.71 mmHg; 95% CI -7.15, -4.28; p < 0.001). CONCLUSION: Aerobic training is effective in reducing blood pressure in patients with type 2 diabetes, regardless of progression in training variables.

Effect of physical training periodization on physical activity level in adults with obesity / Efeito da periodização do treinamento físico no nível de atividade física em adultos com obesidade

The study aimed to compare the effect of physical training with and without periodization on daily physical activity levels and on time spent in sedentary behavior in adults with obesity. In a randomized controlled trial, 69 obese adults of both sexes (BMI ≥ 30 kg/m²) were randomized to three groups: periodized group (PG), non-periodized group (NPG) and control group (CG). The periodized and non-periodized groups underwent 16 weeks of supervised and combined physical training (aerobic and resistance) in 60-minute sessions three times a week. Physical activity and sedentary behavior levels were measured by accelerometry (ActiGraph - GT3x). The time spent in sedentary behavior after the intervention increased 6.5% in the PG and 1.2% in the CG and decreased 0.5% in the NPG. Changes in the levels of light physical activity were -4.6% in the PG, +0.5% in the NPG and -2.3% in the CG, while moderate to vigorous physical activity levels showed a reduction of 3.0% in the PG and increases of 0.5% in the NPG and 12.2% in the CG. It is worth mentioning, however, that no isolated time and group effects or time x group interaction were identified for any of the analyzed variables (p > 0.05). A combined and supervised physical training program, with or without load progression, was not able to promote changes in the sedentary behavior and physical activity levels of obese adults, which shows that specific actions targeted at these behaviors are necessary

O estudo teve por objetivo comparar o efeito do treinamento físico, com e sem periodização, nos níveis de atividade física diária e no tempo em comportamento sedentário de adultos com obesidade. Em um estudo randomizado controlado,69 adultos de ambos os sexos com obesidade (IMC ≥ 30 kg/m²) foram randomizados em três grupos: grupo periodizado (GP), grupo não periodizado (GNP) e grupo controle (GC). Os grupos periodizado e não periodizado foram submetidos a 16 semanas de treinamento físico combinado (aeróbio e resistido) e supervisionado, três vezes na semana, em sessões de 60 minutos. Os níveis de atividade física e comportamento sedentário foram mensurados por meio de acelerometria (ActiGraph - GT3x). O tempo despendido em comportamento sedentário após a intervenção aumentou 6,5% no GP e 1,2% no GC e reduziu 0,5% no GNP. As mudanças nos níveis de atividade física leve foram de -4,6% no GP, +0,5% no GNP e -2,3% no GC, ao passo que os níveis de atividade física moderada a vigorosa apresentaram reduções de 3,0% no GP e aumentos de 0,5% no GNP e 12,2% no GC. Vale destacar, porém, que não foram identificados efeitos isolados do tempo e do grupo e nem interação tempo e grupo para nenhuma das variáveis analisadas (p > 0,05). Um programa de treinamento físico combinado e supervisionado, com ou sem progressão de carga, não foi capaz de promover mudanças no comportamento sedentário e nos níveis de atividade física de adultos com obesidade, sendo necessárias ações específicas voltadas a estes comportamentos

Simultaneity of chronic noncommunicable diseases in 2013 in Brazilian state capital cities: prevalence and demographic profile. / Simultaneidade de doenças crônicas não transmissíveis em 2013 nas capitais brasileiras: prevalência e perfil sociodemográfico.

OBJECTIVE: to describe the prevalence and sociodemographic profile of chronic noncommunicable disease (CNCDs) simultaneity in adults and elderly people resident in Brazilian state capital cities. METHODS: Chronic Noncommunicable Disease Risk and Protection Factor Surveillance System Survey 2013; simultaneity was considered to be two or more CNCDs (diabetes mellitus, dyslipidemia, hypertension, and obesity). RESULTS: of the total 52,929 participants, 13.7% of adult participants and 42.9% of elderly participants had CNCD simultaneity; hypertension and diabetes mellitus simultaneity was greater in adults, while hypertension and obesity simultaneity was greater in the elderly; simultaneity was more prevalent in women, in those between 50 and 59 years old, with partners and up to eight years of schooling; the cities with the lowest and highest prevalence in adults were São Luís and Cuiabá, respectively, while in the elderly, the cities were Belém and Manaus, respectively. CONCLUSION: simultaneity was identified nationwide; prevention measures should be directed especially toward treatment of hypertension.

Resistance Exercise Order Does Not Affect the Magnitude and Duration of Postexercise Blood Pressure in Older Women.

Tomeleri, CM, Nunes, JP, Souza, MF, Gerage, AM, Marcori, A, Iarosz, KC, Cardoso-Júnior, CG, and Cyrino, ES. Resistance exercise order does not affect the magnitude and duration of postexercise blood pressure in older women. J Strength Cond Res 34(4): 1062-1070, 2020-The aim of this study was to compare the effects of 2 resistance exercise order on postexercise blood pressure (BP) in trained nonhypertensive older women. Sixteen women (68.3 ± 3.3 years, 63.5 ± 11.6 kg, 157.5 ± 5.1 cm) performed 2 sessions with 8 exercises (3 sets of 8-12 repetitions) in distinct orders (from multi- to single-joint exercises [MS] or from single- to multijoint exercises [SM]) and a control session (CS), without exercise. Blood pressure and heart rate (HR) were obtained pre- and postsessions (60 minutes). Postexercise hypotension was observed for systolic BP (SBP) and mean BP in both the MS session (SBP: -6.9 mm Hg, mean BP: -3.3 mm Hg, p ≤ 0.05) and SM session (SBP: -4.6 mm Hg; mean BP: -1.1 mm Hg). Postexercise HR was higher than presession values until 30 minutes of recovery in both training sessions. Furthermore, SBP and mean BP, and HR were lower than the values obtained in the CS (30-60 minutes and 0 minutes, respectively; p ≤ 0.05). There were no differences between the SM and MS sessions in any variable or at any moment. In conclusion, resistance exercise order does not interfere in the magnitude and duration of postexercise hypotension in trained nonhypertensive older women.

Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial.

OBJECTIVE: To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. METHODS: Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. RESULTS: Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL-1 to 6.5±2.1mL·100mL-1 tissue·min-1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). CONCLUSION: Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268.

Promotion of physical activities and healthy eating habits in Primary Care: maintenance of benefits / Promoção da atividade física e hábitos alimentares saudáveis na Atenção Primária: manutenção dos benefícios

ABSTRACT Objective To evaluate the maintenance of the beneficial effects of the Vida Ativa Melhorando a Saúde Program, six months after its completion. Methods A randomized controlled community trial was conducted in two poles of the Academia da Saúde Program, randomly identified as control or intervention groups. The study involved 291 adults and elderly involved in the routine activities of the Academia da Saúde Program. Individuals in the intervention group also participated to the Vida Ativa Melhorando a Saúde Program for 12 weeks. Accelerometers were used to evaluate physical activities, questionnaires for the evaluation of eating habits and anthropometric measures for nutritional status. Results Six months after completion of the intervention, the beneficial results obtained for physical activities and nutritional status were not maintained. The benefits related to eating habits remained, but not exclusively due to the effect of the intervention. Conclusion The Vida Ativa Melhorando a Saúde Program, in the applied format, was not able to promote lasting beneficial effects on physical activities and nutritional status. The Program is being restructured regarding the extension of the intervention time and its didactic material.

RESUMO Objetivo Avaliar a manutenção dos efeitos benéficos do programa Vida Ativa Melhorando a Saúde seis meses após a sua finalização. Métodos Foi conduzido um ensaio comunitário controlado e randomizado em dois polos do programa Academia da Saúde, identificados aleatoriamente como grupo controle e grupo intervenção. Participaram do estudo 291 adultos e idosos envolvidos nas atividades rotineiras do programa Academia da Saúde. Indivíduos do grupo intervenção participaram, adicionalmente, do programa Vida Ativa Melhorando a Saúde durante 12 semanas. Foram utilizados acelerômetros para avaliação da atividade física, questionários para a avaliação dos hábitos alimentares e medidas antropométricas para mensuração do estado nutricional. Resultados Seis meses após a finalização da intervenção, os resultados benéficos obtidos com a prática de atividade física e o estado nutricional não se mantiveram. Quanto aos hábitos alimentares, os benefícios se mantiveram, mas não foram exclusivamente pelo efeito da intervenção. Conclusão O programa Vida Ativa Melhorando a Saúde, no formato aplicado, não foi capaz de promover efeitos benéficos duradouros sobre a prática de atividade física e o estado nutricional dos indivíduos. O programa está sendo reformulado com a ampliação do tempo de intervenção e reestruturação do material didático.