Relationship between functional classification, upper extremity muscle strength, and agility in wheelchair rugby athletes / La relación entre la clasificación funcional, la fuerza muscular de las extremidades superiores y la agilidad de los deportistas de rugby en silla de ruedas / A relação entre classificação funcional, força muscular de membros superiores e agilidade de atletas do rúgbi em cadeira de rodas

ABSTRACT This study aimed to compare the strength and agility of wheelchair rugby (WR) athletes with different functional classifications (FC) and describe the relationship between agility and upper extremity isometric muscle strength (IMS). A total of 10 WR athletes were analyzed, divided into two groups: Group 1 (G1): FC 0.5 and 1.0; and Group 2(G2): FC 1.5 to 2.5. IMS was evaluated by a dynamometer, and agility by a zig-zag test. Spearman's correlation was used to describe the relationship between IMS and performance on the agility test. In contrast, the t-test was used to compare strength and agility between different FCs (p≤0.05). Shoulder extensor IMS was higher in G2 athletes (p=0.001; d=3.10), which were also more agile than G1 athletes (G1=23.66s>G2=17.55s; p=0.015; d=2.00). Both groups showed a correlation between bilateral shoulder extensor strength and agility (r=−0.721; p=0.019). Athletes with high FC scores are more agile than athletes with low scores and, therefore, have greater movement speed when performing WR tasks. Greater shoulder extensor muscle strength is associated with greater agility in WR athletes.

RESUMEN El objetivo de este estudio fue comparar la fuerza y la agilidad de los deportistas de rugby en silla de ruedas (RSR) desde diferentes clasificaciones funcionales (CF), así como describir la relación entre la agilidad y la fuerza muscular isométrica (FMI) de las extremidades superiores. Se evaluaron a diez deportistas RSR en dos grupos: Grupo 1 (G1): CF 0,5 y 1,0; y Grupo 2 (G2): CF 1,5 a 2,5. En la evaluación de la FMI se utilizó la dinamometría; y en la evaluación de la agilidad, la prueba de zigzag. La correlación de Spearman se utilizó para describir la relación entre la FMI y el rendimiento en la prueba de agilidad, mientras que la prueba t se utilizó para comparar la fuerza y la agilidad entre las diferentes CF (p≤0,05). La FMI de los extensores del hombro fue mayor en el G2 (p=0,001; d=3,10), y este también fue más ágil que el G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Hubo una correlación entre la fuerza muscular bilateral de los extensores del hombro y la agilidad en ambos grupos (r=−0,721; p=0,019). Los deportistas con altas puntuaciones de CF fueron los más ágiles en comparación con aquellos con bajas puntuaciones, por lo tanto, se constata que tienen una mayor velocidad de desplazamiento en la realización de tareas de RSR. Una mayor fuerza muscular de los extensores de hombro se asocia con una mayor agilidad en los deportistas RSR.

RESUMO O objetivo do estudo foi comparar a força e a agilidade de atletas do rúgbi em cadeira de rodas (RCR) por meio de diferentes classificações funcionais (CFs), bem como descrever a relação da agilidade com a força muscular isométrica (FMI) de membros superiores. Foram analisados 10 atletas de RCR, divididos em dois grupos: Grupo 1 (G1): CF 0,5 e 1,0; e Grupo 2 (G2): CF 1,5 a 2,5. A FMI foi avaliada pela dinamometria, e a agilidade pelo teste em ziguezague. A correlação de Spearman foi utilizada para descrever a relação entre a FMI e o desempenho no teste de agilidade, enquanto o teste t foi usado para comparar a força e a agilidade entre as diferentes CFs (p≤0,05). A FMI dos extensores do ombro foi maior no G2 (p=0,001; d=3,10), que também se mostrou mais ágil que o G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Verificou-se a correlação entre força muscular bilateral de extensores de ombro e agilidade em ambos os grupos (r=−0,721; p=0,019). Atletas com pontuação alta na CF são mais ágeis comparados a atletas com pontuações baixas e, portanto, apresentam maior velocidade de deslocamento ao executar as tarefas do RCR. Maior força muscular dos extensores de ombro é associada à maior agilidade em atletas do RCR.

Sleep regularity in athletes: Comparing sex, competitive level and sport type.

This study aims to describe the athletes' sleep regularity using the Sleep Regularity Index (SRI) and determine whether factors, such as sex, competitive level and sport type, could affect the sleep/wake rhythm. It is a descriptive, cross-sectional study consisting of 172 athletes (25 ± 7 y old; 45 women). Seventy-three competed in team sports and 99 in individual sports. Furthermore, 56 competed in the international level, 95 in the national and 21 in the regional. We recorded the SRI values for at least 5 d via continuous actigraphy. We recorded a mean SRI value of 73 ± 12. We found no significant differences between athletes' sleep parameters in relation to sleep regularity. Furthermore, SRI data showed no correlations (Spearman's ρ) with sleep parameters, bed time and wake time. Female athletes (p = 0.001) and individual sport athletes (p = 0.001) reported better sleep regularity than their counterparts. International-level athletes reported better sleep regularity than those in other competitive levels (national: p = 0.001; regional: p = 0.024). Our study showed that international level athletes, female athletes and individual sport athletes reported better sleep regularity. Additionally, SRI data showed no correlation with athletes' sleep parameters, bed and wake time.

Are physical inactivity, sitting time and screen time associated with obstructive sleep apnea in adults? A cross-sectional study.

BACKGROUND: Sitting time, screen time and low physical activity (PA) levels have been associated with several diseases and all-cause mortality. PA is related to better sleep quality and absence of daytime sleepiness, along with lower risks of obstructive syndrome apnea (OSA). However, studies on the relationship between sitting time, screen time and OSA are scarce in the literature. OBJECTIVE: To analyze associations between PA levels, sitting time, screen time and OSA among adults with suspected sleep disorder. DESIGN AND SETTING: Cross-sectional study conducted at Hospital Israelita Albert Einstein. METHODS: Data were collected from 369 adults with suspected sleep disorders who visited the hospital's neurophysiology clinic between August 2015 and January 2017. RESULTS: Correlations between hypopnea and PA indicators were demonstrated for total sitting time (0.123; P = 0.019) and total screen time (0.108; P = 0.038). There was also a correlation between latency for rapid-eye-movement sleep (REM_LAT) and total sitting time (0.103; P = 0.047) and a negative correlation between mean oxyhemoglobin saturation (SaO_Avg) and total PA time (-0.103; P = 0.048). There were no associations between PA parameters and apnea-hypopnea index. After adjusting for confounding factors (body mass index, age and gender), sitting time and screen time were not associated with OSA. CONCLUSION: After adjusting for anthropometric and clinical factors, excessive sitting time or screen time was not associated with OSA in adults suspected of sleep disorders. Age, gender, hypertension, body mass index and waist circumference were associated with OSA.

Are physical inactivity, sitting time and screen time associated with obstructive sleep apnea in adults? A cross-sectional study

Abstract BACKGROUND: Sitting time, screen time and low physical activity (PA) levels have been associated with several diseases and all-cause mortality. PA is related to better sleep quality and absence of daytime sleepiness, along with lower risks of obstructive syndrome apnea (OSA). However, studies on the relationship between sitting time, screen time and OSA are scarce in the literature. OBJECTIVE: To analyze associations between PA levels, sitting time, screen time and OSA among adults with suspected sleep disorder. DESIGN AND SETTING: Cross-sectional study conducted at Hospital Israelita Albert Einstein. METHODS: Data were collected from 369 adults with suspected sleep disorders who visited the hospital's neurophysiology clinic between August 2015 and January 2017. RESULTS: Correlations between hypopnea and PA indicators were demonstrated for total sitting time (0.123; P = 0.019) and total screen time (0.108; P = 0.038). There was also a correlation between latency for rapid-eye-movement sleep (REM_LAT) and total sitting time (0.103; P = 0.047) and a negative correlation between mean oxyhemoglobin saturation (SaO_Avg) and total PA time (-0.103; P = 0.048). There were no associations between PA parameters and apnea-hypopnea index. After adjusting for confounding factors (body mass index, age and gender), sitting time and screen time were not associated with OSA. CONCLUSION: After adjusting for anthropometric and clinical factors, excessive sitting time or screen time was not associated with OSA in adults suspected of sleep disorders. Age, gender, hypertension, body mass index and waist circumference were associated with OSA.

Training load, stress, recovery, mood, and motivation of athletes with spinal cord injury in wheelchair rugby during a competitive preseason

Abstract Aim: This study aims to characterize the stress, recovery, mood, and motivation together with the training load of athletes with cervical spinal cord injury (CSCI) during a period of resumption of wheelchair rugby (WCR) training. Additionally, it aims to compare the psychological and load training aspects during a competitive preseason and determine the correlations between training load, mood, stress, and recovery. Methods: We evaluated variables such as mood (Brazilian Mood Scale, BRAMS), stress and recovery (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport 76) and training load (Subjective Perception of Effort - SPE) of eight high-performance athletes of wheelchair rugby with CSCIs at three different times (E1 = returning from vacation, E2 = half of the preseason, and E3 = after 2 months of training) for 2 months at a monthly interval. We also evaluated motivation (Sport Motivation Scale) at E1 and E3. Results: Results indicated few changes during the competitive preseason in terms of stress, recovery, and mood. However, the training load decreased toward the end of this period. Furthermore, we found that physical complaints positively correlated with depression when resuming training. In the middle of the competitive preseason period, we also noted positive correlations between conflict/pressure and fatigue and between fatigue and energy loss. At the end of this period, the SPE and arbitrary units correlated positively with conflict/pressure. Conclusion: We found few changes during the competitive preseason in terms of stress, recovery, and mood but not motivation, which did not change during this period. On the other hand, the training load decreased at the end of the competitive preseason. Furthermore, we observed correlations between training load and psychological aspects at different times.

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease.

OBJECTIVE: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. METHODS: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. RESULTS: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. CONCLUSION: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.

Influência da privação de sono no desempenho de atletas: uma revisão sistemática / The influence of sleep deprivation on athletes' performance: a systematic review

RESUMO O sono é uma estratégia importante para a recuperação de atletas e o estado de privação de sono pode influenciar a performance esportiva. O objetivo do estudo foi realizar uma revisão sistemática de literatura para analisar a influência da privação de sono no desempenho físico e esportivo de atletas. A pesquisa foi realizada a partir das bases de dados eletrônicas PubMed, Scopus, SportDiscus e Scielo. Foram selecionados artigos originais publicados escritos no idioma inglês ou português. Após a busca nas bases de dados foram encontrados 143 artigos sendo 45 no PubMed, 72 no Scopus, 1 no Scielo e 25 no SportDiscus. Posteriormente a análise dos artigos, 8 artigos foram incluídos no presente estudo de acordo com os critérios de inclusão. Após análise dos 8 artigos incluídos na revisão, concluiu-se que a privação de sono influenciou negativamente no desempenho físico e esportivo em 5 dos artigos analisados. Além disso, constatou-se que o período de privação de sono é determinante para o desempenho dos atletas nas tarefas esportivas.

ABSTRACT Sleeping is an important strategy for athletes' recovery and the state of sleep deprivation can influence the sports performance.The objective of the study was to carry out a systematic literature review in order to analyze the influence of sleep deprivation on the physical and athletic performance of athletes. The study was carried out from the electronic databases PubMed, Scopus, SportDiscus and Scielo. We selected original articles published and written in English or Portuguese were selected. After the search in the databases we found 143 articles were found being 45 from PubMed, 72 from Scopus, 1 from Scielo and 25 from SportDiscus. After the full analysis of the articles, only 8 of them articles were included in the present study according to the inclusion criteria. After analyzing the 8 articles included in the present review it was concluded that sleep deprivation negatively influenced physical and sports performance in 5 of the analyzed articles. In addition, it was found that the sleep deprivation period is determinant for athletes' performance in sports tasks.

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease / Efeitos do treinamento resistido sobre as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo na doença de Parkinson

ABSTRACT: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. Methods: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.

RESUMO Objetivo: Avaliar os efeitos do treinamento resistido nas respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo em pacientes com doença de Parkinson. Métodos: Vinte e quarto pacientes com doença de Parkinson (estágios 2 a 3 de Hoehn e Yahr modificado) foram aleatoriamente randomizados em dois grupos: Controle e Treinamento Resistido. O Grupo Treinamento Resistido realizou, duas vezes por semana, cinco exercícios resistidos, duas a quatro séries, seis a 12 repetições máximas por série. O Grupo Controle manteve seu estilo de vida. No início e após 12 semanas, consumo de oxigênio, pressão arterial sistólica e frequência cardíaca foram avaliados em repouso e durante um teste de esforço cardiopulmonar máximo realizado em um cicloergômetro. As avaliações durante o exercício foram realizadas nas intensidades submáximas (a inclinação da regressão linear entre as variáveis fisiológicas e as cargas absolutas), nas intensidades submáximas relativas (limiar anaeróbico e ponto de compensação respiratória) e na intensidade máxima (pico do exercício). Adicionalmente, foi avaliada a força muscular. Resultados: Comparado com o início, o consumo de oxigênio pico aumentou, de forma semelhante, em ambos os grupos após 12 semanas. A frequência cardíaca e a pressão arterial sistólica avaliadas nas intensidades submáximas absolutas e relativas, assim como no pico do exercício, não se modificaram em nenhum dos grupos. Finalmente, diferente do Grupo Controle, a força muscular aumentou no Grupo Treinamento Resistido após 12 semanas. Conclusão: Em pacientes com doença de Parkinson sem comorbidades cardiovasculares, o treinamento resistido aumenta a força muscular, mas não modifica as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo.

Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment.

The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.

Was postponing the tokyo 2020 olympic and paralympic games a correct decision? / O adiamento dos jogos olímpicos e paralímpicos de tóquio 2020 foi uma decisão correta? / ¿la postergación de los juegos olímpicos y paralímpicos de tokio 2020 fue una decisión correcta?

ABSTRACT In December 2019, Wuhan, in China, attracted international attention due to a pneumonia outbreak caused by the new coronavirus (2019-nCoV). Infection by 2019-nCoV is more likely in elderly people with comorbidities or with associated chronic diseases. Due to the high transmission rate among humans, this disease is rapidly disseminated, which led to several events being canceled, including the Tokyo 2020 Olympic and Paralympic Games. The aim of this article is to discuss the risk factors for Olympic and Paralympic athletes, as well as for spectators, that justify the decision to postpone the Tokyo Games 2020. Regular physical exercise is associated with health and the prevention of chronic diseases. Although athletes generally appear to be healthy and physically fit, this may not be true. The immune system, which protects the organism from invasive microorganisms, can be affected by the duration and quality of sleep, as well as by physical exercise which influences the quality of the immune response. High volumes of high-intensity physical exercise, as well as changes in sleep patterns during the pre-competition period and the impacts of jet lag on athletes traveling for the Tokyo Games in 2020 may lead to immune system suppression, making these groups more vulnerable to infection by 2019-nCoV. Moreover, during the period planned for the games in 2020 the pandemic may be subsiding in some countries and increasing in others, and this was also taken into consideration as a risk factor. Hence, the decision taken to postpone the Tokyo 2020 Olympic and Paralympic Games until 2021 due to the 2019-nCoV was the correct one, and was extremely important to protect the health of Olympic and Paralympic athletes, as well as spectators. Level of evidence V; expert opinion .

RESUMO Em dezembro de 2019, Wuhan, na China, despertou atenção internacional devido a um surto de pneumonia causada pelo novo coronavírus (2019-nCoV). A infecção pelo 2019-nCoV é mais provável em pessoas idosas com comorbidades ou com doenças crônicas associadas. Em virtude da alta taxa de transmissão entre humanos, essa doença tem disseminação rápida, o que fez com que diversos eventos fossem cancelados, dentre eles os Jogos Olímpicos e Paralímpicos de Tóquio 2020. Nesse sentido, o objetivo deste artigo é discutir fatores de risco dos atletas olímpicos e paralímpicos, bem como dos espectadores, que justificam a decisão de adiamento dos Jogos de Tóquio 2020. A prática de exercício físico regular é associada à saúde e à prevenção de doenças crônicas. Embora normalmente pareça que os atletas estão em boa forma e são saudáveis, isso pode não ser verdade. O sistema imunológico, que protege o organismo de microrganismos invasores, pode ser afetado pela quantidade e qualidade do sono, assim como pela prática de exercício físico que influencia a qualidade da resposta imunológica. A prática de exercícios de alta intensidade e grande volume, além das alterações do sono no período pré-competitivo e os impactos do jet lag dos atletas que viajariam para os Jogos de Tóquio no ano de 2020 podem levar à supressão do sistema imunológico, deixando esses grupos mais vulneráveis à contaminação pelo 2019-nCoV. Além disso, no período previsto de ocorrência dos jogos em 2020 a pandemia poderia estar em regressão em alguns países e ascensão em outros, e isso também foi levado em consideração como um fator de risco. Nesse sentido, a tomada de decisão de adiar os Jogos Olímpicos e Paralímpicos de Tóquio 2020 para o ano de 2021 devido ao 2019-nCoV foi correta e de extrema importância para preservar a saúde dos atletas olímpicos e paralímpicos, bem como dos expectadores. Nível de evidência V; opinião do especialista .

RESUMEN En diciembre de 2019, Wuhan, en China, despertó la atención internacional debido a un brote de neumonía causada por el nuevo coronavirus (2019-nCoV). La infección por el 2019-nCoV es más probable en personas de la tercera edad con comorbidades o con enfermedades crónicas asociadas. En virtud de la alta tasa de transmisión entre humanos, esta enfermedad tiene diseminación rápida, lo que hizo con que diversos eventos fuesen cancelados, entre ellos los Juegos Olímpicos y Paralímpicos de Tokio 2020. En ese sentido, el objetivo de este artículo es discutir factores de riesgo de los atletas olímpicos y paralímpicos, bien como de los espectadores, que justifican la decisión de postergación de los Juegos de Tokio 2020. La práctica de ejercicios físicos de forma regular está asociada a la salud y a la prevención de enfermedades crónicas. Aunque normalmente parezca que los atletas están en buena forma y son saludables, eso puede no ser verdad. El sistema inmunológico, que protege el organismo de microorganismos invasores, puede ser afectado por la cantidad y calidad del sueño, así como por la práctica de ejercicios físicos que influencia la calidad de la respuesta inmunológica. La práctica de ejercicios de alta intensidad y gran volumen, además de las alteraciones del sueño en el período precompetitivo y los impactos del jet lag de los atletas que viajarían para los Juegos de Tokio en el año 2020 pueden llevar a la supresión del sistema inmunológico, dejando a esos grupos más vulnerables a la contaminación por el 2019-nCoV. Además, en el período previsto de ocurrencia de los juegos en 2020 la pandemia podría estar en regresión en algunos países y ascensión en otros, y eso también fue llevado en consideración como un factor de riesgo. En ese sentido, la toma de decisión de postergar los Juegos Olímpicos y Paralímpicos de Tokio 2020 para el año 2021 debido al 2019-nCoV fue correcta y de extrema importancia para preservar la salud de los atletas olímpicos y paralímpicos, bien como de los espectadores. Nivel de evidencia V; opinión del especialista .

Duration and quality of sleep in sprint and recovery performances among elite swimmers / Duração e qualidade de sono no desempenho do sprint e na recuperação de nadadores de elite / Duración y calidad del sueño en el desempeño en el sprint y recuperación d nadadores de élite

ABSTRACT Introduction: Circadian rhythms can impact athletes' sports performance, where the plateau occurs between 15 and 21 hours. Swimming is a peculiar case, as athletes perform training and final sessions in competitions at different times, as in the Rio2016 Olympic Games for example, where the semifinal and final competitions took place from ten o'clock at night. Objectives: (1) to present the protocol of an intervention performed with elite athletes of the Brazilian swimming team during the 2016 Olympic Games in Rio; (2) to find out whether the time at which the competitions were held affected the swimming performances of these athletes during the competition. Materials and Methods: Fourteen athletes of the Brazilian swimming team (males: n= 10; 71% and females: n= 4; 29%) participated in the study. They were followed up during two preparation periods (baseline and intervention) for the 2016 Olympic Games in Rio during June and July 2016. During the competition, we recorded the Reaction Time (RT) and Competition Time (CT) of each athlete in different modalities. The intervention strategies used were light therapy and sleep hygiene. The values of RT at the starting block and CT were registered and conferred with the official results. Results: The athletes showed a decrease in the total time awake (Δ = −13%; Effect size [ES] = 1.0) and sleep latency (Δ = −33%; ES = 0.7), and an increase in total sleep time (Δ = 13%; ES = 1.1; p = 0.04) between the baseline and the period of the intervention, pre-competition. We identified an improvement in the RT (Δ = −2.2% to −1.0%; ES = 0.2 to 0.5) during the competition only for the athletes who participated in the competition finals. Conclusion: We conclude that the intervention carried out was effective in mitigating any negative influence of competition time on the RT and CT of elite athletes of the Brazilian swimming team. Level of evidence II; Prospective comparative study.

RESUMO Introdução: Os ritmos circadianos podem exercer impacto no desempenho esportivo dos atletas, onde o platô ocorre entre as 15 e 21 horas. A natação é um caso peculiar, uma vez que os nadadores realizam sessões de treinamento e provas finais em competições em diferentes horários, como por exemplo, nos Jogos Olímpicos Rio2016, onde as competições semifinais e finais da natação ocorreram a partir das 22 horas. Objetivos: O presente estudo teve como objetivos: (1) apresentar o protocolo de uma intervenção realizada com atletas de elite da equipe de natação brasileira durante os Jogos Olímpicos Rio 2016; (2) identificar se o desempenho dos atletas de natação foi afetado devido aos horários das provas durante a competição. Materiais e Métodos: Participaram do estudo 14 atletas da equipe de natação brasileira (masculino: n= 10; 71% e feminino: n= 4; 29%). Foi realizado acompanhamento dos atletas durante dois períodos de preparação (baseline e intervenção) para os Jogos Olímpicos Rio2016 nos meses de junho e julho de 2016. Durante a competição, foi realizado o registro do Tempo de Reação (TR) e Tempo de Prova (TP) de cada atleta nas diferentes modalidades. As estratégias de intervenção utilizadas foram: terapia de luz e higiene do sono. Os valores de TR no bloco de partida e TP foram registrados e conferidos com os resultados oficiais. Resultados: Os atletas apresentaram decréscimo no tempo total de vigília (Δ = −13%; Tamanho do Efeito (TE) = 1,0) e latência de sono (Δ = −33%; TE = 0,7), e aumento do tempo total de sono (Δ = 13%; TE = 1,1; p = 0,04) entre o baseline e o período de intervenção pré-competição. Nós identificamos melhorias no TR (Δ = −2,2% à −1,0%; TE = 0,2 a 0,5) ao longo da competição somente para os atletas que participaram da fase final da competição. Conclusão: Concluímos que a intervenção realizada foi efetiva para minimizar qualquer influência negativa do horário da competição sobre o TR e TP dos atletas de elite da natação brasileira. Nível de evidência II; Estudo prospectivo comparativo.

RESUMEN Introducción: Los ritmos circadianos pueden ejercer impacto en el desempeño deportivo de los atletas, donde la meseta ocurre entre las 15h y las 21 horas. La natación es un caso peculiar, ya que los nadadores realizan sesiones de entrenamiento y pruebas finales en competiciones en diferentes horarios, como por ejemplo, en los Juegos Olímpicos Rio 2016, en donde las competiciones semifinales y finales de natación ocurrieron a partir de las 22 horas. Objetivos: El presente estudio tuvo como objetivos: (1) presentar el protocolo de una intervención realizada con atletas de élite del equipo de natación brasileño durante los Juegos Olímpicos Rio 2016; (2) identificar si el desempeño de los atletas de natación fue afectado debido a los horarios de las pruebas durante la competición. Materiales y Métodos: Participaron en el estudio 14 atletas del equipo de natación brasileño (masculino: n = 10; 71% y femenino: n= 4; 29%). Fue realizado acompañamiento de los atletas durante dos períodos de preparación (baseline e intervención) para los Juegos Olímpicos Rio 2016 en los meses de junio y julio de 2016. Durante la competición, se realizó el registro del Tiempo de Reacción (TR) y Tiempo de Prueba (TP) de cada atleta en las diferentes modalidades. Las estrategias de intervención utilizadas fueron: terapia de luz e higiene del sueño. Los valores de TR en el bloque de partida y TP fueron registrados y verificados con los resultados oficiales. Resultados: Los atletas presentaron disminución en el tiempo total de vigilia (Δ = −13%; Tamaño de efecto (TE) = 1,0), y latencia del sueño (Δ = −33%; TE = 0,7), y aumento del tiempo total de sueño (Δ = 13%; TE = 1,1; p = 0,04) entre baseline y el período de intervención precompetición. Identificamos mejoras en el TR (Δ = −2,2% a −1,0%; TE = 0,2 a 0,5) a lo largo de la competición sólo para los atletas que participaron en la fase final de la competición. Conclusión: Concluimos que la intervención realizada fue efectiva para minimizar cualquier influencia negativa del horario de la competición sobre el TR y TP de los atletas de élite de la natación brasileña. Nivel de evidencia II; Estudio prospectivo comparativo.

Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögren's syndrome: a cross-sectional study.

BACKGROUND: Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders. OBJECTIVE: To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity. DESIGN AND SETTING: Analytical observational study conducted at an exercise psychobiology laboratory. METHODS: Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics. RESULTS: A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI. CONCLUSION: The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue.

Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögrens syndrome: a cross-sectional study

ABSTRACT BACKGROUND: Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders. OBJECTIVE: To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity. DESIGN AND SETTING: Analytical observational study conducted at an exercise psychobiology laboratory. METHODS: Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics. RESULTS: A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI. CONCLUSION: The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue.

Body image perception and satisfaction in university students / Percepção da imagem e satisfação corporal em estudantes universitários

Abstract Body image represents the mental perception of body shapes and is a multifactorial structure that includes psychological, physical and emotional elements. The discrepancy between the subjective perception of body image and the desire for the ideal body type can interfere with the feeling of satisfaction and trigger the desire for changes in appearance, directly interfering with mental health and general well-being. Men and women may differ in body image satisfaction due to the different social influences and beauty standards imposed. The aim of this study was to evaluate the subjective perception of body image and satisfaction with body shapes among men and women. The sample consisted of 100 college students of both genders. Subjective perception of body image and satisfaction were measured through self-assessment, through scale figure silhouettes. There was a significant difference in the subjective perception of body image in the comparison between genders, and women presented greater discrepancy between the real and the perceived image. In the analysis of satisfaction with body image there were no differences between genders and both presented high percentage of dissatisfaction. In addition, 46.2% of men would like to decrease their body shapes, 53.8% would increase them. As for women, 76.1% would like to decrease their body dimensions and 23.9% to increase them. The strong pressures imposed by society and the standards set by the prevailing media in determining body image dissatisfaction or self-assessment negatively, regardless of gender.

Resumo A imagem corporal representa a percepção mental das formas do corpo e é uma estrutura multifatorial que inclui elementos psicológicos, físicos e emocionais. A discrepância entre a percepção subjetiva da imagem corporal e o desejo do tipo ideal de corpo pode interferir no sentimento de satisfação e desencadear o desejo por mudanças na aparência, interferindo diretamente na saúde psíquica e no bem-estar geral. Homens e mulheres podem apresentar diferenças na satisfação com a imagem corporal, em função das influências sociais distintas e dos padrões de beleza impostos. O objetivo deste estudo foi avaliar a percepção subjetiva da imagem corporal e a satisfação com as formas do corpo entre homens e mulheres. A amostra foi composta por 100 estudantes universitários, de ambos os sexos. A percepção subjetiva da imagem corporal e a satisfação foram medidas através de autoavaliação através da escala de figura de silhuetas. Houve diferença significante na percepção subjetiva da imagem corporal na comparação entre sexos, sendo que as mulheres apresentaram maior discrepância entre a imagem real e a percebida. Na análise da satisfação com a imagem corporal não houve diferenças entre os sexos e ambos apresentaram alto percentual de insatisfação. Além disso, 46,2% dos homens gostariam de diminuir as formas corporais 53,8% de aumentá-las. Já as mulheres, 76,1% gostariam de diminuir suas dimensões corporais e 23,9% de aumentá-las. As fortes pressões impostas pela sociedade e os padrões definidos pela mídia prevaleçam na determinação da insatisfação com a imagem corporal ou na autoavaliação de forma negativa, independentemente do sexo.

Trajetória profissional de treinadores no contexto do esporte paralímpico / Professional trajectory of coaches in the context of paralympic sports / Trajetoria profesional de entrenadores en el contexto del deporte paralímpico

Treinadores do esporte paralímpico apresentam diferenças na atuação comparados a outros treinadores. Assim, o objetivo do presente estudo foi analisar a trajetória profissional dos treinadores da Delegação Paralímpica Brasileira dos Jogos Rio 2016. Este estudo contou com 35 treinadores (idade: 39,7±9,4 anos, tempo de atuação: 10,7±5,4 anos) que responderam a um questionário estruturado com perguntas fechadas relacionadas à sua trajetória e formação profissional. Em relação à formação acadêmica, 97,1% dos treinadores apresentaram graduação em Educação Física, 65,7% cursaram pós-graduação lato sensu e 22,9% pós-graduação stricto sensu (mestrado) na área. Além disso, 65,7% dos treinadores realizaram alguma disciplina na universidade relacionada ao esporte paralímpico e 85% realizaram cursos de formação complementar. Concluimos que os treinadores tiveram oportunidades de aprendizado formal durante a graduação em Educação Física e em outros cursos de formação após a conclusão do curso, bem como oportunidades informais para construírem sua carreira no esporte paralímpico

Paralympic sports coaches work differently from other coaches. This study analyzed the professional trajectory of coaches working with the Brazilian Paralympic Delegation to the Rio 2016 Olympic Games. It included 35 coaches (age: 39.7±9.4; working experience: 10.7±5,4 years) who answered a structured questionnaire with closed-ended questions related to their history and professional training. As for academic training, 97.1% held degrees in Physical Education; 65.7% held specialization diplomas; and 22.9% held master's degrees in the area. In addition, 65.7% of the coaches attended some collegelevel course on Paralympic sports and 85% attended complementary training courses. We concluded that coaches had formal learning opportunities during their undergraduate training in Physical Education and other courses after that, as well as informal opportunities to build their career in Paralympic sports

Los entrenadores del deporte paralímpico presentan diferencias en su actuación en comparación a otros entrenadores. El objetivo del presente estudio fue analizar la trayectoria profesional de los entrenadores de la Delegación Paralímpica Brasileña de los Juegos Río 2016. Este estudio contó con 35 entrenadores (edad: 39,7±9,4 años, tiempo de actuación: 10,7±5,4 años) que respondieron a un cuestionario estructurado con preguntas relacionadas a su trayectoria y formación profesional. En lo referente a formación académica, el 97,1% de los entrenadores eran graduados en Educación Física, 65,7% cursó postgrado lato sensu y 22,9% posgrado strito sensu en el área. Además, 65,7% de los entrenadores realizaron alguna disciplina en la universidad relacionada deporte paralímpico y el 85% realizaron cursos de formación complementaria. Concluimos que los entrenadores tuvieron oportunidades de aprendizaje formal durante su graduación en Educación Física y en otros cursos de formación después de la conclusión del curso, así como oportunidades informales para construir su carrera en el deporte paralímpico

Mapeamento geográfico de atletas paralímpicos brasileiros / Geographic mapping of brazilian paralympic athletes / Mapeo geográfico de atletas paralímpicos brasileños

O estudo teve como objetivo mapear geograficamente os atletas paralímpicos brasileiros de natação e atletismo, bem como identificar suas deficiências. Os dados dos atletas foram obtidos junto ao Comitê Paralímpico Brasileiro (CPB), onde buscamos informações sobre os atletas que participaram do Circuito Loterias Caixa de 2015. A amostra foi de 1.708 atletas paralímpicos das modalidades natação e atletismo, sendo 913 da natação e 795 do atletismo. Observou-se que a maioria dos atletas é da região Sudeste (66%), seguida das regiões Sul (11%), Nordeste (11%), Centro-Oeste (9%) e Norte (3%). Houve predominância de atletas com deficiência físico-motora (65,5%), seguida das deficiências visual (25,1%) e intelectual (9,4%). Concluímos que a região brasileira com maior número de atletas no atletismo e na natação é a Sudeste e a região com menor número foi a Norte. Além disso, encontramos predominância da deficiência físico-motora, tanto no atletismo quanto na natação

The study conducted a geographic mapping of Brazilian Paralympic athletes practicing swimming and athletics and identified their disabilities. Data about the athletes were provided by the Brazilian Paralympic Committee (CPB), where we sought information about those who participated in the 2015 competition Circuito Loterias Caixa. The sample consisted of 1,708 paralympic swimming and athletics athletes ­ 913 and 795 respectively. The study found that most athletes came from Brazil's Southeast region (66%), followed by the South (11%), Northeast (11%), Center-West (9%) and North (3%). Athletes with physical-motor disabilities (65.5%) were the majority, followed by the visually (25.1%) and intellectually (9.4%) impaired. We concluded that the Brazilian region with the most athletics and swimming athletes is the Southeast while the North region had lowest number. In addition, we found predominance of physical-motor disabilities in both sports

El estudio tuvo como objetivo mapear geográficamente a los atletas paralímpicos brasileños de natación y atletismo, además de identificar sus deficiencias. Los datos de los atletas fueron obtenidos junto al Comité Paralímpico Brasileño (CPB), donde buscamos informaciones sobre los atletas que participaron del Circuito Loterías Caixa de 2015. La muestra fue de 1.708 atletas paralímpicos de la modalidades natación y atletismo, siendo 913 de natación y 795 de atletismo. Se observó que la mayoría de los atletas son de la región Sudeste (66%), seguida de la Sur (11%), Nordeste (11%), CentroOeste (9%) y Norte (3%). Se observó un predominio de atletas con deficiencia físico-motora (65,5%), seguida de las deficiencias visual (25,1%) e intelectual (9,4%). Concluimos que la región brasileña con mayor número de atletas en atletismo y natación es la Sudeste y la región con menor número fue la Norte. Además, encontramos predominancia de la deficiencia físico-motora, tanto en el atletismo como en la natación

Gender differences in sleep patterns and sleep complaints of elite athletes.

OBJECTIVE: The present study aimed to investigate the gender differences for sleep complaints, patterns and disorders of elite athletes during preparation for the Rio 2016 Olympic Games. METHODS: The study included 146 athletes from the Brazilian Olympic Team (male: n=86; 59%; female: n=60; 41%). The assessment of the Olympic athletes' sleep took place in 2015, during the preparation period for the Rio Olympic Games. The athletes underwent a single polysomnography (PSG) evaluation. Sleep specialists evaluated the athletes and asked about their sleep complaints during a clinical consultation. In this evaluation week, the athletes did not take part in any training or competitions. RESULTS: The prevalence of sleep complaints was 53% of the athletes during the medical consultation, the most prevalent being insufficient sleep/waking up tired (32%), followed by snoring (21%) and insomnia (19.2%). In relation to the sleep pattern findings, the men had significantly higher sleep latency and wake after sleep onset than the women (p=0.004 and p=0.002, respectively). The sleep efficiency and sleep stages revealed that men had a lower percentage of sleep efficiency and slow wave sleep than the women (p=0.001 and p=0.05, respectively). CONCLUSION: Most athletes reported some sleep complaints, with men reporting more sleep complaints than women in the clinical evaluation. The PSG showed that 36% of all athletes had a sleep disorder with a greater reduction in sleep quality in men than in women.

Maximum effort training performed in hypoxia alters the mood profile / Exercício físico máximo realizado em hipóxia altera o perfil de humor / Ejercicio físico máximo realizado en hipoxia altera el perfil del estado de ánimo

INTRODUCTION: Physical exercise at high altitude has become constant. However, the risks associated with this type of exercise represent a major concern, considering the influence of important stressors such as hypoxia and physical exercise on psychobiological and physiological responses. OBJECTIVE: Analyze the mood state and behavior of physiological variables of volunteers subjected to a progressive loading protocol until they reached maximum volitional exhaustion, both at sea level and at a simulated altitude of 4500 meters. METHOD: For both conditions studied, the volunteers responded to two instruments that assess mood responses: The Brunel Mood Scale and the Visual Analogue Mood Scale. They also underwent blood sampling to measure blood lactate levels and to evaluate oxygen-hemoglobin saturation. These procedures were performed before, immediately after, and 30 and 60 minutes after the end of the protocol. RESULTS: Hypoxia triggered negative effects on mood responses, especially when compared to sea level conditions. An increase in fatigue level (p=0.02) and mental confusion (p=0.04) was observed immediately after the exercise session, and reduction of vigor (p=0.03) was noted at 30 minutes, accompanied by a reduction in oxygen-hemoglobin saturation immediately after the session and at 30 minutes. There was also an increase in blood lactate levels immediately after the session (p=0.006). CONCLUSION: The particularities of the hypoxic environment associated with maximum exercise are able to cause a deterioration of mood and physiological responses, which can negatively modulate physical performance. This is a cross-sectional clinical study.

INTRODUÇÃO: Prática de exercícios físicos em elevadas altitudes tem se tornado constante. Entretanto, os riscos associados a esta representam uma grande preocupação, considerando a influência de importantes agentes estressores, como hipóxia e exercício físico, sobre as respostas psicobiológicas e fisiológicas. OBJETIVO: Analisar o perfil do humor e o comportamento de variáveis fisiológicas de voluntários submetidos a um protocolo de cargas progressivas até a Exaustão Voluntária Máxima no nível do mar e em altitude simulada de 4.500 metros. MÉTODOS: Para ambas as condições estudadas, os voluntários responderam a dois instrumentos que avaliam as respostas do humor, Escala de Humor de Brunel e o Visual Analogue Mood Scale, e foram submetidos à coleta de sangue para verificar a concentração de lactato sanguíneo, bem como para avaliar a saturação de oxi-hemoglobina. Esses procedimentos foram realizados antes, imediatamente depois e 30 e 60 minutos após o término do protocolo. RESULTADOS: A hipóxia desencadeou efeitos negativos sobre as respostas de humor, principalmente com relação ao nível do mar. Verificou-se aumento da fadiga (p = 0,02) e da confusão mental (p=0,04) imediatamente após a prática e redução do vigor (p = 0,03) aos 30 minutos; acompanhadas da diminuição da saturação da oxi-hemoglobina imediatamente após e aos 30 minutos; constatou-se ainda, o aumento da concentração de lactato sanguíneo no momento imediatamente após (p = 0,006). CONCLUSÃO: As particularidades do ambiente hipóxico associadas à realização do exercício físico máximo são capazes de piorar o estado de humor e as respostas fisiológicas, o que pode modular negativamente o desempenho físico. Este estudo é do tipo clínico transversal.

INTRODUCCIÓN: La práctica de ejercicios físicos en elevadas altitudes se ha vuelto constante. Entretanto, los riesgos asociados a ésta representan una gran preocupación, considerando la influencia de importantes agentes estresantes, como hipoxia y ejercicio físico, sobre las respuestas psicobiológicas y fisiológicas. OBJETIVO: Analizar el perfil del humor y el comportamiento de variables fisiológicas de los voluntarios sometidos a un protocolo de cargas progresivas hasta el Agotamiento Voluntario Máximo, al nivel del mar y a una altitud simulada de 4500 metros. MÉTODOS: Para ambas condiciones estudiadas, los voluntarios respondieron a dos instrumentos que evalúan las respuestas del humor: la Escala de Humor de Brunel y el Visual Analogue Mood Scale, y fueron sometidos a colecta de sangre para verificar la concentración de lactato sanguíneo, bien como para evaluar la saturación de oxihemoglobina. Estos procedimientos fueron realizados antes, inmediatamente después, y 30 y 60 minutos después de finalizar el protocolo. RESULTADOS: La hipoxia desencadenó efectos negativos sobre las respuestas de humor, principalmente con relación al nivel del mar. Se verificó aumento de fatiga (p = 0,02) y de la confusión mental (p = 0,04) inmediatamente después de la práctica y reducción del vigor (P = 0,03) a los 30 minutos; acompañadas de la disminución de la saturación de la oxihemoglobina inmediatamente después y a los 30 minutos; se constató además el aumento de la concentración de lactato sanguíneo en el momento inmediatamente después (p = 0,006). CONCLUSIÓN: Las particularidades del ambiente hipóxico asociadas a la realización del ejercicio físico máximo, son capaces de empeorar el estado de humor y las respuestas fisiológicas, lo que puede modular negativamente el desempeño físico. Este estudio es del tipo clínico transversal.