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1.
Health Promot Int ; 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34543431

RESUMO

This study aimed to assess the moderating influence of neighborhood walkability on the association between physical activity (PA) and mental health among older African academics aged 50 years or more in cities with social distancing protocols in response to the Coronavirus disease 2019 (COVID-19). A total of 905 volunteer academics participated in the study. A hierarchical linear regression analysis was employed to conduct sensitivity analyses and test the study hypotheses. After controlling for sex, education and age, there was a positive association between PA and mental health. Neighborhood walkability moderated the relationship between PA and mental health, which suggests that during the pandemic PA was associated with higher mental health scores in more walkable neighborhoods. The study concludes that PA was beneficial to mental health in the social distancing context and was associated with higher mental health in more walkable neighborhoods, particularly in a social distancing context.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34360312

RESUMO

Type 2 Diabetes mellitus (DM2) affects 9.3% of the U.S. population. Health disparities are evident in DM2; twice as many Hispanics as non-Hispanic Whites have DM2. The objective of this study was to pilot test the feasibility of implementing and evaluating trends of nutrition and exercise interventions to improve diabetes management and physical function in 29 disadvantaged older Hispanics with DM2. We delivered combined diet and exercise (n = 8) and diet-only (n = 6) interventions and compared the results to a control/no intervention group (n = 15). We cluster-randomized the participants into the three arms based on the senior center they attended. The interventions were delivered twice a week for 3 months (24 sessions) and assessments were conducted pre and post intervention. The results indicate the feasibility of implementing the interventions and slight improvements in both intervention groups compared to the control group. The diet-only group tended to have larger improvements on body composition measures (especially in muscle mass), while the diet + exercise group tended to have larger improvements on physical function (especially in chair stands). There was a high rate of attrition, especially in the diet + exercise group, but those who completed the intervention tended to have improvements in body composition and physical function.


Assuntos
Diabetes Mellitus Tipo 2 , Idoso , Composição Corporal , Diabetes Mellitus Tipo 2/terapia , Dieta , Exercício Físico , Humanos , Projetos Piloto
3.
Geriatrics (Basel) ; 6(2)2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34204942

RESUMO

Over 80% of adults in the US fail to meet the ≥150 min weekly physical activity guideline; 40% age ≥ 75 are entirely inactive. The study purpose was to understand the reasons why community-dwelling older adults (age ≥ 60) from diverse backgrounds increase, sustain, or decline in their physical activity levels over time. Sixty-two older adults were interviewed. Two-thirds of the African Americans, 57% of the Afro-Caribbeans, and 50% of the European Americans reported being less active than 2-3 years ago. Reasons for activity decline included health issues (e.g., pain, shortness of breath), lack of time, interest, or motivation. Reasons for sustaining or increasing activity levels included meeting personal goals, having a purpose for remaining active, or feeling better when active (e.g., it is important to keep moving, good for the joints, going on a cruise). Themes identified were pride in maintaining activity, goal-driven activity, pushing oneself to get past pain or fatigue, and some confusion between social and physical activity in participant reports. The results indicate widespread acceptance that activity is beneficial, but that knowledge alone was insufficient to maintain activity levels over time unless individuals had a goal or purpose ("means to an end") and could overcome their physical and psychological barriers to physical activity.

4.
Rev. bras. med. esporte ; 27(2): 218-224, Apr.-June 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1280073

RESUMO

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .


RESUMEN Introducción: El uso de órtesis de tobillo reduce el riesgo de lesiones en el tobillo en jugadores de baloncesto. Sin embargo, los mecanismos de protección de lesión proporcionados por las órtesis durante el juego de baloncesto aún son desconocidos. Objetivos: Analizar el efecto del uso de órtesis de tobillo lace-up (con cordón) y de un protocolo de ejercicio que simuló la intensidad del juego de baloncesto sobre la fuerza de reacción del suelo (FRS) durante saltos verticales específicos del baloncesto. Métodos: Once jugadores de baloncesto del sexo masculino con menos de 18 años realizaron 48 saltos verticales, con y sin órtesis de tobillo, durante un protocolo de ejercicios compuesto por cuatro períodos de 10 minutos, que simularon el perfil de actividad e intensidad del juego de baloncesto, así como los intervalos típicos entre los períodos. Las FRS mediolaterales (variables: mayores picos medial y lateral) y verticales (variables: pico vertical, pico de impulso, impulso en 50 ms de aterrizaje, tasa de sobrecarga y altura del salto) fueron medidas durante las fases de despegue y aterrizaje de todos saltos realizados en el protocolo de ejercicio. Resultados: El uso de órtesis redujo la FRS mediolateral en todos los períodos analizados, durante las fases de despegue y aterrizaje (P < 0,05), sin afectar la FRS vertical (P > 0,05). La FRS mediolateral y vertical (picos mediolateral y vertical de despegue, picos mediolaterales de aterrizaje, pico de impulso de aterrizaje, tasa de sobrecarga en el despegue y aterrizaje) aumentaron significativamente durante cuatro períodos subsiguientes de 10 minutos (P < 0,05). Sin embargo, para la FRS mediolateral, el aumento a lo largo del tiempo fue mayor sin el uso de órtesis. Conclusiones: El uso de órtesis de tobillo redujo la FRS mediolateral en el miembro inferior, mientras que hubo un aumento progresivo de la carga externa aplicada al cuerpo durante los saltos en los períodos subsiguientes del protocolo de ejercicios con la misma intensidad del juego de baloncesto. Nivel de evidencia I; Ensayo clínico aleatorizado.


RESUMO Introdução: O uso de órtese de tornozelo reduz o risco de lesões no tornozelo em jogadores de basquetebol. No entanto, os mecanismos de proteção de lesão fornecidos pelas órteses durante o jogo de basquetebol ainda são desconhecidos. Objetivos: Analisar o efeito do uso de órtese de tornozelo lace-up (com cordão) e de um protocolo de exercício que simulou a intensidade do jogo de basquetebol sobre a força de reação do solo (FRS) durante saltos verticais específicos do basquetebol. Métodos: Onze jogadores de basquetebol do sexo masculino com menos de 18 anos realizaram 48 saltos verticais, com e sem órtese de tornozelo, durante um protocolo de exercícios composto por quatro períodos de 10 minutos, que simularam o perfil de atividade e intensidade do jogo de basquetebol, assim como os intervalos típicos entre os períodos. As FRSs mediolaterais (variáveis: maiores picos medial e lateral) e verticais (variáveis: pico vertical, pico de impulso, impulso em 50 ms da aterrissagem, taxa de sobrecarga e altura do salto) foram medidas durante as fases de decolagem e aterrissagem de todos os saltos realizados no protocolo de exercício. Resultados: O uso de órtese reduziu a FRS mediolateral em todos os períodos analisados, durante as fases de decolagem e aterrissagem (P < 0,05), sem afetar a FRS vertical (P > 0,05). A FRS mediolateral e vertical (picos mediolateral e vertical de decolagem, picos mediolaterais de aterrissagem, pico de impulso de aterrissagem, taxa de sobrecarga na decolagem e aterrissagem) aumentaram significativamente durante quatro períodos subsequentes de 10 minutos (P < 0,05). No entanto, para a FRS mediolateral, o aumento ao longo do tempo foi maior sem o uso de órtese. Conclusões: O uso de órtese de tornozelo reduziu a FRS mediolateral no membro inferior, enquanto houve um aumento progressivo da carga externa aplicada ao corpo durante os saltos nos períodos subsequentes do protocolo de exercícios com mesma intensidade do jogo de basquetebol. Nível de evidencia I; Estudo clínico randomizado .


Assuntos
Humanos , Masculino , Adolescente , Entorses e Distensões/prevenção & controle , Basquetebol , Braquetes , Traumatismos do Tornozelo/prevenção & controle , Fenômenos Biomecânicos , Tornozelo/fisiologia
5.
Front Psychol ; 12: 625354, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34025502

RESUMO

We aimed to characterize the age of onset of training, age at menarche, menstrual periodicity, and performance perception during the menstrual cycle and examined the impact of these reproductive variables on body composition, morphology, and body weight satisfaction in Brazilian elite futsal players. The study consisted of 115 female Brazilian elite futsal players from the top national teams. Data were collected during the twentieth Women's Brazil Futsal Cup. Players were interviewed and self-reported their age of onset of training, age at menarche, menstrual periodicity, and the menstrual period, where they performed best. We also asked for what they considered to be their ideal body weight as well as information related to their training (i.e., volume and frequency). Subsequently, anthropometric measurements (i.e., body mass, height, circumferences, diameters, and skinfold thickness) were performed to estimate the body composition and determine morphological characteristics (e.g., somatotype). Fifty-nine (53.2%) players were postmenarche-trained and 52 (46.8%) were premenarche-trained. Eighteen (16.2%), 65 (58.6%), and 28 (25.2%) were classified as early, normal, and late menarche, respectively. Only 11 (9.6%) and 1 (0.9%) had irregular menstrual cycles and were amenorrheic, respectively. Seventy-three (69.5%), 23 (21.9%), and 9 (8.6%) reported that their game performance was the best at the follicular phase, menses, and luteal phase of the menstrual cycle, respectively. No associations between the four reproductive-related variables were found. Postmenarche-trained players had significant lower age at menarche and higher percentage body fat. The somatotype profile registered lower ectomorphy rate for the postmenarche-trained participants after controlling for covariates. Early menarche group presented higher sum of six skinfold thickness and endomorphy rate compared to normal and late menarche groups. No differences were found when menstrual periodicity groups and best performance groups were compared, except for higher femur width in the regular menstrual cycle group compared to the irregular one. The association between body weight satisfaction and the four reproductive-related variables were not observed. Premenarche-trained Brazilian elite futsal players had the menarche later than the postmenarche-trained athletes. Most of the participants had menarche age classified as "normal," presented "regular" menstrual cycles and perceived to perform better during the follicular phase of the menstrual cycle.

6.
J Bodyw Mov Ther ; 25: 140-145, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33714485

RESUMO

OBJECTIVE: Evaluate the effects of Myofascial release (MR) on lower limb ROM, sit and reach and horizontal jump distance in male university students. STUDY DESIGN: Quasi-experimental study. BACKGROUND: MR is a technique that aims to stretch fascia to increase range of motion (ROM), relieve pressure points and improve performance. However, there is limited evidence of its actual effects on flexibility and physical performance. METHODS: Twenty-one uninjured, male university students received MR (11 on the first session and the other 10 on the second session 24 h later), completed lower limb ROM assessments, the sit and reach and the horizontal jump tests in a randomized order. MR was performed before the tests with a myofascial stick in the anterior and posterior aspects of the right and left thigh and calf muscles. Each muscle group was massaged for 90 s, totaling 9 min of MR. The testing conditions with MR and without MR were compared using Student t-tests and the effect sizes (ES) were calculated. RESULTS: There were no significant differences between the testing conditions on horizontal jump distance. However, the sit and reach distance (28 ± 9 vs. 32 ± 9 cm, p = 0.001; ES = 0.44), left hip extension (10 ± 2 vs. 8 ± 2°, p = 0.006; ES = 1.00) and left plantar flexion (36 ± 7 vs. 39 ± 7°, p = 0.044; ES = 0.43) were higher with MR. CONCLUSIONS: MR increased sit and reach distance, left hip extension and plantar flexion, but it did not affect horizontal jump distance in uninjured, male university students.


Assuntos
Massagem , Universidades , Humanos , Extremidade Inferior , Masculino , Amplitude de Movimento Articular , Estudantes
7.
BMJ Open Sport Exerc Med ; 7(1): e000927, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33754080

RESUMO

Background/aim: The purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque. Methods: This is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17-20 years old), G2 (21-24 years old), G3 (25-28 years old), G4 (29-32 years old) and G5 (33 years old or more). Results: The results indicate a moderate effect of age (F(4545)=8.197; p<0.001; η2=0.057) and a small effect of playing position (F(4545)=2.993; p<0.05; η2=0.021) on torque of concentric extensors; mainly from midfielders and goalkeepers with 29 years or more. Conclusions: Soccer players from different field positions are subjected to different ageing related effects on their muscular performance during their career special attention should be given to these players to avoid reduction in physical performance.

8.
Artigo em Inglês | MEDLINE | ID: mdl-33578976

RESUMO

The Work Ability Index (WAI) is a validated and widely used tool in occupational research. However, normative values for physical therapists (PTs) by age and sex are lacking. Although the nature of PTs' work is physically demanding, it is unknown whether muscular fitness is associated with their WAI. This study sought to provide reference WAI data for Spanish PTs and to evaluate the association between PTs' muscular fitness and WAI. Data on WAI of 1005 PTs were collected using a questionnaire. A subgroup (n = 68) performed a battery of physical tests including grip strength, push-ups and back-extension endurance. Associations between muscular fitness and WAI were evaluated using logistic regression controlling for various confounders. PTs aged 50 years or older had lower WAI scores than their younger counterparts. PTs with high back-extension endurance scored 3.5 (95% CI) higher in the WAI than those with low endurance. No associations were found between grip strength or number of push-ups and WAI. Our findings seem to highlight the importance of muscular fitness in PTs, especially the back-extension endurance.


Assuntos
Fisioterapeutas , Exercício Físico , Humanos , Pessoa de Meia-Idade , Resistência Física , Aptidão Física , Inquéritos e Questionários , Avaliação da Capacidade de Trabalho
9.
Dev Neurorehabil ; 24(3): 166-172, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33058745

RESUMO

OBJECTIVE: To develop a predictive model of neuromuscular hip dysplasia (NHD) in teenagers with cerebral palsy (CP) to optimize rehabilitation. DESIGN: A longitudinal, multicenter, double-blinded, descriptive study of one hundred and two teenagers with CP (age 16.5 ± 1.2 years, range 12-18 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, and functional assessments were collected from 2005 to 2017 and entered in the prediction model "PredictMed." RESULTS: Poor walking abilities [p < .001; Odd Ratio (OR) Infinity], scoliosis (p 0.01; OR 3.22), trunk muscles' tone disorder (p 0.002; OR 4.81), spasticity (p 0.006; OR 6.6), poor motor function (p 0.02; OR 5.5), and epilepsy (p 0.03; OR 2.6) were predictors of NHD development. The accuracy of the model was 77%. CONCLUSION: Trunk muscles' tone disorder, severe scoliosis, epilepsy, and spasticity were predictors of NHD in teenagers with CP. Based on the results we have developed appropriate preventative rehabilitation interventions.


Assuntos
Paralisia Cerebral/reabilitação , Luxação do Quadril/prevenção & controle , Reabilitação Neurológica/métodos , Adolescente , Paralisia Cerebral/complicações , Método Duplo-Cego , Epilepsia/epidemiologia , Feminino , Luxação do Quadril/epidemiologia , Humanos , Masculino , Espasticidade Muscular/epidemiologia , Distribuição Aleatória , Escoliose/epidemiologia
10.
Neuropediatrics ; 52(5): 343-350, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33352605

RESUMO

Neuromuscular hip dysplasia (NHD) is a common and severe problem in patients with cerebral palsy (CP). Previous studies have so far identified only spasticity (SP) and high levels of Gross Motor Function Classification System as factors associated with NHD. The aim of this study is to develop a machine learning model to identify additional risk factors of NHD. This was a cross-sectional multicenter descriptive study of 102 teenagers with CP (60 males, 42 females; 60 inpatients, 42 outpatients; mean age 16.5 ± 1.2 years, range 12-18 years). Data on etiology, diagnosis, SP, epilepsy (E), clinical history, and functional assessments were collected between 2007 and 2017. Hip dysplasia was defined as femoral head lateral migration percentage > 33% on pelvic radiogram. A logistic regression-prediction model named PredictMed was developed to identify risk factors of NHD. Twenty-eight (27%) teenagers with CP had NHD, of which 18 (67%) had dislocated hips. Logistic regression model identified poor walking abilities (p < 0.001; odds ratio [OR] infinity; 95% confidence interval [CI] infinity), scoliosis (p = 0.01; OR 3.22; 95% CI 1.30-7.92), trunk muscles' tone disorder (p = 0.002; OR 4.81; 95% CI 1.75-13.25), SP (p = 0.006; OR 6.6; 95% CI 1.46-30.23), poor motor function (p = 0.02; OR 5.5; 95% CI 1.2-25.2), and E (p = 0.03; OR 2.6; standard error 0.44) as risk factors of NHD. The accuracy of the model was 77%. PredictMed identified trunk muscles' tone disorder, severe scoliosis, E, and SP as risk factors of NHD in teenagers with CP.

11.
BMJ Open Sport Exerc Med ; 6(1): e000868, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33304603

RESUMO

Background/Aim: Different authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries. Methods: A retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes. Results: Multivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules). Conclusions: The injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.

12.
Rev. bras. med. esporte ; 26(6): 487-492, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1144194

RESUMO

ABSTRACT Introduction: Muscle activity in the pedal stroke movement on a cycle ergometer can be measured by surface electromyography, as an effective and improved method for studying muscle action and objectively determining the different action potentials of the muscles involved in specific movements. Heart rate behavior is an important factor during exercise with load. Objective: To identify heart rate behavior and pattern of muscle activity of the rectus femoris and vastus medialis in healthy subjects in the pedaling dynamic at different loads, submaximal test, on an instrumented cycle ergometer. Methods: 20 healthy adults were evaluated. Heart rate measurement was performed, together with electromyographic analysis, in the time domain, of the rectus femoris and vastus medialis muscles during incremental exercise of the lower limbs on the cycle ergometer. Results: Heart rate behavior presented significant difference for p≥0.05 in relation to increased loads. The EMG signal intensity from the vastus medialis muscle (normalized RMS value) in each quadrant of the pedaling cycle showed significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants III and IV. In the rectus femoris (RF) muscle, there was significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants I, II and III. Conclusion: An increase in heart rate proportional to the increase in load was observed, as well as an increase in the amplitude of the electromyographic signal proportional to the increase in load. It was possible to identify the pattern of muscle activation in the studied quadrants during pedal stroke movements, independent of load. Level of evidence III; Study of non-consecutive patients; without uniform application of the "gold" standard reference.


RESUMO Introdução: A atividade muscular no gesto motor da pedalada no cicloergômetro pode ser mensurada por meio da eletromiografia de superfície. A eletromiografia de superfície tem sido um método efetivo e aprimorado para estudar a ação muscular, determinando com objetividade os diferentes potenciais de ação dos músculos empenhados em movimentos específicos. O comportamento da frequência cardíaca tem relação importante durante o exercício com carga. Objetivo: Identificar o comportamento da frequência cardíaca e o padrão da atividade muscular do reto femoral e vasto medial em indivíduos saudáveis na dinâmica da pedalada em diferentes cargas, teste submáximo, no cicloergômetro instrumentado. Métodos: Foram avaliados 20 adultos saudáveis, realizando-se a mensuração da frequência cardíaca e a análise eletromiográfica no domínio do tempo dos músculos reto femoral e vasto medial durante o exercício incremental dos membros inferiores em cicloergômetro. Resultados: O comportamento da frequência cardíaca apresentou diferença significante para p ≥ 0,05 com relação ao incremento das cargas. A intensidade do sinal EMG do músculo vasto medial (valor RMS normalizado) em cada quadrante do ciclo da pedalada mostrou diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes III e IV. No músculo reto femoral (RF) verificou-se diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e III. Conclusão: Constatou-se aumento da frequência cardíaca proporcional ao incremento das diferentes cargas e também se evidenciou um aumento na amplitude do sinal eletromiográfico proporcional ao incremento da carga. Foi possível identificar o padrão da ativação dos músculos com relação ao ciclo da pedalada nos quadrantes estudados, independentemente do nível da carga. Nível de evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.


RESUMEN Introducción: La actividad muscular en el gesto motor de la pedaleada en el cicloergómetro se puede medir por medio de la electromiografía de superficie. La electromiografía de superficie ha sido un método efectivo y mejorado para estudiar la acción muscular, determinando con objetividad los diferentes potenciales de acción de los músculos empeñados en movimientos específicos. El comportamiento de la frecuencia cardíaca tiene relación importante durante el ejercicio con carga. Objetivo: Identificar el comportamiento de la frecuencia cardíaca y el patrón de la actividad muscular del recto femoral y vasto medial en individuos en la dinámica de la pedaleada en el cicloergómetro instrumentado. Métodos: Se evaluaron 20 adultos saludables, realizándose la medición de la frecuencia cardíaca y el análisis electromiográfico en el dominio del tiempo de los músculos recto femoral y vasto medial durante el ejercicio incremental de los miembros inferiores en cicloergómetro. Resultados: El comportamiento de la frecuencia cardíaca presentó una diferencia significativa para p ≥ 0,05 con relación al incremento de las cargas. La intensidad de la señal EMG del músculo vasto medial (valor RMS normalizado) en cada cuadrante del ciclo de la pedaleada mostró diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes III y IV. En el músculo recto femoral (RF) se verificó diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV, y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y III. Conclusión: Se constató aumento de la frecuencia cardíaca proporcional al incremento de las diferentes cargas y también se evidenció un aumento en la amplitud de la señal electromiográfica proporcional al incremento de la carga. Fue posible identificar el patrón de la activación de los músculos con relación al ciclo de la pedaleada en los cuadrantes estudiados, independientemente del nivel de la carga. Nivel de evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia "oro" aplicado uniformemente.

13.
Artigo em Inglês | MEDLINE | ID: mdl-32455832

RESUMO

This study calculated the exposure-response rates of social-ecological correlates of practicing regular (>150 min/week) leisure-time physical activity (PA) in 393,648 adults from the 27 Brazilian state capitals who participated in a national survey between 2006 and 2016. Regular PA encouraging factors were inputted into an exposure-response model. Growth rates for the odds ratio and prevalence of regular PA were calculated for each increase of one encouraging factor. Regular PA was reported by 22% of the participants (25% of men and 20% of women). More than 40% of men and 30% of women with higher intra-personal encouraging conditions reported practicing regular PA. There was a 3% (ages 18-32 years) to 5% (ages 46-60 years) increase in regular PA practice in men for each increase in an encouraging climate factor (temperature from 21 °C to 31 °C, humidity from 65% to 85%, 2430 to 3250 h of sun/year, and from 1560 to 1910 mm of rain/year). Encouraging intra-personal factors and favorable climate conditions had larger effects on regular PA practice than the built environment and socio-political conditions; the latter two had independent effects, but did not have a cumulative effect on PA.


Assuntos
Exercício Físico , Atividades de Lazer , Atividade Motora , Meio Social , Adolescente , Adulto , Brasil , Estudos Transversais , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
14.
Health Informatics J ; 26(3): 2105-2118, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31957544

RESUMO

Logistic regression-based predictive models are widely used in the healthcare field but just recently are used to predict comorbidities in children with cerebral palsy. This article presents a logistic regression approach to predict health conditions in children with cerebral palsy and a few examples from recent research. The model named PredictMed was trained, tested, and validated for predicting the development of scoliosis, intellectual disabilities, autistic features, and in the present study, feeding disorders needing gastrostomy. This was a multinational, cross-sectional descriptive study. Data of 130 children (aged 12-18 years) with cerebral palsy were collected between June 2005 and June 2015. The logistic regression-based model uses an algorithm implemented in R programming language. After splitting the patients in training and testing sets, logistic regressions are performed on every possible subset (tuple) of independent variables. The tuple that shows the best predictive performance in terms of accuracy, sensitivity, and specificity is chosen as a set of independent variables in another logistic regression to calculate the probability to develop the specific health condition (e.g. the need for gastrostomy). The average of accuracy, sensitivity, and specificity score was 90%. Our model represents a novelty in the field of some cerebral palsy-related health outcomes treatment, and it should significantly help doctors' decision-making process regarding patient prognosis.


Assuntos
Paralisia Cerebral , Paralisia Cerebral/complicações , Criança , Estudos Transversais , Humanos , Modelos Logísticos , Aprendizado de Máquina , Prognóstico
15.
Nutr Clin Pract ; 35(1): 149-156, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31134674

RESUMO

BACKGROUND: Factors associated with gastrostomy placement in adolescents with developmental disabilities (DDs) and cerebral palsy (CP) are poorly investigated. We aimed to develop and validate a machine learning (ML) model for gastrostomy placement in adolescents with DDs and CP. METHODS: We performed a multinational, double-blinded, case-control study including 130 adolescents with severe DD and CP (72 males, 58 females; mean age 16 ± 2 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, and functional assessments such as the Eating and Drinking Ability Classification System, Manual Ability Classification System, and Gross Motor Function Classification System were collected between 2005 and 2015. Analysis included Fisher exact test, multiple logistic regressions, and a supervised ML model, named PredictMed, to identify factors associated with gastrostomy placement. "Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis" guidelines were followed. RESULTS: Poor motor function (P < 0.001), trunk muscle tone disorder (P < 0.001), male gender (P < 0.01), epilepsy (P = 0.01), and severe neuromuscular scoliosis (P = 0.04) were factors linked with gastrostomy placement in univariate analysis. Epilepsy (P = 0.03), poor motor function (P = 0.04), and male gender (P = 0.04) were associated with gastrostomy placement in multivariate analysis with 95% accuracy. CONCLUSION: Epilepsy, poor motor function, trunk muscles tone disorder, and male gender were accurate, sensitive, and specific factors associated with gastrostomy need.


Assuntos
Paralisia Cerebral/terapia , Deficiências do Desenvolvimento/terapia , Gastrostomia/métodos , Intubação Gastrointestinal/métodos , Adolescente , Estudos de Casos e Controles , Paralisia Cerebral/cirurgia , Deficiências do Desenvolvimento/cirurgia , Nutrição Enteral/métodos , Feminino , Humanos , Modelos Logísticos , Aprendizado de Máquina , Masculino , Modelos Biológicos , Prognóstico
16.
J Nutr Gerontol Geriatr ; 38(3): 205-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223069

RESUMO

Inadequate protein intake contributes to poor nutritional status, reduced muscle mass, strength and function, and increased mortality. Evaluating differences in protein intake and related health indicators among racial/ethnic groups enables the development of targeted interventions. This study's purpose was to determine differences in protein intake, nutritional status, and muscle strength/function among 273 older African, European, and Hispanic Americans. Protein intake, nutritional status, grip strength, timed-up-and-go (TUG), and chair stand assessments were conducted. Protein intake was significantly greater among Hispanic Americans (0.96 g/kg body weight) followed by European Americans (0.83 g/kg body weight), and African Americans (0.64 g/kg body weight). Intakes by all groups were below recommendations. Low nutritional status, grip strength, chair rise, and TUG scores were observed in African Americans and European American females and were consistent with lower protein intakes. Results show significant differences among the groups and the need for interventions to improve diet and physical health.


Assuntos
Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Indicadores Básicos de Saúde , Hispano-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Proteínas na Dieta/metabolismo , Feminino , Florida , Avaliação Geriátrica , Humanos , Masculino , Força Muscular/fisiologia , Avaliação Nutricional , Estado Nutricional/fisiologia
17.
NeuroRehabilitation ; 44(3): 353-360, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31177246

RESUMO

BACKGROUND: Activity levels and disturbances of the sleep-wake pattern affect health and quality of life and need to be further explored in patients with stroke. OBJECTIVE: To evaluate activity levels and their association with sleep-wake patterns in patients with stroke. METHODS: Ten adults with (51±6 years) and 10 without stroke (52±7 years) participated in the study; they were matched on age, sex and educational level. Neurological status, motor function, sleep quality, and activity levels were measured. The groups were compared using Student t-tests and the association between the measures was assessed using Pearson's correlation. RESULTS: Compared to people without stroke, those with stroke had worse sleep quality (p = 0.044), twice lower 24h-activity levels (p < 0.0001), higher interdaily stability and intradaily variability, lower activity during the most active 10 h and during the least active 5 h. Sleep quality was associated with activity level (r= -0.72) and with within-day activity variability (r= 0.53). CONCLUSIONS: Activity level and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke.


Assuntos
Ritmo Circadiano/fisiologia , Qualidade de Vida/psicologia , Sono/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Vigília/fisiologia , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fases do Sono/fisiologia
18.
Neuropediatrics ; 50(3): 178-187, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31018221

RESUMO

Autism spectrum disorder (ASD) is common in adolescents with cerebral palsy (CP) and there is a lack of studies applying artificial intelligence to investigate this field and this population in particular. The aim of this study is to develop and test a predictive learning model to identify factors associated with ASD in adolescents with CP. This was a multicenter controlled cohort study of 102 adolescents with CP (61 males, 41 females; mean age ± SD [standard deviation] = 16.6 ± 1.2 years; range: 12-18 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, communication abilities, behaviors, intellectual disability, motor skills, and eating and drinking abilities were collected between 2005 and 2015. Statistical analysis included Fisher's exact test and multiple logistic regressions to identify factors associated with ASD. A predictive learning model was implemented to identify factors associated with ASD. The guidelines of the "transparent reporting of a multivariable prediction model for individual prognosis or diagnosis" (TRIPOD) statement were followed. Type of spasticity (hemiplegia > diplegia > tri/quadriplegia; OR [odds ratio] = 1.76, SE [standard error] = 0.2785, p = 0.04), communication disorders (OR = 7.442, SE = 0.59, p < 0.001), intellectual disability (OR = 2.27, SE = 0.43, p = 0.05), feeding abilities (OR = 0.35, SE = 0.35, p = 0.002), and motor function (OR = 0.59, SE = 0.22, p = 0.01) were significantly associated with ASD. The best average prediction model score for accuracy, specificity, and sensitivity was 75%. Motor skills, feeding abilities, type of spasticity, intellectual disability, and communication disorders were associated with ASD. The prediction model was able to adequately identify adolescents at risk of ASD.


Assuntos
Inteligência Artificial , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/epidemiologia , Adolescente , Inteligência Artificial/tendências , Transtorno do Espectro Autista/psicologia , Paralisia Cerebral/psicologia , Criança , Estudos de Coortes , Método Duplo-Cego , Feminino , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Masculino
19.
J Child Neurol ; 34(4): 221-229, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30665307

RESUMO

BACKGROUND: Intellectual disability and impaired adaptive functioning are common in children with cerebral palsy, but there is a lack of studies assessing these issues in teenagers with cerebral palsy. Therefore, the aim of this study was to develop and test a predictive machine learning model to identify factors associated with intellectual disability in teenagers with cerebral palsy. METHODS: This was a multicenter controlled cohort study of 91 teenagers with cerebral palsy (53 males, 38 females; mean age ± SD = 17 ± 1 y; range: 12-18 y). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, communication abilities, behaviors, motor skills, eating, and drinking abilities were collected between 2005 and 2015. Intellectual disability was classified as "mild," "moderate," "severe," or "profound" based on adaptive functioning, and according to the DSM-5 after 2013 and DSM-IV before 2013, the Wechsler Intelligence Scale for Children for patients up to ages 16 years, 11 months, and the Wechsler Adult Intelligence Scale for patients ages 17-18. Statistical analysis included Fisher's exact test and multiple logistic regressions to identify factors associated with intellectual disability. A predictive machine learning model was developed to identify factors associated with having profound intellectual disability. The guidelines of the "Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis Statement" were followed. RESULTS: Poor manual abilities (P ≤ .001), gross motor function (P ≤ .001), and type of epilepsy (intractable: P = .04; well controlled: P = .01) were significantly associated with profound intellectual disability. The average model accuracy, specificity, and sensitivity was 78%. CONCLUSION: Poor motor skills and epilepsy were associated with profound intellectual disability. The machine learning prediction model was able to adequately identify high likelihood of severe intellectual disability in teenagers with cerebral palsy.


Assuntos
Paralisia Cerebral/complicações , Deficiência Intelectual/complicações , Modelos Teóricos , Destreza Motora/fisiologia , Adolescente , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Humanos , Deficiência Intelectual/fisiopatologia , Aprendizado de Máquina , Masculino , Prognóstico , Fatores de Risco
20.
Trop Med Int Health ; 23(12): 1394-1400, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30281868

RESUMO

OBJECTIVE: To compare the levels of pain, grip strength, balance and gait in older adults with and without post-Chikungunya chronic arthralgia (PCCA). METHODS: Sixty-two older adults, 30 with and 32 without PCCA participated in the study. Pain level was assessed using a Visual Analogue Scale (VAS). Gait during a 10-m walk was assessed using inertial sensors. Semi-static balance was assessed during an eyes-closed bipedal balance test on a force platform, and grip strength was assessed using a hand dynamometer. RESULTS: Participants with PCCA presented severe levels of pain (VAS > 7.5), poorer balance, lower grip strength, walked slower, with lower cadence and stride length and higher stride time and stride length variability than participants without PCCA (P < 0.001 for all variables). CONCLUSIONS: Older adults with PCCA had high levels of pain, impaired balance and gait and lower grip strength compared to older adults without PCCA.


Assuntos
Artralgia/epidemiologia , Febre de Chikungunya/epidemiologia , Marcha/fisiologia , Força da Mão/fisiologia , Dor/epidemiologia , Equilíbrio Postural/fisiologia , Idoso , Artralgia/fisiopatologia , Brasil , Causalidade , Doença Crônica , Comorbidade , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Masculino , Dor/fisiopatologia
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