Investigating academic performance and perceptions of human physiology and exercise physiology courses among undergraduate students of physical education at a Brazilian public university.

PURPOSE: To compare the academic performance of undergraduate students in physical education who studied exercise physiology before and after studying human physiology and investigate students' perceptions of human physiology and exercise physiology courses. METHODS: This study included 311 undergraduate students pursuing a bachelor's degree in physical education. Participants were divided into two groups: those who had previously attended and completed the human physiology course (group 1, n = 212, 68.2%) and those who had not previously attended or had attended but failed the human physiology course (group 2, n = 99, 31.8%). The prevalence ratio (PR) and 95% confidence interval (95% CI) were calculated using a Poisson regression model with a robust variance estimator. The second aim comprised 67 students with bachelor's degrees in physical education who completed an electronic questionnaire about their perceptions of human physiology and exercise physiology curriculum. RESULTS: Compared with those who attended human physiology and passed, those who had not previously attended or had attended but failed the human physiology course have a higher PR of 2.37 (95% CI, 1.68-3.34) for failing exercise physiology. Regarding the students' perceptions of human physiology and exercise physiology courses, most students reported that they were challenging (58.2% and 64.2%, respectively), but they also recognized the importance of these courses for professional practice (59.7% and 85.1%, respectively). CONCLUSION: Human physiology should be considered a prerequisite for an undergraduate course leading to a bachelor's degree in physical education. Furthermore, students considered human physiology and exercise physiology courses important yet challenging. Therefore, continuous student assessment is vital for improving the teaching-learning process.

Functional exercise capacity in maximal and submaximal activities of individuals with polio sequelae.

PURPOSE: Poliomyelitis is an infectious disease that can cause total paralysis. Furthermore, poliomyelitis survivors may develop new signs and symptoms, including muscular weakness and fatigue, years after the acute phase of the disease, i.e., post-polio syndrome (PPS). Thus, the objective was to compare the functional exercise capacity during maximal and submaximal exercises among individuals with polio sequelae (without PPS diagnosis), PPS, and a control group. METHODS: Thirty individuals participated in three groups: a control group (CG, n = 10); a group of individuals with polio sequelae but without PPS diagnosis (PG, n = 10); and a PPS group (PPSG, n = 10). All participants underwent (i) a cardiopulmonary exercise test to determine their maximal oxygen uptake ([Formula: see text]) and (ii) a series of functional field tests (i.e., walking test, sit-to-stand test, and stair climbing test). RESULTS: [Formula: see text]O2max was 30% lower in PPSG than in CG and PG. Regarding functional field tests, walking and stair climbing test performances were significantly different among all groups. The PPSG sit-to-stand performance was lower than CG. CONCLUSION: The sequelae of paralytic poliomyelitis impair functional exercise capacity obtained from maximal and submaximal tests, especially in patients with PPS. Furthermore, submaximal variables appear to be more negatively impacted than maximal variables.

Shoulder Internal Rotator Strength as Risk Factor for Shoulder Pain in Volleyball Players.

The aim of this study was to identify the intrinsic factors that could increase risk of shoulder pain in adolescent volleyball players. Twenty-eight young male volleyball players (between 14 and 18 years old) participated in this study. Athletes were submitted to: isokinetic muscle strength assessment of shoulder rotator muscles, ball service speed assessment, anterior and posterior drawer test, apprehension test, groove sign and scapular dyskinesia test. Athletes were followed for 16 weeks to monitor the presence of shoulder pain. All athletes were submitted to the same training protocol. During the 16 weeks, 28.5% of the athletes (n=8) experienced shoulder pain in the dominant limb higher than 3 according to Numerical Rating Scale criteria; 71.5% of the athletes (n=20) did not experience pain, or pain equal or lower than 3. The main result of our study was that the odds of feeling pain higher than 3 was significantly higher among players who presented higher values for internal rotation peak torque (OR=1.113, CI 95%=1.006 to 1.232 and p=0.038). The odds of feeling pain increased by 11% for every N·m of the internal rotator muscles. Pre-season isokinetic rotator strength assessments can help identify adolescent volleyball players at increased risk of a shoulder injury.

Prevalence of fear of COVID-19, depression, and anxiety among undergraduate students during remote classes.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, undergraduate students were exposed to symptoms of psychological suffering during remote classes. Therefore, it is important to investigate the factors that may be generated and be related to such outcomes. OBJECTIVE: To investigate the association between fear of COVID-19, depression, anxiety, and related factors in undergraduate students during remote classes. METHODS: This cross-sectional study included 218 undergraduate students (60.6% women and 39.4% men). Students answered a self-administered online questionnaire designed to gather personal information, pandemic exposure, physical activity level, fear of COVID-19 using the 'Fear of COVID-19 Scale', symptoms of depression using the Patient Health Questionnaire-9, and anxiety using General Anxiety Disorder-7. RESULTS: Undergraduate students had a high prevalence of depression and anxiety (83.0% and 76.1%, respectively) but a low prevalence of fear of COVID-19 (28.9%) during remote classes. Multivariate analysis revealed that women who reported health status as neither good nor bad and who had lost a family member from COVID-19 had the highest levels of fear. For depression and anxiety, the main related factors found were female gender, bad health status, insufficiently active, and complete adherence to the restriction measures. CONCLUSION: These findings may be used to develop actions to manage symptoms of anxiety and depression among students, with interventions through physical activity programmes to improve mental health.

Technology and Sleep Quality: Friend or Foe? Let the Exergames Come into Play!

Low sleep quality is associated with many health problems. Although physical exercise is a nonpharmacological tool that positively impacts sleep quality, there are many barriers (lack of energy, lack of motivation, lack of skills, lack of resources, and fear of injury) for people to adopt an active lifestyle. Exergames are an alternative way of physical exercise that are funnier and more attractive than traditional forms of physical exercise and, therefore, has the potential to increase adherence to a physical exercise program. Given that previous studies showed that exergames presents similar physiological and psychological outcomes to traditional forms of exercise, we aimed to discuss in this narrative review potentials applications, limitations and perspectives of using exergames to improve sleep quality.

Unpleasant Pictures Exposure Evokes Different Repercussion on Emotional State and Heart Rate Response in Healthy Women and Men.

To evaluate the heart rate response, emotion and changes in anxiety and anger levels after exposure to unpleasant pictures from the International Assessment Pictures System (IAPS) compared with neutral picture exposure in healthy individuals. Forty participants (23 women) visited the laboratory on two occasions. State anger and state anxiety levels were evaluated pre- and post-visualization of a set of IAPS pictures and heart rate was monitored during exposure. Two different picture sets were utilized-one with neutral pictures (that served as the control) and the other with unpleasant pictures. State anxiety and state anger were higher in post-unpleasant session for women than before (p < 0.001). For men, only state anxiety was higher in the post-unpleasant session (p < 0.001). State anxiety (p = 0.004) and state anger (p < 0.001) post-unpleasant session was higher for women than in men. The pleasure and dominance domains were lower in the unpleasant session for both men and women (p < 0.001), and the arousal domain was higher for both men and women (p < 0.001) than in the neutral session. In the unpleasant session, arousal was higher (p = 0.004), and dominance was lower (p < 0.001) among women than among men, but no difference in pleasure was found (p > 0.05). For women, average heart rate was higher on unpleasant session, compared to neutral (p = 0.01), but not for men (p > 0.05). Women are more sensitive and react strongly to unpleasant picture exposure. The IAPS unpleasant session was not able to induce anger levels in men.

The effects of exergames on muscle strength: A systematic review and meta-analysis.

This systematic review and meta-analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand-searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non-randomized exergame intervention studies with or without a non-exercise group and/or a "usual care intervention group" (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty-seven and 25 studies were included in the qualitative review and meta-analysis, respectively. The between-groups meta-analyses showed no significant differences between exergames and non-exercise control groups for handgrip strength in heathy/unhealthy middle-aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.

Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a strong negative impact on economic and social life worldwide. It has also negatively influenced people's general health and quality of life. The aim of the present study was to study the impact of social distancing on physical activity level, and the association between mood state (depression and anxiety level) or sex with actual physical activity levels, the change in physical activity caused by social distancing period, the adhesion level to social distancing, the adoption time of social distancing, family income and age. METHODS: A self-administered questionnaire with personal, quarantine, physical activity, and mood state disorders information's was answered by 2140 Brazilians of both sex who were recruited through online advertising. RESULTS: The physical activity level adopted during the period of social distancing (3.5 ± 0.8) was lower than that the adopted prior to the pandemic period (2.9 ± 1.1, p < 0.001). Thirty percent of the participants presented symptoms of moderate/severe depression and 23.3% displayed moderate/severe anxiety symptoms. A greater presence of symptoms related to anxiety and depression were associated with low physical activity levels, low family monthly income, and younger age. A higher percentage of men who had no mood disorders was observed among those who were very active than among those less active. CONCLUSION: The COVID-19 pandemic has a negative impact on physical activity. Those who reduced their level of physical activity had the highest levels of mood disorders. Therefore, physical activity programs should be encouraged, while respecting the necessary social distancing to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2.

Presence of exercise physiology or similar coursework in the curricula of Brazilian health science undergraduate programs.

Bolstered by evidence of the health benefits of exercise, health professionals advise their patients about it. Thus these professionals should have a basic knowledge of exercise physiology. In Brazil, a graduate degree is not mandatory, so for many health providers, the only opportunity to receive information on exercise physiology content is during their undergraduate study. Therefore, it is imperative that health science undergraduate programs include content on exercise physiology. The aim of the study was to verify the presence of exercise physiology (or similar coursework) in the curricula of seven health science undergraduate programs (biomedicine, physical education, nursing, physiotherapy, medicine, nutrition, and psychology). The study was divided into three phases: 1) a survey of the total number of undergraduate programs (n = 4,940) through an electronic system of the Brazilian Ministry of Education (e-MEC); 2) a random selection of 10% of the total undergraduate programs (n = 494) for further analysis of the curriculum; and 3) analysis of the curricula of the selected undergraduate programs. Of 494 undergraduate programs, we did not find curricula for 77 of them. Therefore, the final sample consisted of 417 undergraduate programs. In total, 65.9% of the undergraduate programs did not offer coursework in exercise physiology. The chi-square test revealed a significant association between undergraduate curricula in health science and the presence or absence of exercise physiology coursework [X2(6, n = 417) = 293.0, P < 0.0001]. We did not find exercise physiology coursework in most of the analyzed undergraduate programs. Alternatives to solve the lack of exercise physiology coursework would be the inclusion of content related to exercise physiology in professional/graduate education or in continuing education programs.

Identifying mood disorders and health-related quality of life of individuals submitted to mandatory military service.

OBJECTIVE: To assess the prevalence of mood disorders in Brazilian soldiers. METHODS: A total of 353 soldiers answered the following questionnaires: the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Profile of Mood States (POMS), the medical outcomes study SF-36 questionnaire, the Baecke questionnaire to assess the level of habitual physical activity (HPA) and the socioeconomic (SE) status questionnaire. Participants were classified according to their desire to pursue a military career. RESULTS: Accordingly, 246 participants were allocated to a volunteer group (VG) and 107 to a non-volunteer group (NVG). According to the BDI data for both groups, 66.5% of the soldiers showed at least mild depressive symptoms. Additionally, the STAI data revealed that 27.8% and 8.4% of the soldiers showed high scores on state anxiety and trait anxiety, respectively. The POMS scores were higher in the NVG compared to the VG (Δ%=+263%, p<0.0001). Of the eight subscales, the SF-36 questionnaire showed statistical differences between the groups in the following five dimensions: functioning capacity (p = 0.0046), pain (p = 0.0011), vitality (p < 0.0001), role limitations due to emotional problems (p < 0.0001) and mental health (p < 0.0001). CONCLUSIONS: Mood disorder levels were higher and health status and related quality of life levels were lower in the NVG as compared to the VG.

The effects of exergames on anxiety levels: A systematic review and meta-analysis.

There are currently many different approaches to performing exergames and there is still no consensus as to whether exergames are able to reduce anxiety levels, as well as whether exergames provide greater reductions on anxiety levels when added to traditional forms of clinical interventions. Therefore, the aim of the present systematic review and meta-analysis was to access data from studies that evaluated the effects of exergames on anxiety levels in humans. PubMed, Scopus and Cochrane databases were searched up to 22 February 2019. Inclusion criteria were acute and chronic (short-term and long-term interventions) studies which evaluated the effects of exergames in anxiety levels as primary or secondary aim. Of the 1342 studies found, 17 and 10 were included in qualitative analyses and meta-analyses, respectively. The within-group analysis found that exergames (standardized mean difference [SMD]: -0.57 [95% Confidence interval (CI): -0.86 to -0.28], P < .001) and usual care (SMD: -0.21 [95% CI: -0.34 to -0.08], P = .002) resulted in significant improvements on anxiety levels. However, the between-group meta-analysis on the effects of control interventions vs exergames (SMD: 0.02 [95% CI: -0.55 to 0.60], P = .939) found no significant difference between groups in anxiety levels reductions. There was also no significant difference (SMD: -0.04 [95% CI: -0.32 to 0.25], P = .805) between usual care vs exergames plus usual care interventions in anxiety levels reductions. Although exergames demonstrated within-group improvements in anxiety levels across different clinical populations, it was not greater than the effects from non-exercise interventions. Also, given the paucity of studies, small sample sizes, different research designs, and different population investigated, the existing evidence is insufficient to support the advantages of usual care supplemented by exergame intervention over usual care standalone in anxiety levels reduction.

Is the Energy Expenditure Provided by Exergames Valid?

To assess energy expenditure (EE) estimated by a metabolic system during the exergame Hollywood Workout on Xbox 360Kinect® and to compare this measure with the EE estimated by the exergame (EEEx). thirty-four physically active young males performed the Sports Athlete protocol of the Hollywood Workout. Oxygen uptake (V̇O2) and carbon dioxide production (V̇CO2) were measured before and during the protocol using a metabolic system. The absolute means V̇O2 and V̇CO2 were used to calculate the EE during the exergame session (EEMS). The EEEx (kcal) provided by the exergame was collected, and the two measures were compared. Mean V̇CO2 and V̇O2 during the Sports Athlete protocol were 1.8±0.4 L·min-1 (22.9±3.2 mL·kg-1.min-1) and 2.0±0.4 L·m-1 (25.4±2.6 mL·kg-1·min-1), respectively. The EEMS (300.3±53.4 kcal) was 88.6±34.7% greater than the EEEx (160.3±16.5 kcal; p<0.0001; d=3.7 [large effect size]). The EEMS was almost double EEEx. Thus, it is necessary to use caution when using EE information provided by an exergame interface. Further, future studies need to evaluate EE provided by other exergames. The companies that produce the games must be more attentive and adopt more precise methods in order to provide more accurate information to the users.

Analysis of type 2 diabetes mellitus and arterial hypertension content in exercise physiology textbooks.

The textbook is a pedagogical tool that provides students and professionals with scientific information. As exercise is an important strategy for the prevention and treatment of noncommunicable diseases, such as type 2 diabetes mellitus (T2DM) and arterial hypertension, the presence of correct and up-to-date scientific information in exercise physiology textbooks is important. Our aim was to analyze T2DM and arterial hypertension content in exercise physiology textbooks and compare this content with the American College of Sports Medicine (ACSM) position stands. Comparative descriptions were made between information regarding T2DM and arterial hypertension found in textbooks (n = 10) and similar information contained in the official ACSM position stands. The quality of the content was compared with current scientific information present in the ACSM position stands. In regards to T2DM, eight textbooks provided information regarding the purpose and benefits of exercise, two provided information regarding exercise prescription, seven provided information regarding the type of exercise, six provided information regarding general care and recommendations, and five provided information regarding the mechanisms involved. In regards to arterial hypertension, all textbooks provided information regarding the purpose and benefit of exercise, six provided information regarding exercise prescription, nine provided information regarding the type of exercise, two provided information regarding general care and recommendations, and seven provided information regarding the mechanisms involved. All textbooks analyzed contained information related to physical exercise for patients with T2DM and arterial hypertension. However, the textbooks differed in terms of the quality of the contents, especially in regard to exercise prescription.

Strength Training Using Elastic Bands: Improvement of Muscle Power and Throwing Performance in Young Female Handball Players.

CONTEXT: Imbalance in shoulder-rotator muscles has been considered a risk factor for injuries in handball. Strength training programs (STPs) may play an important preventive role. OBJECTIVE: To verify the effects of an STP using elastic bands on shoulder muscles and ball-throwing speed. DESIGN: Randomized and prospective controlled trial. SETTING: Exercise physiology laboratory. PARTICIPANTS: Thirty-nine female handball players were randomly assigned to an experimental (EG, n = 21, 15.3 ± 1.1 y) or a control (CG, n = 18, 15.0 ± 0.8 y) group. INTERVENTION: The EG performed the STP with elastic-band progressive exercises for 6 wk before regular handball training, and the CG underwent only their regular training. MAIN OUTCOME MEASURES: Before and after the STP, both groups underwent a ball-throwing-speed test and isokinetic test to assess shoulder internal- (IR) and external-rotator muscle performance. RESULTS: Average power values for IR muscles presented a significant group-vs-time interaction effect (F = 3.9, P = .05); EG presented significantly higher values after the STP (P = .03). Ball speed presented higher values in EG after the STP in standing (P = .04) and jumping (P = .03) throws. IR peak-torque values and balance in shoulder-rotator muscles presented no group-vs-time interaction effect. CONCLUSIONS: STP using elastic bands performed for 6 wk was effective to improve muscle power and ball speed for young female handball players.

Characterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study.

BACKGROUND & OBJECTIVES: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. METHODS: This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. RESULTS: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. INTERPRETATION & CONCLUSIONS: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.