Respostas fisiológicas durante teste de caminhada dos 6 minutos em mulheres com diferentes níveis de adiposidade

Backgroud: Obesity is a major public health problem and is related to the low physical capacity when obese are compared to no-obese people, however the cause of this limitation is not completely understood. The measurement associated of physiological response to the telemetric 6MWT adds information of metabolic and respiratory system for diagnose of the functional limitation. Objective: Analyze physiological, metabolic and ventilatory responses in women with different body fat during the 6MWT. Methods: 32 women (8 non-obese, 8 Overweight, 8 Obese and 8 morbidly obese) were evaluated for anthropometry, lung function and exercise capacity. Results: Morbidly obese walked the shortest distance (400.2±38.7m), had lower VO2/Kg (12.75±3.20l/Kg/min) and lower R (0.74± 0.11) in the 6MWT compared to other groups. Analyses of metabolic (VO2 and VCO2) and respiratory (VE, VT and BF) during the test did not identify differences between groups. The evaluation of cardiac function (O2 pulse) found higher values in the OM (12.3 ± 4.9ml/bat). Conclusion: The OM had worse performance in the 6MWT compared to other groups. The physical performance may be reduced in this population related to a protocol-dependent response because the speed of 6MWT is self-adjusted allows the individual himself select the intensity of the test, making it set at a speed where there is energy saving

Comparação das respostas fisiológicas entre diferentes testes funcionais em obesos

obesity affects rightly functional capacity diminishing the cardiovascular system efficiency and oxygen uptake (VO2). Field tests, such as, Incremental Shuttle Walking Test (ISWT) and Six Minute Walk Test (6MWT) has been employed as alternative of Cardiopulmonary Exercise Test (CPX), to functional assessing for conditions which transport of oxygen to peripheral is diminished. Nevertheless, the knowing about metabolic variables response in real time and it comparing among different maximal and submaximal tests in obese is absent. Aim: to compare cardiopulmonary, metabolic response during CPX, ISWT and 6MWT and to analyse it influence of adiposity markers in obese. Material e Method: crosssectional, prospective study. Obese included if: (BMI>30Kg/m2; FVC>80%), were assessed as clinical, anthropometric (BMI, body adiposity index-BAI, waist-WC, hip- HC and neck-NC circumferences) and spirometry (forced vital capacity-FVC, Forced expiratory volume-1°second-FEV1, maximal voluntary ventilation-MVV) variables. Obese performed the sequence of tests: CPX, ISWT and 6MWT. Throughout tests was assessed breath-by-breath by telemetry system (Cortex-Biophysik-Metamax3B) variables; oxygen uptake on peak of activity (VO2peak); carbon dioxide production (VCO2); Volume Expiratory (VE); ventilatory equivalents for VO2 (VE/VO2) and CO2 (VE/VCO2); respiratory exchange rate (RER) and perceived effort-Borg6-20). Results: 15 obese (10women) 39.4+10.1years, normal spirometry (%CVF=93.7+9.7) finished all test. They have BMI (43.5+6.6kg/m2) and different as %adiposity (BAI=50.0+10.5% and 48.8+16.9% respectively women and men). Difference of VO2ml/kg/min and %VO2 were finding between CPX (18.6+4.0) and 6MWT (13.2+2.5) but not between ISWT (15.4+2.9). Agreement was found for ISWT and CPX on VO2Peak (3.2ml/kg/min; 95%; IC-3.0 9.4) and %VO2 (16.4%). VCO2(l/min) confirms similarity in production for CPX (2.3+1.0) and ISWT (1.7+0.7) and difference for 6MWT (1.4+0.6). WC explains more the response of CPX and ISWT than other adiposity markers. Adiposity diminishes 3.2% duration of CPX. Conclusion: ISWT promotes similar metabolic and cardiovascular response than CPX in obese. It suggesting that ISWT could be useful and reliable to assess oxygen uptake and functional capacity in obese

Utilização da macroalga Ulva lactuca linnaeus na redução de nutrientes (NH4+,NO3- e PO4-2) provenientes da carcinicultura

Dentre as macroalgas capazes de absorver altas concentrações de N e P dissolvidos na água, destaca-se a Chlorophyta Ulva lactuca, bastante adaptável e resistente às adversidades ambientais, como grandes variações de temperatura, salinidade, matéria orgânica e metais pesados. Trata-se também de uma espécie bastante comum nas áreas intertidais do litoral norte-riograndense. Devido a suas características ecológicas, fisiológicas e nutricionais, foi avaliado nesse estudo, o seu potencial como biofiltro na redução de NH4+, NO3- e PO4-2, tanto em condições controladas como também em um viveiro de camarão. No experimento laboratorial, foram utilizados quatro aquários de vidro de 30 x 20 x 20cm com 10L de água, sendo três aquários experimentais contendo 20g de U. lactuca e um controle. O acréscimo de biomassa foi de 2,92g (22,92 ± 6,29g; p < 0,05) em relação ao inóculo inicial de 20g, sob temperatura (28,50 ± 0,58ºC), salinidade (35,00 ± 0,00 ), pH (8,26 ± 0,02) e luz constante (250 μmol.m2s-1). O crescimento positivo (1,78 ± 4,38%dia-1; p < 0,05), juntamente com a alta eficiência de absorção de amônio (83%; p < 0,001), nitrato (83%; p < 0,001) e ortofosfato (53%; p < 0,001), demonstrou que, nessas condições, a Ulva lactuca absorveu os nutrientes e aumentou sua biomassa. Já no experimento de campo, realizado na fazenda TECNARÃO, situada no município de Arez/RN (06° 11 40 Latitude Sul, e 35º 09 37 Longitude Oeste), foram utilizadas três gaiolas de PVC, posicionadas a 12cm da superfície da água, cada uma com dimensões de aproximadamente 59 x 59 x 15cm, onde foram colocadas 200g de U. lactuca. O ganho de biomassa de 3g (203,00 ± 41,02g; p < 0,001) foi muito semelhante às condições controladas, demonstrando a adaptabilidade da espécie em condições ambientais variáveis, onde, apesar da temperatura pouco variável (27,45 ± 0,64ºC), houve progressiva diminuição de salinidade (25 - 15 ), devido ao período de fortes chuvas (34,70 ± 23,78mm). Somado a isso, foram observados vários fatores biológicos interferindo no viveiro, como a presença de epífitas, organismos endofíticos, fouling e a herbivoria por parte dos próprios camarões. Houve aumento nas concentrações de NH4+ (4,36 ± 1,69 μmol.L-1), NO3- (0,17 ± 0,25μmol.L-1) e PO4-2 (0,41 ± 0,13μmol.L-1), coincidindo com o crescimento da espécie até a terceira semana. Todos os parâmetros ambientais analisados, assim como a biomassa e a Taxa de Crescimento Relativo (TCR), obtidos no campo, apresentaram variações altamente significativas (p < 0,001). As correlações observadas entre biomasa e NH4+ (r = 0,82; p < 0,001) e entre biomassa e PO4-2 (r = 0,87; p < 0,001), indicam que esta espécie é capaz de ter um crescimento satisfatório nas condições eutróficas de um viveiro de camarão, sendo possível seu uso como biofiltro.

Avaliação do retinol em parturientes com diabetes mellitus gestacional no pós parto imediato

Micronutrient deficiencies affect individuals mainly in developing countries, where vitamin A deficiency is a public health problem worldwide more worrying, especially in groups with increased physiological needs such as children and women of reproductive age. Vitamin A is supplied to the body through diet and has an important role in the visual process, cell differentiation, maintenance of epithelial tissue, reproductive and resistance to infection. The literature has demonstrated the relationship between vitamin A and diabetes, including gestational, leading to a risk to both mother and child. Gestational diabetes is any decrease in glucose tolerance of variable magnitude diagnosed each the first time during pregnancy, and may or may not persist after delivery. Insulin resistance during pregnancy is associated with placental hormones, as well as excess fat. Studies have shown that retinol transport protein produced in adipose tissue in high concentrations, this would be associated with resistance by interfering with insulin signaling. Therefore, this study aimed to evaluate the concentration of retinol in serum and colostrum from healthy and diabetic mothers in the immediate postpartum period. One hundred and nine parturient women were recruited, representing seventy-three healthy and thirty-six diabetic. Retinol was extracted and subsequently analyzed by High Performance Liquid Chromatography. Among the results highlights the mothers with gestational diabetes were older than mothers healthy, had more children and a higher prevalence of cases of cesarean section. Fetal macrosomia was present in 1.4% of healthy parturient women and in 22.2% of diabetic mothers. The maternal serum retinol showed an average of 39.7 ± 12.5 mg/dL for healthy parturients 35.12 ± 15 mg/dL for diabetic and showed no statistical difference. It was observed that in the group of diabetic had 17% vitamin A deficiency, whereas in the healthy group, only 4% of the women were deficentes. Colostrum, the concentration of retinol in healthy was 131.3 ± 56.2 mg/dL and 125.3 ± 41.9 mg/dL in diabetic did not differ statistically. This concentration of retinol found in colostrum provides approximately 656.5 mg/day for infants born to healthy mothers and 626.5 mg/day for infants of diabetic mothers, based on a daily consumption of 500 mL of breast milk and need Vitamin A 400 mg/day, thus reaching the requirement of the infant. The diabetic mothers showed significant risk factors and complications related to gestational diabetes. Although no 11 difference was found in serum retinol concentration and colostrum among women with and without gestational diabetes, the individual analysis shows that parturients women with diabetes are 4.9 times more likely to develop vitamin A deficiency than healthy parturients. However, the supply of vitamin A to the newborn was not committed in the presence of gestational diabetes

Arthropoda de solo em um ecossistema semi-árido da região neotropical: composição, variabilidade temporal e estratificação

Caatinga is an important laboratory for studies about arthropods adaptations and aclimatations because its precipitation is highly variable in time. We studied the effects of time variability over the composition of Arthropods in a caatinga area. The study was carried out at a preservation area on Almas Farm, São José dos Cordeiros, Paraíba. Samples were collected in two 100 m long parallel transects, separated for a 30 m distance, in a dense tree dominated caatinga area, between August 2007 and July 2008. Samples were collected in each transect every 10 m. Ten soil samples were taken from each transect, both at 0-5 cm (A) and 5-10 cm (B) depth, resulting in 40 samples each month. The Berlese funnel method was used for fauna extraction. We registered 26 orders and the arthropods density in the soil ranged from 3237 to 22774 individuals.m-2 from January 2007 to March 2008, respectively. There was no difference between layers A and B regarding orders abundance and richness. The groups recorded include groups with few records or that had no records in the Caatinga region yet as Pauropoda, Psocoptera, Thysanoptera, Protura and Araneae. Acari was the most abundant group, with 66,7% of the total number of individuals. Soil Arthropods presented a positive correlation with soil moisture, vegetal cover, precipitation and real evapotranspiration. Increases in fauna richness and abundance were registered in February, a month after the beginning of the rainy season. A periodic rain events in arid and semiarid ecosystems triggers physiological responses in edafic organisms, like arthropods. Edafic arthropods respond to time variability in the Caatinga biome. This fauna variation has to be considered in studies of this ecosystem, because the variation of Arthropods composition in soil can affect the dynamics of the food web through time

Modelos matemáticos para estimativa do consumo máximo de oxigênio pela ventilometria de esforço em indivíduos saudáveis

The relation between metabolic demand and maximal oxygen consumption during exercise have been investigated in different areas of knowledge. In the health field, the determination of maximal oxygen consumption (VO2max) is considered a method to classify the level of physical fitness or the risk of cardiocirculatory diseases. The accuracy to obtain data provides a better evaluation of functional responses and allows a reduction in the error margin at the moment of risk classification, as well as, at the moment of determination of aerobic exercise work load. In Brasil, the use of respirometry associated to ergometric test became an opition in the cardiorespiratory evaluation. This equipment allows predictions concerning the oxyredutase process, making it possible to identify physiological responses to physical effort as the respiratory threshold. This thesis focused in the development of mathematical models developed by multiple regression validated by the stepwise method, aiming to predict the VO2max based on respiratory responses to physical effort. The sample was composed of a ramdom sample of 181 healthy individuals, men and women, that were randomized to two groups: regression group and cross validation group (GV). The voluntiars were submitted to a incremental treadmill test; objetiving to determinate of the second respiratory threshold (LVII) and the Peak VO2max. Using the método forward addition method 11 models of VO2max prediction in trendmill were developded. No significative differences were found between the VO2max meansured and the predicted by models when they were compared using ANOVA One-Way and the Post Hoc test of Turkey. We concluded that the developed mathematical models allow a prediction of the VO2max of healthy young individuals based on the LVII

Tradução, adaptação cultural e análise das propriedades psicométricas do activities of daily living questionnaire - ADLQ - para avaliação funcional de pacientes com a doença de alzheimer

O Activities daily living questionnaire - ADLQ foi elaborado para avaliar atividades básicas e instrumentais em pacientes com a doença de Alzheimer. O objetivo principal deste estudo consistiu em realizar a tradução do ADLQ para a língua portuguesa, adaptação transcultural e análise das suas propriedades psicométricas. A amostra foi composta por 60 pacientes e os respectivos 60 cuidadores. O estudo iniciou-se com a tradução do instrumento pela técnica de retrotradução associada ao método bilíngüe. A versão traduzida foi respondida pelo cuidador e o Mini Exame do Estado Mental (MEEM) aplicado ao paciente. A análise psicométrica foi realizada através da validade das medidas do instrumento. Os resultados verificaram uma correlação inversamente significativa (r=-0,793;p<0,05) entre os instrumentos avaliados, com uma explicação da variância total de 62%. A coerência interna do instrumento foi realizada através da correlação com os resultados do MEEM sugerindo uma versão condensada do ADLQ. Avaliando-se através do teste t para amostras correlacionadas, as médias do ADLQ-versão traduzida e versão condensada não apresentaram diferenças significativas, demonstrado assim que a simplificação do instrumento não alterou os valores do nível de dependência funcional observados. A análise fatorial realizada através da rotação Varimax indicou seis dimensões. Atividades como; comer, vestir-se, banho, necessidades fisiológicas, tomar comprimidos, participação em grupos, administrar finanças, manusear dinheiro, locomover pela vizinhança, usar telefone, compreensão, dentre outras, são os mais importantes preditores da capacidade funcional, no grupo estudado. Atividades com desempenho pouco comum a ambos os sexos, e no desempenho de papéis sociais enquanto gênero na sociedade brasileira (afazeres domésticos, consertos e manutenção em casa), na amostra estudada, não demonstraram ter importância na determinação da capacidade funcional com o paciente com a Doença de Alzheimer. O presente estudo disponibiliza uma nova ferramenta de avaliação funcional, visando contribuir para a mensuração mais cuidadosa do estado funcional do paciente por todos os profissionais da área da saúde

Associação da frequência alélica dos polimorfismos dos genes do sistema renina angiotensina com a força muscular e pressão arterial de idosas

Physiological changes induced by the aging process is dynamic and progressive, reducing the adaptability and independence of older people and may be influenced by genetic and environmental factors. Thus the aim of this thesis was to investigate the association between polymorphism of the ACE gene ID and the phenotypes of muscular strength and blood pressure of 62 elderly Brazilian (67.35 ± 5.66 years) during a 16-week program of supervised training. The elderly women were stratified by age, with the group 1 (G1, n = 34) <70 years and group 2 (G2 n = 28) ≥ 70 years, and in three groups by ACE, ACE-II (n = 8) ACE- DD (n = 35) and ACE-ID (n = 19). The level of muscle strength was evaluated by the method of maximum repetitions and measures of blood pressure (BP) were measured before and after training (PAPré1 and PAPós1) and before and after each training session (PAPre2 and PAPós2), in place of training. DNA samples were isolated from peripheral blood leukocytes polymorphism and insertion / deletion (ID) of the ACE gene (rs1800795) was genotyped by polymerase chain reaction (PCR) plus PCR-confirmatory. The genotype distribution of the polymorphism ID attended the prerogatives of Hardy-Weitíherg. There was variation in power levels before and after training and the age between groups (t-test) and the ACE polymorphism (ANOVA) (p <0.05). Depending on the results it was concluded that resistance training helps to reduce SBP and increased muscle strength of upper and lower limbs when considering the age and ACE polymorphism. In this study the Elderly carriers of the D allele were more reactive to changes in BP resistance training. This study was multidisciplinary project involving researchers in the areas Medical, Physical Education, Pharmacy, Nutrition, Gerontology and Statistics. This fulfilled the requirements of the multidisciplinary Graduate Program in Health Sciences

Atuação de técnicos de enfermagem junto ao recém-nascido com dor em uma unidade de terapia intensiva neonatal

The pain is a sensuous and emotional experience unpleasant associated or related to real injury or potencial of the tissues. It is considered an individual and subjective experience generally has been described in the literature about in the neonatal stage a lot. This study has descriptive and exploratory character with a qualitative approach. The study has with objectives to analyze the performance of the nursing technicians working with newborns admitted in the ITUN, seeking to describe the perception of the nursing technicians about the pain, identify the parameters used for the detection and evaluation of pain in them, trying to describe the ons of this team about the pain in the newborns in ITUN. The subjects are nine nursing technicians of the ITU of the Parenting School Januário Cicco in Natal-RN, engaged in direct assistance to newborns in the ITU, on the turn of the morning, which was prepared to participate in the search. The collection of the data was conducted through a structured interview with tree questions; through a non-participatory observation with a structured roadmap and were used to record and pass on call was also as a way of obtaining data. The start of the collection made after the assent of the Ethics Committee / UFRN in November, 2007. The speakings have been transcribed and data read extensively to obtain categories.The analysis of the content made in terms of Bardin. Emerged three main categories of significance: Perceptioning of pain in newborns; Caring for the newborns with pain; Registering the pain in the newborns. A nursing technicians identifies the pain in the newborns, for the most part, so empirical, using signs of behavioral or physiological changes in isolation, giving little emphasis to the environment and to respect that the newborns is inserted. It was found that the attitudes cited by subjects of the search before the newborns with pain, are for the most part non-pharmacological actions such as sucking nutrient not, a proper positioning and measures of comfort, however pharmacological actions have also been reported.These is also the absence of records of nursing records in the report of pain and actions to minimize them and, in records and for the passage of call. With this study we understand the role of the nursing technicians, and seek to contribute to subsidies for the practice of professionals involved in caring for this age group, and also in the search for a humane assistance to the newborns

A fragilidade e suas representações para idosos domiciliados no contexto da estratégia de Saúde da Família

This study aims to analyze social representations of elders to their fragile situation at home, with the presence of one or more characteristics, as defined by the Brazilian Ministry of Health. It is a descriptive and qualitative study, based on methodological -principles of the Theory of Social Representations. Setting was the homes of elderly residents in the area ascribed to a Family Health Unit (FHU) in the city of Natal. A total of 10 elderly subjects, whose choice was intentional and according to the need for USF home visit in a period of time, considering the saturation process of the information. As collection procedures were used the semi-structured interview and participant observation in accordance with the ethical rules of Resolution No. 196/96, with the assent of the Ethics and Research UFRN. To analyze the results, it was used the thematic content analysis in the aspect of preparation of representations, focusing on the totality of the discourse of the subjects. The results indicate that most study participants felt difficult to give meaning to the terms weakness and to be weak, although many present one or more aspects of the syndrome of frailty. From the content analysis of participants speeches in this study, we achieved the following categories: fragility as illness and disease as aging, aging and frailty as causes of changes and difficulties in daily life, the presence of family life in the fragile elderly, fragility as weakness and the risk for falls, the perception of being weak like a different person in addition to the absence of fragility in elderly life. Thus, through the processes of anchoring and objectification, the "fragile being" became familiar and concrete, showing that the meaning of weakness, besides the scientific definition found in the reified universes, can be reinterpreted and built within the consensus universes. About the care received by the staff of Family Health, from the viewpoint of older people there seems to be an understanding about the role of professional nurses; on the other hand, older people often mention the role of the Community Health Agent

Influência do estresse nutricional programado na composição da microalga isochrysis galbana

Global warming due to Greenhouse Gases (GHG) emissions, especially CO2, has been identified as one of the major problems of the twenty-first century, considering the consequences that could represent to planet. Currently, biological processes have been mentioned as a possible solution, especially CO2 biofixation due to association microalgae growth. This strategy has been emphasized as in addition to CO2 mitigation, occurs the production of biomass rich in compounds of high added value. The Microalgae show high photosynthetic capacity and growth rate higher than the superior plants, doubling its biomass in one day. Its culture does not show seasons, they grow in salt water and do not require irrigation, herbicides or pesticides. The lipid content of these microorganisms, depending on the species, may range from 10 to 70% of its dry weight, reaching 90% under certain culture conditions. Studies indicate that the most effective method to promote increased production of lipids in microalgae is to induce stress by limiting nitrogen content in the culture medium. These evidences justify research continuing the production of biofuels from microalgae. In this paper, it was studied the strategy of increasing the production of lipids in microalgae I. galbana with programmed nutritional stress, due to nitrogen limitation. The physiological responses of microalgae, grown in f / 2 with different concentrations of nitrogen (N: P 15,0-control, N: 5,0 P and N: P 2,5) were monitored. During exponential phase, results showed invariability in the studied conditions. However the cultures subjected to stress in stationary phase, showed lower biomass yields. There was an increase of 32,5% in carbohydrate content and 87.68% in lipids content at N: P ratio of 5,0 and an average decrease of 65% in protein content at N: P ratios of 5, 0 and 2.5. There were no significant variations in ash content, independently of cultivation and growth phase. Despite the limitation of biomass production in cultures with N: P smaller ratios, the increase of lipid accumulation highest lipids yields were observed as compared to the control culture. Given the increased concentration of lipids associated to stress, this study suggests the use of microalgae Isochrysis galbana as an alternative raw material for biofuel production

Secagem de grãos de girassol em leito fixo e em leito de jorro

This work studies two methods for drying sunflower grains grown in the western region of Rio Grande do Norte, in the premises of the Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte - IFRN - Campus Apodi. This initiative was made because of the harvested grain during the harvest, being stored in sheds without any control of temperature, humidity etc. Therewith, many physical, chemical and physiological characteristics are compromised and grains lose much quality for oil production as their germination power. Taking into account that most of the stored grain is used for replanting, the studied methods include drying of grains in a thin layer using an oven with air circulation (fixed bed) and drying in a spouted bed. It was studied the drying of grains in natura, i.e., newly harvested. The fixed bed drying was carried out at temperatures of 40, 50, 60 and 70°C. Experiments in spouted bed were performed based on an experimental design, 2² + 3, with three replications at the central point, where the independent variables were grains load (1500, 2000 and 2500 g) and the temperature of the inlet air (70, 80, and 90 °C), obtaining the drying and desorption equilibrium isotherms. Previously, the characteristic curves of the bed were obtained. Both in the fixed bed as in the spouted bed, drying and desorption curves were obtained by weighing the grains throughout the experiments and measurements of water activity, respectively. The grains drying in the spouted bed showed good results with significant reduction of processing time. The models of FICK and PAGE were fitted to the experimental data, models which will represent the drying of grains both in the fixed bed as in the spouted bed. The desorption curves showed no influence of the processing temperature in the hygroscopic characteristics of the grains. The models of GAB, OSWIN and LUIKOV could well represent the desorption isotherms

Síndrome da fragilidade e fatores associados em idosos comunitários do município de Santa Cruz RN

The frailty in the elderly is characterized by decreased physiological reserves, and is associated with increased risk of disability and high vulnerability to morbidity and mortality. This study is part of a multicentric project on Frailty in Elderly Brazilians (REDE FIBRA). Aims: to investigate characteristics, prevalence and associated factors related to frailty. Metodology: We interviewed 391 elderly patients aged 65 years, selected randomly. Data collection was performed using a multidimensional questionnaire containing information about socio-demographic and clinical variables. To characterize the frail elderly, was considered the phenotype proposed by Fried. Data were analyzed using descriptive statistics, bivariate analysis (χ ²) and binary logistic regression. Results: The prevalence of frailty was 17.1%. In the final model of multivariate analysis, was obtained as factors associated with frailty: advanced chronological age (p <0.001), have comorbidity (p <0.035), show dependence on performing basic activities of daily living (p <0.010) and instrumental (p <0.003) and have poor perception of health status (p <0030). Conclusions: The factors associated with frailty suggest a predictive model helping to understand the syndrome, guiding actions that minimize adverse effects on the aging process

Influência do método pilates na força e atividade elétrica dos músculos respiratórios de idosas - ensaio clínico controlado randomizado

The reduction of physiological capacity present in the process of aging causes a marked decline in lung function. The exercise does promote several positive changes in the physical health of people and protect the cardiorespiratory function. The aim of this study was to investigate the effects of a program of Pilates exercices on the strengh and electrical activity of respiratory muscles of elderly. This is a randomized, controlled clinical trial, evaluating 33 elderly aged 65 and 80 (70.88 ± 4.32), healthy, sedentary, without cognitive impairment and able the practice physical activity. The sample was divided into two groups, one experimental group with 16 elderly women who did Pilates exercises and a control group (17) that was not submitted to the exercises, but received educational booklets on aging and health care. The elderly were evaluated initially and after a period of three months, taking into account the Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP), obtained by Manovacuometry and intensity of EMG activity was measured using the values of Root Mean Square (RMS) for the diaphragm and rectus abdominis muscles, during the course of diaphragmatic breathing and MIP maneuver. Data were analyzed using SPSS version 17.0. For all tests, we used a significance level or p value < 0.05 and confidence interval 95%. RMS in diaphragm and rectus abdominis muscles in both tests increased, but the data were significant for the rectus abdominis during diaphragmatic breathing (p = 0.03) and the diaphragm during the MIP maneuver (p = 0.01). There was no significant variation of the MIP and MEP. Pilates exercises were responsible for increasing the electrical activation of the diaphragm and rectus abdominis muscles in a group of healthy elderly, but had no influence on changes in strength of respiratory muscles

Exercícios respiratórios para asma: revisão sistemática com metanálise

Introdução: A asma se tornou um problema de saúde pública devido aos seus grandes custos em cuidados de saúde. Os exercícios respiratórios constituem uma intervenção não farmacológica de baixo custo e baixo risco que vem sendo utilizada por fisioterapeutas em diferentes países no tratamento de pacientes asmáticos. Objetivo: Avaliar a eficácia dos exercícios respiratórios no tratamento de pacientes adultos com asma nos seguintes desfechos: qualidade de vida, sintomas da asma, número de exacerbações agudas, episódios de hospitalização, mensurações fisiológicas (função pulmonar e capacidade funcional), número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, avaliação subjetiva do paciente em relação à intervenção. Método: Revisão sistemática de estudos controlados randomizados com metanálise realizada em parceria com a Colaboração Cochrane. As seguintes bases de dados foram consultadas: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, e PsycINFO, além de busca manual em revistas da área e em resumos de congressos. Os seguintes termos foram utilizados: (breath*) and (exercise* or retrain* or train* or re-educat* or educat* or physiotherap* or "physical therap*" or "respiratory therapy" or buteyko ). As listas de referências dos estudos selecionados e registros de ensaios clínicos também foram consultados. A seleção dos estudos e a avaliação do risco de viés dos estudos incluídos foram realizadas de maneira independente por dois revisores. O software Review Manager foi utilizado para análise dos dados, no qual o modelo de efeito fixo foi utilizado. As variáveis contínuas foram expressas como diferença de média ponderada com um intervalo de confiança de 95%. A heterogeneidade dos resultados dos estudos incluídos foi realizada por meio da análise dos Forest plots. O teste qui-quadrado (Chi2) com um P valor de 0.10 foi utilizado para indicar significância estatística. O Índice de heterogeneidade (I2) foi implementado com um valor acima de 50% como um nível substancial de heterogeneidade. Resultados: 13 estudos envolvendo 906 pacientes estão atualmente incluídos na revisão. Os seguintes desfechos foram mensurados pelos estudos incluídos: qualidade de vida, sintomas da asma, número de exacerbações agudas e função pulmonar. Os estudos relataram uma melhora na qualidade de vida, sintomas da asma e número de exacerbações agudas. Seis dos onze estudos que avaliaram função pulmonar mostraram uma diferença significativa favorável aos exercícios respiratórios. Não houve relato de efeitos adversos. Devido à heterogeneidade substancial encontrada entre os estudos, metanálise foi possível apenas para sintomas da asma, a qual incluiu dois estudos e mostrou uma diferença significativa favorável aos exercícios respiratórios. A avaliação do risco de viés foi prejudicada devido ao relato incompleto de aspectos metodológicos pela maioria dos estudos incluídos. Conclusão: Embora os resultados encontrados pelos estudos incluídos demonstraram individualmente que os exercícios respiratórios podem ser importantes no tratamento da asma, não há evidência conclusiva nesta revisão para suportar ou refutar a eficácia desta intervenção no tratamento de pacientes asmáticos. Este fato foi devido às diferenças metodológicas entre os estudos incluídos e à ausência de relato de aspectos metodológicos por parte da maioria dos estudos incluídos. Não há dados disponíveis em relação aos efeitos dos exercícios respiratórios nos seguintes desfechos: episódios de hospitalização, número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, e avaliação subjetiva do paciente em relação à intervenção