A influência do Método Pilates sobre a capacidade funcional, a qualidade de vida e a remodelação óssea em mulheres idosas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Efeito de um programa de treinamento funcional de curta duração sobre a composição corporal de mulheres na pós-menopausa

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Exercício físico e funções cognitivas em pacientes com doença de Alzheimer: associação com BDNF e APOE

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Indicadores Antropométricos do Estado Nutricional de Idosas Praticantes e Não Praticantes de Exercício Fisíco na Zona Norte de São José do Rio Preto-SP

Although the regular practice of physical exercise for the maintenance of the nutritional state and quality of life is important, it is not a common habit among the elderly, especially those of the lower income social bracket. The objective was to characterize and compare according to social-economic conditions and anthropometric indexes of the nutritional state of the elderly who regularly practice and those who do not practice exercises, offered at no cost, in the Northern zone of São José do Rio Preto-SP. In this study, 110 elderly women participated, of which 60 (group P) exercised regularly and 50 did not (group NP). Group P participated in a special gym program, free of charge, for at least 2 years, 2 to 3 times a week, one hour a day. Group NP was recruited from the same location as Group P. The comparison between the groups of elderly women was proportionately distributed according to marital status, level of education, means of locomotion, results of body mass index (IMC), waist to hip ratio (RCQ) and calf circumference, using the chi-square test. Comparisons were also made of average age, per capita family income, individual income, IMC, arm and triceps skin fold measured by t-Test. Differences were not found in all the comparisons made. The variables that stood out were the IMC (overweight) and RCQ (risk of chronic diseases) results, which were above what was expected, and the high frequency of walking and riding buses for both groups of elderly women (about 60%). We came to the conclusion that the low-intensity exercise program evaluated made no difference in the nutritional profile of the elderly who also used walking as a means of getting around.

Outros benefícios do exercício físico para o hipertenso

Aerobic exercise has been suggested as a non-pharmacological treatment for hypertension, and the previous paper of this set demonstrated some of the physiological responses induced by exercise. It has been shown an increment on expenditures for appropriate hypertension management in both, public and private services, which reinforces the inclusion of preventive programs to reduce healthcare costs. However, little is known about physical exercise cost-effectiveness for hypertensive patients. There are several interventions like a simple doctor/dietitian counselling in order to change life style, wed-based nutrition program, pharmacological treatment and assisted or non-assisted physical exercise program that evaluate the costs savings. We have shown that regular exercise (combined or not with another diet counselling and antihypertensive treatment) may effectively contribute to reduce the health care costs (up to -38%). Also, we have shown that exercise improves body composition and lipid profile which are important risk factors to development of cardiovascular disease. So, exercise can lead to significant reduction in blood pressure medication use and, therefore, it causes cost savings, justifying the implementation of exercise programs in all healthcare units.

Gestão da atividade física no SUS: o processo de inserção do Programa de Exercícios Físicos em Unidades de Saúde no município de Rio Claro-SP : um estudo de caso

Pós-graduação em Ciências da Motricidade - IBRC

Avaliação dos efeitos do treinamento do exercício físico aeróbico de curta duração em pacientes hospitalizados com DPOC exacerbado

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Biomarcadores cardíacos em cães com degeneração mixomatosa da valva mitral submetidos a um programa de condicionamento físico

Pós-graduação em Medicina Veterinária - FCAV

Exercício físico e fatores de risco cardiovasculares em mulheres obesas na pós-menopausa

Introduction: physical exercise has been recommended as a non-pharmacological, therapeutic strategy in the treatment of important cardiovascular risk factors. Objective: to analyze the impact of an exercise program, tailored to the reality of the Family Health Units (FHU), on body composition, cardiovascular risk factors and Framingham score in obese postmenopausal. Methods: 70 women between 50 and 79 years, sedentary, obese and without menstruating for at least twelve months, were randomly assigned to a trained group (TG) (n = 35) and an untrained (GnT) (n = 35). The GT took 20 weeks of a physical exercise program with three weekly sessions, consisting of monitoring activities and heating (10 minutes), 25 minutes of exercise flexibility and strength, 50 minute walk with intensity between 50-65% of VO2max and 5-minute cool-down. The GnT was instructed to maintain their normal activities. Results: TG showed significant reductions in body mass index (30,1+3,7 vs. 29,3+3,7; p=0,0001), waist circumference (93,3+10,3 vs. 89,1+10,4; p=0,0001), percentage of fat (54,2+2,9 vs. 53,2+3,3; p=0,0001), systolic blood pressure (128,0+14,6 vs. 119,2+10,3; p=0,0001), triglycerides (148,4+66,1 vs. 122,8+40,7; p=0,006), VLDL cholesterol (29,7+13,2 vs. 24,5+8,0; p=0,005) and Framingham score (13,08+4,0 vs. 11,77+4,1; p=0,010). In the untrained group were observed significant increases in the percentage of fat (55,0+4,0 vs. 57,0+3,8; p=0,0001), systolic blood pressure (128,6+10,5 vs. 133,7+12,0; p=0,001), fasting glucose (95,2+18,4 vs. 113,7+28,8; p=0,001) and Framingham score (12,82+3,2 vs. 13,91+4,0; p=0,043), but also decreases levels of HDL cholesterol (55,1+10,5 vs. 51,7+11,0; p=0,017). Conclusion: the exercise program, adapted to the conditions of FHU, was effective in reducing cardiovascular risk factors in obese postmenopausal women served by the SUS program.

Indicadores antropométricos do estado nutricional entre idosas praticantes e não praticantes de exercício físico na zona norte de São José do Rio Preto-SP

Although the regular practice of physical exercise for the maintenance of the nutritional state and quality of life is important, it is not a common habit among the elderly, especially those of the lower income social bracket. The objective was to characterize and compare according to social-economic conditions and anthropometric indexes of the nutritional state of the elderly who regularly practice and those who do not practice exercises, offered at no cost, in the Northern zone of São José do Rio Preto-SP. In this study, 110 elderly women participated, of which 60 (group P) exercised regularly and 50 did not (group NP). Group P participated in a special gym program, free of charge, for at least 2 years, 2 to 3 times a week, one hour a day. Group NP was recruited from the same location as Group P. The comparison between the groups of elderly women was proportionately distributed according to marital status, level of education, means of locomotion, results of body mass index (IMC), waist to hip ratio (RCQ) and calf circumference, using the chi-square test. Comparisons were also made of average age, per capita family income, individual income, IMC, arm and triceps skin fold measured by t-Test. Differences were not found in all the comparisons made. The variables that stood out were the IMC (overweight) and RCQ (risk of chronic diseases) results, which were above what was expected, and the high frequency of walking and riding buses for both groups of elderly women (about 60%). We came to the conclusion that the low-intensity exercise program evaluated made no difference in the nutritional profi le of the elderly who also used walking as a means of getting around.

Avaliação funcional pré e pós programa de exercício físico de pacientes em hemodialise

Model Study: An experimental study Introduction: Chronic Kidney Disease (CKD) refers to a syndromic diagnosis which leads to a progressive and irreversible loss of renal function. A hemodialysis patient may have limitations in functional capacity, pulmonary function and respiratory musclular strength impacting in quality of life. Objective: To evaluate the effects of an exercise program on pulmonary function, functional capacity, quality of life and pain in patients undergoing hemodialysis. Methodology: The study included 28 patients of both genders, women and men aged between 40 and 60 years undergoing dialysis at the Kidney Institute, Santa Casa de Misericordia in Presidente Prudente-SP. Primary outcomes included respiratory muscular strength measurements assessed by manovacuometry. The functional capacity was evaluated by a six minute walking test. A life quality questionnaire was applied to evaluate quality of life (SF36-KDQOL). Lung function was evaluated by spirometry. Pain was assessed by a visual analogue scale. The exercise program consisted of training 3 times a week for 40 minutes on hemodialysis during eight weeks. At the end of the program all patients were reassessed. Results: There was no significant difference in the values of FVC and FEV1 before and after the exercise program as well as the index Tiffenau. The value of post MIP was significantly higher than the value obtained in the pre program. For variable MEP no significant difference was found. Functional capacity evaluations showed that there were no significant differences (p> 0.05). The evaluation of quality of life, about the domains of specific areas of CKD showed statistical significance when comparing the list of symptoms and problems with overloading of renal disease and professional role. Indicators related to pain were significantly reduced after the program (P <0.05). Discussion: A chronic kidney patient faces complex situations of physical, social and financial aspects. Although no statistically significant results were found in all variables, the study corroborates to others found in the literature, which suggests that an exercise program can be positive for this population. Conclusion: Although lung capacity and functional capacity did not submit changes to the end of the study, reduced levels of pain, fatigue and dyspnea suggest improvement in functional performance after exercise programs.

Impacto do exercício físico combinado na função diastólica de pacientes com insuficiência cardíaca e fração de ejeção reduzida

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

Background: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. Objective: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. Methods: The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). Results: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p<0.05). In the within-group comparison, there were differences in final heart rate and quadriceps and hamstring strength pre- and post-intervention in the exercise group (p<0.05). Conclusion: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women. Trial registration ACTRN12609001053213.

Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: a randomized trial

Context: Liposuction is suggested to result in long-term body fat regain that could lead to increased cardiometabolic risk. We hypothesized that physical activity could prevent this effect. Objective: Our objective was to investigate the effects of liposuction on body fat distribution and cardiometabolic risk factors in women who were either exercise trained or not after surgery. Design, Setting, and Participants: Thirty-six healthy normal-weight women participated in this 6-month randomized controlled trial at the University of Sao Paulo, Sao Paulo, Brazil. Interventions: Patients underwent a small-volume abdominal liposuction. Two months after surgery, the subjects were randomly allocated into two groups: trained (TR, n = 18, 4-month exercise program) and nontrained (NT, n = 18). Main Outcome Measures: Body fat distribution (assessed by computed tomography) was assessed before the intervention (PRE) and 2 months (POST2), and 6 months (POST6) after surgery. Secondary outcome measures included body composition, metabolic parameters and dietary intake, assessed at PRE, POST2, and POST6, and total energy expenditure, physical capacity, and sc adipocyte size and lipid metabolism-related gene expression, assessed at PRE and POST6. Results: Liposuction was effective in reducing sc abdominal fat (PRE vs. POST2, P = 0.0001). Despite the sustained sc abdominal fat decrement at POST6 (P = 0.0001), the NT group showed a significant 10% increase in visceral fat from PRE to POST6 (P = 0.04; effect size = -0.72) and decreased energy expenditure (P = 0.01; effect size = 0.95) when compared with TR. Dietary intake, adipocyte size, and gene expression were unchanged over time. Conclusion: Abdominal liposuction does not induce regrowth of fat, but it does trigger a compensatory increase of visceral fat, which is effectively counteracted by physical activity. (J Clin Endocrinol Metab 97: 2388-2395, 2012)

Modelado de sistemas de inteligencia ambiental para el entrenamiento de las cualidades físicas

En un ejercicio no extenuante la frecuencia cardíaca (FC) guarda una relación lineal con el consumo máximo de oxígeno (V O2max) y se suele usar como uno de los parámetros de referencia para cuantificar la capacidad del sistema cardiovascular. Normalmente la frecuencia cardíaca puede remplazar el porcentaje de V O2max en las prescripciones básicas de ejercicio para la mejora de la resistencia aeróbica. Para obtener los mejores resultados en la mejora de la resistencia aeróbica, el entrenamiento de los individuos se debe hacer a una frecuencia cardíaca suficientemente alta, para que el trabajo sea de predominio dinámico con la fosforilación oxidativa como fuente energética primaria, pero no tan elevada que pueda suponer un riesgo de infarto de miocardio para el sujeto que se está entrenando. Los programas de entrenamiento de base mínima y de base óptima, con ejercicios de estiramientos para prevenir lesiones, son algunos de los programas más adecuados para el entrenamiento de la resistencia aeróbica porque maximizan los beneficios y minimizan los riesgos para el sistema cardiovascular durante las sesiones de entrenamiento. En esta tesis, se ha definido un modelo funcional para sistemas de inteligencia ambiental capaz de monitorizar, evaluar y entrenar las cualidades físicas que ha sido validado cuando la cualidad física es la resistencia aeróbica. El modelo se ha implementado en una aplicación Android utilizando la camiseta inteligente “GOW running” de la empresa Weartech. El sistema se ha comparado en el Laboratorio de Fisiología del Esfuerzo (LFE) de la Universidad Politécnica de Madrid (UPM) durante la realización de pruebas de esfuerzo. Además se ha evaluado un sistema de guiado con voz para los entrenamientos de base mínima y de base óptima. También el desarrollo del software ha sido validado. Con el uso de cuestionarios sobre las experiencias de los usuarios utilizando la aplicación se ha evaluado el atractivo de la misma. Por otro lado se ha definido una nueva metodología y nuevos tipos de cuestionarios diseñados para evaluar la utilidad que los usuarios asignan al uso de un sistema de guiado por voz. Los resultados obtenidos confirman la validez del modelo. Se ha obtenido una alta concordancia entre las medidas de FC hecha por la aplicación Android y el LFE. También ha resultado que los métodos de estimación del VO2max de los dos sistemas pueden ser intercambiables. Todos los usuarios que utilizaron el sistema de guiado por voz para entrenamientos de 10 base mínima y de base óptimas de la resistencia aeróbica consiguieron llevar a cabo las sesiones de entrenamientos con un 95% de éxito considerando unos márgenes de error de un 10% de la frecuencia cardíaca máxima teórica. La aplicación fue atractiva para los usuarios y hubo también una aceptación del sistema de guiado por voz. Se ha obtenido una evaluación psicológica positiva de la satisfacción de los usuarios que interactuaron con el sistema. En conclusión, se ha demostrado que es posible desarrollar sistemas de Inteligencia Ambiental en dispositivos móviles para la mejora de la salud. El modelo definido en la tesis es el primero modelo funcional teórico de referencia para el desarrollo de este tipo de aplicaciones. Posteriores estudios se realizarán con el objetivo de extender dicho modelo para las demás cualidades físicas que suponen modelos fisiológicos más complejos como por ejemplo la flexibilidad. Abstract In a non-strenuous exercise, the heart rate (HR) shows a linear relationship with the maximum volume of oxygen consumption (V O2max) and serves as an indicator of performance of the cardiovascular system. The heart rate replaces the %V O2max in exercise program prescription to improve aerobic endurance. In order to achieve an optimal effect during endurance training, the athlete needs to work out at a heart rate high enough to trigger the aerobic metabolism, while avoiding the high heart rates that bring along significant risks of myocardial infarction. The minimal and optimal base training programs, followed by stretching exercises to prevent injuries, are adequate programs to maximize benefits and minimize health risks for the cardiovascular system during single session training. In this thesis, we have defined an ambient intelligence system functional model that monitors, evaluates and trains physical qualities, and it has been validated for aerobic endurance. It is based on the Android System and the “GOW Running” smart shirt. The system has been evaluated during functional assessment stress testing of aerobic endurance in the Stress Physiology Laboratory (SPL) of the Technical University of Madrid (UPM). Furthermore, a voice system, designed to guide the user through minimal and optimal base training programs, has been evaluated. Also the software development has been evaluated. By means of user experience questionnaires, we have rated the attractiveness of the android application. Moreover, we have defined a methodology and a new kind of questionnaires in order to assess the user experience with the audio exercise guide system. The results obtained confirm the model. We have a high similarity between HR measurements made of our system and the one used by SPL. We have also a high correlation between the VO2max estimations of our system and the SPL system. All users, that tried the voice guidance system for minimal and optimal base training programs, were able to perform the 95% of the training session with an error lower than the 10% of theoretical maximum heart rate. The application appeared attractive to the users, and it has also been proven that the voice guidance system was useful. As result we obtained a positive evaluation of the users' satisfaction while they interacted with the system. In conclusion, it has been demonstrated that is possible to develop mobile Ambient Intelligence applications for the improvement of healthy lifestyle. AmIRTEM model is the first theoretical reference functional model for the design of this kind of applications. Further studies will be realized in order to extend the AmIRTEM model to other physical qualities whose physiological models are more complex than the aerobic endurance.