Description and analysis of pulmonary rehabilitation care programs current state in four cities of Colombia

Purpose: there are many studies reporting the benefits of pulmonary rehabilitation, but few of them exhibit the behavior and activities of these services. This article presents the characteristics of services, parts management and training level of team members, in addition to the variables or instruments used to measure the effectiveness and impact in these programs. Method: it was made a cross sectional convenience sample which included seven pulmonary rehabilitation services in four Colombian cities (Bogotá, Medellín, Manizales and Cali), selected by the coverage, for having at least one year of experience and for being formally established and recognized nationwide. The interdisciplinary team of each service answered a survey that was validated through a pilot test and expert consensus. Participation was voluntary. Results: labor onset pulmonary rehabilitation services correspond to an average of a decade, with COPD and asthma pathologies of attention. The programs are characterized by an outpatient treatment with an average duration of eight to twelve weeks, with a frequency of an hour three times a week. Also, the director of the service is regularly a pulmonologist and the coordinator a physiotherapist (57.14%). The posgradual training of these professionals is notable, and they report to have procedural, administrative and communicative skills, but qualify regular there research skills. The physical and technological resources are well tested. 71.42% have done impact studies, but only 28.57% have been published. All have in common training in upper limbs, lower limbs, respiratory muscles, counseling, functional assessment and quality of life. The effectiveness and impact of programs is measured by the walking test, quality of life questionnaires and activities of daily living.

Niveles de actividad física, condición física y tiempo en pantallas en escolares de Bogotá, Colombia: Estudio FUPRECOL

Examina la relación entre los niveles de actividad física (AF) de forma objetiva, la condición física (CF) y el tiempo de exposición a pantallas en niños y adolescentes de Bogotá, Colombia.

Associação entre a aptidão cardiorrespiratória e a circunferência da cintura, pressão arterial, e glicemia em adolescentes

A relação entre aptidão cardiorrespiratória e um menor perfil de risco cardiovascular tem sido demonstrado em crianças e adolescentes (Janssen & Leblanc, 2010; 2006; Kriemler et al., 2008). Objetivo: verificar a associação entre o consumo máximo de oxigénio ( 2max) e a circunferência da cintura (CC), pressão arterial sistólica (PAS), pressão arterial diastólica (PAD) e glicemia em adolescentes utilizando a base de dados do projeto Rastresaúde. Método: este ro eto tin a co o ob etivo ava iar os rinci ais indicadores de sa de cardiovascu ar e inc u a as vari veis 2max A A e ice ia. ontudo nesse ro eto o 2max tinha sido obtido através do chester step test (CST) ue não estava va idado ara ado escentes. este sentido oi rea i ado u estudo re i inar co o ob etivo de estudar a associação entre va ores do 2max estimados utilizando o CST e o teste do Vaivém que está validado para adolescentes (Leger, Mercier, Gadoury, & Lambert, 1988). Pretendíamos com este objetivo poder eventualmente utilizar, os va ores do 2max da referida base de dados. endo-se veri icado u a associação estatistica ente si ni icativa orte e ositiva entre os va ores de 2max obtidos utilizando o CST e o teste Vaivém para o sexo masculino, r=0,92, p<0,05 e para o sexo feminino, r=0,78, p<0,05 decidimo-nos e a uti i ação da base de dados do astresa de. este sentido a re erida base de dados oi uti i ada ara investi ar a associação do 2max com a CC, PAS, PAD e glicemia em adolescentes. Resultados: verificou-se nos indivíduos do sexo feminino uma associação inversa e estatistica ente si ni icativa entre o 2max e a A r - 1 5 entre o 2max e a A r - 1 5 e entre o 2max e a CC, r=-0,182, p< 5. ara os indiv duos do se o ascu ino veri icou-se u a associação inversa e estatistica ente si ni icativa a enas entre o 2max e a CC, r=-0,229, p<0,05 sendo que todas as associações encontradas foram consideradas fracas, r<0,3 (Field, 2005). Conclusão: os resultados do estudo sugerem uma associação inversa entre o 2max e a PAS, PAD e CC em adolescentes do sexo feminino e entre 2max e a CC em adolescentes do sexo masculino. Dada a escassez de estudos e derivado ao aumento da prevalência dos fatores de risco associados às doenças cardiovasculares na infância e adolescência é relevante realizar mais estudos na população jovem.

Marcadores genéticos, antropometria e qualidades físicas básicas nos estágios maturacionais de nadadores paraibanos

The aim of this research was to analyse genetic markers, anthropometry and basic physical qualities in the differret stages of sexual maturation in swimmers in Paraíba. It is characterised as a descriptive cross sectional study. The sample was composed of 119 swimmers (males) that were divided among the stages of sexual maturation, from 7 to 17,9 years of age. They were associated to a local federation, the Confederação Brasileira de Desportes Aquáticos. The tests used were: genetic markers dermatoglyphics; Anthropometry body mass, stature, arm span, fat percentage and somatotype; physical qualities speed tests (25 meters crawl), strength (vertical jump) to inferior limbs, verarm throwing arremesso of a 2kg medicineball to superior limbs and abdominal), resistence (12 minutes to swimming), agility (he multistage 20-meter shuttle run test), flexibility (sit and reach test ) and coodination (stroke index); power of swimming (mean velocity in 25 meters mutiplied by body mass) and the self assessment of the sexual maturation supervised by a pediatric specialist. In the analyses we used the test normality of Shapiro-Wilk, then, we used ANOVA- one way followed by Post-Hoc test of Scheffé. The data showed in dermatogliphics a genetic tendence to velocity (L>W) with a predominance of the meso-ectomorphic somatotype profile; in relation to the physical qualities there was an evolution of the results in every stage due to the antropometric variables, except in the coordination tests. There were no significative differences between the stages. We conclude that swimming in Paraíba is composed of a signicative number of velocists with a mesomorph somatotype profile and low fat percentage, and that made it posssible to us to recomend that the trainings must be individual and according to personal characteristics of each athlete, and that the used variables must be specific for every region of the country. This dissertation presents a relation of multidiciplinar interface and its content has an application in Physical Education and Medicine

Técnica para avaliação da pressão arterial pulmonar de equinos durante o exercício progressivo em esteira rolante

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

O índice BODE reflete o nível de atividade física na vida diária de pacientes com DPOC?

Objectives: To study the relationship between the level of physical activity in daily life and disease severity assessed by the BODE index in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixty-seven patients with COPD (36 men) with forced expiratory volume in the first second (FEV(1)) of 39 (27-47)% predicted and age of 66 (61-72) years old were evaluated by spirometry, dyspnea levels (measured by the Medical Research Council scale, MRC) and by the 6-minute walking test (6MWT). The BODE index was calculated based on the body mass index (weight/height(2)), FEV(1), MRC and 6MWT, and then the patients were divided in four quartiles according to their scores (Quartile I: 0 to 2 points, n=15; Quartile II: 3 to 4 points, n=20; Quartile III: 5 to 6 points, n=23; Quartile IV: 7 to 10 points, n=9). Two activity monitors (DynaPort (R) and SenseWear (R)) were used to evaluate the level of physical activity in daily life. The Kruskal-Wallis test (Dunns's post-hoc test), the Mann-Whitney test and the Spearman Correlation Coefficient were used for statistical analysis. Results: There were modest correlation between the BODE index and the time spent walking per day, the total daily energy expenditure and the time spent in moderate and vigorous activities per day (-0.32 <= r <=- 0.47; p <= 0.01 for all variables). When comparing the pooled quartiles I+II with III+IV, there were significant difference between the time spent walking per day, the total daily energy expenditure and the time spent in moderate activities per day (p <= 0.05). Conclusion: The level of physical activity in daily life has a modest correlation with the classification of COPD severity assessed by the BODE index, reflecting only differences between patients with classified as mild-moderate and severe-very severe COPD.

Força muscular respiratória e capacidade funcional em idosas hipertensas com sonolência diurna excessiva

The restriction of physical fitness is directly related with hypertension and sleep disorders, while the respiratory muscle strength is associated with hypertension, but the literature is scarce regarding its relationship with sleep disorders and particularly with excessive daytime sleepiness. Objectives: To compare physical fitness and strength of respiratory muscles between people with hypertension with excessive daytime sleepiness (EDS) and non EDS people, those who do not feel excessive daytime sleepiness, in addition to relate aerobics resistance and functional mobility of patients. Methods: An observational, analytical and transversal study, evaluated 32 elderly with hypertension, divided into two groups (EDS and non EDS), in which the following topics were measured; respiratory muscular strength, functional fitness, level of physical activity, level of excessive daytime sleepiness, quality of sleep and intensity of the patients snoring. Results: There was a significant difference in the level of EDS (P=0,00) and quality of sleep (p=0,03), however, the data related to snoring intensity (p=0,18), maximum inspiratory pressure PImax (p=0,39) and maximum expiratory pressure PEmax (p=0,98) did not show any difference. Also, no significant difference was observed concerning physical fitness, presenting p=0,08 for the sitting and getting up test on the chair in 30 ; p=0,54 for the extension and flexing of the elbow test in 30 ; p=0,38 for the walking test 6 ; p=0,38 for the parking gear test 2 , p=0,08 for the sitting and reaching test; p=0,42 for the scratching the back test; p=0,49 for the getting up and walking test; and p=0,62 for the global rate of activity limitation. There was moderate positive correlation between 6MWT and 2MST, r=0,54 (p=0,01) and negative moderate correlation between 6MWT and TUG, r=-0,61 (p=0,000) and between 2MST and TUG, r=-0,60 (p=0,000). Conclusion: The presence of EDS in the hypertension people studied, showed a bad quality of sleep, however this sleepiness did not influence the strength of the respiratory muscles. The physical fitness came out diminished in all hypertension people, regardless of the presence or non presence of sleep disturbance; and there is a close relationship between cardiovascular resistance and physical mobility, since when there is less cardiovascular resistance, there is precarious physical mobility and vice-versa

Efeitos da respiração em freno-labial sobre os volumes pulmonares e o padrão de hiperinsuflação dinâmica em pacientes com asma

Objectives: To evaluate how to develop dynamic hyperinflation (DH) during exercise, the influence of pursed-lip breathing in (PLB) on breathing pattern and operating volume in patients with asthma. Methods: We studied 12 asthmatic patients in three moments: (1) anthropometry and spirometry, (2) submaximal incremental cycle ergometer test in spontaneous breathing and (3), submaximal incremental test on a cycle ergometer with PLB using the Opto-electronic plethysmography. Results: Evaluating the end-expiratory lung volume (EEV) during submaximal incremental test in spontaneous breathing, patients were divided into euvolume and hyperinflated. The RFL has increased significantly, the variation of the EEV group euvolume (1.4L) and decreased in group hyperinflated (0.272L). In group volume observed a significant increase of 140% in Vt at baseline, before exercise, comparing the RFL and spontaneous breathing. Hyperinflated group was observed that the RFL induced significant increases of Vt at all times of the test incremental baseline, 50%, 100% load and 66% recovery, 250%, 61.5% and 66% respectively. Respiratory rate decreased significantly with PLB at all times of the submaximal incremental test in the group euvolume. The speed of shortening of inspiratory muscles (VtRcp/Ti) in the hyperinflated increased from 1.6 ± 0.8L/s vs. 2.55 ± 0.9L/s, whereas in the RFL euvolume group ranged from 0.72 ± 0.31L/s vs. 0.65 ± 0.2L/s. The velocity of shortening of the expiratory muscles (VtAb/Te) showed similarity in response to RFL. In group hyperinflated varied vs. 0.89 ± 0.47 vs. 0.80 ± 0.36 and ± 1.17 ± 1L vs. 0.78 ± 0.6 for group euvolume. Conclusion: Different behavior in relation to EEV in patients with moderate asthma were observed, the HD and decreased EEV in response to exercise. The breathing pattern was modulated by both RFL performance as at home, making it more efficient

Comparação da cifose torácica e capacidade funcional de mulheres idosas com e sem osteoporose

A diminuição da densidade mineral óssea das vértebras, própria do processo de envelhecimento e que pode ser agravada pela osteoporose, determina uma diminuição da região anterior dos corpos vertebrais, resultando em compressão e colapso dessas vértebras, com maior estreitamento dos discos e espaços intervertebrais. Essas novas condições interferem no funcionamento normal de órgãos e sistemas do organismo. O objetivo foi avaliar o grau de cifose torácica e a capacidade funcional de mulheres idosas com e sem osteoporose. Foram avaliadas 30 idosas ativas fisicamente, sendo 20 sem osteoporose ( GSO: 65,1± 4,67 anos) e 10 idosas com osteoporose (GCO: 68,6± 6,46anos). Foram avaliados a medida da cifose torácica, teste de caminhada de seis minutos (TC6'), Timed Up and go (TUG) e força dos músculos respiratórios (PImáx e PEmáx). Os dados obtidos foram analisados utilizando o teste t de Student. O nível de significância utilizado foi de 5% (α£ 0,05). Houve diferença significativa entre os grupos sem (GSO) e com osteoporose (GCO) somente no TC6'(GSO: 426,63±46,36 m; GCO: 392,64±36,68 m , α =0,02). As outras variáveis analisadas não apresentaram diferença significativa (Cifose torácica: α = 0,17; TUG: α =0,49; PImax: α =0,45; PEmax: α =0,19). A osteoporose não influenciou o grau de cifose torácica, a força dos músculos respiratórios e mobilidade das idosas. Entretanto, o desempenho no TC6' foi influenciado negativamente pela osteoporose.

Physical fitness and associations with anthropometric measurements in 7 to 15-year-old school children

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of the aerobic capacity on the validity of the anaerobic threshold for determination of the maximal lactate steady state in cycling

The maximal lactate steady state (MLSS) is the highest blood lactate concentration that can be identified as maintaining a steady state during a prolonged submaximal constant workload. The objective of the present study was to analyze the influence of the aerobic capacity on the validity of anaerobic threshold (AT) to estimate the exercise intensity at MLSS (MLSS intensity) during cycling. Ten untrained males (UC) and 9 male endurance cyclists (EC) matched for age, weight and height performed one incremental maximal load test to determine AT and two to four 30-min constant submaximal load tests on a mechanically braked cycle ergometer to determine MLSS and MLSS intensity. AT was determined as the intensity corresponding to 3.5 mM blood lactate. MLSS intensity was defined as the highest workload at which blood lactate concentration did not increase by more than 1 mM between minutes 10 and 30 of the constant workload. MLSS intensity (EC = 282.1 ± 23.8 W; UC = 180.2 ± 24.5 W) and AT (EC = 274.8 ± 24.9 W; UC = 187.2 ± 28.0 W) were significantly higher in trained group. However, there was no significant difference in MLSS between EC (5.0 ± 1.2 mM) and UC (4.9 ± 1.7 mM). The MLSS intensity and AT were not different and significantly correlated in both groups (EC: r = 0.77; UC: r = 0.81). We conclude that MLSS and the validity of AT to estimate MLSS intensity during cycling, analyzed in a cross-sectional design (trained x sedentary), do not depend on the aerobic capacity.

Correlações entre os níveis de L-carnitina plasmática, o estado nutricional e a função ventilatória de portadores de doença pulmonar obstrutiva crônica

OBJETIVO: Avaliar os níveis de L-carnitina livre no plasma, o estado nutricional, a função pulmonar e a tolerância ao exercício em pacientes com doença pulmonar obstrutiva crônica e verificar as correlações entre a composição corporal e as frações de L-carnitina no plasma. MÉTODOS: Quarenta pacientes entre 66,2±9 anos, com diagnóstico clínico de doença pulmonar obstrutiva crônica, foram divididos em dois grupos: G1, com índice de massa corporal menor que 20kg/m², e G2, com índice de massa corporal maior que 20kg/m². Foram mensurados os parâmetros espirométricos, a tolerância ao exercício no teste de caminhada, a força muscular respiratória, a composição corporal por meio da impedância bioelétrica e as dosagens da L-carnitina plasmática, através de amostras de sangue. RESULTADOS: Foram observados menores valores das variáveis espirométricas (p<0,01), da força muscular respiratória e dos níveis de L-carnitina nos pacientes do G1; porém, não houve diferença entre os grupos quanto à capacidade de realizar exercício físico dinâmico de baixa intensidade. Correlações significativas entre o percentual de gordura e os níveis de L-carnitina plasmática foram observadas nos pacientes (r=0,53 com p<0,002); sendo que, nos pacientes com índice de massa corporal menor que 18kg/m², essa relação aumentou (r<0,73 com p<0,01). CONCLUSÃO: Na doença pulmonar obstrutiva crônica, a desnutrição está associada tanto aos prejuízos da função pulmonar e da força muscular respiratória, quanto aos baixos níveis de L-Carnitina plasmática.

Maximal lactate steady state concentration independent of pedal cadence in active individuals

The maximal lactate steady state (MLSS) is defined as the highest blood lactate concentration that can be maintained over time without a continual blood lactate accumulation. The objective of the present study was to analyze the effects of pedal cadence (50 vs. 100 rev min(-1)) on MLSS and the exercise workload at MLSS (MLSSworkload) during cycling. Nine recreationally active males (20.9 +/- 2.9 years, 73.9 +/- 6.5 kg, 1.79 +/- 0.09 m) performed an incremental maximal load test (50 and 100 rev min(-1)) to determine anaerobic threshold (AT) and peak workload (PW), and between two and four constant submaximal load tests (50 and 100 rev min(-1)) on a mechanically braked cycle ergometer to determine MLSSworkload and MLSS. MLSSworkload was defined as the highest workload at which blood lactate concentration did not increase by more than 1 mM between minutes 10 and 30 of the constant workload. The maximal lactate steady state intensity (MLSSintensity) was defined as the ratio between MLSSworkload and PW. MLSSworkload (186.1 +/- 21.2 W vs. 148.2 +/- 15.5 W) and MLSSintensity (70.5 +/- 5.7% vs. 61.4 +/- 5.1%) were significantly higher during cycling at 50 rev min(-1) than at 100 rev min(-1), respectively. However, there was no significant difference in MLSS between 50 rev min(-1) (4.8 +/- 1.6 mM) and 100 rev min(-1) (4.7 +/- 0.8 mM). We conclude that MLSSworkload and MLSSintensity are dependent on pedal cadence (50 vs. 100 rev min(-1)) in recreationally active individuals. However, this study showed that MLSS is not influenced by the different pedal cadences analyzed.

Short-Term Effects of Using Pedometers to Increase Daily Physical Activity in Smokers: A Randomized Trial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Componente lento do V̇O2 em crianças durante exercício pesado de corrida: Análise com base em diferentes modelos matemáticos

The purpose of this study was to identify and quantify the magnitude of the slow component of VO2 (SC) in children during running exercise, performed at heavy intensity domain (75%Δ), using two different mathematical models: a) three-exponential model and; b) ΔVO2 6-3 min. Eight healthy male children (11.92 ± 0.63 years; 44.06 ± 13.01 kg; 146.63 ± 7.25 cm; and sexual maturity levels 1 and 2), not trained, performed in different days the following tests: 1) incremental running treadmill test to determine the peak oxygen uptake (VO2peak) and the lactate threshold (LT); and 2) two transitions from baseline to 75%Δ [75%Δ = LT + 0.75 x (VO2 peak - LT)] for six minutes on treadmill. The SC was determined by two models: a) three-exponential model (Exp3); and b) the VO2 difference between the sixth and the third exercise minute (ΔVO2 6-3min). The SC was expressed as the absolute (ml/min) and percent contribution (%) to the total change in VO 2. The SC values determined by model Exp3 (129.69 ± 75.71 ml/min and 8.4 ± 2.92%) and ΔVO2 6-3 min (68.69 ± 102.54 ml/min and 3.6 ± 7.34%) were significantly different. So, the SC values in children during running exercise performed at heavy intensity domain (75%Δ) are dependent of the analysis model (Exp3 x ΔVO2 6-3 min).