ABSTRACT This study aimed to analyze the effects of 12 weeks of a progressive resistance training (PRT) intervention on postural balance and concerns about falling in older adults. This study is a randomized controlled trial. Fifty men and women, community-dwelling older adults (aged 60 and older), were randomly assigned to a PRT (n= 25) or control group (n= 25). Participants allocated to the PRT performed a supervised RT program for 12-weeks (three times per week; three sets of 10-15 repetition maximum of nine whole-body exercises). Control group participants did not perform any structured exercise. Outcomes were obtained at baseline and follow-up and included postural balance assessment using the centre of pressure (CoP) variables. Concerns about falling and leg extension muscle strength were also evaluated using the falls efficacy scale international (FESI) and 1-RM, respectively. At the end of the intervention, PRT did not improve anteroposterior and mediolateral amplitude and velocity, and total velocity and area of CoP in any condition (bipodal, with eyes open and closed — p> 0.05 for all) or concerns about falling (mean difference: +1 point; 95%CI −2; +5). Conversely, compared with the control group, participants in the PRT demonstrated muscle strength gains in the leg extension exercise (+19 kg; 95%CI +3; +35) after the intervention. In summary, 12-weeks of PRT did not improve postural balance or concerns about falling in healthy older adults.

Abstract Aims: To verify the effects of flexibility training conducted at different intensities in young adults. Methods: Twenty-one (21) young adults of both genders with no history of surgery, fracture, and/or rheumatic diseases in the lower limbs and hip, were randomly assigned to low intensity (LI) or high intensity (HI) stretching groups. Two researchers were assigned to evaluate the active knee extension range of motion (ROM) of the volunteers and two other researchers were responsible for the training program. The training consisted of a single exercise for the hamstring muscles (biceps femoris, semimembranosus, semitendinosus). Each session consisted of three repetitions of passive static stretching, maintained for the 60s each, with 30s interval between them, and performed three times a week for four weeks. The stretching intensity was based on the Numerical Verbal Scale, the LI group maintained the intensity between 1 and 2, while the HI group between 9 and 10. Three ROM evaluations were performed pre-intervention, after the 6th session and at the end of the 12th session. Results: No difference was observed between the groups that underwent either high- or low-intensity programs. Both groups achieved gains in flexibility after four weeks of training. Conclusions: The study demonstrated that both high- and low-intensity stretching exercises are effective for ROM and there were no differences between them. Therefore, the intensity can be defined by the preference of the therapist or patient.

RESUMO Objetivo Analisar a eficácia do programa de mudança de comportamento Vida Ativa Melhorando a Saúde sobre parâmetros cardiovasculares em pacientes hipertensos. Métodos Noventa pacientes hipertensos ≥40 anos foram aleatoriamente randomizados em dois grupos: Vida Ativa Melhorando a Saúde (n=45) e Controle (n=45). O Grupo Vida Ativa Melhorando a Saúde participou de um programa de mudança de comportamento que objetiva motivar mudanças na atividade física e nos hábitos alimentares, de acordo com a teoria sociocognitiva. O programa foi conduzido em grupos, durante 12 semanas consecutivas, em encontros semanais (~90 minutos), conduzidos por um profissional de edução física e um nutricionista. Um capítulo do material didático era discutido em cada um desses encontros. O Grupo Controle participou de uma única palestra educativa sobre mudanças de estilo de vida. Medidas de pressão arterial braquial e central, rigidez arterial, e de função endotelial foram realizadas nos momentos pré e pós-intervenção. Resultados O Grupo Vida Ativa Melhorando a Saúde reduziu a pressão arterial sistólica braquial (de 131,3±15,8mmHg a 125,1±17,3mmHg; p<0,01) e central (de 123,6±16,3mmHg a 119,0±20,6mmHg; p=0,02) e a pressão arterial diastólica braquial (123,6±16,3mmHg a 119,0±20,6mmHg; p<0,01) e apresentou melhora na hiperemia reativa pós-oclusão (de 5,7±2,5mL·100mL−1a 6,5±2,1mL·100mL−1tecido·min−1; p=0,04). Não houve modificação na composição corporal, na frequência cardíaca e nem nos parâmetros de rigidez arterial em ambos os grupos (p>0,05). Conclusão O Programa Vida Ativa Melhorando a Saúde melhorou a pressão arterial e a reatividade microvascular em pacientes hipertensos. Registro do estudo: ClinicalTrials.gov: NCT02257268

ABSTRACT Objective To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. Methods Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. Results Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL−1 to 6.5±2.1mL·100mL−1 tissue·min−1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). Conclusion Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268

Abstract Aim: Resistance exercise (RE) is a widely accepted strategy to counteract the effects of aging and chronic diseases on health-related outcomes. Studies have been suggested that RE improves brain and cognitive health. RE with unstable devices (REI) is a neuromotor complexity strategy with the potential to improve strength, power, and balance in onder adults, however, their effects on neurocognitive function in individuals at risk of cognitive decline are poorly understood. Thus, we describe the REI study protocol, a randomized clinical trial design to assess the effects of 12-weeks of REI and RE on neurocognitive functions in older adults with subjective cognitive complaints. Methods: The sample will consist of individuals (aged 65 or older) with subjective cognitive complaints, who will be randomized in one of three experimental groups: control, RE or REI. Participants of the RE group will receive 12-weeks of progressive resistance training (seven exercises structured into 3 sets of 10-15 repetitions maximum, three times per week). Participants of the REI group will receive the same RE protocol performed on unstable devices that promote progressive instability. The control group received a health education program. The primary outcome is a composite score of neurocognitive functions. Secondary outcomes include each separately neurocognitive domain, functional performance, balance, falls-related parameters, cardiovascular and mood variables. The study results will provide information to design a future and larger preventive trial on populations at risk of cognitive decline and dementia, which is imperative in public health terms. Trial registration: Brazilian registry of clinical trials number RBR-4kqs22.

Resumo Objetivou-se avaliar a potencial relação entre a composição corporal (percentual de gordura (% gord.), massa gorda e massa magra), função muscular (i.e., músculos; deltoide anterior, deltoide lateral, peitoral maior e redondo maior) e a força propulsiva da braçada (FPB). Dezesseis surfistas competitivos (29,1 ± 7,3 anos, 1,72 ± 0,06 m, 74,2 ± 1,4 kg) tiveram a altura, massa corporal, composição corporal (dual-energy-DXA), função muscular e FPB avaliados. O coeficiente de correlação de Pearson foi empregado para avaliar a relação entre todas as variáveis. Foram observadas relações inversas entre a FPB e os parâmetros isocinéticos a 60°/s: rotação externa (pico de torque: r = -0,71; p = 0,014; trabalho total: r = -0,75; p = 0,007; potência: r = -0,72; p = 0,011) e rotação interna (pico de torque: r = -0,61; p = 0,045; trabalho total= r = -0,73; p = 0,010; potência: r = -0,61; p = 0,045) e 300o/s: rotação externa (pico de torque: r = -0,79; p = 0,003; trabalho total: r = -0,84; p<0,001; potência: r = -0,81; p = 0,002) e rotação interna (pico de torque: r = -0,69; p = 0,017; trabalho total: r = -0,72; p = 0,011; potencia: r = -0,69; p = 0,017). Não foram observadas correlações significativas entre os componentes da composição corporal e a FPB (p>0,05). Embora as correlações não impliquem em causa e efeito, a FPB não está correlacionada com a composição corporal em surfistas e estas relações são inversas com os parâmetros da função muscular.

Abstract This study aimed to evaluate the potential relationship between body composition (percentage of fat mass (FM %), fat mass and lean mass), muscle function (i.e., muscles; deltoid side and front, pectoralis major and teres major) and the propulsive force of the arm (PFA). Sixteen competitive surfers (29.1 ± 7.3 years; 1.72 ± 0.06 m; 74.2 ± 1.4 kg) were assessed for height, body mass, body composition (dual-energy-DXA), muscle function and PFA. Pearson correlation analyses were used to verify the relationship between all variables. An inverse correlations were found between PFA and isokinetic parameters to 60o/s: external rotation (peak torque: r = -0.71; p = 0.014; total work: r = -0.75; p = 0.007; power: r = -0.72; p = 0.011) and internal rotation (peak torque: r = -0.61; p = 0.045; total work: r = -0.73; p = 0.010; power: r = -0.61; p = 0.045) and 300o/s: external rotation (peak torque: r = -0.79; p = 0.003; total work: r = -0.84; p<0,001; power: r = -0.81; p = 0.002) and internal rotation (peak torque: r = -0.69; p = 0.017; total work: r = -0.72; p = 0.011; power: r = -0.69; p = 0.017). There was no significant correlation between body composition components and PFA (p>0.05). Although correlations do not imply cause and effect, PFA is not correlated with body composition in surfers and these relationships are inversely related to the parameters of muscle function.

RESUMO Objetivo: Investigar a associação entre parâmetros de variabilidade da frequência cardíaca (VFC) e atividades físicas de lazer e deslocamento em adolescentes do sexo masculino. Métodos: A amostra incluiu 1.152 adolescentes do sexo masculino com idades entre 14 e 19 anos. A variação dos batimentos cardíacos consecutivos (intervalos entre duas ondas R sucessivas - RR) foi avaliada, e calcularam-se os parâmetros da VFC no tempo (desvio padrão de todos os intervalos RR - SDNN, raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes - RMSSD, porcentagem dos intervalos RR adjacentes com diferença de duração maior que 50 ms - pNN50) e domínios de frequência (low frequency - LF/high frequency - HF). Informações sobre atividades físicas de lazer e deslocamento foram obtidas por meio de um questionário. Realizou-se regressão logística binária entre parâmetros de VFC e atividade física. Resultados: Foi descoberta associação entre atividades físicas de lazer e as variáveis SDNN, RMSSD e pNN50, mas não houve associação entre tais atividades e a razão LF/HF. Essas associações foram mais fortes entre adolescentes que se mantinham fisicamente ativos havia mais de seis meses. Atividades físicas de deslocamento não foram associadas a nenhum parâmetro de VFC. Jovens que praticavam atividades físicas de deslocamento e também se mantinham fisicamente ativos havia mais de seis meses apresentaram menor chance de ter baixa SDNN e RMSSD. Conclusões: Atividades físicas de lazer e de deslocamento foram associadas a melhor VFC, e tais associações foram reforçadas quando os adolescentes mantinham atividade física havia mais de seis meses. Atividade física de deslocamento não foi associada com os parâmetros da VFC, no entanto tal associação surgiu nos casos de adolescentes fisicamente ativos em atividades de deslocamento havia mais de seis meses.

ABSTRACT Objective: To investigate the association between heart rate variability (HRV) parameters with leisure time and commuting physical activities in adolescent boys. Methods: The sample included 1152 male adolescents aged 14 to 19 years. The variation of consecutive heart beats (RR intervals) was assessed and HRV parameters in time (SDNN, RMSSD, pNN50) and frequency domains (LF/HF) were calculated. Leisure time and commuting physical activities were obtained using a questionnaire. A binary logistic regression was performed between HRV parameters and physical activity. Results: Leisure time physical activity was associated with SDNN, RMSSD, pNN50, while LF/HF was not associated. These associations were stronger when adolescents were also physically active for more than six months. Commuting physical activity was not associated with any HRV parameter. Boys who practiced commuting physical activity and were also physically active for more than six months presented a lower chance of having low SDNN and RMSSD. Conclusions: Leisure time physical activity was associated with better HRV and these associations were enhanced when adolescents were physically active for more than six months. Commuting physical activity was not associated with HRV parameters; however, it became associated with better HRV when adolescents were physically active in commuting for more than six months.

Abstract Chikungunya, an alphavirus infection presenting with fever, rash, and polyarthritis, is most often an acute febrile illness. Neurologic complications of chikungunya infection have been reported. Here we report the clinical and neuroimaging data of 2 patients with chikungunya-associated encephalitis during the recent Brazilian epidemic.

Estudos vêm demonstrando que o exercício de força reduz a pressão arterial para níveis abaixo dos valores de repouso, entretanto este não é um achado universal. O número de repetições do exercício parece influenciar essas respostas. Assim, o objetivo do estudo foi analisar os efeitos do exercício de força realizado com repetições até a falha concêntrica sobre a pressão arterial de 24 horas em mulheres hipertensas. Treze mulheres hipertensas foram submetidas a três sessões experimentais em ordem aleatória: controle (C), exercício de força até a falha concêntrica (FC) e exercício de força com repetições até a redução da cadência (RC). Antes e 24 horas após as sessões as variáveis cardiovasculares - descenso noturno, ascensão matutina e presença ou não de padrão dipper - foram avaliadas por meio de monitorização ambulatorial da pressão arterial. Nos períodos diurno e noturno, não houve diferença significativa entre os três grupos. Entretanto, após FC e C, menos sujeitos apresentaram padrão dipper da pressão arterial (46% e 38%, respectivamente) do que quando comparado aos grupos RC (77%), p=0.047. Como conclusão, o FC atenuou a o padrão dipper da pressão arterial noturna em mulheres hipertensas.

Studies have shown that resistance exercise reduces 24-hour blood pressure to levels below resting values, although this is not a universal finding. The number of repetitions has been shown to influence this response. Thus, the aim of the study was to analyze the effects of resistance exercise performed until failure (UF) on 24-hour blood pressure in hypertensive women. Thirteen hypertensive women underwent three experimental sessions in random order: UF, resistance exercise with repetitions before concentric failure (BF) and control (C). Prior to and up to 24 hours after the sessions, cardiovascular variables, as well as the nocturnal fall in blood pressure, the morning surge, and the presence or absence of a blood pressure dip pattern were established using an ambulatory blood pressure monitor. In both wakefulness and sleep there was no significant difference among the three groups. However, after UF and C fewer patients presented a dip in blood pressure (46% and 38%, respectively) compared BF (77%), p=0.047. In conclusion, the UF attenuated blood pressure dips at night in hypertensive patients.

BACKGROUND: Sickle cell disease is a genetic, hereditary and chronic disease that affects the health of its carriers and might impair their health-related quality of life. OBJECTIVE: The aim of the current study was to assess the health-related quality of life of individuals with sickle cell disease followed at referral centers in Alagoas, Brazil. METHODS: A total of 40 individuals with sickle cell disease aged 12 to 43 years old were evaluated by means of sociodemographic and clinical questionnaires, the Medical Outcomes Study 36-Item Short Form Health Survey and the Beck Depression Inventory. The latter was applied only to adults. RESULTS: Most participants were adults (62.5%) with a predominance of the SS genotype (85%) with pain being the commonest complication (95%). Mood disorder was found in 40% of the adults. The patients exhibited overall impairment of quality of life, which was more pronounced among the adults and under 15-year-old adolescents. Married adults exhibited less impairment of most quality of life domains compared to unmarried adults, and the adults with mood disorder exhibited greater impairment of all quality of life domains. CONCLUSIONS: These results suggest that interventions that aim to improve vitality, pain, and mental health might contribute to maintaining high levels of quality of life in patients with sickle cell disease, especially among adults and under 15-year-old adolescents.

Objetivos: Detectar os principais achados fundoscópicos em crianças portadoras de hemoglobinopatias falciformes. Métodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Serviço de Oftalmologia do Hospital Universitário Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pré-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade média foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqüente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqüência da retinopatia por células falciformes foi maior após os 10 anos de idade, sendo mais freqüente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e "black sunburst" (7/26). Conclusões: Observamos que a incidência de retinopatia por células falciformes aumentou após os 10 anos de idade e não evidenciamos achados da doença proliferativa. Portanto, enfatizamos a necessidade do exame oftalmológico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicações oculares.

Purpose: To point out the main fundoscopic findings in children with sickle cell trait hemoglobinopathies. Methods: We studied 26 patients with sickle cell hemoglobinopathies in the ophthalmological ward at the Hospital Universitário Onofre Lopes, Natal, RN. The patients were submitted to a research questionnaire and the results were statistically evaluated by the chi² test. Results: The average age was 10,6 years, with visual acuity equal or better than 20/25 in the majority, except for three eyes which presented other associated pathologies. The most frequent type was SS in 57.7% (15/26) of cases, followed by SC e SA in 15.4% (4/26) each, and by S-Thal in 11.5% (3/26). The frequency of sickle cell retinopathy was higher after 10 years of age, being more frequent, in relative values, in type S-Thal (100%) and, in absolute values, in type SS (9 cases). The two most common findings were venous tortuosity (12/26) and "black sunburst" (7/26). Conclusion: We observed that the incidence of retinopathy in sickle cell increased with age over 10 years and no evidence of proliferative disease was found. Therefore, we emphasize the need for early ophthalmological examination in carriers of sickle cell disease as a form of preventing future complications.