ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease. Objective selfreported self reported COVID19 COVID 19 COVID-1 Methods 9 53 (5 4 ie i e . 2020 followup follow up follow-up 2021. 2021 2021) telephone obtained Results 630 63 0 63.0 453 45 3 45.3 fatigue 739 73 73.9 849 84 84.9 time 239 23 23.9 396 39 6 39.6 activity respectively followup, up, (women 261 26 1 26.1 p<0.001 p0001 p 001 717 71 7 71.7% p=0.001 43 4.3 217 21 21.7% p=0.013 p0013 013 94 9.4 245 24 5 24.5% p=0.038. p0038 p=0.038 038 p=0.038) Conclusion Selfreported Self COVID1 COVID- 202 63. 45. 73. 8 84. 2 23. 39. 26. p<0.00 p000 00 71.7 p=0.00 4. 21.7 p=0.01 p001 01 9. 24.5 p003 p=0.03 03 20 p<0.0 p00 71. p=0.0 21. 24. p<0. p0 p=0. p<0 p=0 p< p=

ABSTRACT Objective: To analyze the association between the time spent in sedentary behavior and physical activity of different intensities with cardiovascular health in men and women with peripheral artery disease. Methods: Two hundred and sixty patients with peripheral artery disease and claudication symptoms (65.7% men; 66±1 years; ankle brachial index 0.57±0.18) were evaluated. Physical activity and sedentary behavior were assessed using an accelerometer. Physical activity was classified into light and moderate-vigorous intensities. The cardiovascular outcomes included blood pressure (oscillometric method), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave velocity). Results: Women spent more time engaged in light physical activity than men (341±14 min/day versus 306±9 min/day; p=0.040, respectively). There was no significant difference in the time spent on sedentary behavior and moderate-vigorous physical activity. Women had a higher systolic blood pressure (p=0.025), higher augmentation index (p<0.001), and lower sympathovagal balance (p=0.047) than men. Pulse wave velocity was only negatively associated with light physical activity (β= -4.66; 95%CI= -8.57; -0.76) in men. Light and moderate-vigorous physical activity and sedentary behavior were not associated with other cardiovascular outcomes. Conclusion: Higher levels of light physical activity were associated with lower arterial stiffness in men with peripheral artery disease. Objective Methods 65.7% 657 65 7 (65.7 661 66 1 66± years 0.57±0.18 057018 0 57 18 evaluated accelerometer moderatevigorous moderate vigorous oscillometric method, method , method) heart variability, variability variability) pulse velocity. . velocity) Results 341±14 34114 341 14 (341±1 minday min day 3069 306 9 306± p0040 p 040 p=0.040 respectively. respectively respectively) p=0.025, p0025 p=0.025 025 (p=0.025) p<0.001, p0001 p<0.001 001 (p<0.001) p=0.047 p0047 047 (p=0.047 β= β (β 4.66 466 4 -4.66 95CI CI 95 95%CI 8.57 857 8 -8.57 0.76 076 76 -0.76 Conclusion 65.7 6 (65. 0.57±0.1 05701 5 341±1 3411 34 (341± 30 p004 04 p=0.04 p002 p=0.02 02 (p=0.025 p000 p<0.00 00 (p<0.001 (p=0.04 4.6 46 -4.6 8.5 85 -8.5 0.7 07 -0.7 65. (65 0.57±0. 0570 341± 3 (341 p00 p=0.0 (p=0.02 p<0.0 (p<0.00 (p=0.0 4. -4. 8. -8. 0. -0. (6 0.57±0 057 (34 p0 p=0. p<0. (p<0.0 (p=0. -4 -8 -0 ( 0.57± 05 (3 p=0 p<0 (p<0. (p=0 - 0.57 p= p< (p<0 (p= 0.5 (p< (p

Resumo Avaliar a confiabilidade e a concordância intra-avaliador das avaliações da pressão arterial (PA), rigidez arterial e variabilidade da frequência cardíaca (VFC) em pacientes com doença de Parkinson (DP). Vinte pacientes com DP realizaram três visitas ao laboratório, durante as quais foram realizadas avaliações da PA braquial e central (tonometria de aplanação e auscultatório, respectivamente), rigidez arterial (velocidade da onda de pulso carotídeo-femoral e índice de aumento) e VFC em repouso. A PA sistólica braquial e central apresentou valores maiores na visita 1 quando comparada às visitas 2 e 3 (122±13 vs. 116±16 vs. 120±15, p=0,029). Não houve diferenças significativas (p>0,05) entre as visitas experimentais para outros parâmetros. A PA braquial e central apresentou um coeficiente de correlação intraclasse (CCI) acima de 0,842 e um erro padrão de medida (EPM) menor que 5,0%. Os gráficos de Bland–Altman indicaram baixa concordância entre as visitas 1 e 2 e boa concordância entre as visitas 2 e 3. Os índices de rigidez arterial exibiram valores de CCI entre 0,781 e 0,886, e o EPM variou de 7,3% a 25,2%. Os gráficos de Bland–Altman indicaram concordância moderada a boa entre as visitas para os parâmetros de rigidez arterial. Os índices de VFC apresentaram valores de CCI variando de 0,558 a 0,854 e valores de EPM que variam de 5,1% a 76,0%. Os gráficos de Bland–Altman indicaram concordância moderada entre as visitas para os parâmetros de VFC. Em pacientes com DP, a PA braquial e central apresenta baixa confiabilidade intra-avaliador e concordância entre as visitas 1 e 2 e boa confiabilidade intra-avaliador e concordância entre as visitas 2 e 3. Em geral, as avaliações de rigidez arterial e VFC apresentam confiabilidade intra-avaliador e concordância aceitáveis entre as visitas, exceto para o equilíbrio simpático-vagal cardíaco. intraavaliador intra avaliador PA, , (PA) (VFC DP. . (DP) laboratório tonometria auscultatório respectivamente, respectivamente respectivamente) velocidade carotídeofemoral carotídeo femoral aumento repouso 122±13 12213 122 13 (122±1 vs 11616 116 16 116±1 12015 120 15 120±15 p=0,029. p0029 p p=0,029 0 029 p=0,029) p>0,05 p005 05 (p>0,05 (CCI 0842 842 0,84 (EPM 50 5 5,0% BlandAltman Bland Altman 0781 781 0,78 0886 886 0,886 73 7 7,3 252 25 25,2% 0558 558 0,55 0854 854 0,85 51 5,1 760 76 76,0% geral simpáticovagal simpático vagal cardíaco (PA (DP 122±1 1221 12 (122± 1161 11 116± 1201 120±1 p002 p=0,02 02 p>0,0 p00 (p>0,0 084 84 0,8 5,0 078 78 0,7 088 88 0,88 7, 25,2 055 55 0,5 085 85 5, 76,0 122± (122 120± p=0,0 p>0, p0 (p>0, 08 8 0, 07 25, 76, (12 p=0, p>0 (p>0 (1 p=0 p> (p> ( p= (p

Abstract To assess the intrarater reliability and agreement of blood pressure (BP), arterial stiffness, and heart rate variability (HRV) assessments in patients with Parkinson`s disease (PD). Twenty patients with PD visited the laboratory three times, during which brachial and central BP (auscultatory and applanation tonometry, respectively), arterial stiffness (carotid-femoral pulse wave velocity and augmentation index), and HRV assessments were performed at rest. Brachial and central systolic BP presented greater values on visit 1 when compared to visits 2 and 3 (122±13 vs. 116±16 vs. 120±15, p=0.029). There were no significant differences (p>0.05) among the experimental visits for other parameters. Brachial and central BP showed an intraclass correlation coefficient (ICC) above 0.842 and a standard error of measurement (SEM) lower than 5.0%. Bland–Altman plots indicated low agreement between visits 1 and 2 and good agreement between visits 2 and 3. Arterial stiffness indices exhibited ICC values between 0.781 and 0.886, and SEM ranged from 7.3% to 25.2%. Bland–Altman plots indicated moderate to good agreement among visits for arterial stiffness parameters. HRV indices presented ICC values ranging from 0.558 to 0.854 and SEM values ranging from 5.1% to 76.0%. Bland–Altman plots indicated moderate agreement among visits for HRV parameters. In PD patients, brachial and central BP present low intrarater reliability and agreement between visits 1 and 2 and good intrarater reliability and agreement between visits 2 and 3. In general, arterial stiffness and HRV assessments present acceptable intrarater reliability and agreement among visits, except for cardiac sympathovagal balance. BP, , (BP) (HRV Parkinsons Parkinson s PD. . (PD) times auscultatory tonometry respectively, respectively respectively) carotidfemoral carotid femoral index, index index) rest 122±13 12213 122 13 (122±1 vs 11616 116 16 116±1 12015 120 15 120±15 p=0.029. p0029 p p=0.029 0 029 p=0.029) p>0.05 p005 05 (p>0.05 parameters (ICC 0842 842 0.84 (SEM 50 5 5.0% BlandAltman Bland Altman 0781 781 0.78 0886 886 0.886 73 7 7.3 252 25 25.2% 0558 558 0.55 0854 854 0.85 51 5.1 760 76 76.0% general balance (BP (PD 122±1 1221 12 (122± 1161 11 116± 1201 120±1 p002 p=0.02 02 p>0.0 p00 (p>0.0 084 84 0.8 5.0 078 78 0.7 088 88 0.88 7. 25.2 055 55 0.5 085 85 5. 76.0 122± (122 120± p=0.0 p>0. p0 (p>0. 08 8 0. 07 25. 76. (12 p=0. p>0 (p>0 (1 p=0 p> (p> ( p= (p

Resumo Contexto A pandemia do Coronavírus 2019 (COVID-19) tem afetado negativamente o comportamento da população. Nesse contexto, o impacto da pandemia da COVID-19 no tratamento medicamentoso dos pacientes com doença arterial periférica (DAP) e claudicação intermitente (CI) permanece obscuro. Objetivos Analisar o impacto da pandemia da COVID-19 no tratamento medicamentoso dos pacientes com DAP e CI. Métodos Neste estudo observacional transversal, 136 pacientes com DAP e CI, recrutados do nosso banco de dados, responderam por telefone um questionário envolvendo as seguintes questões: a) cuidados com a COVID-19; b) saúde global; c) tratamento das doenças. Posteriormente, os pacientes foram divididos em dois grupos, de acordo com a dificuldade para a aquisição dos medicamentos (DAM: dificuldade e SDAM: sem dificuldade), para a comparação da saúde global entre os dois grupos. Resultados Dezessete porcento dos pacientes reportaram dificuldades para a aquisição dos medicamentos durante a pandemia. Uma maior prevalência desses pacientes reportou estar mais triste (56,5% versus 24,8%, p < 0,01) e com mais dificuldades para dormir (56,5% versus 24,8%, p < 0,01) em relação aos pacientes do grupo SDAM. Os grupos não apresentaram diferenças para o declínio na capacidade de caminhada, ansiedade, estresse e depressão (p > 0,05). Conclusões Uma maior prevalência de pacientes do grupo DAM reportou estar mais triste e com mais dificuldade para dormir em comparação ao grupo SDAM durante a pandemia da COVID-19.

Abstract Background The Coronavirus 2019 (COVID-19) pandemic has had a negative impact on the population’s behavior. In this context, the effect of the COVID-19 pandemic on drug treatment of patients with peripheral arterial disease (PAD) and intermittent claudication (IC) remains unclear. Objectives To analyze the impact of the COVID-19 pandemic on drug treatment of patients with PAD and IC. Methods In this cross-sectional, observational study, 136 patients with PAD and IC were recruited from our database and answered a questionnaire by telephone involving the following questions: a) precautions related to COVID-19; b) general health status; and c) treatment of diseases. Subsequently, patients were divided into two groups according to difficulty in obtaining their drugs (DOD: difficulty obtaining drugs, or NDOD: no difficulty obtaining drugs) and overall health was compared between groups. Results Seventeen percent of patients reported difficulties with obtaining drugs during the pandemic. A higher proportion of these patients reported being sadder (56.5% vs. 24.8%, P < 0.01) and having more difficulty sleeping (56.5% vs. 24.8%, P < 0.01) than of the patients in the NDOD group (P <0.01). The groups did not differ in terms of impairment of walking capability, anxiety, stress, or depression (P> 0.05). Conclusions A higher proportion of patients in the DOD group reported being sadder and having greater difficulty sleeping compared to the NDOD group during the COVID-19 pandemic.

SUMMARY OBJECTIVE: To describe physical activity habits and barriers for physical activity practice in patients with peripheral artery disease and claudication symptoms during Coronavirus 2019 (COVID-19) pandemic. METHODS: In this cross-sectional survey study, 127 patients with peripheral artery disease (59.8% men; 68±9 years old; and 81.9% had the peripheral artery disease diagnosis ≥5 years old) were included. The physical activity habits and barriers for physical activity practice were assessed through telephone interview using a questionnaire with questions related to: (a) COVID-19 personal care; (b) overall health; (c) physical activity habits; (d) for those who were inactive, the barriers for physical activity practice. RESULTS: Only 26.8% of patients reported practicing physical activity during the COVID-19 pandemic. Exercise characteristics more common among these patients include walking, performed at least 5 days a week, during 31–60 min at light intensity. In contrast, among physically inactive patients, pain, injury or disability (55%), the COVID-19 pandemic (50%), the need to rest due to leg pain (29%), and lack of energy (27%) were the most frequent barriers to physical activity practice. CONCLUSION: The physical activity level of patients with peripheral artery disease is impacted by the COVID-19 pandemic.

RESUMO Objetivo: Avaliar os efeitos do treinamento resistido nas respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo em pacientes com doença de Parkinson. Métodos: Vinte e quarto pacientes com doença de Parkinson (estágios 2 a 3 de Hoehn e Yahr modificado) foram aleatoriamente randomizados em dois grupos: Controle e Treinamento Resistido. O Grupo Treinamento Resistido realizou, duas vezes por semana, cinco exercícios resistidos, duas a quatro séries, seis a 12 repetições máximas por série. O Grupo Controle manteve seu estilo de vida. No início e após 12 semanas, consumo de oxigênio, pressão arterial sistólica e frequência cardíaca foram avaliados em repouso e durante um teste de esforço cardiopulmonar máximo realizado em um cicloergômetro. As avaliações durante o exercício foram realizadas nas intensidades submáximas (a inclinação da regressão linear entre as variáveis fisiológicas e as cargas absolutas), nas intensidades submáximas relativas (limiar anaeróbico e ponto de compensação respiratória) e na intensidade máxima (pico do exercício). Adicionalmente, foi avaliada a força muscular. Resultados: Comparado com o início, o consumo de oxigênio pico aumentou, de forma semelhante, em ambos os grupos após 12 semanas. A frequência cardíaca e a pressão arterial sistólica avaliadas nas intensidades submáximas absolutas e relativas, assim como no pico do exercício, não se modificaram em nenhum dos grupos. Finalmente, diferente do Grupo Controle, a força muscular aumentou no Grupo Treinamento Resistido após 12 semanas. Conclusão: Em pacientes com doença de Parkinson sem comorbidades cardiovasculares, o treinamento resistido aumenta a força muscular, mas não modifica as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo.

ABSTRACT: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease. Methods: Twenty-four patients with Parkinson’s disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease without cardiovascular comorbidities.

INTRODUÇÃO: Devido à difusão dos benefícios da atividade física, muitas pessoas passaram a se exercitar em parques públicos, o que incentivou o surgimento de projetos que orientam a prática nestes locais. Estes projetos precisam avaliar a aptidão física de seus clientes com testes fáceis, cujos resultados são comparados a padrões de estadiamento. Porém, os padrões existentes não se adequam à população em questão. OBJETIVO: Construir tabelas de estadiamento para a avaliação da aptidão física de adultos e idosos. MÉTODOS: Foram utilizados os dados de 713 avaliações feitas em indivíduos de ambos os sexos e com mais de 20 anos. Foram avaliadas a aptidão cardiorrespiratória (marcha estacionária e Cooper), a capacidade muscular (flexão de cotovelo, impulsão vertical e resistência abdominal) e a flexibilidade (sentar e alcançar e flexibilidade de ombros). RESULTADOS: Foi avaliado o percentil 50 de cada teste: marcha estacionária = 105 passadas; Cooper = 1.200m; flexão de cotovelo = 20 rep; resistência abdominal = 18 rep; força de membros inferiores: 18cm; flexibilidade de ombros = 1cm e flexibilidade lombar = 23cm. Estes resultados foram maiores que os verificados nas tabelas originais, o que confirmou a necessidade da criação das tabelas específicas. CONCLUSÃO: Foram construídas sete tabelas separadas por gênero e faixa etária e com o desempenho classificado em: fraco - < que percentil 20; regular - entre 20 e 40; médio - entre 40 e 60; bom - entre 60 e 80; e ótimo - > que o percentil 80.

INTRODUCTION: Due to the spread of the health benefits of physical activity, many subjects began to exercise in public parks. This behavior promoted the creation of projects which stimulate and guide on physical activity practice. Nevertheless, for being considered effective, these projects need to evaluate the subjects' physical aptitude by applying easy tests, whose results are compared to classification tables. However, these tables are not adequate to the target population. OBJECTIVE: To design fitness classification tables based on simple fitness tests applied to adults and elderly subjects. METHODS: Data from 713 evaluations conducted with subjects of both genders older than 20 years were analyzed. Cardiorespiratory fitness (stationary gait and Cooper tests), muscle fitness (elbow flexion, vertical jump and abdominal resistance), and flexibility (sit and reach and shoulder flexibility) were evaluated. RESULTS: The 50 percentile for the tests were stationary gait = 105 steps; Cooper = 1200m; elbow flexion = 20 repetitions; abdominal resistance = 18 repetitions; legs strength =18 cm; shoulder flexibility = 1 cm; and lumbar flexibility = 23 cm. These results were higher than the original ones described for each test, which confirmed the need for specific classifications tables. CONCLUSION: Seven tables were designed with the results separated by gender and age group (20 to 80 year-olds divided in 10-year stages). Results were classified as: weak = < than 20 percentile; average= from 20 to 40 percentile; medium = from 40 to 60 percentile; good = from 60 to 80 percentile; and excellent = > than 80 percentile.

O processo de envelhecimento reduz drasticamente a massa, a força e a potência musculares, diminuindo a capacidade de execução das atividades da vida diária. A prática de exercícios resistidos pode reverter esse quadro, auxiliando na manutenção da massa muscular e melhorando sua força e resistência. No entanto, o envelhecimento ocasiona alterações cardiovasculares, que podem resultar em aumento nos níveis de pressão arterial de repouso, sendo importante analisar os efeitos do exercício resistido sobre a pressão arterial de indivíduos idosos. O objetivo deste estudo é avaliar o conhecimento científico existente sobre as respostas da pressão arterial aos exercícios resistidos e seus mecanismos em idosos. Para tanto, realizou-se uma revisão bibliográfica baseada nas literaturas portuguesa e inglesa relacionadas ao tema. Com base nos estudos encontrados, o corpus atual, embora escasso e controverso, sugere que, de forma crônica, os exercícios resistidos podem ter efeito hipotensor em indivíduos idosos. Entretanto, esse efeito ocorre, principalmente, em idosos normotensos e com o treinamento de baixa intensidade. Os mecanismos envolvidos nessa resposta hipotensora ainda precisam ser elucidados. Embora o treinamento resistido esteja sendo recomendado para idosos e haja alguns indicativos de que ele possa ter efeito hipotensor crônico, ainda há carência de dados científicos e muitas controvérsias sobre o assunto, o que evidencia que este ainda é um campo aberto à investigação.

The aging process drastically reduces muscle mass, strength and power, decreasing the capacity to perform the activities of daily living. The practice of resistance exercises can reverse this picture, helping to maintain the muscular mass and improving muscular strength and resistance. However, the aging process causes cardiovascular alterations, which can result in increased blood pressure levels at rest and it is important to analyze the effects of resistance exercises on the blood pressure of elderly individuals. The objective of this study is to evaluate the current scientific knowledge on the responses of the blood pressure to resistance exercises and their mechanisms in elderly individuals. In order to do that, we carried out a literature review related to the theme, in both Portuguese and English. Based on the studies found, the current corpus, although scarce and controversial, suggests that, chronically, resistance exercises can have a hypotensive effect on elderly individuals. However, this effect occurs mainly in normotensive elderly individuals submitted to low-intensity training. The mechanisms involved in the hypotensive response still need to be clarified. Although the resistance training is recommended for elderly individuals and there is some evidence that it can have a chronic hypotensive effect, there is still lack of scientific data and much debate on the subject, which demonstrates that this field is still open to investigation.

El proceso de envejecimiento reduce drásticamente la masa, la fuerza y la potencia muscular, disminuyendo la capacidad de ejecución de las actividades de la vida diaria. La práctica de ejercicios de resistencia puede revertir ese cuadro, auxiliando en la manutención de la masa muscular y mejorando su fuerza y resistencia. Mientras tanto, el envejecimiento ocasiona alteraciones cardiovasculares, que pueden resultar en aumento en los niveles de presión arterial de reposo, siendo importante analizar los efectos del ejercicio de resistencia sobre la presión arterial de individuos añosos. El objetivo de este estudio es evaluar el conocimiento científico existente sobre la respuesta de la presión arterial a los ejercicios de resistencia y sus mecanismos en añosos. Para esto, se realizó una revisión bibliográfica basada en la literatura portuguesa e inglesa relacionadas al tema. Con base en los estudios encontrados, el corpus actual, a pesar de ser escaso y controvertido, sugiere que, de forma crónica, los ejercicios de resistencia pueden tener efecto hipotensor en individuos añosos. Entre tanto, este efecto ocurre, principalmente en añosos normotensos y con entrenamiento de baja intensidad. Los mecanismos envueltos en esa respuesta hipotensora todavía precisan ser elucidados. Aunque el entrenamiento con resistencia esté siendo recomendado para añosos y haya algunos indicativos de que pueda tener efecto hipotensor crónico, todavía hay carencia de datos científicos y muchas controversias en el asunto, lo que evidencia que éste todavía es un campo abierto a la investigación.