SUMMARY OBJECTIVE: The objective of the present study was to verify the indication of common mental disorder and changes in healthy lifestyle among individuals affected by coronavirus disease, as well as to evaluate if changes in healthy lifestyle are predictors of common mental disorder. METHODS: This descriptive, cross-sectional study employed an exploratory approach and quantitative methodology, using the Self-Reporting Questionnaire to assess the indication of common mental disorder and questions regarding healthy lifestyle during the pandemic. RESULTS: A total of 280 individuals affected by coronavirus disease, aged 18 years and above, participated in the study. The average indication for common mental disorder was 5.0±5.34. The average age was characterized by adults (41.24±14.03 years), with the majority being women (57.9%), White (51.4%), and those in stable relationships (55.7%). Worsening sleep quality (β==6.327; p<0.001) was the main predictor of common mental disorder, followed by female gender (β==2.814; p<0.001) and worsening dietary habits (β==2.227; p<0.012). CONCLUSION: These factors should be considered in the assessment of individuals affected by coronavirus disease to provide comprehensive care.

RESUMO Objetivo: Identificar as indicações de fisioterapia e avaliar as práticas fisioterapêuticas em pacientes com COVID-19 internados na UTI (em ventilação mecânica) ou na enfermaria (em respiração espontânea). Métodos: Questionário online, com 50 questões, respondido por fisioterapeutas que atendiam pacientes hospitalizados com COVID-19 no Brasil. Resultados: Dos 644 fisioterapeutas que iniciaram o questionário, 488 (76%) o concluíram. As principais indicações de fisioterapia relatadas como “muito frequente” e “frequentemente” tanto na UTI quanto na enfermaria pela maioria dos respondentes foram melhora da oxigenação (> 95%) e prevenção de complicações gerais (> 83%). Descondicionamento físico foi considerado uma indicação pouco frequente. Em comparação com as estratégias de mobilização, as intervenções respiratórias apresentaram grande variabilidade em ambos os setores de trabalho, e técnicas consideradas eficazes foram subutilizadas. As técnicas respiratórias mais utilizadas na UTI foram posicionamento (86%), recrutamento alveolar (73%) e compressão torácica expiratória forte e rápida (46%), enquanto, na enfermaria, as mais utilizadas foram posição prona ativa (90%), exercícios respiratórios (88%) e tosse assistida/dirigida (75%). As intervenções de mobilização relatadas por mais de 75% dos respondentes foram sedestação a beira leito, exercícios ativos e resistidos de membros superiores/inferiores, ortostatismo, deambulação e marcha estacionária. Conclusões: A indicação menos frequente de fisioterapia foi prevenção do descondicionamento, enquanto melhora da oxigenação foi a mais frequente. Observou-se grande variabilidade nas intervenções respiratórias em comparação com as terapias de mobilização, e há uma clara necessidade de padronização do tratamento fisioterapêutico respiratório para pacientes hospitalizados com COVID-19.

ABSTRACT Objective: To identify the indications for physiotherapy and to evaluate physiotherapy practices in patients with COVID-19 admitted to the ICU (on mechanical ventilation) or to the ward (spontaneously breathing). Methods: An online, 50-item survey was completed by physiotherapists who had been treating hospitalized patients with COVID-19 in Brazil. Results: Of the 644 physiotherapists who initiated the survey, 488 (76%) completed it. The main reasons for indications for physiotherapy in both settings reported as “very frequently” and “frequently” both in the ICU and the ward by most respondents were oxygenation improvement (> 95%) and prevention of general complications (> 83%). Physical deconditioning was considered an infrequent indication. When compared with mobilization strategies, the use of respiratory interventions showed great variability in both work settings, and techniques considered effective were underutilized. The most frequently used respiratory techniques in the ICU were positioning (86%), alveolar recruitment (73%), and hard/brief expiratory rib cage compression (46%), whereas those in the ward were active prone positioning (90%), breathing exercises (88%), and directed/assisted cough (75%). The mobilization interventions reported by more than 75% of the respondents were sitting on the edge of the bed, active and resistive range of motion exercises, standing, ambulation, and stepping in place. Conclusions: The least common reason for indications for physiotherapy was avoidance of deconditioning, whereas oxygenation improvement was the most frequent one. Great variability in respiratory interventions was observed when compared with mobilization therapies, and there is a clear need to standardize respiratory physiotherapy treatment for hospitalized patients with COVID-19.

Resumo Fundamento: Gráficos de recorrência (GR) permitem uma análise não linear da variabilidade de frequência cardíaca (VFC) e fornecem informações sobre o sistema nervoso autônomo (SNA). Objetivos: Avaliar se a mobilização precoce em pacientes submetidos a angioplastia coronária transluminal percutânea (ACTP) influencia os componentes quantitativos e qualitativos dos GR. Métodos: Um total de 32 participantes que foram submetidos a ACTP foram divididos entre um grupo de controle (GC - sem exercícios físicos) e grupo de mobilização precoce (GMP - com exercícios físicos) A frequência cardíaca batimento a batimento foi registrada utilizando um cardiofrequencímetro em ambos os grupos na admissão e na alta. Os índices lineares nos domínios de tempo e frequência foram analisados, bem como os índices não lineares obtidos pelos GR. O protocolo fisioterapêutico de mobilização precoce começou 12-18 horas após a ACTP. Um teste T não pareado bicaudal foi utilizado para as comparações, e p-valores <0,05 foram aceitos como significativos. Resultados: Ao comparar os dois grupos, na alta, o GMP apresentou um aumento no SDNN (23,55 ± 12,05 a 37,29 ± 16,25; p=0,042), índice triangular (8,99 ± 3,03 a 9,66 ± 3,07; p=0,014) e VLF (694,20 ± 468,20 a 848,37 ± 526,51; p=0,004), mas não apresentou alterações significativas na avaliação não linear. Além disso, na análise qualitativa dos GR, observou-se um padrão mais difuso e menos geométrico no GMP, indicando maior variabilidade, enquanto no GC, notou-se um padrão geométrico mais alterado. Conclusão: O protocolo de mobilização precoce promove uma melhoria no comportamento autonômico, conforme avaliado por VFC e GR, e pode ser considerado um procedimento útil para a melhor recuperação de pacientes submetidos a ACTP.

Abstract Background: Recurrence Plots (RP) enable a nonlinear analysis of Heart Rate Variability (HRV) and provide information on the Autonomic Nervous System (ANS). Objectives: To evaluate whether early ambulation in patients undergoing Percutaneous Transluminal Coronary Angioplasty (PTCA) influences the quantitative and qualitative components of RP. Methods: A total of 32 participants who underwent PTCA were divided into a Control Group (CG - no physical exercises) and an Early Ambulation Group (EAG – with physical exercises). Beat-to-beat heart rate was recorded using a heart rate monitor in both groups upon admission and discharge. The linear indices in the time and frequency domains were analyzed, and nonlinear indices were obtained through RP. The Early Ambulation Physical Therapy Protocol began 12-18 hours after PTCA. A two-tailed unpaired t-test was used for comparisons, and p-values < 0.05 were accepted as significant. Results: When comparing both groups, upon discharge, EAG showed an increase in SDNN (23.55 ± 12.05 to 37.29 ± 16.25; p=0.042), Triangular Index (8.99 ± 3.03 to 9.66 ± 3.07; p=0.014), and VLF (694.20 ± 468.20 to 848.37 ± 526.51; p=0.004), but without significant changes in the nonlinear evaluation. In addition, in the qualitative analysis of RP, a more diffuse and less geometric pattern was observed in EAG, indicating greater variability, while in CG, an altered and more geometric pattern was noted. Conclusion: The Early Ambulation Protocol promotes an improvement in autonomic behavior as evaluated by HRV and by RP, which can thus be considered a useful procedure for better recovery of patients undergoing PTCA.

Resumo O WHODAS 2.0 (World Health Organization Disability Assesment Schedule) é um instrumento criado pela OMS (Organização Mundial da Saúde) para medida de funcionalidade e deficiência, fundamentado no modelo biopsicossocial e totalmente amparado no arcabouço teórico-conceitual da CIF (Classificação Internacional de Funcionalidade, Incapacidade e Saúde). O objetivo deste artigo é validar a versão brasileira do WHODAS 2.0 para o uso em pessoas com HIV/AIDS. Participaram 100 pessoas com diagnóstico de HIV/AIDS. Foram utilizados dois instrumentos de avaliação, o WHODAS 2.0 na versão de 36 itens e o WHOQoL-HIV-Bref (World Health Organization Quality of Life em pessoas com HIV, versão abreviada). As propriedades psicométricas testadas foram consistência interna e validade de critério. A consistência interna foi adequada para todos os domínios, com exceção do domínio Atividades de Vida (α = 0,69) e Autocuidado (α = 0,32). A validade de critério foi adequada, com correlações moderadas aos domínios do WHODAS 2.0 com os domínios do WHOQoL-HIV-Abreviado. Os resultados indicaram o instrumento WHODAS 2.0 como válido para avaliação da funcionalidade de pessoas com HIV/AIDS. O uso dos dados do domínio de Autocuidado deve ser cuidadosamente considerado.

Abstract The WHODAS 2.0 (World Health Organization Disability Assessment Schedule) is an instrument developed by the WHO (World Health Organization) for functioning and disability assessment based on the biopsychosocial framework, fully supported by the theoretical-conceptual framework of the ICF (International Classification of Functioning, Disability and Health). To validate the Brazilian version of the WHODAS 2.0 for individuals with HIV/AIDS. 100 individuals with diagnosis of HIV/AIDS participated in the study. Two assessment instruments were used: the 36-item version of WHODAS 2.0 and the WHOQOL-HIV-BREF (World Health Organization Quality of Life assessment in persons infected with HIV, shorter version). The psychometric properties tested were internal consistency and criterion validity. Internal consistency was adequate for all domains, with the exception of Life Activities (α = 0.69) and Self-care (α = 0.32). Criterion validity was adequate, with moderate correlations between the WHODAS 2.0 and the WHOQOL-HIV-BREF domains. The results indicated the WHODAS 2.0 instrument as a valid tool for assessing functioning of individuals with HIV/AIDS. The use of data from the Self-care domain should be carefully considered.

Resumo O WHODAS 2.0 (World Health Organization Disability Assesment Schedule) é um instrumento criado pela OMS (Organização Mundial da Saúde) para medida de funcionalidade e deficiência, fundamentado no modelo biopsicossocial e totalmente amparado no arcabouço teórico-conceitual da CIF (Classificação Internacional de Funcionalidade, Incapacidade e Saúde). O objetivo deste artigo é validar a versão brasileira do WHODAS 2.0 para o uso em pessoas com HIV/AIDS. Participaram 100 pessoas com diagnóstico de HIV/AIDS. Foram utilizados dois instrumentos de avaliação, o WHODAS 2.0 na versão de 36 itens e o WHOQoL-HIV-Bref (World Health Organization Quality of Life em pessoas com HIV, versão abreviada). As propriedades psicométricas testadas foram consistência interna e validade de critério. A consistência interna foi adequada para todos os domínios, com exceção do domínio Atividades de Vida (α = 0,69) e Autocuidado (α = 0,32). A validade de critério foi adequada, com correlações moderadas aos domínios do WHODAS 2.0 com os domínios do WHOQoL-HIV-Abreviado. Os resultados indicaram o instrumento WHODAS 2.0 como válido para avaliação da funcionalidade de pessoas com HIV/AIDS. O uso dos dados do domínio de Autocuidado deve ser cuidadosamente considerado.

Abstract The WHODAS 2.0 (World Health Organization Disability Assessment Schedule) is an instrument developed by the WHO (World Health Organization) for functioning and disability assessment based on the biopsychosocial framework, fully supported by the theoretical-conceptual framework of the ICF (International Classification of Functioning, Disability and Health). To validate the Brazilian version of the WHODAS 2.0 for individuals with HIV/AIDS. 100 individuals with diagnosis of HIV/AIDS participated in the study. Two assessment instruments were used: the 36-item version of WHODAS 2.0 and the WHOQOL-HIV-BREF (World Health Organization Quality of Life assessment in persons infected with HIV, shorter version). The psychometric properties tested were internal consistency and criterion validity. Internal consistency was adequate for all domains, with the exception of Life Activities (α = 0.69) and Self-care (α = 0.32). Criterion validity was adequate, with moderate correlations between the WHODAS 2.0 and the WHOQOL-HIV-BREF domains. The results indicated the WHODAS 2.0 instrument as a valid tool for assessing functioning of individuals with HIV/AIDS. The use of data from the Self-care domain should be carefully considered.

Abstract Aim: To analyze whether the proposed physiotherapy protocol during hemodialysis (HD) increases knee extensor muscle strength, palmar grip strength, respiratory muscle strength, lung function, and functional capacity of individuals with Chronic Renal Insufficiency (CRI) on HD. Methods: A preliminary results study, in which physical therapy intervention was performed in 11 subjects (49.2 ± 8.6 years) with CRI on HD treatment. Initially, Heart Rate Variability (HRV) was collected, with the individual at rest, for 15 minutes, and later, HRV linear and non-linear analyses were performed using HRV Kubios Premium Software. The protocol was performed in the first two hours of the HD session, three times a week for eight weeks, consisting of respiratory exercises, aerobic exercises, and electrical stimulation associated with progressive resistive exercises. The variables evaluated were respiratory muscle strength, knee extensor muscle strength, palmar grip strength, lung function, and functional capacity. Student's t-tests for paired samples and Wilcoxon's tests for non-parametric samples were used considering a significance level of 5%. Results: There was a significant increase in expiratory muscle strength (p = 0,012; Cohen’s d = 0,59), knee extensor muscle strength (p = 0,025; Cohen’s d = 0,77), palmar grip strength (P = 0,001; Cohen’s d = 0,52) and functional capacity (P = 0,009; Cohen’s d = 0,83). Conclusion: The proposed protocol is effective in increasing knee extensor muscle strength, palmar grip strength, expiratory muscle strength, and functional capacity of individuals with CRI on HD.

RESUMO Visando avaliar a funcionalidade dos sujeitos com diabetes mellitus (DM) usando um modelo biopsicossocial, recomendado pela Organização Mundial de Saúde, e ancorado no arcabouço teórico-conceitual da Classificação Internacional de Funcionalidade, Incapacidade e Saúde, este estudo propôs a validação da versão brasileira do WHODAS 2.0 (World Health Organization Disability Assessment Schedule). A versão de 36 itens do WHODAS 2.0 foi aplicada a 100 sujeitos com DM. Como instrumentos auxiliares à validação, utilizou-se o instrumento Diabetes Quality of Life Measure (DQOL-Brasil) e a dinamometria. As propriedades psicométricas analisadas foram consistência interna (coeficiente Alfa de Cronbach) e validade externa - convergente e divergente (coeficiente de correlação de Spearman). A análise de consistência interna mostrou-se apropriada, à exceção do domínio “relações interpessoais”. A análise da validade externa confirmou as hipóteses de convergência esperadas na comparação dos domínios correlatos dos instrumentos auxiliares utilizados no processo de validação, exceto no domínio “atividades de vida” (WHODAS) com a dinamometria da mão esquerda. Conclui-se que a versão brasileira do instrumento WHODAS 2.0 é válida para aferição da funcionalidade nesses indivíduos.

ABSTRACT To evaluate the functioning of individuals with diabetes mellitus (DM) using a biopsychosocial model, recommended by the World Health Organization and sustained in the theoretical-conceptual framework of the International Classification of Functioning, Disability and Health (ICF), this study proposed validating the Brazilian version of WHODAS 2.0 (World Health Organization Disability Assessment Schedule). The 36-item version of WHODAS 2.0 was applied to 100 participants with DM as validation procedures, using the measurement of Diabetes Quality of Life Measure (DQOL-Brazil) and a dynamometry. The psychometric properties analyzed were internal consistency (Cronbach Alpha coefficient) and convergent and divergent external validity (Spearman correlation coefficient). The internal consistency analysis was appropriate, except for the “having a good relationship with people” domain in the alpha Cronbach coefficient. External validity analysis confirmed the convergence hypothesis between the correlate domains of the different tools. The exception was the “life activities” domain (WHODAS) with the left-hand dynamometry. The Brazilian version of the WHODAS 2.0 instrument is a valid instrument to assess the functioning of these individuals.

RESUMEN Para evaluar las limitaciones funcionales de las personas con diabetes mellitus (DM) utilizando un modelo biopsicosocial, recomendado por la Organización Mundial de la Salud y anclado en el marco teórico-conceptual de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud, este estudio propuso validar la versión brasileña de WHODAS 2.0 (World Health Organization Disability Assessment Schedule). La versión de 36 ítems de WHODAS 2.0 se aplicó a 100 participantes con DM. Como procedimientos auxiliares de validación, se utilizaron la Diabetes Quality of Life Measure (DQOL-Brasil) y la dinamometría. Las propiedades psicométricas analizadas fueron la consistencia interna (coeficiente alfa de Cronbach) y la validez externa convergente y divergente (coeficiente de correlación de Spearman). El análisis de la consistencia interna fue apropiado, excepto en el dominio “llevarse bien con las personas” en el coeficiente alfa de Cronbach. El análisis de validez externa confirmó la hipótesis de convergencia entre los dominios correlacionados de las diferentes herramientas. La excepción fue el dominio “actividades de la vida” (WHODAS) con la dinamometría izquierda. Se concluye que la versión brasileña del WHODAS 2.0 es un instrumento válido para evaluar el funcionamiento de estos individuos.

Resumo Introdução: A doença renal crônica e a hemodiálise normalmente têm um impacto na funcionalidade. Objetivo: Validar a versão brasileira do World Health Organization Disability Assessment Schedule - WHODAS 2.0 em indivíduos com doença renal crônica em tratamento de hemodiálise. Métodos: A versão de 36 itens foi aplicada por entrevista em 51 indivíduos com doença renal crônica submetidos a tratamento de hemodiálise. Para verificar a aplicabilidade do instrumento, sua consistência interna e estabilidade teste-reteste foram estudadas. Para verificar a validade, a análise convergente/divergente foi realizada. Resultados: Os participantes responderam às perguntas do instrumento principal em dois momentos distintos no tempo, e do instrumento abreviado sobre Qualidade de Vida da Organização Mundial de Saúde e do questionário Qualidade de Vida com Doença Renal - Short FormTM 1.3 uma vez cada u m. O coeficiente α de Cronbach foi apropriado em todos os domínios, exceto o domínio “Relações Interpessoais”. Os coeficientes teste-reteste estavam acima do valor recomendado (> 0,70). A análise de validade convergente e divergente também mostrou resultados consistentes pela avaliação dos coeficientes de correlação. Conclusão: O instrumento é válido e confiável. Este estudo apoia o uso do instrumento pela apresentação das suas propriedades psicométricas apropriadas. Sugerimos que alguns cuidados devem ser tomados especificamente nas questões sobre relações sexuais.

Abstract Introduction: Chronic kidney disease and hemodialysis normally have an impact on the functioning. Objective: To validate the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 in individuals with chronic kidney disease on hemodialysis treatment. Methods: The 36-item version was applied to interview 51 individuals with chronic kidney disease undergoing dialysis treatment. To ascertain the instrument’s applicability, its internal consistency and test-retest stability were studied. To check the validity, a convergent/divergent analysis was performed. Results: The participants answered the questions on the main instrument at two timepoints and on the World Health Organization Quality of Life Abbreviated instrument and the Kidney Disease Quality of Life - Short FormTM 1.3 once each. Cronbach’s α coefficient was appropriate in all domains except the “Getting along” domain. The test-retest coefficients were above the recommended value (> 0.70). Convergent and divergent validity analysis also showed consistent results by correlation coefficient assessment. Conclusion: The instrument is valid and reliable. This study supports the use of the questionnaire by presenting its appropriate psychometric properties. We suggest that some care should be taken specifically in the sexual questions of the “Getting along” domain.

Resumen Introducción: La enfermedad renal crónica y la hemodiálisis normalmente tienen un impacto en el funcionamiento. Propósito: Validar la versión brasileña del World Health Organization Disability Assessment Schedule - WHODAS 2.0 en individuos con enfermedad renal crónica en tratamiento de hemodiálisis. Métodos: La versión de 36 ítems se aplicó a 51 personas con enfermedad renal crónica sometidas a tratamiento de diálisis. Para determinar la aplicabilidad del instrumento, se estudió su consistencia interna y estabilidad test-retest. Para verificar la validez, se realizó el análisis convergente / divergente. Resultados: Los participantes respondieron las preguntas sobre el instrumento principal en dos puntos de tiempo y sobre el instrumento abreviado de calidad de vida de la Organización Mundial de la Salud y la calidad de vida de la enfermedad renal-Short FormTM 1.3 una vez. El coeficiente alpha de Cronbach fue apropiado en todos los dominios, excepto en el dominio “Getting along”. Los coeficientes de prueba-reprueba estaban por encima del valor recomendado (>0,70). El análisis de validez convergente y divergente también mostró resultados consistentes por la evaluación del coeficiente de correlación. Conclusión: El instrumento es válido y confiable. Este estudio apoya el uso del instrumento por presentación de sus las propiedades psicométricas apropiadas. Sugerimos que se tenga algo de cuidado específicamente en las cuestiones sexuales del dominio de la apropiación.

Introdução A prática de exercícios físicos é preconizada pelos profissionais da saúde para a prevenção de eventos cardiovasculares; para tal é importante que os praticantes sigam recomendações de profissionais qualificados. Objetivos Analisar os riscos cardiovasculares e a prática do exercício físico dos frequentadores de um parque público municipal. Materiais e métodos Foram avaliados por meio de questionário e exame físico, 110 frequentadores de um parque público municipal, sendo 60 homens e 50 mulheres com idade média de 48,8 ± 11,76 anos. O risco cardiovascular foi classificado de acordo com a Tabela Americana e a atividade física seguindo as recomendações da American College of Sports Medicine e da American Heart Association. Resultados Quanto à classificação do risco cardiovascular, 54% da população avaliada apresentou risco potencial e 31%, moderado. Quanto ao exercício físico praticado 58% foram considerados inativos, 14% ativos e 28% muito ativos. 90% não receberam orientações profissionais. Conclusão Os frequentadores do parque público apresentam risco cardiovascular e praticam exercício físico sem orientações individualizadas.

Introduction Physical exercise is recommended by health professionals for the prevention of cardiovascular events; for it is important that practitioners follow recommendations of qualified professionals. Objectives To analyze the cardiovascular risks and the physical exercise of regulars of a municipal public park. Materials and methods 110 regulars of a municipal public park were evaluated by questionnaire and physical examination, 60 men and 50 women with a mean age of 48.8 ± 11.76 years. Cardiovascular risk was classified according to the American Table and physical activity following the recommendations of the American College of Sports Medicine and the American Heart Association. Results Regarding the classification of cardiovascular risk, 54% of the studied population presented potential risk and 31% moderate. As for physical exercise, 58% were considered inactive, 14% active and 28% were very active. 90% received no professional guidelines. Conclusion The public park goers have cardiovascular risk and do exercise without individualized guidance.

The present study was carried out to evaluate the effect of statins associated with physical exercise (PE) in liver cells in dyslipidemic rats through cariometry. The animals were divided into six groups: animals subjected to a hypercholesterolemic diet (HD), simvastatin, with (G1) and without (G2) physical exercise (PE); HD submitted (G3) or not (G4) to PE, and commercial food diet (F) with (G5) and without (G6) PE. Histological analysis of the liver was performed by staining the slides with hematoxylin and eosin. The cariometric study included measuring the major and minor diameters of the hepatocytes nuclei. The Shapiro-Wilk test was also performed. To determine the differences among the groups, the Kruskal-Wallis Test with Dunn's post-test were conducted. The significance level was set at 5%. No difference was found in the hepatocytes nuclei between G5 and G6. When these groups were related with G3 and G4, reduced nuclei were observed. There was no difference between G1 and G6. The comparison between G6 and G2 showed that the nuclei in G2 were smaller. No difference was detected between G5 and G1. Changes were observed in the nuclei shape in G2 in comparison to G1. Considering G2 and G3, a decrease in the size of nuclei was observed in G3. On the other hand, G2 showed changes in shape in the comparative analysis with G4. The size and shape of G1 nuclei were larger than G3 as well as changes in shape were observed when compared to G4. G4 showed smaller nuclei than G3. Therefore, F, associated or not with the practice of PE, does not alter the size and shape of the hepatocytes nuclei; HD combined with sedentarism influences changes in the morphometric parameters of hepatocytes; and the association of simvastatin and PE seems to protect the hepatocytes nuclei with regard to HD.

As estatinas são utilizadas no tratamento das dislipidemias, com grande tolerância; no entanto, vários efeitos colaterais podem surgir, destacando-se miopatia. A prática regular do exercício físico (EF) produz modificações favoráveis no perfil lipídico; entretanto, pode gerar lesões musculares. OBJETIVO: Avaliar o efeito da associação entre exercício físico e estatinas na função muscular, pela análise histológica, em modelo experimental animal com dislipidemia. MÉTODOS: Foram utilizados 80 ratos machos Wistar, distribuídos em oito grupos, incluindo animais submetidos à dieta hipercolesterolêmica (DH), sinvastatina com (G1) e sem (G2) EF; DH e fluvastatina, com (G3) e sem EF (G4); alimentados com ração comercial (RC) na presença (G5) e ausência de (G6) EF; DH submetidos (G7) ou não (G8) a EF. A DH foi administrada por 90 dias, as estatinas e prática de EF em esteira rolante por oito semanas. Os animais foram sacrificados, e o músculo sóleo retirado para análise histológica. Aplicaram-se os testes t de Student pareado e análise multivariada, com nível significante para p < 0,05. RESULTADOS: As principais alterações histológicas encontradas foram fibras de diferentes diâmetros, atróficas, em degeneração, splitting, edema, infiltrado inflamatório. Essas alterações foram observadas em 90% dos animais do grupo G1, 80% do G2, 70% do G3, 30% do G4, 40% do G5 e 30% do G7. Nos grupos G6 e G8 identificaram-se fibras musculares com morfologia preservada. CONCLUSÕES: Na avaliação histológica muscular, a associação entre fluvastatina, sinvastatina e exercício físico acarreta alterações morfológicas com predomínio no uso da sinvastatina, variando de grau leve a grave, no músculo sóleo de ratos, induzidos pelos inibidores da HMG-CoA redutase.

Statins are used in the treatment of dyslipidemias with great tolerance; however, several side effects can arise, mainly myopathies. Regular practice of physical exercises (PE) produces beneficial alteration in the lipid profile, but it can result in muscular lesions. OBJECTIVE: to evaluate the effect of the association between physical exercise and statins in the muscular function through histological analysis in an experimental animal model with dyslipidemia. METHODS: 80 male Wistar mice, distributed in 8 groups, namely: animals submitted to a hypercholesterolemic diet (HD), symvastatin with (G1) and without PE (G2) ; HD and fluvastatin with (G3) and without PE (G4); fed with commercial food (CR) in the presence (G5) and absence of PE (G6); HD submitted (G7) or not (G8) to PE were used. The HD was administered statins and PE practice on treadmill for 90 days for 8 weeks. The animals were sacrificed, and the soleus muscle was removed for histological analysis. Paired t-tests and multivariate analysis were applied with significance level of p<0.05. RESULTS: The most important histological alterations found were fibers with different diameters and atrophic, with degeneration, splitting, edema and inflammatory infiltrate. These alterations were observed in 90% of animals from G1; 80% from G2; 70% from G3; 30% from G4; 40% from G5 and 30% from G7. In the G6 and G8 groups muscular fibers with preserved morphology were identified. CONCLUSION: In the muscular histological evaluation, the association of fluvastatin, symvastatin and physical exercise results in morphological alterations with predominance with the use of simvastatin, varying from a light to a high level, in the soleus muscle of mice, induced by HMG-CoA reductase inhibitors.

Physical exercise and statins, which are recommended for the treatment of dyslipidemia, are independently associated to the occurrence of muscle injury. The objective is analyze the effect of aerobic exercise associated to the use of simvastatin on the morphology of the gastrocnemius muscle. Thirty Wistar rats were divided into six groups, two of which received a standard diet (1 sedentary and 1 exercised) and four (1 sedentary with medication, 1 sedentary without medication, 1 exercised with medication, 1 exercised without medication) received a hypercholesterolemic diet (standard diet with the addition of cholesterol and coconut oil). Simvastatin (20 mg/Kg) was administered five days a week for eight weeks, together with aerobic training on a treadmill (9.75 m/min) for 60 minutes a day. The gastrocnemius muscle was removed, sliced, stained with Hematoxylin-Eosin and submitted to a histochemical reaction to determine mitochondrial activity. The data were analyzed using a paired t-test, analysis of variance and Scheffé's post hoc test (p<0.05). Greater histological alterations were found in the medicated and exercised animals, with a greater frequency of occurrence as well. The histochemical analysis revealed that the medicated groups had fibers with more intensive mitochondrial activity alongside fibers with an absence of reaction. The morphometric analysis revealed no significant differences between groups. It is suggested that simvastatin is a medication that leads to the occurrence of muscle injury and its administration in association with physical activity may exacerbate these injuries. This finding may be related to cellular respiration.

El ejercicio físico y las estatinas, son intervenciones recomendadas para el tratamiento de la dislipidemia y están independientemente asociadas con la ocurrencia de lesiones musculares. El objetivo fue analizar el efecto del ejercicio aeróbico asociado al uso de la sinvastatina en la morfología del músculo gastrocnemio. 30 ratas macho Wistar fueron divididos en 6 grupos, de los cuales 2 recibieron ración padrón, sedentarios, ejercitados y 4 recibieron dieta con alto nivel de colesterol, sedentarios con y sin medicamento, ejercitados con y sin medicamentos. La dieta fue elaborada a partir de una dieta padrón aumentada de colesterol y aceite de coco. La Sinvastatina (20 mg) fue administrada por 5 días por semana durante 8 semanas (20 mg/kg), junto al entrenamiento aeróbico en la estera (9,75 m/min) por 60 minutos por día. El músculo gastrocnemio colectado fue cortado y colorido por el método Hematoxilina-Eosina y sometido a una reacción histoquímica para verificar la actividad mitocondrial. Los datos fueron analizados utilizando el test t pareado, análisis de la variancia e Pos-Hoc de Scheffé, adoptándose p<0,05. Se verifico la presencia de alteraciones histológicas más significativas en los animales medicados y ejercitados, siendo también mayor la frecuencia de ocurrencia. El análisis histoquímica apunto que los grupos medicados presentaron fibras con actividad mitocondrial más intensa, al lado de fibras con pérdida de reacción. Los resultados de la morfometría no mostraron diferencias significativas entre los grupos estudiados. Se puede sugerir que la simvastatina es un medicamento que lleva a la ocurrencia de lesiones musculares e que su administración concomitante con la práctica de actividad física puede exacerbar estas lesiones, pudiendo tal hecho, estar relacionado con la respiración celular.

Physical exercise and statins, recommended interventions to dyslipidaemia treatment, are independently related to cardiomyocytes alterations, characterized by miocardic hypertrophy and apoptosis, respectively. Thus, the objective of the present study was to analyze the effects of statin and aerobic physical exercise association in the morphometric parameters of cardiac cell nucleus. 40 male rats adults were divided into four groups: exercised (DE); sedentary (DS), exercised and statin use (DES); sedentary and statin use (DSS). The animals received during the whole experimental period a hiperlipidic diet added 20% of coconut oil and 1.25% of cholesterol; after 30 days of its ingestión, a blood collection was made to verify the dyslipidaemia. Simvastatin (20 mg) was taken five days a week, during eight weeks. During this period, the animals exercised 60 minutes daily in the treadmill. After the last day of the protocol, the cardiac muscle was collected and maintained in liquid nitrogen (-180°C); the cuts were stained by Hematoxilin-Eosin method, and the cardiac fibers were submitted to the nuclear morphometric analyses. The data were analyzed using descriptive analyses, paired T test, Kruskal-Wallis test and Dunn post hoc test; for all analyses, it was adopted p<0.05. It was verified that the group receiving statin presented values statistically significant in comparison to the other groups, in the tridimensional and linear variables. The exercised and statin group, the values obtained in the morphometric analyses were similar to the control group. It is suggested that statins alone can cause alterations in the nucleus of cardiac cells that can be related to apoptosis occurrence and, when exercise is practiced associated to statin administration, the effects of statin can be reduced, what can be related to beneficial adaptations of cardiac mitochondrial in response to physical exercise, turning them more resistant to apoptotic stimuli.

El ejercicio físico y las estatinas, intervenciones recomendadas para tratamiento de la dislipidemia, están independientemente relacionadas con las alteraciones de los cardiomiocitos, que se caracterizan por hipertrofia miocárdica y apoptosis, respectivamente. El objetivo del presente estudio fue analizar los efectos de la asociación de estatinas y el ejercicio físico aeróbico en los parámetros morfométricos del núcleo de células cardíacas. 40 ratas macho adultas se dividieron en cuatro grupos: ejercitadas (DE); sedentarias (DS), ejercitadas y con uso de estatina (DES), sedentarias y con uso de estatina (DSS). Los animales recibieron durante todo el período experimental una dieta hiperlipidemica añadiendo 20% de aceite de coco y 1,25% de colesterol. Después de 30 días de su ingestión, se les extrajo sangre para verificar la dislipidemia. Los ejemplares ingirieron Simvastatina (20 mg) cinco días a la semana, durante ocho semanas. Durante este período, los animales ejercitaron 60 minutos diarios en la rueda de andar. Después del último día del protocolo,los animales fueron sacrificados y se les extrajo músculo cardiaco que fue mantenido en nitrógeno líquido (-180°C). De este material se obtuvieron cortes que fueron teñidos por el método de hematoxilina-eosina y las fibras cardiacas fueron sometidas a análisis morfométrico nuclear. Los datos fueron analizados mediante el análisis descriptivo, prueba de la t de Student, prueba de Kruskal-Wallis y Dunn test post hoc. Para todos los análisis fue aprobado p <0,05. Se comprobó que el grupo que recibió estatinas presentó valores estadísticamente significativos en comparación con los otros grupos, en las variables lineales y tridimensionales. En el grupo ejercitado y estatina, los valores obtenidos de los análisis morfométricos fueron similares a los del grupo control. Se sugiere que las estatinas, por sí solas, pueden causar alteraciones en el núcleo de las células cardiacas las cuales pueden estar relacionadas con la ocurrencia de apoptosis y, cuando se practica ejercicio asociado a la administración de estatina, los efectos de las estatinas pueden reducirse, pudiendo resultar beneficioso, en relación con las adaptaciones en la respuesta mitocondrial cardiaca al ejercicio físico, convirtiéndose en más resistentes a los estímulos de apoptosis.