Relación entre la Actividad Física e Indicadores de Salud Mental / Relationship between Physical Activity and Mental Health Indicators

Resumen Introducción: Los avances científicos y tecnológicos del último siglo han promovido estilos de vida inactivos y nocivos para la salud humana, resultando en repercusiones tanto físicas como mentales que han terminado por acentuarse durante el confinamiento por la pandemia de COVID-19. Considerando a la actividad física como cualquier movimiento corporal producido por los músculos esqueléticos que exija gasto de energía se indagó su posible relación con los factores de estrés y ansiedad, al igual que su influencia sobre el autoconcepto y autoestima, dependiendo de las horas invertidas en la actividad física (considerando desde niveles sedentarios hasta ejercicio físico). Objetivo: Identificar la relación que tiene la actividad física con variables de la salud mental (el estrés, la ansiedad, el autoconcepto y la autoestima) en adultos jóvenes mexicanos. Método: Se utilizó una muestra no probabilística de 273 personas voluntarias, entre las edades de 18 a 25 años, quienes respondieron la Escala de Estrés Percibido, el Inventario de Ansiedad Rasgo-Estado, la Escala de Autoestima y el Listado de Adjetivos para la Evaluación del Autoconcepto en Adolescentes y Adultos. Resultados: Se llevó a cabo un análisis de correlación entre estrés y ansiedad, donde ambas variables mostraron significancia en la autoestima positiva, el autoconcepto físico y el autoconcepto emocional. El análisis de varianza mostró diferencias estadísticamente significativas en las variables de estrés, autoconcepto y autoestima total al compararse con algunos de los grupos. Los jóvenes sedentarios presentaron los niveles más altos de estrés, mientras que aquellos más físicamente activos mostraron mayor ansiedad. El grupo que realiza de 4 a 5 horas de ejercicio semanal presentó los niveles de autoconcepto y autoestima más altos. Discusión: La ansiedad mantiene una relación variable dependiendo de las horas dedicadas al ejercicio físico, mientras que el estrés se relaciona con el sentimiento de capacidad que la persona tiene de sí misma. El autoconcepto y autoestima se ven afectadas positivamente con la presencia de actividad física por un incremento de percepción de bienestar, control y salud emocional.

Abstract Introduction: The scientific and technological advances of the last century have promoted inactive and harmful lifestyles for human health, resulting in both physical and mental repercussions that have ended up being accentuated during the confinement due to the COVID-19 pandemic. Considering physical activity as any body movement produced by skeletal muscles that requires energy expenditure, its possible relationship with stress and anxiety factors was investigated, as well as its influence on the self-concept and self-esteem, depending on the hours invested in physical activity (considering from sedentary levels to physical exercise). Objective: To identify the relationship between physical activity and mental health variables (stress, anxiety, self-concept, and self-esteem) in young Mexican adults. Method: A non-probabilistic sample of 273 volunteers was used, between the ages of 18 and 25, who answered the Perceived Stress Scale, the Trait-State Anxiety Inventory, the Self-Esteem Scale and the List of Adjectives for the Evaluation of Self-concept in Adolescents and Adults. Results: A correlation analysis between stress and anxiety was carried out, where both variables showed significance in positive self-esteem, physical self-concept and emotional self-concept. The analysis of variance showed statistically significant differences in the variables of stress, self-concept and total self-esteem when compared to some of the groups. Sedentary youths reported the highest levels of stress, while those who were more physically active reported higher anxiety. The group that performs 4 to 5 hours of weekly exercise presented the highest levels of self-concept and self-esteem. Discussion: Anxiety maintains a variable relationship depending on the hours dedicated to physical exercise, while stress is related to the feeling of capacity that the person has of himself. Self-concept and self-esteem are positively affected by the presence of physical activity due to an increase in the perception of well-being, control and emotional health.

Parâmetros Ecocardiográficos Simples são Fortes Preditores de Risco Cardiovascular em Indivíduos Assintomáticos: Coorte Elsa-Brasil / Simple Echocardiographic Parameters are Strong Predictors of the Cardiovascular Risk in Asymptomatic Individuals: Elsa-Brasil Cohort

Resumo Fundamento vários estudos avaliam alterações ecocardiográficas como preditores de risco cardiovascular; entretanto, nenhum associa risco cardiovascular global com alterações ecocardiográficas em brasileiros. Objetivo Este estudo avalia a associação entre risco cardiovascular global (ASCVD) e achados ecocardiográficos como hipertrofia ventricular esquerda (HVE), disfunção diastólica (DDVE) e aumento do volume do átrio esquerdo (AE). Métodos A população foi composta por participantes do ELSA-Brasil que realizaram ecocardiografia entre 2008 e 2010 (n = 2.973). Eram assintomáticos e não tinham história de doença cardiovascular (DCV). O escore ASCVD foi calculado em dois períodos: 2008-2010 e 2012-2014. Razões de prevalência (RP) foram estimadas com intervalos de confiança (IC) de 95%. Resultados Evidenciou-se associação entre alterações ecocardiográficas e alto risco cardiovascular global (escore ASCVD ≥ 7,5) nos dois períodos do estudo, separadamente. O risco global combinado (baixo risco no primeiro período e alto risco no segundo período) teve associação significativa apenas com DDVE (RP = 3,68; IC 95%: 2,63-5,15) e HVE (RP = 2,20; IC 95%: 1,62-3,00). Conclusão Alterações ecocardiográficas (DDVE, HVE e aumento do volume do AE) são preditores independentes de risco cardiovascular em adultos brasileiros sem DCV prévias.

Abstract Background Several studies have evaluated echocardiographic abnormalities as predictors of cardiovascular risk; however, none have associated the global cardiovascular risk with echocardiographic abnormalities in the Brazilian population. Objective This study evaluates the association between the global cardiovascular risk (ASCVD score) and three echocardiographic abnormalities: left ventricular hypertrophy (LVH), left ventricular diastolic dysfunction (LVDD), and increased left atrium (LA) volume. Methods The study population was composed of participants from ELSA-Brasil who underwent echocardiography between 2008 and 2010 (n = 2973). They were asymptomatic and had no history of cardiovascular disease. The ASCVD score was calculated in two periods: 2008-2010 and 2012-2014. Prevalence ratios (PR) were estimated with 95% confidence intervals (CI). Results There is an association between echocardiographic abnormalities and high global cardiovascular risk (ASCVD score ≥ 7.5) in both study periods, separately. The combined global risk (low risk in the first period and high risk in the second period) was significantly associated only with LVDD (PR = 3.68, CI 95% 2.63-5.15) and LVH (PR = 2.20, 95% CI 1.62-3.00). Conclusion Echocardiographic abnormalities (LVDD, LVH, and increased LA volume) are independent predictors of cardiovascular risk in Brazilian adults.

Increased Maximal Expiratory Pressure, Abdominal and Thoracic Respiratory Expansibility in Healthy Yoga Practitioners Compared to Healthy Sedentary Individuals

Abstract Background Increasing thoracic expansion is effective at reducing blood pressure in hypertensive subjects. Yoga prescribes many respiratory techniques with a growing number of practitioners. However, very little is known whether sedentary or yoga practitioners show measurable differences in their respiratory patterns. Objective This study aims to demonstrate differences between healthy sedentary individuals and healthy yoga practitioners regarding maximal respiratory pressures and thoracic and abdominal respiratory expansibility. Methods Maximal inspiratory and expiratory pressures (MIP and MEP, respectively) were evaluated by manovacuometry, while respiratory expansion was assessed by the cirtometry of abdominal (CA), thoracic xiphoidal (CTX), and thoracic axillary (CTA) circumferences at rest (end expiratory moment) and at full inspiration in healthy sedentary individuals (SED) and yoga practitioners (YOGA). A delta derived from rest and full inspiration measures (ΔCA, ΔCTX, and ΔCTA, respectively), followed by a percentage of each item (ΔCA/CA, ΔCTX/CTX, and ΔCTA/CTA) was then calculated. Groups were compared by means of an unpaired Student's t-test, with a significance level p < 0.05. Results All respiratory expansion measures were significantly higher in in the YOGA group. A significantly higher MEP (cmH2O) was also detected in yoga practitioners: SED 89.3 ± 19.3 and YOGA 114.7 ± 24.8 ( p = 0.007), along with decreased heart rate at rest (bpm): SED 84±6 and YOGA 74±15 ( p = 0.001). Conclusions Yoga practitioners have shown greater thoracic and abdominal expansion and increased MEP, when compared to healthy sedentary individuals, as well as significantly lower heart rates at rest and body mass index (BMI). However, whether or not these findings are related to respiratory patterns is uncertain.

Breaks no tempo em comportamento sedentário e marcadores cardiometabólicos em adolescentes / Breaks in sedentary time and cardiometabolic markers in adolescents

Resumo Fundamento: Interrupções no tempo despendido em comportamento sedentário (breaks) têm sido associadas a melhores níveis de indicadores cardiometabólicos na população adulta. No entanto, em adolescentes, os achados sobre essa associação ainda são conflitantes. Objetivos: Analisar a associação do número de breaks por dia em comportamento sedentário com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário em adolescentes. Métodos: Estudo transversal com 537 adolescentes (52,3% do sexo feminino), de 10 a 14 anos de idade, de escolas públicas de João Pessoa (PB). O número diário de breaks em comportamento sedentário (>100 counts/minutos) foi mensurado por meio de acelerômetros (Actigraph GT3X+). Os marcadores cardiometabólicos analisados foram: pressão arterial sistólica e diastólica (mmHg), glicose de jejum, colesterol total, triglicerídeos, HDL-c, LDL-c (todos em mg/dL) e índice de massa corporal (IMC) (kg/m2). Utilizou-se a regressão linear para analisar a associação do número de breaks com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário. O nível de significância de p<0,05 foi adotado para todas as análises. Resultados: O número de breaks por dia se associou negativamente ao IMC (ß = −0,069; IC95%: −0,102; −0,035), mas não aos demais marcadores cardiometabólicos, e essa associação não foi moderada pelo estado nutricional dos adolescentes (p=0,221) e nem pelo tempo excessivo em comportamento sedentário (p=0,176). Conclusão: A inclusão de breaks no tempo em comportamento sedentário parece contribuir para valores mais baixos do IMC em adolescentes.

Abstract Background: The interruption of the time spent in sedentary behavior (breaks) has been associated with better levels of cardiometabolic indicators in the adult population, but in adolescents, further investigations are still needed to confirm these findings. Objectives: To analyze the association of the number of breaks per day in sedentary behaviors with cardiometabolic markers and whether it was moderated by nutritional status and excessive time on sedentary behavior in adolescents. Methods: This is a cross-sectional study of 537 adolescents (52.3% girls), aged between 10 and 14 years, enrolled in public schools in the city of João Pessoa, Paraíba state, Brazil. The number of daily breaks (>100 counts/minutes) in sedentary time was measured by Actigraph GT3X+ accelerometers. The following cardiometabolic markers were analyzed: systolic and diastolic blood pressure (mmHg), fasting blood glucose levels, total cholesterol, triglycerides, HDL-c, LDL-c (all in mg/dL) and body mass index (BMI) (kg/m2). Linear regression was used to analyze the association between the number of breaks and cardiometabolic markers and whether this association was moderated by nutritional status and excessive time in sedentary behavior. The significance level of p<0.05 was adopted for all analyses. Results: The number of daily breaks was negatively associated with BMI (boys - ß = −0.083; 95%CI: −0.132; −0.034 and girls - ß = −0.115; 95%CI: −0.169; −0.061), but not with the remaining cardiometabolic markers. The number of breaks per day was negatively associated with BMI (ß = −0.069; 95% CI: −0.102; −0.035), but not with the other cardiometabolic markers and this association was not moderated by the adolescents' nutritional status (p=0.221), or by excessive time in sedentary behavior (p=0.176). Conclusions: Including breaks in sedentary time seems to contribute to lower BMI values in adolescents.

Physical Activity Level, Anthropometric and Cardiovascular Profile Among Students in Sergipe State Attending Public Schools

Abstract Background Cardiovascular diseases are the leading cause of mortality among adults. Evidence has shown that sedentary behaviors are the main preventable outcome, however, many sedentary children also become sedentary adults. Therefore, identifying potential risk factors as early as possible contributes to therapeutic success. Objective To achieve an anthropometric and cardiovascular mapping of school-age students from Sergipe State, Brazil. Methods A school-based cross-sectional study with a representative sample from public schools in the state of Sergipe (n= 4700). Anthropometric and blood pressure measurements were performed, and the Global School-based Student Health Survey was used to assess the physical activity level. An independent samples t-test was performed for all comparisons, and significance was established at 5% (p<0.05). Results Despite showing mean blood pressure values within reasonable limits (SBP = 114.1±12.4 mm Hg and DBP = 66.3±8.1 mm Hg), school-age students did not comply with global recommendations for health promotion. It was also observed a high rate of low body weight (42.6%), suggesting dietary compromises, which can interfere with the development of this population. In addition, only 7.3% of students met the minimum physical activity criteria proposed for maintaining their health status. Conclusion The findings of the present study emphasize the importance of maintaining Physical Education classes as an essential curricular component, since they provide several health benefits and ensure that this population reaches the minimum daily recommendations, preventing diseases in adult life. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Ejercicios de bajo impacto en prevención de complicaciones por inactividad física en niños con leucemia linfoblástica aguda / Low-impact exercises to prevent complications from physical inactivity in children with acute lymphoblastic leukemia / Exercícios de baixo impacto para prevenir complicações de inatividade física em crianças com leucemia linfoblástica aguda

La Organización Mundial de la Salud (OMS), en el año 2018 reporta a la leucemia linfoblástica aguda (LLA) como principal causa de mortalidad en niños y adolescentes en el rango de edad de 0 a 19 años, cada año se diagnostican 300.000 casos nuevos. OBJETIVO: determinar los efectos de los ejercicios de bajo impacto en la prevención de las complicaciones asociadas a la inactividad física en niños y niñas con Leucemia en el Hospital Oncológico SOLCA de la ciudad de Guayaquil. MATERIAL Y MÉTODOS: el alcance de la investigación es descriptivo, observacional con diseño no experimental y de corte transversal. Los datos fueron obtenidos mediante el test de Cpax y la escala de fatiga, aplicada a 57 pacientes. RESULTADOS: la evaluación por el test Cpax presentó que un 81% tenían una buena condición física y un 19% presentó una condición regular; en relación a la saturación de oxígeno post evaluación un 98% presentaron valores superiores a >90 y un 2% valores <90; con respecto a la fatiga inicial se reportó un 49% con fatiga moderada, 42% fatiga extrema, 4% fatiga leve, 4% sin fatiga y 2% con la peor fatiga mientras que en la post evaluación un 51% presentó fatiga moderada, 35% fatiga leve, 11% fatiga extrema, 4% sin fatiga y 0% sin el nivel máximo de fatiga. El resultado de la prueba Chi-Cuadrado sobre la comparación Cpax pre y post evaluación, fue de p <0.05 con un nivel de confianza del 99.9% por lo que se presentó una significancia. CONCLUSIÓN: se evidenció el efecto positivo del plan de ejercicios de bajo impacto aplicado en pacientes con LLA. (AU)

The World Health Organization (WHO), in 2018 reported acute lymphoblastic leukemia (ALL) as the main cause of mortality in children and adolescents in the age range from 0 to 19 years, each year 300,000 are diagnosed new cases. OBJECTIVE: to determine the effects of low-impact exercises in the prevention of complications associated with physical inactivity in boys and girls with Leukemia at the SOLCA Oncological Hospital in the city of Guayaquil. MATERIAL AND METHODS: the scope of the research is descriptive, observational with a non-experimental and cross-sectional design. The data were obtained using the Cpax test and the fatigue scale, applied to 57 patients. RESULTS: the evaluation by the Cpax test showed that 81% had a good physical condition and 19% had a regular condition; in relation to postevaluation oxygen saturation, 98% showed values higher than> 90 and 2% values <90; Regarding the initial fatigue, 49% were reported with moderate fatigue, 42% extreme fatigue, 4% mild fatigue, 4% without fatigue and 2% with the worst fatigue, while in the post-evaluation 51% presented moderate fatigue, 35 % mild fatigue, 11% extreme fatigue, 4% without fatigue and 0% without the maximum level of fatigue. The result of the Chi-Square test on the Cpax comparison before and after the evaluation was p <0.05 with a confidence level of 99.9%, therefore, a significance was presented. CONCLUSION: the positive effect of the low-impact exercise plan applied in patients with ALL was evidenced.(AU)

A Organização Mundial da Saúde (OMS), em 2018 relatou a leucemia linfoblástica aguda (LLA) como principal causa de mortalidade em crianças e adolescentes na faixa etária de 0 a 19 anos, a cada ano 300.000 novos casos são diagnosticados. OBJETIVO: determinar os efeitos dos exercícios de baixo impacto na prevenção de complicações associadas à inatividade física em meninos e meninas com leucemia no Hospital SOLCA Oncológico da cidade de Guayaquil. MATERIAL E MÉTODOS: o escopo da pesquisa é descritivo, observacional com um desenho não experimental e transversal. Os dados foram obtidos por meio do teste Cpax e da escala de fadiga, aplicados em 57 pacientes. RESULTADOS: a avaliação pelo teste Cpax mostrou que 81% apresentavam boa condição física e 19% regularidade; em relação à saturação de oxigênio pós-avaliação, 98% apresentaram valores superiores a> 90 e 2% valores <90; Em relação à fadiga inicial, 49% foram relatados com fadiga moderada, 42% fadiga extrema, 4% fadiga leve, 4% sem fadiga e 2% com a pior fadiga, enquanto na pós-avaliação 51% apresentaram fadiga moderada, 35% leve fadiga, 11% fadiga extrema, 4% sem fadiga e 0% sem o nível máximo de fadiga. O resultado do teste Qui-Quadrado na comparação Cpax antes e após a avaliação foi p <0,05 com nível de confiança de 99,9%, portanto, houve significância. CONCLUSÃO: foi evidenciado o efeito positivo do plano de exercícios de baixo impacto aplicado em pacientes com LLA.(AU)

Prevalencia en diabetes y factores de riesgo en enfermedades discapacitantes / Prevalence in diabetes and risk factors in disabling diseases / Prevalência em diabetes e fatores de risco em doenças incapacitantes

La diabetes es una de las principales enfermedades metabólicas en la cual los niveles de glucosa se ven afectados debido a que el cuerpo no produce insulina suficiente, para controlar la glucosa proveniente de los alimentos, lo que deriva o desencadena en los distintos tipos de diabetes, como la diabetes mellitus tipo 1 (DM1) y la diabetes mellitus tipo 2 (DM2). OBJETIVO: determinar la prevalencia de diabetes y factores de riesgo en enfermedades discapacitantes METODOLOGIA: el trabajo de investigación tuvo un alcance descriptivo, corte transversal y un enfoque cuantitativo. Se utilizó el instrumento RFT5-33 como principal material de apoyo para la recolección de datos. RESULTADOS: se determinó que la prevalencia de diabetes fue de 23,6% dejando como muestra 172 familias, de las cuales se observó como factores de riesgo que el 70,6% realiza una escasa actividad física; el consumo de alcohol representa el 14,1% y en base a la alimentación se constató que el 14% se alimenta menos de 3 veces al día y el 15,1% no desayunan. CONCLUSION: los factores de riesgo que más afectaron a la comunidad San Eduardo fueron el sedentarismo, consumo de alcohol y mala nutrición.(AU)

Diabetes is one of the major metabolic diseases level are affected because the body does not produce enough insulin to control glucose from food, which derives or triggers different types of diabetes such as one or two. OBJECTIVE: determine the prevalence of diabetes and risk factors in disabled diseases. METHODOLOGY: the research work had a descriptive scope, nonexperimental design and a quantitative approach. The RFT 5-33 instrument was used as the main supporting material for data collection. RESULTS: the prevalence of diabetes was determined in 23.6%, leaving 172 families, of which 70.6% were observed as rick factors performing low physical activity; alcohol consumption was 14.1% and 14% were found to be fed less than 3 times a day and 15.1% were not eating breakfast. CONCLUSION: the risk factors that most affected the San Eduardo community were sedentarism, alcohol consumption, and poor nutrition.(AU)

O diabetes é uma das principais doenças metabólicas em que os níveis de glicose são afetados porque o corpo não produz insulina suficiente para controlar a glicose dos alimentos, o que leva ou desencadeia diferentes tipos de diabetes, como diabetes mellitus tipo 1 (DM1) e diabetes tipo 2 mellitus (DM2). OBJETIVO: determinar a prevalência de diabetes e os fatores de risco em doenças incapacitantes METODOLOGIA: o trabalho de pesquisa teve um escopo descritivo, transversal e com abordagem quantitativa. O instrumento RFT5-33 foi utilizado como principal material de apoio para a coleta de dados. RESULTADOS: constatou-se que a prevalência de diabetes foi de 23,6%, deixando como amostra 172 famílias, das quais se observou como fatores de risco que 70,6% realizam pouca atividade física; O consumo de álcool representa 14,1% e com base na alimentação, verificou-se que 14% comem menos de 3 vezes ao dia e 15,1% não tomam café da manhã. Conclusão: Os fatores de risco que mais afetaram a comunidade San Eduardo foram o sedentarismo, o consumo de álcool e a má alimentação. (AU)

Fibrilação Atrial (Parte 1): Fisiopatologia, Fatores de Risco e Bases Terapêuticas / Atrial Fibrillation (Part 1): Pathophysiology, Risk Factors, and Therapeutic Basis

Resumo A fibrilação atrial é a arritmia sustentada mais comum na prática clínica com predileção pelas faixas etárias mais avançadas. Com o envelhecimento populacional, as projeções para as próximas décadas são alarmantes. Além de sua importância epidemiológica, a fibrilação atrial é destacada por suas repercussões clínicas, incluindo fenômenos tromboembólicos, hospitalizações e maior taxa de mortalidade. Seu mecanismo fisiopatológico é complexo, envolvendo uma associação de fatores hemodinâmicos, estruturais, eletrofisiológicos e autonômicos. Desde os anos 1990, o estudo Framingham em análises multivariadas já demonstrou que, além da idade, a presença de hipertensão, diabetes, insuficiência cardíaca e doença valvar é preditor independente dessa normalidade do ritmo. Entretanto, recentemente, vários outros fatores de risco estão sendo implicados no aumento do número de casos de fibrilação atrial, tais como sedentarismo, obesidade, anormalidades do sono, tabagismo e uso excessivo de álcool. Além disso, as mudanças na qualidade de vida apontam para uma redução na recorrência de fibrilação atrial, tornando-se uma nova estratégia para o tratamento de excelência dessa arritmia cardíaca. A abordagem terapêutica envolve um amplo conhecimento do estado de saúde e hábitos do paciente, e compreende quatro pilares principais: mudança de hábitos de vida e tratamento rigoroso de fatores de risco; prevenção de eventos tromboembólicos; controle da frequência; e controle do ritmo. Pela dimensão de fatores envolvidos no cuidado ao paciente portador de fibrilação atrial, ações integradas com equipes multiprofissionais estão associadas aos melhores resultados clínicos.

Abstract Atrial fibrillation is the most common sustained arrhythmia in clinical practice, with a preference for older age groups. Considering population ageing, the projections for the next decades are alarming. In addition to its epidemiological importance, atrial fibrillation is evidenced by its clinical repercussions, including thromboembolic phenomena, hospitalizations, and a higher mortality rate. Its pathophysiological mechanism is complex and involves an association of hemodynamic, structural, electrophysiological, and autonomic factors. Since the 1990s, the Framingham study of multivariate analyses has demonstrated that hypertension, diabetes, heart failure, and valvular disease are independent predictors of this rhythm abnormality along with age. However, various other risk factors have been recently implicated in an increase of atrial fibrillation cases, such as sedentary behavior, obesity, sleep disorders, tobacco use, and excessive alcohol use. Moreover, changes in quality of life indicate a reduction in atrial fibrillation recurrence, thus representing a new strategy for excellence in the treatment of this cardiac arrhythmia. Therapeutic management involves a broad knowledge of the patient's health state and habits, comprehending 4 main pillars: lifestyle changes and rigorous treatment of risk factors; prevention of thromboembolic events; rate control; and rhythm control. Due to the dimension of factors involved in the care of patients with atrial fibrillation, integrated actions performed by interprofessional teams are associated with the best clinical results.