Efeito de video games ativos sobre a capacidade funcional e o humor de idosos: revisão sistemática e meta-análise / Effect of active video games on functional capacity and mood in older adults: systematic review and meta-analysis

Nos últimos anos, os video games ativos (VGAs) têm sido utilizados pela população geral como uma alternativa para a prática de exercício físico associada ao entretenimento. O objetivo deste estudo foi realizar uma revisão sistemática sobre o efeito dos VGAs na capacidade funcional e no estado de humor de idosos. Para a seleção dos artigos, considerou-se estudos publicados entre 2006 e 2017, realizados com idosos (> 60 anos); que utilizaram como intervenção, exercícios realizados em VGAs Nintendo Wii ou Xbox Kinect. Os resultados observados sugerem melhoras no equilíbrio, na força muscular de membros inferiores e na mobilidade funcional. No perfil de humor, os resultados são controversos. Sendo assim, podemos concluir que o exercício realizado em VGAs pode melhorar a capacidade funcional, no entanto, os benefícios no humor precisam ser mais investigados, especial-mente em estudos de longo prazo.

In the last years, the active video games (AVGs) have been used by the general population as an alternative to exercise and entertainment. The aim of this study was to do a systematic review about the effects of AVGs on the functional capacity and the mood in older adults. We selected studies published between 2006 and 2017, with older adults (> 60 years) and only that had interventions with Nintendo Wii or Xbox Kinect. The results suggested improvements in the balance, muscle strength of lower limbs and functional mobility. In the mood profile, the results are controversial. We could conclude that AVGs exercising may improve functional capacity, however, the benefits in the mood, need further investigations, especially in the long-term studies.

Is exercise an alternative treatment for chronic insomnia?

The purposes of this systematic/critical review are: 1) to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2) to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary.

Tratamento não farmacológico para a insônia crônica / Nonpharmacologic treatment of chronic insomnia

O objetivo deste artigo é descrever, resumidamente, quais são as terapias não farmacológicas e também a atualização do uso destas para o tratamento da insônia crônica. Além da insônia ser o mais prevalente distúrbio do sono, ela está diretamente associada aos transtornos psiquiátricos. Embora o tratamento farmacológico seja o mais comumente utilizado, as terapias não farmacológicas vêm sendo amplamente estudadas, em particular as relacionadas às mudanças de comportamento. Entre estas estão a cognitiva; a higiene do sono; a do controle de estímulos; a de restrição do sono; a do relaxamento muscular; a da intenção paradoxal e, mais recentemente, a prática regular de exercícios físicos. Inicialmente, o principal objetivo dos estudos realizados com as intervenções comportamentais foi o de melhorar a qualidade do sono dos pacientes. No entanto, alguns estudos recentes têm sido desenvolvidos com o objetivo de avaliar o efeito de tais terapias auxiliando à redução da dose e da freqüência de uso de medicamentos utilizados, bem como à melhora da qualidade de vida dos pacientes. Como a insônia é um problema crônico, os tratamentos de longo prazo têm sido alvos de estudos e de uso comum entre os clínicos.

The purpose of this manuscript is to briefly describe the main modalities of non-pharmacological therapy and its utilization on the chronic insomnia treatment. Insomnia is the most frequent sleep disorder and that is more associated with psychiatry disorders. The pharmacotherapy is the most frequent treatment, but the nonpharmacologic therapy has been studied. The most common therapy modalities include behavioral approaches, stimulus control, sleep restriction, paradoxical intention, sleep hygiene, progressive muscle relaxation and biofeedback and, more recently, physical exercise practices. At first behavioral therapy aimed to improve sleep quality, however, recent studies have been emphasizing the effect of behavioral and cognitive approaches on quality of life, on decrease of dosage and frequency of drugs intake. Since insomnia is a chronic condition, long-term and safe treatments are warranted.