Effects of bariatric surgery on muscle strength and quality: A systematic review and meta-analysis.

Obesity is a major health burden worldwide. Although bariatric surgery (BS) is recognized as an effective strategy for weight loss and comorbidities improvement, its impact on muscle strength and quality is still unclear. We aimed to examine postoperative changes in muscle strength and quality and their relationship with body mass index (BMI) changes among adults undergoing BS. To this end, we systematically searched the WoS, PubMed, EBSCO, and Scopus databases. The meta-analyses, which included 24 articles (666 participants), showed that BS reduces absolute lower-limb isometric strength (ES = -0.599; 95% CI = -0.972, -0.226; p = 0.002). Subjects who experienced a more significant reduction in BMI after BS also suffered a higher loss of absolute muscle strength. Similarly, absolute handgrip strength showed a significant decrease (ES = -0.376; 95% CI = -0.630, -0.121; p = 0.004). We found insufficient studies investigating medium- and long-term changes in muscle strength and/or quality after BS. This study provides moderate-quality evidence that BS-induced weight loss can reduce the strength of appendicular muscles in the short term, which should be addressed in management these subjects. More high-quality studies are needed to evaluate the impact of BS on muscle strength and the different domains of muscle quality in the medium and long term (registered on PROSPERO CRD42022332581).

Consideraciones Éticas y Académicas sobre el Uso de Inteligencia Artificial en Cursos de Metodología de la Investigación en Rehabilitación / Ethical and Academic Reflections on the Integration of Artificial Intelligence in Research Methodology Courses in Rehabilitation Science

En el cruce entre la revolución tecnológica y la educación en ciencias de la rehabilitación y del movimiento humano, la inteligencia artificial (IA) emerge como herramienta transformadora en los cursos de metodología de investigación. Este artículo destaca su potencial para optimizar la experiencia de aprendizaje y personalizar la instrucción, pero enfatiza la necesidad crucial de abordar desafíos éticos y pedagógicos. Propone orientaciones para equilibrar la innovación educativa y la responsabilidad académica, resaltando la importancia de la implementación consciente y planificada de la IA en los equipos de investigación en ciencias de la rehabilitación y del movimiento humano, garantizando así la integridad científica y ética en este campo en constante evolución.

In the intersection between technological advancements and education in rehabilitation science, artificial intelligence (AI) emerges as a transformative tool in research methodology. This article navigates the ethical and academic considerations tied to the incorporation of AI in rehabilitation and movement science courses. While acknowledging its potential to enhance learning experiences, it critically addresses the imperative to tackle ethical and pedagogical challenges. The paper offers guidance to strike a balance between educational innovation and academic responsibility. It emphasizes the need for a conscientious and planned implementation of AI, ensuring both scientific integrity and ethical adherence in this dynamically evolving field.

Effects of bariatric surgery on cardiorespiratory fitness: A systematic review and meta-analysis.

Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss, its impact on cardiorespiratory fitness (CRF) is still unclear. We aimed to examine postoperative changes in CRF (VO2max/peak ) and its relationship with weight loss among adults undergoing BS. We systematically searched the WoS, PubMed, MEDLINE, and Scopus databases. Observational and intervention studies were selected reporting the presurgery and postsurgery CRF, measured by breath-by-breath VO2 or its estimation. Eleven articles (312 patients) revealed that BS leads to a reduction in absolute VO2max/peak in the short term (effect size, ES = -0.539; 95%CI = -0.708, -0.369; p < 0.001), and those patients who suffered a more significant decrease in BMI after BS also had a greater loss of absolute VO2max/peak . However, VO2max/peak relative to body weight increased after surgery (ES = 0.658; 95%CI = 0.473, 0.842; p < 0.001). An insufficient number of studies were found investigating medium and long-term changes in CRF after BS. This study provides moderate-quality evidence that the weight loss induced by BS can reduce CRF in the short term, which represents a therapeutic target to optimize BS outcomes. More high-quality studies are needed to evaluate the impact of BS on VO2max/peak in the short, medium, and long term including normalized values for fat-free mass.

Respuesta a la prueba de caminata de seis minutos en niños con riesgo cardiovascular / Response to the six-minute walk test in children with cardiovascular risk

INTRODUCCIÓN: El riesgo cardiovascular (RCV) se define como la posibilidad que tiene un sujeto de sufrir una enfermedad cardiovascular dentro de un determinado plazo de tiempo. Si bien la patología se hace sintomatica en etapa adulta, los cambios fisiopatológicos comienzan a desarrollarse en edades tempranas. OBJETIVO: Establecer la relación entre capacidad cardiorrespiratoria, estimada a través de la prueba de caminata de seis minutos (PC6M), y el RCV en niños con síndrome metabólico. PACIENTES Y MÉTODO: Se analizaron 42 niños, edad 5 a 15 años, que asistieron a la Unidad de Cardiología Infantil del Hospital Carlos Van Buren entre los años 2015 y 2017. Cada participante se categorizó de acuerdo al puntaje de RCV de Alustiza, que define 3 niveles de riesgo: bajo (0 a 6 puntos), medio (7 a 8 puntos) y alto (9 o más puntos), lo que se traduciría en una mayor probabilidad de desarrollar una enfermedad cardiovascular, y realizó concomitantemente la PC6M. RESULTADOS: La edad media del grupo de ni ños fue de 10,9 ± 2,7 años, con un Índice de Masa Corporal (IMC) = 31,0 ± 4,6 kg/m2 (z-score 3,2 ± 0,7). Los niños recorren 75,2 ± 8,9 por ciento de la distancia teórica, con un porcentaje de frecuencia cardíaca de reserva (FCR) = 31,0 ± 9,4. No se observaron relaciones estadísticamente significativas entre RCV y PC6M. CONCLUSIONES: No se encuentra relación entre la capacidad cardiorrespiratoria y RCV. Se cuestiona la utilidad de la PC6M para valorar el RCV en la población de estudio.

INTRODUCTION: Cardiovascular risk (CVR) is defined as the possibility of a subject suffering from car diovascular disease within a certain period. Although the pathology appears in adult life, the physiopathological changes start to develop at an early age. OBJECTIVE: To establish the relationship bet ween cardiorespiratory capacity (CRC)and CVR in children with metabolic syndrome. PATIENTS AND METHODS: We analyzed data corresponding to 42 children aged from 5 to 15 years who were seen at the Children's Cardiology Unit of the Carlos Van Buren Hospital between 2015 and 2017. Each parti cipant was categorized according to the Alustiza's CVR score, which defines 3 levels of risk: low (0 to 6 points), medium (7 to 8 points) and high (9 or more points), which representing a greater probability of developing cardiovascular disease, and performed 6MWT. RESULTS: The mean age of the children was 10.9 ± 2.7 years, body mass index (BMI) = 31.0 ± 4.6 kg/m2 (z-score 3.2 ± 0.7), percentage of theoretical distance walked = 75.2 ± 8.9, and percentage of heart rate reserve (HRR) = 31.0 ± 9.4. There was no statistical association between 6MWT and CVR. CONCLUSIONS: There is no relationship between the cardiorespiratory capacity and the CVR. The use of the 6MWT is questioned as an ins trument to assess CVR in the population under study.

Improvements in Heart Rate Variability in Women with Obesity: Short-term Effects of Sleeve Gastrectomy.

PURPOSE: Obesity has been associated with reduced vagal function and increased sympathetic activity. Cardiac autonomic dysfunction has emerged as a major risk factor in the development of cardiovascular disease. Cardiac autonomic function (CAF) can be assessed by heart rate variability (HRV), an independent predictor of mortality based on changes in time intervals between adjacent heartbeats (RR). Bariatric surgery is considered the most effective treatment for obesity and its comorbidities, with sleeve gastrectomy (SG) being the most frequent bariatric procedure. There are few studies on HRV changes in women with obesity after SG. The aim of this study was to evaluate the short-term impact of SG on CAF and its relationship with weight loss. MATERIALS AND METHODS: An observational cohort study was conducted. Twenty-three female patients were assessed before SG and at 1 and 3 months after surgery. CAF was evaluated by analyzing HRV from 5-min records of RR intervals while the subject was supine. HRV was analyzed in time and frequency domains and with a nonlinear method. RESULTS: Patients (36.0 ± 11.1 years old, BMI 35.1 ± 3.4 kg/m2) presented higher HRV values, on average, in all domains both at 1 and 3 months after SG (p < 0.05). In addition, all anthropometric parameters improved (p < 0.001) although there was no relationship between HRV improvements and anthropometric changes. CONCLUSION: SG seems to be effective at reducing excess weight and improving HRV at the short term, and these changes are detectable as early as the first month after surgery. HRV assessment appears as a promising low-cost tool that deserves further research.

[Response to the six-minute walk test in children with cardiovascular risk]. / Respuesta a la prueba de caminata de seis minutos en niños con riesgo cardiovascular.

INTRODUCTION: Cardiovascular risk (CVR) is defined as the possibility of a subject suffering from car diovascular disease within a certain period. Although the pathology appears in adult life, the physiopathological changes start to develop at an early age. OBJECTIVE: To establish the relationship bet ween cardiorespiratory capacity (CRC)and CVR in children with metabolic syndrome. PATIENTS AND METHODS: We analyzed data corresponding to 42 children aged from 5 to 15 years who were seen at the Children's Cardiology Unit of the Carlos Van Buren Hospital between 2015 and 2017. Each parti cipant was categorized according to the Alustiza's CVR score, which defines 3 levels of risk: low (0 to 6 points), medium (7 to 8 points) and high (9 or more points), which representing a greater probability of developing cardiovascular disease, and performed 6MWT. RESULTS: The mean age of the children was 10.9 ± 2.7 years, body mass index (BMI) = 31.0 ± 4.6 kg/m2 (z-score 3.2 ± 0.7), percentage of theoretical distance walked = 75.2 ± 8.9, and percentage of heart rate reserve (HRR) = 31.0 ± 9.4. There was no statistical association between 6MWT and CVR. CONCLUSIONS: There is no relationship between the cardiorespiratory capacity and the CVR. The use of the 6MWT is questioned as an ins trument to assess CVR in the population under study.

Impacto de la gastrectomía vertical sobre la cinética de consumo de oxígeno en mujeres post cirugía bariátrica / Impact of sleeve gastrectomy on the kinetics of oxygen consumption in women after bariatric surgery

Introducción: La obesidad es considerada uno de los principales problemas de salud de la sociedad moderna, existiendo variados tratamientos para revertirla, siendo la cirugía bariátrica (CB) el método más efectivo en los casos de obesidad severa. La capacidad cardiorrespiratoria (CCR) es un componente de la condición física valorada a través del consumo máximo de oxígeno (VO2max); la cinética del VO2 es un aspecto poco estudiado de la CCR; se ha descrito que esta variable permite estimar la CCR sin elevados esfuerzos físicos en comparación con otras formas de evaluación; a pesar de lo anterior, no existe información respecto del impacto que tiene la gastrectomía vertical (GV) sobre la CCR evaluada a través de esta variable. Objetivo: Determinar el impacto de la GV en la cinética del VO2 de mujeres con obesidad. Material y método: Estudio de tipo cuasi experimental, participaron 15 mujeres con edad de 32,9±10,3 años y un IMC inicial de 35,2 ± 3,9 kg/m2. La muestra es de tipo no probabilística a través de grupo de voluntarios evaluados en tres momentos: previo a la cirugía (pre), 30 y 90 días post gastrectomía vertical (30post y 90post respectivamente). Se evaluó peso corporal, índice de masa corporal (IMC), circunferencia cintura (CC), VO2peak y cinética del VO2. Resultados: Post cirugía las variables peso corporal, CC e IMC reportan disminución significativa (p < 0,001) respecto del momento pre-cirugía. El VO2peak relativo (ml/kg/min) aumentó entre 30post y 90post (p < 0,001); el VO2peak absoluto (L/min) disminuyó entre los momentos pre con 30post y pre con 90post (p < 0,05); la cinética del VO2 presentó un incremento del tiempo a los 30post (p < 0,05). Conclusión: La cinética del VO2 se ve incrementada en mujeres obesas intervenidas con GV a los 30 días post cirugía, lo que evidencia un deterioro de la capacidad cardiorrespiratoria

Introduction: Obesity is considered one of the main health problems of modern society, there are several treatments to reverse it, being bariatric surgery (BS) the most effective method in cases of severe obesity. Cardiorespiratory fitness (CRF) is an aspect of physical condition assessed through maximum oxygen consumption (VO2max); the kinetics of VO2 is a less studied aspect of CRF; it has been described that this variable allows estimation of the CRF without high physical efforts in comparison with other forms of evaluation; In spite of the above, there is no information regarding the impact that sleeve gastrectomy (SG) has on the CRF evaluated through this variable.Objective: To determine the impact of SG on the VO2 kinetics of women with obesity. Material and method: Quasi-experimental study, 15 women with an age of 32,9 ± 10,3 years and an initial BMI of 35,2 ± 3,9 kg/m2 participated. The sample is non-probabilistic through a group of volunteers evaluated at three times: before surgery (pre), 30 and 90 days post vertical gastrectomy (30post and 90post respectively). Body weight, body mass index (BMI), waist circumference (WC), VO2peak and VO2 kinetics were evaluated. Results: After surgery, the variables body weight, CC and BMI reported a significant decrease (p < 0,001) compared to the pre-surgery moment. The relative VO2peak (ml/kg/min) increases between 30post and 90post (p < 0,001); the absolute VO2peak (L/min) decreased between the pre moments with 30post and pre with 90post (p < 0,05); the kinetics of VO2 showed an increase intime at 30post (p < 0,05). Conclusion: The VO2 kinetics is increased in obese women undergoing SG at 30post surgery, which shows a deterioration of this capacity

Physical fitness and physical activity in women with obesity: short term effects of sleeve gastrectomy / Condición física y actividad física en mujeres con obesidad: efectos a corto plazo de una gastrectomía vertical

Introduction: the increase on prevalence of obesity has been linked to a higher number of bariatric surgeries, being sleeve gastrectomy (SG) the most frequent bariatric procedures in the world. However, there are few studies that determine the impact of SG on health's determinants such as physical fitness (PF) and physical activity (PA). Objectives: to describe the changes in PF and PA of patients after SG. Methods: twenty-three women with obesity (mean 36.1 ± 11.1 years old and body mass index [BMI] of 35.1 ± 3.4 kg/m2) were evaluated preoperatively to SG and at one and three months after surgery. An assessment of PF was conducted, including handgrip (HGS) and quadriceps muscle strength (QMS) with dynamometers and cardiorespiratory fitness (CRF) with an ergospirometer. PA was assessed with a three-axis accelerometer. Results: the absolute VO2 peak decreased after the first and third month (p < 0.001) post SG. The VO2 peak relative to body weight showed an increase from baseline after the SG (p = 0.002). After SG, there was a reduction in absolute values for HGS and QMS (p < 0.001) and an increase in relative HGS after three months post-surgery compared to preoperative (p = 0.011), without changes in relative QMS (p = 0.596). No changes in PA were observed. Conclusions: after SG, there is a short term decline on PF when it is expressed on absolute values. However, when it is expressed in relative terms to body weight, some components of PF improve, while others showed no change. There was no modification in PA levels of the participants

Introducción: el incremento en la prevalencia de la obesidad se ha relacionado con un mayor número de cirugías bariátricas, siendo la gastrectomía vertical (SG) el procedimiento bariátrico más frecuente en el mundo. Sin embargo, hay pocos estudios que analicen el impacto de la SG en determinantes de la salud, como la condición física (PF) y la actividad física (PA). Objetivo: describir los cambios en la PF y la PA después de la SG. Métodos: veintitrés mujeres con obesidad (36,1 ± 11,1 años e índice de masa corporal [IMC] de 35,1 ± 3,4 kg/m2) fueron evaluadas previo a una SG y al primer y tercer mes postoperatorio. Las evaluaciones incluyeron la valoración de fuerza de prensión manual (HGS) y de cuádriceps (QMS) con dinamómetros y de capacidad cardiorrespiratoria (CRF) con ergoespirometría. La PA fue evaluada con acelerómetros triaxiales. Resultados: el VO2 peak absoluto disminuyó al primer y tercer mes (p < 0,001) luego de la SG. El VO2 peak relativo al peso corporal aumentó después de la SG (p = 0,002). Luego de la cirugía disminuyeron HGS y QMS absolutas (p < 0,001) y aumentó HGS relativa al peso corporal al tercer mes postoperatorio (p = 0,011), sin cambios en QMS relativa (p = 0,559). No se observaron cambios en la PA posterior a SG. Conclusiones: después de SG hay un deterioro a corto plazo de la PF expresada en términos absolutos, pero al expresarse en relación al peso corporal, algunos componentes de la PF no cambian y otros mejoran. No se observaron cambios en la PA poscirugía

Physical fitness and physical activity in women with obesity: short term effects of sleeve gastrectomy.

INTRODUCTION: Introduction: the increase on prevalence of obesity has been linked to a higher number of bariatric surgeries, being sleeve gastrectomy (SG) the most frequent bariatric procedures in the world. However, there are few studies that determine the impact of SG on health's determinants such as physical fitness (PF) and physical activity (PA). Objectives: to describe the changes in PF and PA of patients after SG. Methods: twenty-three women with obesity (mean 36.1 ± 11.1 years old and body mass index [BMI] of 35.1 ± 3.4 kg/m2) were evaluated preoperatively to SG and at one and three months after surgery. An assessment of PF was conducted, including handgrip (HGS) and quadriceps muscle strength (QMS) with dynamometers and cardiorespiratory fitness (CRF) with an ergospirometer. PA was assessed with a three-axis accelerometer. Results: the absolute VO2 peak decreased after the first and third month (p < 0.001) post SG. The VO2 peak relative to body weight showed an increase from baseline after the SG (p = 0.002). After SG, there was a reduction in absolute values for HGS and QMS (p < 0.001) and an increase in relative HGS after three months post-surgery compared to preoperative (p = 0.011), without changes in relative QMS (p = 0.596). No changes in PA were observed. Conclusions: after SG, there is a short term decline on PF when it is expressed on absolute values. However, when it is expressed in relative terms to body weight, some components of PF improve, while others showed no change. There was no modification in PA levels of the participants.

INTRODUCCIÓN: Introducción: el incremento en la prevalencia de la obesidad se ha relacionado con un mayor número de cirugías bariátricas, siendo la gastrectomía vertical (SG) el procedimiento bariátrico más frecuente en el mundo. Sin embargo, hay pocos estudios que analicen el impacto de la SG en determinantes de la salud, como la condición física (PF) y la actividad física (PA). Objetivo: describir los cambios en la PF y la PA después de la SG. Métodos: veintitrés mujeres con obesidad (36,1 ± 11,1 años e índice de masa corporal [IMC] de 35,1 ± 3,4 kg/m2) fueron evaluadas previo a una SG y al primer y tercer mes postoperatorio. Las evaluaciones incluyeron la valoración de fuerza de prensión manual (HGS) y de cuádriceps (QMS) con dinamómetros y de capacidad cardiorrespiratoria (CRF) con ergoespirometría. La PA fue evaluada con acelerómetros triaxiales. Resultados: el VO2 peak absoluto disminuyó al primer y tercer mes (p < 0,001) luego de la SG. El VO2 peak relativo al peso corporal aumentó después de la SG (p = 0,002). Luego de la cirugía disminuyeron HGS y QMS absolutas (p < 0,001) y aumentó HGS relativa al peso corporal al tercer mes postoperatorio (p = 0,011), sin cambios en QMS relativa (p = 0,559). No se observaron cambios en la PA posterior a SG. Conclusiones: después de SG hay un deterioro a corto plazo de la PF expresada en términos absolutos, pero al expresarse en relación al peso corporal, algunos componentes de la PF no cambian y otros mejoran. No se observaron cambios en la PA poscirugía.

Oxygen pulse as a protective factor of insulin resistance in sedentary women with overweight or obesity / Pulso de oxígeno como factor protector de resistencia a la insulina en mujeres sedentarias con sobrepeso u obesidad

Background: obesity is associated with insulin resistance (IR). Through exercise, insulin resistant obese patients can effectively improve their cardiorespiratory fitness (CRF). The effect of exercise on patients CRF can be determined by oxygen pulse (PO2) analysis. Despite its usefulness, there is limited literature on PO2 analysis in patients with obesity and insulin resistance. Objective: the goal of the present study is to evaluate the relation between PO2 and IR in sedentary obese women. Methods: fifty-five women were submitted to a maximal exercise test for evaluation of maximal oxygen consumption and PO2. The subjects with a homeostatic model assessment of IR index greater or equal to 2.5 were considered as insulin-resistant (IR). Participants were divided into two groups, IR group (n = 35) and non-IR group (n = 20). Results: the IR group had lower values of PO2 relative to body weight (11.0 ± 1.7 versus 12.6 ± 1.4 ml∙kg∙beats-1, p = 0.001) and relative to lean mass (21.7 ± 2.9 versus 23.2 ± 2.8 ml∙kg∙beats-1, p = 0.038) than non-IR group. No statistical differences were found in maximal oxygen consumption between the groups (non-IR = 1.53 ± 0.27 l∙min-1, IR = 1.51 ± 0.28 l∙min-1; p = 0.386). PO2 relative to body weight and HOMA-IR was inversely correlated (p < 0.001; r = -0.465). Logistic regression analysis showed an association between PO2 relative to weight (p = 0.001, OR = 0.47) and fat free mass (p = 0.01, OR = 0.73), both models adjusted by age. Conclusions: this study demonstrates a relation between HOMA-IR and PO2. Our results suggest that PO2 could be a protective factor against insulin resistance

Introducción: la sensibilidad a la insulina ha sido ampliamente relacionada con el fitness cardiorrespiratorio (FCR), el cual puede ser evaluado a través del pulso de oxígeno (PO2). Este corresponde al producto entre el volumen sistólico y la diferencia arteriovenosa de oxígeno y en sujetos sin alteraciones cardiovasculares podría ser un indicador de alteraciones del metabolismo a nivel periférico como la resistencia a la insulina (RI). Objetivo: el objetivo del presente estudio es evaluar la relación entre el PO2 y la RI en mujeres sedentarias con obesidad. Métodos: cincuenta y cinco mujeres fueron sometidas a una prueba de ejercicio maximal para la evaluación del consumo máximo de oxígeno (VO2max) y del PO2. Los sujetos con un índice HOMA-IR mayor o igual a 2,5 fueron considerados con resistencia a la insulina. Los participantes fueron divididos en dos grupos, RI (n = 35) y no-RI (n = 20). Resultados: el grupo RI presentó valores menores de PO2 relativo al peso corporal (11,0 ± 1,7 versus 12,6 ± 1,4 ml∙kg∙latidos-1, p = 0,001) y relativo a la masa libre de grasa (21,7 ± 2,9 versus 23,2 ± 2,8 ml∙kg∙latidos-1, p = 0,038) respecto al grupo no-RI. No se encontraron diferencias estadísticamente significativas en el VO2max entre ambos grupos (no-RI = 1.53 ± 0.27 l∙min-1, RI = 1,51 ± 0,28 l∙min-1; p = 0,386). Se encontró una correlación inversa entre el PO2 relativo al peso y el índice HOMA-IR (p < 0,001; r = -0,465). El análisis de regresión logística mostró una asociación entre el PO2 relativo al peso (p = 0,001, OR = 0,47) y la masa libre de grasa (p = 0,01, OR = 0,73), ambos modelos ajustados por edad. Conclusiones: este estudio demuestra que existe una relación entre el índice HOMA-IR y el PO2. Estos resultados sugieren que el PO2 podría ser un factor protector de RI

Evaluación de la actividad física en pacientes con enfermedad pulmonar obstructiva crónica / Tools for physical activity assessment in chronic obstructive pulmonary disease

The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is increasing in Chile, constituting a public health problem. Pulmonary and systemic consequences of COPD affect physical activity, as the disease progresses. There are multiple means for physical activity assessment, from low cost and easily applicable questionnaires to sophisticated laboratory tests. Physical inactivity is a modifiable risk factor for morbidity and mortality in patients with COPD. Physical activity interventions not only contribute to decrease the likelihood of mortality, but also protect from comorbidities, especially cardiovascular ones. It also plays a major role avoiding functional limitations of these subjects. Dyspnea and fatigue render exercise as an unpleasant activity for most patients with COPD. If psychological alterations such as anxiety and depression are summed, these patients drift towards an inactive lifestyle. This article analyzes several tools available to assess physical activity is patients with COPD, useful in clinical practice.

[Tools for physical activity assessment in chronic obstructive pulmonary disease]. / Evaluación de la actividad física en pacientes con enfermedad pulmonar obstructiva crónica.

The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is increasing in Chile, constituting a public health problem. Pulmonary and systemic consequences of COPD affect physical activity, as the disease progresses. There are multiple means for physical activity assessment, from low cost and easily applicable questionnaires to sophisticated laboratory tests. Physical inactivity is a modifiable risk factor for morbidity and mortality in patients with COPD. Physical activity interventions not only contribute to decrease the likelihood of mortality, but also protect from comorbidities, especially cardiovascular ones. It also plays a major role avoiding functional limitations of these subjects. Dyspnea and fatigue render exercise as an unpleasant activity for most patients with COPD. If psychological alterations such as anxiety and depression are summed, these patients drift towards an inactive lifestyle. This article analyzes several tools available to assess physical activity is patients with COPD, useful in clinical practice.

Acute Effects of Contract-Relax Stretching vs. TENS in Young Subjects With Anterior Knee Pain: A Randomized Controlled Trial.

Valenza, MC, Torres-Sánchez, I, Cabrera-Martos, I, Valenza-Demet, G, and Cano-Cappellacci, M. Acute effects of contract-relax stretching vs. TENS in young subjects with anterior knee pain: A randomized controlled trial. J Strength Cond Res 30(8): 2271-2278, 2016-The aim of this study was to examine the immediate effects on pressure point tenderness, range of motion (ROM), and vertical jump (VJ) of contract-relax stretching vs. transcutaneous electrical nerve stimulation (TENS) therapy in individuals with anterior knee pain (AKP). Eighty-four subjects with AKP were randomly assigned to 1 of 3 different intervention groups: a contract-relax stretching group (n = 28), a TENS intervention group (n = 28), and a control group (n = 28). The participants included in the sample were both sex (37.5% men vs. 62.5% women) at a mean age of 21 years, with mean values of height and weight of 169 cm and 64 kg, respectively. The main outcome measures were knee ROM, pressure pain threshold (PPT), and VJ. The participants were assessed at baseline and immediately after treatment. In the case of VJ, at baseline, immediately after the intervention, at 3 and at 6 minutes posttreatment. The data analysis showed that PPT scores of participants in the stretching and TENS group significantly increased from pretest to posttest (p ≤ 0.05). A significant increase pre- to posttreatment in ROM (p < 0.001) was also observed in both treatment groups. In VJ measures, TENS and stretching groups showed significant differences between preintervention and all postintervention values (p ≤ 0.05), whereas no significant differences were found in the control group. In conclusion, the results show significant pre-to-post-treatment effects in PPT, ROM, and VJ from both contract-relax stretching and TENS in young subjects with AKP.

Content validity and reliability of test of gross motor development in Chilean children.

OBJECTIVE: To validate a Spanish version of the Test of Gross Motor Development (TGMD-2) for the Chilean population. METHODS: Descriptive, transversal, non-experimental validity and reliability study. Four translators, three experts and 92 Chilean children, from five to 10 years, students from a primary school in Santiago, Chile, have participated. The Committee of Experts has carried out translation, back-translation and revision processes to determine the translinguistic equivalence and content validity of the test, using the content validity index in 2013. In addition, a pilot implementation was achieved to determine test reliability in Spanish, by using the intraclass correlation coefficient and Bland-Altman method. We evaluated whether the results presented significant differences by replacing the bat with a racket, using T-test. RESULTS: We obtained a content validity index higher than 0.80 for language clarity and relevance of the TGMD-2 for children. There were significant differences in the object control subtest when comparing the results with bat and racket. The intraclass correlation coefficient for reliability inter-rater, intra-rater and test-retest reliability was greater than 0.80 in all cases. CONCLUSIONS: The TGMD-2 has appropriate content validity to be applied in the Chilean population. The reliability of this test is within the appropriate parameters and its use could be recommended in this population after the establishment of normative data, setting a further precedent for the validation in other Latin American countries.

Content validity and reliability of test of gross motor development in Chilean children / Confiabilidad y validez de contenido de test de desarrollo motor grueso en niños chilenos

ABSTRACT OBJECTIVE To validate a Spanish version of the Test of Gross Motor Development (TGMD-2) for the Chilean population. METHODS Descriptive, transversal, non-experimental validity and reliability study. Four translators, three experts and 92 Chilean children, from five to 10 years, students from a primary school in Santiago, Chile, have participated. The Committee of Experts has carried out translation, back-translation and revision processes to determine the translinguistic equivalence and content validity of the test, using the content validity index in 2013. In addition, a pilot implementation was achieved to determine test reliability in Spanish, by using the intraclass correlation coefficient and Bland-Altman method. We evaluated whether the results presented significant differences by replacing the bat with a racket, using T-test. RESULTS We obtained a content validity index higher than 0.80 for language clarity and relevance of the TGMD-2 for children. There were significant differences in the object control subtest when comparing the results with bat and racket. The intraclass correlation coefficient for reliability inter-rater, intra-rater and test-retest reliability was greater than 0.80 in all cases. CONCLUSIONS The TGMD-2 has appropriate content validity to be applied in the Chilean population. The reliability of this test is within the appropriate parameters and its use could be recommended in this population after the establishment of normative data, setting a further precedent for the validation in other Latin American countries.

RESUMEN OBJETIVO Validar una versión en español de la prueba de desarrollo motor grueso TGMD-2 para la población chilena. MÉTODOS Estudio de validez y confiabilidad, no experimental, transversal, de tipo descriptivo. Participaron cuatro traductores, tres expertos y 92 niños chilenos, entre cinco y 10 años, alumnos de un colegio de Santiago de Chile. Se realizaron los procedimientos de traducción, retro-traducción y revisión, por parte del comité de expertos, para determinar la equivalencia trans-lingüística y la validez de contenido del test, usando el índice de validez de contenido en 2013. También se realizó una aplicación piloto para determinar la confiabilidad del test en español, utilizando el coeficiente de correlación intraclase y el método Bland-Altman. Se evaluó si existían diferencias significativas en los resultados, al reemplazar el bate por una raqueta, usando la prueba T-test. RESULTADOS Se obtuvo un índice de validez de contenido mayor de 0,8 para pertinencia y claridad del lenguaje del test TGMD-2 para los niños. Hubo diferencias significativas en el subtest de control de objetos, al comparar los resultados con bate y raqueta. El coeficiente de correlación intraclase para la confiabilidad interevaluador, intraevaluador y test re-test, resultó ser mayor de 0,8 en todos los casos. CONCLUSIONES El test TGMD-2 presenta adecuada validez de contenido para ser aplicado en la población chilena. La confiabilidad de este test está dentro de los parámetros adecuados y su uso sería recomendado en esta población luego de establecer los datos normativos, sentando un precedente adicional para la validación en otros países latinoamericanos.

[Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children]. / Estudio piloto de la efectividad de una intervención basada en juegos sobre el estado nutricional y la fuerza muscular en niños.

INTRODUCTION: The overnutrition is a constant on developing countries; Chile is not an exception because it has a marked tendency to overweight and obesity in schoolchildren. The muscular strength has been associated with cardiovascular and metabolic health status in scholars. Effective interventions using games are needed to improve the nutritional status and physical fitness in school children. OBJECTIVE: To assess the intervention effectiveness based on games played at school time to improve the nutritional status and physical fitness in schoolchildren. METHOD: 156 students aged between 7 to 15 years, attending to two public schools with full school day, to which a pilot program was applied. This pilot program was based on dynamic recreational games during 45 minutes from monday to friday for 3 months in the largest playtime of the school day. RESULTS: At the end of the intervention, we observed a significant modification on children nutritional status, which highlights an increase in the number of children that reached the normal nutritional status (p < 0.001). We also observed a significant number of obese children who reached overweight nutritional status (p < 0.001). We also observed a decrease of leg muscular strength at the end of the study. CONCLUSIONS: We found a positive effect of a program based on dynamic recreational games in the largest school playtime, improving nutritional status. However, we didn't observed modifications in the muscular strength.

INTRODUCCIÓN: La malnutrición por exceso es una constante en países en vías de desarrollo, Chile no es una excepción ya que existe una marcada tendencia hacia el sobrepeso y obesidad en la población escolar. La fuerza muscular ha sido asociada con un adecuado estado de salud cardiovascular y metabólica en la población escolar. Se necesitan intervenciones efectivas, que utilicen herramientas lúdicas y que permitan mejorar el estado nutricional y la capacidad física de los escolares. OBJETIVO: Valorar la efectividad de una intervención basada en juegos realizados dentro de la jornada escolar de los niños para mejorar el estado nutricional y la fuerza muscular. MÉTODO: 156 escolares de 7 a 15 años, pertenecientes a dos colegios municipalizados con jornada escolar completa, participaron de un programa piloto basado en juegos recreativos dinámico durante 45 minutos de lunes a viernes durante 3 meses, en el recreo más extenso de la jornada escolar. RESULTADOS: Al finalizar la intervención se observó una modificación estadísticamente significativa en el estado nutricional, donde destaca un aumento de niños que alcanza el estado nutricional normal. En aquellos que fueron clasificados previamente como obesos se logra modificar su estado nutricional hacia sobrepeso (p < 0,001). Se observó una disminución de la fuerza muscular del tren inferior al término del estudio (p < 0,001). CONCLUSIONES: Se demostró el impacto positivo de una intervención basada en juegos recreativos dinámicos durante los recreos escolares, con modificación positiva en el estado nutricional, pero sin mejoría de la fuerza muscular de los escolares.

Estudio piloto de la efectividad de una intervención basada en juegos sobre el estado nutricional y la fuerza muscular en niños / Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children

Introducción: La malnutrición por exceso es una constante en países en vías de desarrollo, Chile no es una excepción ya que existe una marcada tendencia hacia el sobrepeso y obesidad en la población escolar. La fuerza muscular ha sido asociada con un adecuado estado de salud cardiovascular y metabólica en la población escolar. Se necesitan intervenciones efectivas, que utilicen herramientas lúdicas y que permitan mejorar el estado nutricional y la capacidad física de los escolares. Objetivo: Valorar la efectividad de una intervención basada en juegos realizados dentro de la jornada escolar de los niños para mejorar el estado nutricional y la fuerza muscular. Método: 156 escolares de 7 a 15 años, pertenecientes a dos colegios municipalizados con jornada escolar completa, participaron de un programa piloto basado en juegos recreativos dinámico durante 45 minutos de lunes a viernes durante 3 meses, en el recreo más extenso de la jornada escolar. Resultados: Al finalizar la intervención se observó una modificación estadísticamente significativa en el estado nutricional, donde destaca un aumento de niños que alcanza el estado nutricional normal. En aquellos que fueron clasificados previamente como obesos se logra modificar su estado nutricional hacia sobrepeso (p < 0,001). Se observó una disminución de la fuerza muscular del tren inferior al término del estudio (p < 0,001). Conclusiones: Se demostró el impacto positivo de una intervención basada en juegos recreativos dinámicos durante los recreos escolares, con modificación positiva en el estado nutricional, pero sin mejoría de la fuerza muscular de los escolares (AU)

Introduction: The overnutrition is a constant on developing countries; Chile is not an exception because it has a marked tendency to overweight and obesity in schoolchildren. The muscular strength has been associated with cardiovascular and metabolic health status in scholars. Effective interventions using games are needed to improve the nutritional status and physical fitness in school children. Objective: To assess the intervention effectiveness based on games played at school time to improve the nutritional status and physical fitness in schoolchildren. Method: 156 students aged between 7 to 15 years, attending to two public schools with full school day, to which a pilot program was applied. This pilot program was based on dynamic recreational games during 45 minutes from monday to friday for 3 months in the largest playtime of the school day. Results: At the end of the intervention, we observed a significant modification on children nutritional status, which highlights an increase in the number of children that reached the normal nutritional status (p < 0.001). We also observed a significant number of obese children who reached overweight nutritional status (p < 0.001). We also observed a decrease of leg muscular strength at the end of the study. Conclusions: We found a positive effect of a program based on dynamic recreational games in the largest school playtime, improving nutritional status. However, we didn’t observed modifications in the muscular strength (AU)

Evaluación y entrenamiento de la condición física del paciente con enfermedad renal crónica terminal / Physycal fitness in patient with end-stage renal disease

La mala condición física es un factor de riesgo importante de mortalidad por problemas de origen cardiovascular, siendo además un predictor de diferentes enfermedades. Cuando la condición física es evaluada adecuadamente, puede ser utilizada como un valioso indicador de salud, expectativa de vida y calidad de vida en pacientes con enfermedad renal crónica terminal (ERCT), por lo cual debiera ser un procedimiento de rutina en el manejo de estos pacientes. El ejercicio físico es presentado como Un medio efectivo para tratar y prevenir las principales alteraciones músculo esqueléticas originadas por la ERCT y por el sedentarismo que presentan estos pacientes. Por esta razón se debería diseñar programas individuales de entrenamiento físico basados en los resultados de la evaluación de la condición física, en el conocimiento del estilo de vida, en la actividad física diaria realizada por cada paciente. Ese tipo de entrenamiento debería permitir a los pacientes desarrollar su máximo potencial físico, mejorar su salud física y mental y disminuir las consecuencias negativas de a ERCT.

Low physical fitness is an important risk factor for cardiovascular and all-causes morbidity and mortality; indeed, it is even a predictor of these problems. When properly measured, the assessment of physical fitness can be a highly valuable indicator of health, life expectancy and quality of life on patients with end stage renal disease (ESRD), therefore, should be performed routinely in the clinical setting. Physical exercise is proposed as a highly effective means of treating and preventing the main causes muscle skeletal disorders and sedentary life style that presents those patients. Individually adapted training programs could be prescribed based on fitness assessment results and an adequate knowledge of patient lifestyle, daily physical activity and personal goals. Such training programs would allow patients to develop their maximum physical potential, improve their physical and mental health, and attenuate the negative consequences of ESRD.