Associations between physical activity and cardiorespiratory fitness with vascular health phenotypes in older adults: a cross-sectional study.

Objective: We investigated the associations between physical activity (PA) and cardiorespiratory fitness (CRF) with vascular health phenotypes in community-dwelling older adults. Methods: This cross-sectional study included 82 participants (66.8 ± 5.2 years; 81% females). Moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers, and CRF was measured using the distance covered in the 6-min walk test (6MWT). The vascular health markers were as follows: i) arterial function measured as aortic pulse wave velocity (aPWV) estimated using an automatic blood pressure device; and ii) arterial structure measured as the common carotid intima-media thickness (cIMT). Using a combination of normal cIMT and aPWV values, four groups of vascular health phenotypes were created: normal aPWV and cIMT, abnormal aPWV only, abnormal cIMT only, and abnormal aPWV and cIMT. Multiple linear regression was used to estimate the beta coefficients (ß) and their respective 95% confidence intervals (95% CI) adjusting for BMI, and medication for diabetes, lipid, and hypertension, sex, age, and blood pressure. Results: Participants with abnormal aPWV and normal cIMT (ß = -53.76; 95% CI = -97.73--9.78 m; p = 0.017), and participants with both abnormal aPWV and cIMT (ß = -71.89; 95% CI = -125.46--18.31 m; p = 0.009) covered less distance in the 6MWT, although adjusting for age, sex and blood pressure decreased the strength of the association with only groups of abnormal aPWV and cIMT covering a lower 6MWT distance compared to participants with both normal aPWV and cIMT (ß = -55.68 95% CI = -111.95-0.59; p = 0.052). No associations were observed between MVPA and the vascular health phenotypes. Conslusion: In summary, poor CRF, but not MVPA, is associated with the unhealthiest vascular health phenotype (abnormal aPWV/cIMT) in older adults.

Daily step volume and intensity moderate the association of sedentary time and cardiometabolic disease risk in community-dwelling older adults: A cross-sectional study.

OBJECTIVE: To investigate the moderating effect of step count and peak cadence on the relationship of sedentary time and cardiometabolic disease risk in community-dwelling older adults. METHODS: This cross-sectional study included 248 older adults aged 60-80 years without cardiovascular disease (66.0 ± 4.6 years of age; 78 % females). Sedentary time, step count and peak cadence were measured by a hip-worn accelerometer for seven days. Peak cadence was defined as the average of 30 min of the day (but not necessarily consecutive) with the highest cadence (steps per minute) for all valid days. Cardiometabolic disease risk was defined using a sex-specific continuous metabolic syndrome score (cMetS). Sedentary time was used as an explanatory variable for cMetS and step count and peak cadence as moderators. The analyses were adjusted for known cardiometabolic disease risk factors and accelerometer wear time. The Johnson-Neyman technique was used to specify the value of moderator variables at which the significant relationship between sedentary time and cMetS disappears. RESULTS: Both step count (ß = -0.186, P = 0.032) and peak cadence (ß = -0.003, P = 0.007) showed a moderating effect on the relationship of sedentary time and cMetS. The association of sedentary time and cMetS was not statistically significant (p > 0.05) when step count or peak cadence exceed 5715 steps per day and 57 steps per minute, respectively. CONCLUSION: Steps per day and peak cadence moderate the association of sedentary time and cardiometabolic disease risk in older adults. Therefore, steps per day and peak cadence seem to offset the deleterious effects of sedentary time on cardiometabolic health in this population.

Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases.

PURPOSE: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. METHODS: In total, 249 community-dwelling older adults aged 60-80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. RESULTS: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (ß = 0.19 m/s; p = 0.007) compared to their robust peers. CONCLUSIONS: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60-80 years. Pre-frail older adults may have a higher risk for CVD.

Joint associations of accelerometer-measured physical activity and sedentary time with cardiometabolic risk in older adults: A cross-sectional study.

To investigate the joint associations of accelerometer-measured moderate-vigorous physical activity (MVPA) and sedentary time (ST) with cardiometabolic risk in older adults. This cross-sectional study included 248 participants (aged 65.8 ± 5.1 years; 73.7% females). Cardiometabolic risk was defined using continuous metabolic syndrome score (cMetS). MVPA and ST were assessed by accelerometry. Participants were categorized according to their MVPA and ST levels: i) 'Inactive + High ST' (<150 min/week and > 10.6 h/day); ii) 'Inactive + Low ST' (< 150 min/week and ≤ 10.6 h/day); iii) 'Active + High ST' (≥ 150 min/week and > 10.6 h/day) and iv) 'Active + Low ST' (≥ 150 min/week and ≤ 10.6 h/day). The cut-offs for active and inactive were based on current PA guidelines. The cut-offs for low and high ST were based on the median value from this cohort. Generalized linear models were used for data analyses ('Inactive + High ST' as group reference) controlling for known cardiometabolic risk factors. The 'Active + Low ST' (ß = -0.34, 95% CI -0.57, -0.11) and 'Active + High ST' (ß = -0.28, 95% CI -0.55, -0.02) groups had lower cMetS compared to the 'Inactive + High ST' group (p < 0.05). No difference was found between the 'Inactive + Low ST' and 'Inactive + High ST' groups (ß = -0.19, 95% CI -0.41, 0.03). Meeting MVPA recommendations (≥ 150 min/week) is associated with a lower cardiometabolic risk in older adults, even in those with high ST.

Cardiorespiratory Fitness and Performance in Multiple Domains of Executive Functions in School-Aged Adolescents.

The objective of this study was to investigate the association between cardiorespiratory fitness (CRF) and performance in multiple domains of executive functions in school-aged adolescents. A sample of 132 adolescents (43% girls) aged 11-16 years were included in this cross-sectional study. Each participant completed a progressive aerobic cardiovascular endurance running (PACER) test, computerized cognitive tasks (Attentional Network, Berg's Card Sorting, Go/No-Go oddball, Sternberg's Working Memory, and Tower of London) and questionnaire for daytime sleepiness, as well as other factors that might influence cognitive performance (age, sex, school year, pubertal stage, and body mass index - BMI). Generalized linear model was used to calculate the coefficient estimates (ß) and its 95% confidence interval (CI) for the cognitive tasks using PACER laps as a predictor, controlling for potential confounding variables. There was a negatively association of PACER laps with planning (ß = -17.1, 95% CI -31.9, -2.3) and solution (ß = -44.6, 95% CI -75.1, -14.2) time in performing the Tower of London task, as well as with perseverative errors in performing Berg's task (ß = -0.073, 95% CI -0.133, -0.013). Moderating effect of sex was found for the association of PACER laps with completed categories and perseverative errors in Berg's task (p < 0.05). Mediating effect of BMI was found for the association between PACER laps and NoGo task, revealing a full mediator accounted for 81% of the total effect mediated (standardized indirect effect, -0.069, 95% CI -0.140, -0.020; standardized direct effect, 0.011, 95% CI -0.149, 0.165). No association was found for Attentional or Sternberg's tasks. The findings suggest that school-aged adolescents with higher CRF level showed better planning and problem-solving abilities and cognitive flexibility. Additionally, the positive association of CRF with cognitive flexibility was sex-moderated and with inhibitory control was BMI-mediated.

Effects of Isometric Biceps Exercise on Blood Pressure in Adults with Hypertension.

We investigated the acute effects of isometric biceps exercise on resting and ambulatory blood pressure in hypertensive adults. A total of 12 medicated hypertensive adults (aged 47±7 years; body mass index 27.2±2.7 kg/m2; resting blood pressure 123±12/74±6 mmHg) performed an isometric biceps exercise session (bilateral biceps exercise; 4×1 min at 30% of 1-RM, 2 min recovery) and a control session (without exercise) in a randomized order separated by a 7 to 10-day period. Resting blood pressure, heart rate, and heart rate variability indexes (SDNN, RMSSD, LF, HF, and LF/HF) were measured pre- and up to 30 min post-sessions. Next, ambulatory blood pressure was monitored during 22-hour post-sessions (awake and asleep periods). No significant changes were observed for resting blood pressure, heart rate, or heart rate variability indexes up to 30 min post-sessions (p>0.05). Furthermore, no significant differences were observed in average ambulatory blood pressure values in 22-hour (126±11/71±6 mmHg vs. 126±15/71±9 mmHg), awake (127±10/74±6 mmHg vs. 130±14/75±10 mmHg), and asleep (123±15/68±6 mmHg vs. 120±17/66±9 mmHg) periods between the control and isometric sessions, respectively (p>0.05). In conclusion, an isometric biceps exercise session does not elicit an acute antihypertensive effect in adults with hypertension, which suggests that its prescription to improve the acute BP control is limited.

Housing type is associated with objectively measured changes in movement behavior during the COVID-19 pandemic in older adults with hypertension: An exploratory study.

PURPOSE: To investigate the association between housing characteristics with objectively measured changes in physical activity (PA) and sedentary behavior (SB) during the COVID-19 pandemic in older adults with hypertension. METHODS: Thirty-five older adults with hypertension were included in this exploratory study. Accelerometer-based PA and SB measures were assessed before and during a period of social distancing policy imposed due to the COVID-19 pandemic. Housing type, housing surface area and household size were tested as predictors of changes in PA and SB. A generalized linear mixed model was used for the analysis. RESULTS: Housing type was associated with changes in PA and SB. Individuals residing in an apartment showed a greater decrease in light PA on weekdays (ß= -65 min/day, p=0.035) and a trend for an increase in SB (ß= 55 min/day, p=0.056) compared to those residing in a detached house. Individuals residing in a row house showed a greater decrease in moderate-vigorous PA (ß= -10 min/day, p=0.037) and steps/day (ß= -2064, p=0.010) compared to those residing in a detached house. Individuals residing in an apartment showed a greater decrease in light PA on the weekends (ß= -83 min/day, p=0.015) and an increase in SB (ß= 72 min/day, p=0.036) compared to those residing in a detached house. No association was found for housing surface area and household size. CONCLUSIONS: Older adults with hypertension residing in an apartment or row house have greater unhealthy changes in movement behavior during the COVID-19 pandemic. Further studies are needed to confirm our preliminary findings.

Effect of High-velocity Resistance Exercise on 24-h Blood Pressure in Hypertensive Older Women.

This study investigated the acute post-exercise effect of high-velocity resistance exercise on ambulatory blood pressure in hypertensive older women. Fourteen volunteers (67.9±5.1 years) performed a high-velocity resistance exercise session (8 exercises using Thera-Band, 3 sets of 6 repetitions as fast as possible in the concentric phase with moderate intensity) and a control session, separated by a 7-10-day period. Ambulatory blood pressure was monitored following 12-h post-sessions and compared between conditions at 1 to 4-h, 5 to 8-h, and 9 to 12-h. Average 24-h ambulatory blood pressure, awake, asleep periods, and blood pressure load were also analyzed. There was a condition by time interaction for systolic ambulatory blood pressure over 12-h post-sessions (P=0.043). It was observed a lower systolic ambulatory blood pressure in the first 4-h period following the high-velocity resistance exercise session compared to the control session (-6.7 mmHg, 95% CI - 11.6 to -1.8 mmHg; P=0.011). No changes were observed for diastolic ambulatory blood pressure over 12-h post-sessions as well as for the other variables analyzed (P>0.05). In summary, a single high-velocity resistance exercise session elicits a post-exercise antihypertensive effect and may be considered as a strategy to acutely improve blood pressure control in hypertensive older women.

Short-Term Effect of Self-Selected Training Intensity on Ambulatory Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial.

PURPOSE: To investigate the short-term effect of self-selected training intensity (SSTI) on ambulatory blood pressure (BP) in hypertensive older women. PARTICIPANTS AND METHODS: This is a randomized, single-blind, two-arm, parallel-group controlled trial that included 40 medicated hypertensive older women (64.4±3.6 years; resting systolic 118±19 and diastolic BP 68±9 mmHg). SSTI intervention was performed three times per week, 30-50 minutes per session (n=20). The control group participated in health education meetings once per week (n=20). Ambulatory BP (primary outcome) and six-minute walking test performance (secondary outcome) were assessed at baseline and following 8 weeks of intervention. Heart rate (HR), rating of perceived exertion (RPE, 6-20), and affective valence (ie, feeling scale, -5/+5) were recorded during all SSTI sessions. Intention-to-treat and per-protocol analyses were used for data analyses. RESULTS: Fifteen participants from the SSTI group and 17 from the control group completed the study. No differences in ambulatory BP (24-h, awake, and asleep) were observed between SSTI and control groups (intention-to-treat and per-protocol analyses; p>0.05). The SSTI group showed a greater six-minute walking test performance than the control group in the intention-to-treat and per-protocol analyses (p<0.05). The participants exercised at 52±10% of HR reserve reported an RPE of 11±1 and an affective valence of 3.4±1.1 over the 8-week period. CONCLUSION: SSTI is a feasible approach to induce a more active lifestyle and increase health-related fitness in hypertensive older women, although it does not improve BP control over a short-term period.

Efeito do tempo sentado prolongado sobre marcadores cardiometabólicos em adultos fisicamente ativos e inativos: um estudo piloto / Effect of prolonged sitting time on cardiometabolic markers in physically active and inactive adults: a pilot study

O objetivo deste estudo foi analisar o efeito do tempo sentado prolongado sobre marcadores cardio-metabólicos em adultos fisicamente ativos e inativos. Participaram do estudo 10 adultos fisicamente ativos (27,30 ± 4,90 anos de idade) e 11 fisicamente inativos (26,27 ± 3,17 anos de idade). Todos realizaram uma sessão de tempo sentado prolongado de 10 horas, com quatro refeições padroniza-das. Os níveis de glicose e pressão arterial foram mensurados no jejum, antes e 1 hora após cada refeição e também 2 horas após o almoço. Os níveis de triglicerídeos foram medidos no jejum, 2 e 3,5 horas após o almoço. O modelo linear generalizado foi utilizado para comparar a área sob a curva incremental (ASCi) dos níveis de glicose e triglicerídeos e a área sob a curva (ASC) dos níveis de pressão arterial entre os grupos, com ajuste pelos valores de linha de base. O grupo fisicamente ativo apresentou menor ASCi para os níveis de glicose no período de 10 horas (ß = -5,55 mg/dL/10h; IC95%: -9,75; -1,33; p = 0,010) e no período da manhã (ß = -7,05 mg/dL/5h; IC95%: -12,11; -1,99; p = 0,006) comparado ao grupo fisicamente inativo. Não houve diferença da ASCi dos triglicerídeos (p = 0,517) e na ASC da pressão arterial (p = 0,145) entre os grupos. Em conclusão, adultos fisicamente ativos apresentaram melhor controle glicêmico comparados àqueles fisicamente inativos durante a exposição a tempo sentado prolongado

The purpose of this study was to analyze the effect of prolonged sitting time on cardiometabolic markers in physically active and inactive adults.Ten physically active adults (27.30 ± 4.90 years old) and 11 physically inactive (26.27 ± 3.17 years old) participated in the study. All performed a 10-hour long sitting session, with a total of four standardized meals. Glucose and blood pressure levels were measured at fasting, before and 1 hour after each meal, and 2 hours after lunch. Triglycerides levels were measured on fasting at 2 and 3.5 hours after lunch. The generalized linear model was used to compare the area under the incremental curve (AUCi) of the glucose and triglycerides lev-els, and the area under the curve (AUC) of the blood pressure levels between the groups, adjusted for baseline values. The physically active group showed lower blood glucose AUCi of 10 hours (ß = -5.55 mg/dL/10h; 95%CI: -9.75; -1.33, p = 0.010), and morning (ß = -7.05 mg/dL/5h; 95%CI: -12.11; -1.99, p = 0.006) compared to the physically inactive group. There was no difference in triglycerides AUCi (p = 0.517) and blood pressure AUC (p = 0.145) between groups. In conclusion, physically active adults have better glycemic control than physically inactive adults during exposure to prolonged sitting time

Educação precoce: uma revisão integrativa de literatura / Educación precoz: una revisión integrativa de literatura / Early education: an integrative literature review

O objetivo deste estudo foi descrever as tendências atuais nas pesquisas científicas do Brasil sobre o tema educação precoce, presentes nas bases indexadas do Portal de Periódicos da CAPES. A metodologia utilizada foi a revisão integrativa de literatura. Realizou-se a busca através do acesso remoto ao conteúdo assinado, a partir do acesso CAFe ­ Comunidade Aca-dêmica Federada, provido pela Rede Nacional de Ensino e Pesquisa (RNP) para instituições federadas, através da Universidade de Brasília. Os critérios de inclusão foram artigos publica-dos em português, na íntegra, que retratassem a educação precoce e que fossem indexados no referido banco de dados nos últimos cinco anos. Conclui-se que a educação precoce exige profissionais multidisciplinares e a família também faz parte desse processo. São necessários mais estudos intervencionais com os envolvidos neste processo.

The aim of this study was to describe the current trends scientific research in Brazil on the precocious education, present in the indexed databases of the Portal of Periodicals of CAPES. The methodology used was the integrative review, the search was done through remote access to the signed content, from the access CAFe - Federated Academic Community, provided by the National Network of Teaching and Research (RNP) for federated institutions, through University of Brasilia. The inclusion criteria were articles published in Portuguese, in full that portrayed the early education and indexed in the referred database in the last five years. We conclude that precocious education requires multidisciplinary professionals, in which the fam-ily is also part of this process. Further interventional studies are needed with those involved in this process.

El objetivo de este estudio fue describir las tendencias actuales de la investigación científica en Brasil sobre el tema de la educación precoz, presentes en las bases de datos indexadas del Portal de Periódicos CAPES. La metodología utilizada fue la revisión integradora de la litera-tura. Se desarrolló una busca a través del acceso remoto, al contenido suscrito, desde el acceso Café - Comunidad Académica Federada, ofrecido por la Rede Nacional de Ensino e Investi-gação (RNP) para instituciones del gobierno a través de la Universidad de Brasilia. Los crite-rios de inclusión fueron los artículos publicados en portugués en su totalidad, que retratasen la educación precoz y artículos indexados en la base de datos mencionada, en los últimos cin-co años. Llegamos a la conclusión de que la educación precoz requiere profesionales multi-disciplinares, la familia también fue parte de este proceso. Se necesitan más estudios de in-tervención con los involucrados en este proceso.

Effect of hippotherapy in the global motor coordination in individuals with Down Syndrome / Efeito da equoterapia na coordenação motora global em sujeitos com Síndrome de Down

Abstract Introduction: Down syndrome (DS) of all genetic syndromes is the most common. In Hippotherapy, three-dimensional movements, provided by horse walking, awaken in the body of children with DS a large amount of sensory and neuromuscular stimuli, which directly interfere with overall development and the acquisition of motor skills. Objective: To analyze the effects of an Hippotherapy program on global motor coordination variables in individuals with DS of both genders and to compare individuals with the same syndrome who do not practice Hippotherapy. Methods: 41 individuals participated in the study, 20 of them practicing Hippotherapy (EG) and 21 who did not practice Hippotherapy (CG). The Körperkoordinations test für Kinder (KTK) test was used, consisting of four tasks: Balance on beams, Single-lever jump, Side-jump and Transfer on platform for analysis of motor coordination for individuals. Results: Comparing the groups, a significant difference (p < 0.01) was observed for the Lateral Leap Motor Quotient, the EG presented a better score (114.10) than the CG (88.47), and also in the Total Motor Ratio (EG = 115.10, GC = 102.47). The individuals that practice Hippotherapy presented better results in the global motor coordination, with significant difference (p < 0.05). In EG, 5% had high global motor coordination, 40% good and 55% normal, whereas in CG only 10% had good global motor coordination and 90% normal global motor coordination. Conclusion: It can be emphasized that equine therapy presents benefits of improvement in global motor coordination. Specifically in tasks such as the balance beam, single jump and side jump, besides global motor coordination.

Resumo Introdução: A Síndrome de Down (SD), de todas as síndromes genéticas é a mais comum. Na Equoterapia, os movimentos tridimensionais, proporcionados pelo andadura do cavalo, despertam no corpo das crianças com SD uma grande quantidade de estímulos sensoriais e neuromusculares, que interferem diretamente no desenvolvimento global e na aquisição de habilidades motoras. Objetivo: Analisar os efeitos de um programa de Equoterapia sobre as variáveis de coordenação motora global em indivíduos com SD de ambos os gêneros e comparar indivíduos com a mesma síndrome que não praticam Equoterapia. Métodos: Participaram do estudo 41 indivíduos sendo 20 que praticavam Equoterapia (GE) e 21 que não praticavam Equoterapia (GC). Utilizou-se o teste Körperkoordinations test für Kinder (KTK) composto por quatro tarefas: Equilíbrio sobre traves, Salto monopedal, Salto lateral e Transferência sobre plataforma para análise de coordenação motora para indivíduos. Resultados: Comparando os grupos observou-se diferença significativa (p < 0,01) para o Quociente Motor da Tarefa de Salto lateral, o GE apresentando melhor escore (114,10) em relação ao GC (88,47), e ainda, no Quociente Motor Total (GE =115,10; GC =102,47). Os indivíduos que praticam Equoterapia apresentaram melhores resultados na coordenação motora global, com diferença significativa (p < 0,05). No GE, 5% apresentaram coordenação motora global alta, 40% boa e 55% normal, já no GC, apenas 10% apresentaram coordenação motora global boa e 90% normal. Conclusão: Pode-se destacar que a equoterapia apresenta benefícios de melhora na coordenação motora global. Especificamente nas tarefas como a trave de equilíbrio, salto monopedal e salto lateral, além da coordenação motora global.