Maria Imaculada de Lima Montebelo

Effect of the home environment on motor and cognitive behavior of infants

Although information is sparse, research suggests that affordances in the home provide essential resources that promote motor and cognitive skills in young children. The present study assessed over time, the association between motor affordances in the home and infant motor and cognitive behavior. Thirty-two (32) infants were assessed for characteristics of their home using the Affordances in the Home Environment for Motor Development--Infant Scale and motor and cognitive behavior with the Bayley Scales of Infant and Toddler Development--III. Infants home and motor behavior were assessed at age 9 months and 6 months later with the inclusion of cognitive ability. Results for motor ability indicated that there was an overall improvement in performance from the 1st to the 2nd assessment. We found significant positive correlations between the dimensions of the home (daily activities and play materials) and global motor performance (1st assessment) and fine-motor performance on the 2nd assessment. In regard to cognitive performance (2nd assessment), results indicated a positive association with fine-motor performance. Our results suggest that motor affordances can have a positive impact on future motor ability and speculatively, later cognitive behavior in infants.

Family socioeconomic status and the provision of motor affordances in the home

BACKGROUND Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). RESULTS SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infants age. CONCLUSIONS This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.

Efeitos do treinamento de resistência de força com alto número de repetições no consumo máximo de oxigênio e limiar ventilatório de mulheres

The effects of strength training on womens cardiorespiratory capacity have not been widely established. The purpose of this study was to investigate the effects of resistance strength training with high number of repetitions on maximum oxygen uptake and ventilatory threshold in young women during 12 weeks. Twenty women, aged 21.2 + 2.7 years, were included in the study and assigned to two groups: I - resistance strength training with high number of repetitions group (TG, n = 10), and II - control group (CG, n = 10). All volunteers were submitted to the following protocol: anthropometry, cardiopulmonary testing on treadmill and 1 RM tests in the following exercises: leg-press 45o, seated leg extension, hamstring curl, bench press, lat pull-down, military press, standing barbell curls and lying barbell extension. The tests were performed before and after 12 weeks of training. Along the proposed period, the groups performed: I -TG: resistance exercises, the same of 1 RM tests, with three series of 25 repetitions, almost 30% of 1 RM; II - CG: no physical training whatsoever. CG did not show changes in the studied variables (p 0.05) after 12 weeks. It is concluded that the resistance strength training with high number of repetitions improved the aerobic power of volunteers, evidenced by the increase of maximum oxygen uptake. However, the ventilatory threshold did not change.

Analysis of the prevalence of atelectasis in patients undergoing bariatric surgery

BACKGROUND AND OBJECTIVE To observe the prevalence of atelectasis in patients undergoing bariatric surgery and the influence of the body mass index (BMI), gender and age on the prevalence of atelectasis. METHOD Retrospective study of 407 patients and reports on chest X-rays carried out before and after bariatric surgery over a period of 14 months. Only patients who underwent bariatric surgery by laparotomy were included. RESULTS There was an overall prevalence of 37.84% of atelectasis, with the highest prevalence in the lung bases and with greater prevalence in women (RR=1.48). There was a ratio of 30% for the influence of age for individuals under the age of 36, and of 45% for those older than 36 (RR=0.68). There was no significant influence of BMI on the prevalence of atelectasis. CONCLUSION The prevalence of atelectasis in bariatric surgery is 37% and the main risk factors are being female and aged over 36 years.

Use of positive pressure in the bariatric surgery and effects on pulmonary function and prevalence of atelectasis: randomized and blinded clinical trial

Background In surgical procedures, obesity is a risk factor for the onset of intra and postoperative respiratory complications. Aim Determine what moment of application of positive pressure brings better benefits on lung function, incidence of atelectasis and diaphragmatic excursion, in the preoperative, intraoperative or immediate postoperative period. Method Randomized, controlled, blinded study, conducted in a hospital and included subjects with BMI between 40 and 55 kg/m2, 25 and 55 years, underwent bariatric surgery by laparotomy. They were underwent preoperative and postoperative evaluations. They were allocated into four different groups: 1) Gpre: treated with positive pressure in the BiPAP mode (Bi-Level Positive Airway Pressure) before surgery for one hour; 2) Gpos: BIPAP after surgery for one hour; 3) Gintra: PEEP (Positive End Expiratory Pressure) at 10 cmH2O during the surgery; 4) Gcontrol: only conventional respiratory physiotherapy. The evaluation consisted of anthropometric data, pulmonary function tests and chest radiography. Results Were allocated 40 patients, 10 in each group. There were significant differences for the expiratory reserve volume and percentage of the predicted expiratory reserve volume, in which the groups that received treatment showed a smaller loss in expiratory reserve volume from the preoperative to postoperative stages. The postoperative radiographic analysis showed a 25% prevalence of atelectasis for Gcontrol, 11.1% for Gintra, 10% for Gpre, and 0% for Gpos. There was no significant difference in diaphragmatic mobility amongst the groups. Conclusion The optimal time of application of positive pressure is in the immediate postoperative period, immediately after extubation, because it reduces the incidence of atelectasis and there is reduction of loss of expiratory reserve volume.

The Effect Of Local Muscle Endurance Training on Cardiorespiratory Capacity in Young Women

Cesar, MC, Borin, JP, Gonelli, PRG, Simões, RA, Souza, TMF, and Montebelo, MIL. The effect of local muscle endurance training on cardiorespiratory capacity in young women. J Strength Cond Res 23(6): 1637-1643, 2009-The purpose of this study was to investigate the effect of local muscle endurance training on maximal oxygen uptake and ventilatory threshold in young women. Nineteen untrained women, ranging in age from 18 to 26 years, were included in the study and assigned to two groups: the control group (n = 10), and the resistance training group (n = 9). The following variables were obtained at baseline and after 12 weeks: body mass; maximal oxygen uptake, maximal heart rate, maximal oxygen pulse, oxygen uptake at the ventilatory threshold, heart rate at the ventilatory threshold, and oxygen pulse at the ventilatory threshold assessed by cardiopulmonary exercise testing on treadmill; 1-repetition maximum (RM) tests in bench press, latissimus pull down, military press, lying barbell extension, standing barbell curls, leg press, knee extension, and hamstring curl. The training group underwent resistance strength training. Loading during training followed the concept of maximum repetitions. Each session was defined as the performance of three sets of 15RM with a 60-second rest between sets and exercises. No significant changes were observed in the control group before and after 12 weeks (p > 0.05). All 1RM tests increased after training (p ≤ 0.01) in the training group, but no significant change was observed in body mass (p > 0.05). Cardiopulmonary variables showed no significant differences before and after resistance training (p > 0.05). These findings indicate that the local muscle endurance training realized produces no improvement in cardiorespiratory capacity in young women.

Application of positive airway pressure in restoring pulmonary function and thoracic mobility in the postoperative period of bariatric surgery: a randomized clinical trial

Objective: To evaluate whether the application of bilevel positive airway pressure in the postoperative period of bariatric surgery might be more effective in restoring lung volume and capacity and thoracic mobility than the separate application of expiratory and inspiratory positive pressure. Method: Sixty morbidly obese adult subjects who were hospitalized for bariatric surgery and met the predefined inclusion criteria were evaluated. The pulmonary function and thoracic mobility were preoperatively assessed by spirometry and cirtometry and reevaluated on the 1st postoperative day. After preoperative evaluation, the subjects were randomized and allocated into groups: EPAP Group (n=20), IPPB Group (n=20) and BIPAP Group (n=20), then received the corresponding intervention: positive expiratory pressure (EPAP), inspiratory positive pressure breathing (IPPB) or bilevel inspiratory positive airway pressure (BIPAP), in 6 sets of 15 breaths or 30 minutes twice a day in the immediate postoperative period and on the 1st postoperative day, in addition to conventional physical therapy. Results: There was a significant postoperative reduction in spirometric variables (p<0.05), regardless of the technique used, with no significant difference among the techniques (p>0.05). Thoracic mobility was preserved only in group BIPAP (p>0.05), but no significant difference was found in the comparison among groups (p>0.05). Conclusion: The application of positive pressure does not seem to be effective in restoring lung function after bariatric surgery, but the use of bilevel positive pressure can preserve thoracic mobility, although this technique was not superior to the other techniques.

Avaliação da atenção primária no município de Piracicaba, SP, Brasil

Este estudo teve por objetivo avaliar o funcionamento da rede de Atencao Basica do municipio de Piracicaba, SP. Foram realizadas 69 entrevistas, 37 com profissionais de saude das Unidades de Saude da Familia (USF), 23 das Unidades Basicas de Saude (UBS) e nove gestores, utilizando-se o Primary Care Assessment Tool (PCATool). As USF apresentaram maiores valores que as UBS para vinculo, elenco de servicos, enfoque familiar, orientacao para comunidade e total da Atencao Basica. Os gestores apresentaram maior valor para acesso que os profissionais das unidades. As USF apresentam melhor funcionamento que as UBS, mas os resultados para acesso sugerem que esta dimensao nao foi melhorada com a USF.

AIRWAY POSITIVE PRESSURE VS. EXERCISES WITH INSPIRATORY LOADING FOCUSED ON PULMONARY AND RESPIRATORY MUSCULAR FUNCTIONS IN THE POSTOPERATIVE PERIOD OF BARIATRIC SURGERY

ABSTRACT Background: Bariatric surgery can trigger postoperative pulmonary complications due to factors inherent to the procedure, mainly due to diaphragmatic dysfunction. Aim: To evaluate and compare the effects of two levels of positive pressure and exercises with inspiratory load on lung function, inspiratory muscle strength and respiratory muscle resistance, and the prevalence of atelectasis after gastroplasty. Methods: Clinical, randomized and blind trial, with subjects submitted to bariatric surgery, allocated to two groups: positive pressure group, who received positive pressure at two levels during one hour and conventional respiratory physiotherapy and inspiratory load group, who performed exercises with load linear inspiratory pressure, six sets of 15 repetitions, in addition to conventional respiratory physiotherapy, both of which were applied twice in the immediate postoperative period and three times a day on the first postoperative day. Spirometry was performed for pulmonary function analysis, nasal inspiratory pressure for inspiratory muscle strength and incremental test of respiratory muscle resistance for sustained maximal inspiratory pressure, both preoperatively and on hospital discharge on the second postoperative day. Results: There was no significant difference (p> 0.05) in the expiratory reserve volume and in the tidal volume in the pre and postoperative periods when compared intra and intergroup. There was no significant difference (p>0.05) in the nasal inspiratory pressure and the maximal inspiratory pressure maintained in the inspiratory load group in the intragroup evaluation, but with a significant difference (p<0.05) compared to the positive pressure group. The prevalence of atelectasis was 5% in both groups with no significant difference (p>0.05) between them. Conclusion: Both groups, associated with conventional respiratory physiotherapy, preserved expiratory reserve volume and tidal volume and had a low atelectasis rate. The inspiratory loading group still maintained inspiratory muscle strength and resistance of respiratory muscles.

ANÁLISE DA COMPOSIÇÃO CORPORAL, HÁBITOS ALIMENTARES E NÍVEL DE ATIVIDADE FÍSICA DE MENINAS

Objetivo: comparar a composicao corporal, habitos alimentares e nivel de atividade fisica de meninas de uma escola publica e uma particular no municipio de Santa Barbara d’ Oeste/ SP. Metodo: Foram avaliadas 103 meninas com idade media de 12,5 + 1,35 anos. Elas foram submetidas a afericao de peso e estatura e dobras cutâneas tricipital e panturrilha medial. Alem disso, as voluntarias responderam a dois questionarios, sendo um de nivel socioeconomico e outro para avaliar o nivel de atividade fisica, e preencheram um registro de 24 horas para se verificar os habitos alimentares. Resultados: Na analise das meninas, quando separadas por escola, foi possivel observar diferenca apenas na classificacao socioeconomica e na ingestao de proteina de alto valor biologico. Quando separados por nivel socioeconomico, nao houve diferenca significativa em nenhuma das variaveis analisadas. Em relacao ao nivel de atividade fisica nao foram encontradas diferencas para todas as classes sociais. Conclusao: Os resultados obtidos indicam que o excesso de peso pode acometer criancas e adolescentes independentemente da classe social e do tipo de escola frequentada.