Raphael Gonçalves de Oliveira

Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults.

Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence

Background Metabolic syndrome (MetS) has been diagnosed in adolescents and among the associated factors are low levels of physical activity, sedentary behavior over long periods and low cardiorespiratory fitness. However, specifically in adolescents, studies present conflicting results. The aim of the present study was to conduct a systematic review and meta-analysis of observational studies, in order to map the association between physical activity, sedentary behavior, cardiorespiratory fitness and MetS in adolescents. Methods A search was performed in the databases PubMed, SPORTDiscus, LILACS and the Cochrane Library. For the meta-analysis, the odds ratio (OR) was calculated together with the respective confidence intervals (95% CI), in which the measures of effect were analyzed by dichotomous data (exposure variables) with MetS used as events. Results Eighteen studies were included in the meta-analysis. Primary analysis demonstrated that low levels of physical activity (OR = 1.35 [1.03 to 1.79]; p = 0.03) and low cardiorespiratory fitness (OR = 4.05 [2.09 to 7.87]; p < 0.01) were significantly associated with the development of MetS, while for sedentary behavior, represented by screen time > 2 hours/day, a significant association was not identified (OR = 1.20 [0.91 to 1.59]; p = 0.20). Subgroup analyses demonstrated that the association between low physical activity and MetS was dependent on the use of the accelerometry technique (OR = 2.93 [1.56 to 5.47]; p < 0.01). Screen time > 2 hours/day was significantly associated with MetS only on weekends (OR = 2.05 [1.13 to 3.73]; p = 0.02). With respect to cardiorespiratory fitness, a significant association with MetS was found independent of the maximal oxygen uptake (VO2max) measurement method. Conclusions Low levels of physical activity, low indices of cardiorespiratory fitness and sedentary behavior, represented by screen time > 2 hours/day on weekends, were significantly associated with the development of MetS in adolescence.

O método Pilates no tratamento de espondilolistese traumática em L4-L5: estudo de caso

INTRODUCAO: O metodo Pilates e uma forma de tratamento conservador, que vem sendo utilizado em patologias da coluna vertebral. Dentre estas se encontra a espondilolistese, que se mostra como uma ocorrencia rara, quando do tipo traumatica entre as vertebras L4-L5. OBJETIVO: Verificar os efeitos do metodo Pilates sobre forca, flexibilidade e dor de um paciente com espondilolistese traumatica em L4-L5, que apresentava quadro estavel. MATERIAIS E METODOS: Avaliacoes pre e pos-intervencao foram realizadas com o intuito de avaliar a forca da musculatura abdominal e paravertebral, a flexibilidade da cadeia posterior e a dor lombar, envolvendo os seguintes testes: enrolamento repetitivo do tronco, estatico de resistencia das costas de Sorenson, sentar e alcancar e escala visual analogica (EVA) da dor. Para a intervencao, foram realizados exercicios do metodo Pilates, uma hora por dia, quatro vezes na semana, durante 12 semanas, nesta sequencia: alongamentos iniciais, fortalecimento de membros inferiores, abdominais e membros superiores, alongamentos finais e relaxamento. RESULTADOS: O paciente passou de 28 para 39 repeticoes no teste de enrolamento repetitivo do tronco, e de 17 para 65 segundos, no teste estatico de resistencia das costas de Sorenson. No teste de sentar e alcancar passou de -5 para 2 cm e o nivel de dor, de 7 para 3. CONCLUSAO: O metodo Pilates se mostrou eficiente no aumento da forca da musculatura abdominal e paravertebral, da flexibilidade da cadeia posterior e na melhora da dor na coluna lombar, em um paciente com espondilolistese traumatica de L4-L5, sendo uma alternativa para o tratamento conservador, em casos em que nao exista instabilidade no quadro.

Performance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescents

OBJECTIVE To analyze the performance of three different diagnostic criteria of overweight and obesity (WHO, IOTF and Conde and Monteiro) using body mass index (BMI) as predictors of metabolic syndrome (MetS) in a representative sample of adolescents. METHODS A sample of 1035 adolescents aged 12-20 years (565 girls and 470 boys) was used in the study. BMI was calculated through the quotient of weight (kg)/height squared (m)2, and MetS was defined according to the criteria of the International Diabetes Federation. Sensitivity, specificity, and overall accuracy (area under the curve) were estimated using the receiver operating characteristic (ROC) curves method and used to describe the predictive performance. RESULTS The three diagnostic criteria showed higher absolute values of sensitivity and specificity for predicting MetS in boys and older adolescents. The highest sensitivity to identify MetS was found using the IOTF criterion (60-85%), while specificity values ≥ 90% were found for the three criteria. The Conde and Monteiro diagnostic criterion pointed to a significantly lower overall accuracy (0.52-0.64) than that of the WHO (0.70-0.84) and IOTF (0.75-0.89) diagnostic criterion. CONCLUSIONS Overweight and obesity using BMI showed a moderate association with MetS, regardless of the diagnostic criteria used. However, the IOTF criterion showed better predictive capacity for the presence of MetS than the WHO and the Conde and Monteiro criteria.

Efeitos do método pilates no torque isocinético dos extensores e flexores do joelho: estudo piloto

INTRODUCCION: a pesar de la popularizacion del metodo Pilates, como una forma de ejercicio fisico, los estudios con la tecnica aun no han explorado sus efectos sobre el torque isocinetico de los musculos extensores y flexores de la rodilla.OBJETIVOS: verificar los efectos del metodo Pilates, el torque isocinetico de los extensores y flexores de la rodilla en mujeres jovenes.METODOS: diez voluntarias fueron sometidas a evaluacion isocinetica (60°/s y 300o/s) de los extensores y flexores de la rodilla, del miembro inferior dominante, antes y despues de la intervencion con el metodo Pilates, considerandose el pico de torque (PT) y trabajo total (TT). Ocho intervenciones fueron realizadas durante cuatro semanas, siendo 28 ejercicios de alongamiento y fortalecimiento para los principales grupos musculares. Fue aplicado analisis estadistico utilizando los tests t de Student o de Wilcoxon para muestras dependientes (p <0,05).RESULTADOS: los resultados mostraron mejora significativa para la mayoria de las variables observadas, tanto en extension de la rodilla (TT 60°/s - 8,98%, p = 0,0166, PT 300°/s - 11,80%, p = 0,0077, TT 300°/s - 19,68%, p = 0,0051) como en la flexion (PT 60°/s - 11,44%, p = 0,0171; TT 60°/s - 11,55%, p = 0,0395; TT 300°/s - 12,86%, p = 0,0145), como excepcion a dos variables: una referente al movimiento de extension de la rodilla (PT 60°/s - 3,04 %, p = 0,4413) y otra al movimiento de flexion (PT 300°/s - 2,30%, p = 0,3873).CONCLUSION: fue posible verificar que ocho sesiones de Pilates, realizadas a lo largo de cuatro semanas, proporciono mejora significativa en el torque isocinetico, de los musculos extensores y flexores de la rodilla en mujeres jovenes, en relacion al PT y TT (60°/s y 300o/s), para la mayoria de las variables analizadas.INTRODUCTION: despite the popularity of Pilates as a form of exercise, studies with the technique still have not explored their effects on isokinetic torque of the extensor and flexor muscles of the knee.OBJECTIVES: check the effects of the Pilates method on isokinetic torque of the knee extensors and flexors in young women.METHODS: 10 volunteers underwent isokinetic evaluation (60°/s and 300°/s) of the knee extensors and flexors of the dominant leg, pre-and post-intervention with the Pilates method, considering the peak torque (PT) and total work (TW). Eight interventions were conducted over four weeks, 28 consisting of stretching and strengthening exercises for the major muscle groups. Statistical analysis using the Student t or Wilcoxon for dependent samples was used (p<0.05).RESULTS: the results showed significant improvement for most of the observed variables in both knee extension (TW 60°/s - 8.98%, p = 0.0166, PT 300°/s - 11.80%, p = 0.0077, TW 300°/s - 19.68%, p = 0.0051) and in flexion (PT 60°/s - 11.44%, p = 0.0171; TW 60°/s - 11.55%, p = 0.0395; TW 300°/s - 12.86%, p = 0.0145), as an exception to two variables: one related to the movement of knee extension (PT 60°/s - 3.04 %, p = 0.4413) and the other to flexion (PT 300°/s - 2.30%, p = 0.3873).CONCLUSION: we found that eight sessions of Pilates, conducted over four weeks, provided significant improvement in isokinetic torque of the extensor and flexor muscles of the knee in young women, in relation to the PT and TT (60°/s and 300°/s) for most variables.

Physical Fitness and Metabolic Syndrome in Brazilian Adolescents: Validity of Diagnostic Health Criteria

We tested health criteria cutoff points from physical fitness variables proposed by the Fitnessgram program for detecting metabolic syndrome (MetS) in a representative sample of 1,035 Brazilian adolescents (565 girls and 470 boys) aged 12-20 years. We studied five fitness tests: (a) back-saver sit and reach, (b) trunk lift, (c) curl-up, (d) push-up, and (e) progressive aerobic cardiovascular endurance run (PACER), and we defined MetS through the criteria of the International Diabetes Federation. We described the predictive performance of each fitness test in terms of sensitivity, specificity, and area under the curve (AUC) estimates of the receiver operating characteristic method. The AUCs for four tests (back-saver sit and reach, trunk lift, curl-up, and push-up) revealed low accuracy for identifying MetS in both sexes (0.50 ≥ AUC ≤ 0.60), but AUCs for the PACER test demonstrated good accuracy values between 0.72 (0.68–0.76) and 0.83 (0.78–0.89). Thus, cutoff points proposed in the Fitnessgram program for the PACER test offer an effective means of screening adolescents at higher cardiometabolic risk, which, for the age-group used in this study, should be from 40.3-44.3 ml/kg/min for boys and 38.6-40.1 ml/kg/min for girls.

Accuracy of motor tests related to musculoskeletal fitness as predictors of low back pain in adolescents: a pilot study

Background: The prevalence of low back pain in adolescents is close to that found in the adult population. In view of the relationship between low back pain and the resistance of the spine stabilizing muscles, studies have sought to identify the ability of specific motor tests to predict this condition. Objectives: Our objective was to verify the predictive ability of three motor tests related to musculoskeletal fitness to identify adolescents with low back pain. Methods: The sample consisted of 150 adolescents, of both sexes, aged between 15 and 19 years. The Nordic questionnaire validated for Brazilian adolescents was applied to identify those with low back pain. Subsequently, three motor tests (one-minute sit-up test, Sorensen test and lateral plank test) were applied. Statistical analysis involved the ROC curve, to identify the Area Under the Curve (AUC), assuming a 95% confidence interval. Results: It was observed in males that all the tests had a low AUC (between 0.56 and 0.57), without statistical significance (p > 0.05). For females, AUC ranged from 0.62 to 0.66, with statistical significance (p < 0.05) for the cut-off points identified in the one-minute sit-up test (≤ 24 repetitions) and Sorensen test (≤ 28 seconds), however, without significance (p > 0.05) for the lateral plank test. Conclusion: Motor tests of abdominal and paravertebral muscle resistance were not predictors of low back pain in male adolescents. Despite the low accuracy, the cut-off points identified in the one-minute sit-up test and Sorensen test, can be used with some caution to predict low back pain in female adolescents.

Translation, transcultural adaptation and validation of the Nordic questionnaire for the evaluation of low back pain in Brazilian adolescents

Background: Low back pain has been configured as a public health problem capable of compromising functional capacity, even in adolescents, however, there are no validated instruments for Brazilian adolescents. Objective: Validate the psychometric properties of the Nordic questionnaire for the evaluation of low back pain in Brazilian adolescents. Methods: The sample consisted of 150 adolescents (84 female), aged between 15 and 19 years. The Nordic questionnaire for the evaluation of low back pain in adolescents, was translated and culturally adapted into Portuguese (Brazil). A committee of experts followed the entire validation process. The questionnaire was administered in two moments, with a 14-day interval. Statistical analysis involved Kappa index. Results: After the slight modifications in the translation process, the expert committee considered that the Brazilian Portuguese version of the questionnaire presented semantic, idiomatic, cultural and conceptual equivalence. The results showed that, among the 15 items considered in the eight questions of the questionnaire, 66.6% presented substantial agreement (kappa between 0.61-0.80). The other items presented almost perfect agreement (kappa > 0.80). Conclusion: The Nordic questionnaire for the evaluation of low back pain in adolescents, after being translated and culturally adapted into the Portuguese (Brazil) language, showed adequate psychometric properties, with high reproducibility in all items, demonstrating that it can be used safely to evaluate the low back pain in Brazilian adolescents.

Artigo OriginalPerformance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescentsDesempenho de diferentes critérios diagnósticos de sobrepeso e obesidade como preditores de síndrome metabólica em adolescentes

Objective To analyze the performance of three different diagnostic criteria of overweight and obesity (WHO, IOTF and Conde and Monteiro) using body mass index (BMI) as predictors of metabolic syndrome (MetS) in a representative sample of adolescents.

Effects of the Pilates method on variables related to functionality of a patient with traumatic spondylolisthesis at L4-L5: A case study.

INTRODUCTION Traumatic spondylolisthesis at L4-L5 is a rare complication in the spine, which impairs variables related to the functionality of the person affected. OBJECTIVE To verify the effects of the Pilates method on strength and muscular resistance, flexibility, postural balance and level of pain in a patient with traumatic spondylolisthesis at L4-L5. METHODS The following evaluations were performed pre and post-intervention: resistance of the flexor and extensor muscles of the trunk; isokinetic peak torque of the extensor and flexor muscles of the knee; hip and torso flexibility; static postural balance; and the visual analog scale of pain. The treatment consisted of three weekly sessions of Pilates, performed over 12 weeks. RESULTS There was improvement in all the tests, except for one variable related to postural balance. CONCLUSIONS The Pilates method was effective for improving muscle resistance and strength, flexibility, postural balance and pain, in a patient with traumatic spondylolisthesis at L4-L5.