Home-Based Indoor Physical Activity Programs for Community-Dwelling Older Adults: A Systematic Review

CONTEXT

Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside.

OBJECTIVE

To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults.

DATA SOURCES

A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases.

STUDY SELECTION

A total of 11 studies (13 publications) were included involving a total of 1004 older adults.

STUDY DESIGN

A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

LEVEL OF EVIDENCE

Level 2.

DATA EXTRACTION

Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome.

RESULTS

There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home.

CONCLUSION

The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling.

PROTOCOL REGISTER NUMBER

CRD42020182008.

Influence of Advancing Biological Maturation on Aerobic and Anaerobic Power and on Sport Performance of Junior Rowers: A Longitudinal Study

Background: Researches are linking Biological Maturation (BM) with the performance of adolescent rowers from both genders. Despite this, there is still not enough information about the influence of BM advancement correlating to sports, aerobic and anaerobic performance in adolescent athletes at the sport modality rowing. Objective: Investigate the influence of Biological Maturation on sports performance and aerobic and anaerobic power in adolescent rowing athletes. Methods: A longitudinal observational study, developed over 3 years, with a sample of 52 adolescents, rowing athletes, of both genders (61% male and 39% female) mean age of 16.0 ± 0.5 years old at the start and 18.4 ± 0.5 years old at the end of the study. Analysis was performed once a year. BM was evaluated through maturational groups generated from Age Peak Height Velocity; maximum aerobic power [VO₂Max (ml/kg/min)] and mean anaerobic power (Watts) through the ergometer test (indoor rowing); peak anaerobic power (Watts) through a mathematical model derived from competition time, to determine sports performance analyzed the race time during world championship tryouts. Results: The advancement of BM influenced the reduction of the test time and increase of the mean anaerobic power (Watts) in indoor rowing (η2p > 0.36, p < 0.05), as well as an improvement in performance in sports competition (η2p > 0.35, p < 0.05). However, the advancement of BM did not affect VO2Max (ml/kg/min) in young elite rowing athletes of both sexes (p > 0.05). Conclusion: Advances in biological maturation have been shown to influence the anaerobic and sports performance (reduction of the execution time in 2,000-m) of adolescent rowing athletes of both genders.

Performance of postural balance in children and adolescents living with and without HIV

RESEARCH QUESTION

The present study aimed to compare the postural control of children and adolescents with and without Human Immunodeficiency Virus (HIV).

METHODS

A total of 32 children and adolescents (18 with HIV and 14 without) of both sexes, aged 6-18 years, were included in the present study. Participants in the HIV + group were infected through vertical transmission and received antiretroviral therapy. Participants maintained an erect, bipedal posture in the following conditions: with vision, without vision, and on a foam base.

RESULTS

Concerning the evaluation of time variables, higher values ​​were observed in the HIV + group for mean anterior-posterior (AP) velocity, mean medial-lateral (ML) velocity, AP perimeter (p = 0.001), and ML perimeter (p = 0.001). Concerning the evaluation of conditions, a difference was observed in the mean AP mean sway amplitude (MSA) (p = 0.039), as the AP MSA was lower with vision than without vision or with foam. Concerning the evaluation of spectral domain variables, higher values ​​were observed in the HIV+ group for the predominant ML frequency (p = 0.04) and mean AP (p = 0.001) and ML frequencies (p = 0.001). Regarding the evaluation of conditions, a difference was found only in the predominant AP frequency (p = 0.001). Higher values ​​were found in the closed eye condition than in with foam (Δ = +103 %).

CONCLUSION

The results of the present study indicated that children and adolescents living with HIV have poorer postural control performance than those without HIV.

Effect of Training and Detraining in the Components of Physical Fitness in People Living With HIV/AIDS

The aim of the study was to evaluate the effect of training and detraining on the physical fitness components of people living with HIV/AIDS (PLHA). The study was characterized as experimental with a sample composed of 21 people divided into two groups: 11 volunteers (PLHA, 46.9 ± 8.0 years, 63.8 ± 12.7 kg, 161.7 ± 8.7 cm, 7 men, and 4 women), using antiretroviral therapy (ART) and 10 people without HIV/AIDS in the control group (CG, 43.8 ± 13.8 years, 75.2 ± 11.2 kg, 163.3 ± 7.8 cm, 3 men, and 7 women), with the same average age and level of physical activity. The intervention, applied to both groups, consisted of combined training for 15 weeks, followed by detraining for 5 weeks. Before and after the training and detraining period the following parameters were evaluated: body composition by dual energy radiological absorptiometry (DXA), cardiorespiratory fitness by ergospirometer, and strength of upper and lower limbs by isometric dynamometer. The results show the effect of the intervention moments on the strength and oxygen consumption variables (time factor), considering the two study groups. Regarding the analysis of the interaction (group vs. time), there was a significant effect on the isometric extension strength of the left (p = 0.019) and right (p = 0.030) knees, with training (left: 10.4%; right: 12.4%) and detraining (left: −10.8%; right: −12.1%) effect in PLHA, when compared with the control group (left: 8.1 and 3.9%, respectively; right: 11.5 and −0.2%, respectively). In addition, there was a significant interaction on ventilatory threshold 1 (p = 0.002), indicating a significantly greater increase with training (27.3%) and decrease with detraining (−22.7%) in the PLHA group compared with the Control group (19.9 and −6.7%, respectively). In conclusion, combined training and the subsequent period of detraining caused similar responses in body composition, isometric strength, and cardiorespiratory fitness of PLHA and CG, except for the extensor strength of the lower limbs and ventilatory threshold 1, which presented positive effects on training and negative effects on detraining for PLHA.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03075332.

Lean mass and biological maturation as predictors of muscle power and strength performance in young athletes

Background

The biological maturation (BM) analyzed by peak height velocity (PHV) and bone age (BA), and lean body mass has been associated with the strength and muscle power of young athletes. However, the ability of BM (PHV and BA) and LM markers to predict muscle strength and power in young athletes remains uncertain.

Objective

The Aim was determine the predicting power of BM markers (PHV and BA) and LM in relation to muscle power of upper and lower limbs and muscle strength of upper limbs in adolescent athletes at puberty.

Methods

Ninety-two adolescent athletes (both sexes; age 12.4 ± 1.02 years) were assessed for body composition by dual-energy X-ray absorptiometry (DXA). Power of upper limbs (ULP), force handgrip (HG), vertical jump (VJ) and countermovement jump (CMJ) were recorded. BM was predicted by mathematical models to estimate PHV and BA. Multilayer artificial neural network analyses (MLP’s) were used to determine the power of prediction of LM, PHV and BA on muscle power and strength of upper- and lower-limbs of the athletes.

Results

LM, BA and PHV were associated with HG (r>0.74, p<0.05) and ULS (r>0.60, p<0.05) in both sexes. In both sexes BA was associated with VJ (r>0.55, p<0.05) and CMJ (r>0.53, p<0.05). LM indicated associations (r>0.60, p<0.05) with BA and with PHV (r<0.83, p<0.05) in both sexes. MLP’s analysis revealed that the LM provides > 72% of probability to predict the muscle power of upper- and lower-limbs, and the strength of the upper limbs; whereas PHV provides > 43% and bone age >64% in both female and male adolescent athletes.

Conclusion

We identified that, like PHV and BA, LM is a strong predictor of low cost of both upper limbs muscle strength and upper and lower limbs power in adolescent athletes.

Comparison of Muscle Strength, Aerobic Capacity and Body Composition between Healthy Adolescents and Those Living with HIV: A Systematic Review and Meta-Analysis

Background: The adverse effects of antiretroviral therapy associated with complications generated by human immunodeficiency virus (HIV) promote impairments in physical fitness in adolescents. Objective: To analyze the aerobic capacity, muscle strength, and body composition of adolescents living with HIV compared with a healthy population of the same age. Methods: Searches were performed in the MEDLINE, Embase, Web of Science, Scopus and SportDiscus databases until September 2019 and updated in April 2020. Eligibility Criteria: adolescents of both sexes in the age group from 10 to 19 years; living with HIV; cross-sectional, case–control, cohort studies; comparing with a healthy population. Mean differences and 95% Confidence intervals (CIs) were calculated using RevMan (software for systematic reviews). Results: Five articles were included, involving 197 adolescents living with HIV (16 to 18 years) and 185 without infection (13 to 18 years), with the sample in each study ranging from 15 to 65 adolescents. Aerobic capacity and muscle strength were reduced in adolescents with HIV, and body mass index was also significantly lower in this group. Conclusion: Adolescents living with HIV have impaired cardiorespiratory fitness, muscle strength, and body composition when compared to their uninfected peers. However, this systematic review provides limited evidence on the differences between the physical fitness outcomes of adolescents living with HIV compared to healthy adolescents.

Active Video Games for Improving Mental Health and Physical Fitness-An Alternative for Children and Adolescents during Social Isolation: An Overview

The aim of this study was to synthesize the evidence on the effects of active video games (AVGs) on mental health, physical fitness and body composition of children and adolescents. A search was conducted in the following databases: PubMed; MEDLINE (by Ovid); SportDiscus, Cochrane library systematic reviews (CENTRAL) and EMBASE with no language restrictions during October 2020. Reviews on the use of AVGs were included in the study. We use the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) scale to analyze the methodological quality of the studies. Seventeen systematic reviews and meta-analyzes were included on the effects of AVGs with 30 to 4728 children and adolescents of both sexes with ages ranging from 6 to 19 years. In five studies, the population was overweight or obese. Regarding the quality, 12 studies were of moderate quality, two had high quality, two had low quality and one showed very low quality. The analyzed data indicate that the use of AVGs with a frequency of 1 to 3 times a week with durations of between 10 and 90 min per day shows positive effects on mental health and physical functioning. There was moderate quality evidence that AVGs can result in benefits for self-esteem, increased energy expenditure, physical activity and reduced body mass index in children and adolescents who used AVGs in the home environment. Further research is needed on this tool to help in the process of social isolation and consequently in promoting health and well-being.

Influence of curcumin on glycemic profile, inflammatory markers, and oxidative stress in HIV-infected individuals: A randomized controlled trial

To evaluate the influence of curcumin supplementation on the glycemic profile, inflammatory markers, and oxidative stress in HIV-infected individuals under antiretroviral therapy. This double-blind, crossover, randomized clinical trial was composed of 20 subjects arranged initially into experimental group (n = 10) and placebo group (n = 10) groups, receiving 1,000 mg curcumin/day or microcrystalline cellulose/day, respectively, during a 30-day period and 12-day washout. Subsequently, the groups were switched to follow the crossover design. Fasting glucose and insulin, IL-10, tumor necrosis factor alpha, malonialdehyde, and reduced glutathione were measured. Food consumption was evaluated as a control variable. Descriptive statistics are presented as mean and standard deviation, and inferential analyses were performed from two-way analysis of variance and the magnitude of the effect. No significant improvements were observed in the glycemic, inflammatory, or oxidative stress profiles. Although the mean serum fasting glucose levels and the homeostatic model assessment index presented qualitative improvement in the CG, this result should be interpreted with caution since the observed variation may represent acceptable fluctuation, in addition to the small difference between the means, added to the large variation observed in the standard deviation. Supplementation with curcumin in HIV-infected individuals undergoing antiretroviral therapy and training did not improve the glycemic, inflammatory, or oxidative stress profiles.

A comparative analysis of physical fitness of children and adolescents with HIV infection: A systematic review protocol

BACKGROUND

The impaired physical capacity of children and adolescents with HIV can directly influence their physical performance, activities of daily living and social participation. The purpose of this systematic review protocol is to perform a systematic review and meta-analysis on physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV, compared with healthy controls.

METHODS

We will be following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) statement guidelines. There will be cross-sectional, longitudinal and case-controlled studies, and there will be no restrictions on language and year of publication in the search. The search strategy will be to use databases including: MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Scopus, SportDiscus and CINAHL; The MeSH terms will be: physical fitness, fitness trackers, agility, flexibility, physical endurance, muscle strength, aerobic capacity, human immunodeficiency virus, HIV, children, and adolescents, to discuss and compare physical fitness (cardiorespiratory capacity, agility, flexibility, strength, and muscular endurance) in children and adolescents with HIV and healthy control. The reviewers will independently read the articles, extract the data information and analyze the risk of bias using the Cochrane criteria for observational studies. The Cohen's will be used to calculate the agreement between the revisions.

RESULTS

This study will provide a high-quality synthesis of observational studies on the analysis and comparison of physical fitness in children and adolescents with HIV compared with healthy controls.

CONCLUSION

This systematic review will be very important for the creation of proposals aimed at providing high quality subsidies in the management of HIV during the development phase of children and adolescents.

ETHICS AND DISSEMINATION

Ethics approval is not required because individual patient data and privacy were not involved in this study.

PROSPERO REGISTRATION NUMBER

CRD42019140955.

PROSPERO REGISTRATION DATE

23/09/2019.

Quality of life, socioeconomic and clinical factors, and physical exercise in persons living with HIV/AIDS

OBJECTIVE

To analyze whether socioeconomic and clinical aspects and the aspects of healthy life habits are associated with the quality of life of persons living with HIV/AIDS.

METHODS

This is a cross-sectional exploratory quantitative research, with 227 persons living with HIV/AIDS, treated at two hospitals of reference between April 2012 and June 2014. We used structured questionnaires to assess socioeconomic aspects (gender, age, education level, marital status, race, socioeconomic status, dependents on family income, employment relationship), clinical parameters (time of disease diagnosis, use and time of medication, CD4 T-cell count, and viral load), and practice of physical exercise. To assess quality of life, we used the Quality of Life questionnaire (HAT-QoL). For characterization of the socioeconomic and clinical data and domains of quality of life, we conducted a descriptive analysis (simple frequency, averages, and standard deviations). We applied linear regression, following a hierarchical model for each domain of quality of life.

RESULTS

The domains that presented lower averages for quality of life were financial concern, concern with confidentiality, general function, and satisfaction with life. We found associations with the variables of socioeconomic status and physical exercise, therapy, and physical exercise for the last two domains, consecutively.

CONCLUSIONS

The quality of life of persons living with HIV/AIDS shows losses, especially in the financial and confidentiality areas, followed by general function of the body and satisfaction with life, in which socioeconomic and clinical aspects and healthy living habits, such as the practice of physical exercise, are determining factors for this reality.

OBJETIVO

Analisar se aspectos socioeconômicos, clínicos e de hábitos de vida saudável estão associados à qualidade de vida em pessoas vivendo com HIV/aids.

MÉTODOS

Pesquisa quantitativa exploratória de corte transversal, com 227 pessoas vivendo com HIV/aids, atendidos em dois hospitais de referência entre os períodos de abril 2012 a junho de 2014. Foram utilizados questionários estruturados para avaliar aspectos socioeconômicos (sexo, idade, escolaridade, estado civil, cor de pele, status socioeconômico, dependentes da renda familiar, vínculo empregatício), parâmetros clínicos (tempo de diagnóstico da doença, uso e tempo de medicação, contagem de células TCD4 e carga viral) e prática de exercício físico. Para avaliar qualidade de vida, utilizou-se o questionário Quality of Life (HAT-QoL). Para caracterização dos dados socioeconômicos, clínicos e domínios da qualidade de vida, conduzimos análise descritiva (frequência simples, médias e desvios-padrão). Aplicamos regressão linear, seguindo um modelo hierárquico para cada domínio da qualidade de vida.

RESULTADOS

Os domínios que apresentaram menores médias para a qualidade de vida foram preocupação financeira, preocupação com sigilo, função geral e satisfação com a vida. Foram encontradas associações com as variáveis status socioeconômico e exercício físico; terapia; e exercício físico para os dois últimos domínios, consecutivamente.

CONCLUSÕES

A qualidade de vida de pessoas vivendo com HIV/aids apresentam prejuízos, principalmente nas questões financeiras e de sigilo, seguidos da função geral do corpo e satisfações com a vida, em que os aspectos socioeconômicos, clínicos e hábitos de vida saudável, como a prática de exercício físico, são fatores determinantes para essa realidade.

SOMATÓTIPO E IMAGEM CORPORAL EM PESSOAS VIVENDO COM HIV/AIDS

RESUMO Introdução: A terapia antirretroviral de alta atividade (HAART) está associada ao surgimento de diversos efeitos adversos na população com HIV/Aids, dentre as quais, a lipodistrofia. Caracterizada pela reorganização anormal de gordura pelo corpo, é um dos efeitos mais relevantes, envolvendo riscos cardiometabólicos e prejuízos na imagem corporal. Objetivo: Analisar a somatotipia e a imagem corporal em pessoas vivendo com HIV/AIDS. Métodos: A amostra foi composta por cinco mulheres (47,8 ± 6,53 anos) em uso da HAART e fisicamente ativas. Foi realizada uma intervenção com o treinamento concorrente e aconselhamento dietético e avaliou-se a conformação corporal pelo somatótipo e a imagem corporal pela escala de silhuetas. Resultados: Não houve diferença na classificação do somatótipo, entretanto, os resultados apontaram diferença significativa para a análise da distância de dispersão entre somatótipos (DDS) na 1ª semana (DDS = 2,63) e 16ª semana de intervenção (DDS = 2,96), quando avaliado pelas médias; e quando avaliado individualmente, verificou-se diferença significativa tanto na DDS quanto na distância espacial entre somatótipos (DES) nos casos 1, na 8ª semana (DDS = 3,20 e DES = 1,01) e 16.a semana (DDS = 2,73); e caso 3, na 1ª semana (DDS = 9,25 e DES = 1,44) e 16ª semana (DDS = 8,06 e DES = 1,37). Quanto à imagem corporal, observou-se a aproximação da imagem atual à imagem ideal (imagem atual inicial = 6; imagem atual final = 5; e imagem ideal inicial e final = 3). Conclusão: O programa de treinamento concorrente associado à orientação nutricional produziu resultados positivos tanto no somatótipo quanto na percepção da imagem corporal das participantes, comprovando sua eficácia no controle da lipodistrofia e na satisfação da imagem corporal do grupo avaliado.

Relationship between dietary intake and use of protease inhibitors with anthropometric and biochemical parameters of lipodystrophy in people living with hiv

The lipodystrophy syndrome is characterized by redistribution of body fat and disorders of glicidic and lipid metabolism. Although its etiology is related to infection and drug therapy, there is little evidence regarding the nutritional disturbances on this association. This study aimed to assess the relationship between dietary intake and use of protease inhibitors (PIs) with anthropometric and biochemical parameters in HIV positive patients. The study included 50 patients. A questionnaire about socioeconomic status, lifestyle and infection history was taken. In addition, it was conducted the evaluation of dietary intake (frequency questionnaire), anthropometric parameters (body mass index, waist circumference, triceps skinfold, corrected arm muscle area) and biochemistry tests (glycemia and lipid profile). Only 37% of the sample was classified as "good food consumption", 54% were overweight or obese and 66% presented high waist circumference. The group with good food consumption had higher HDL-C (p=0.04) levels than the group with poor food consumption. Patients taking PIs presented VLDL-C (p=0.023) and triglycerides (p=0.024) levels significantly higher. These results indicated the necessity for continuous monitoring of HIV-positive patients and non-pharmacological interventions such as nutrition education and practice of physical exercises.