Next steps to advance general physical activity recommendations towards physical exercise prescription: a narrative review

Physical inactivity is a major health concern, associated with the development of several non-communicable diseases and with an increased mortality rate. Therefore, promoting active lifestyles has become a crucial public health necessity for enhancing overall health and quality of life. The WHO guidelines for physical activity (PA) present valuable contributions in this respect; however, we believe that greater specificity should be added or complemented towards physical exercise (PE) testing, prescription and programming in future recommendations. In this review article, we suggest simple and practical tools accessible to the entire population to improve the specificity of this approach, highlighting aspects of PE programming used by trained subjects. By adopting these suggestions, exercise professionals, clinicians and physical trainers can optimise the current general PA recommendations towards PE prescription to improve fitness status and encourage PE adherence in the general population.

Habilidades motoras fundamentales en preescolares chilenos

Las habilidades motoras fundamentales (HMF) son vinculadas como un factor clave en la promoción de estilos de vida activos y de salud a lo largo de la vida. No obstante, los resultados sobre HMF en preescolares son heterogéneos. El objetivo del estudio es describir la categorización de la puntuación obtenida en el test de HMF, así como dilucidar las diferencias por sexo y edad. Se realizó un estudio de diseño transversal, con 145 preescolares (84 varones) de 4 a 6 años (5.44 ± 0.58 años) participantes de un programa nacional del Ministerio del Deporte. Las HMF se midieron usando la prueba de desarrollo motor grueso (segunda edición). Para el análisis por categorías de las HMF, se convirtieron en percentiles los puntajes obtenidos en la prueba presentados a través de tablas de frecuencias. Para analizar las diferencias por sexo y edad se utilizaron U de Mann-Whitney y Kruskal-Wallis para aquellos sin distribución normal y los análisis de t de student y ANOVA de una vía para aquellas variables con distribución normal. Los principales resultados indican que los preescolares presentan mayormente puntajes sobre el percentil ( p50). Los niños poseían mayores puntajes  p50 en las habilidades de locomoción, control de objetos (p=0,007) y HMF total que las niñas. Niños y niñas mostraron mayores puntajes  p50 con el aumento de la edad en habilidades de locomoción (p=0,002), control de objetos (p=0,000) y HMF total (p=0,000). En conclusión, los preescolares chilenos presentan un adecuado desempeño en las HMF, dilucidando diferencias significativas por sexo y edad, principalmente en el control de objetos.

Telerehabilitation is Effective to Recover Functionality and Increase Skeletal Muscle Mass Index in COVID-19 Survivors

Objective: The purpose of this study was to evaluate the effects of a telerehabilitation program for COVID-19 survivors on their functionality, aerobic capacity, upper-lower body strength and skeletal muscle mass index. Methods: Fifty patients (22 M); age 54.1±15.4 who became ill with COVID-19 during 2020 completed a 24-session telerehabilitation program. The following measures were taken: Barthel’s index, two minutes step test (2MST), elbow flexion one-repetition maximal (1RM), short physical performance battery (SPPB), hand grip strength, 30-second chair stand, skeletal muscle index (SMI), body fat percentage, resting pulse, arterial blood pressure, and pulse oximetry. Results: There was a significant increase in the Barthel index (p?0.0001), 2MST (p?0.0001), 1RM elbow flexion (p?0.0001), SPPB (p?0.0001), hand grip strength (p?0.0001), 30-second chair stand (p?0.0001), and SMI (p?0.0001). Conclusion: A 24 session in-home telerehabilitation program promoted the recovery of physical independence and increases in skeletal muscle mass index and physical fitness.

[Maximum aerobic power output in overweight and obese individuals]

BACKGROUND

The evaluation of physical fitness is important to determine workloads and to assess the effectiveness of exercise interventions in obese people.

AIM

To determine the maximum aerobic power output (MAPO) in overweight and obese individuals and to establish reference parameters for the Chilean population.

MATERIAL AND METHODS

One hundred five men and 218 women performed a cycle ergometer test up to 85% of their maximum heart rate. MAPO was determined by linear extrapolation of the theoretical maximum heart rate.

RESULTS

Among men, MAPO values were 234.9 ± 48.4 w for body mass index (BMI) values between 30 and 34.9 kg/m2, 235.1 ± 69.7 w for BMI between 35 and 39.9 kg/m2, 270.2 ± 86.5 w for BMI over 40 kg/m2. MAPO relative values were 2.27 ± 0.5, 2.16 ± 0.6 and 1.96 ± 0.8 w/kg, respectively. Among women, MAPO was 172.6 ± 36.1 w for a BMI < 30 kg/m2, 169.2 ± 39.4 w for BMI between 30 and 34.9 kg/m2, 179.5 ± 48.8 w f179.5 ± 48.8 w for BMI between 35 and 39.9 kg/m2 and 202.3 ± 57.3 w for BMI of 40 kg/m2 or over. The relative values were 2.33 ± 0.5; 2.02 ± 0.5; 1.91 ± 0.5 and 1.81 ± 0.5 w / kg (p < 0.05).

CONCLUSIONS

MAPO estimation with a cycle ergometer test is well tolerated in overweight and obese individuals. MAPO decreased along with BMI increments in women. No association between BMI and MAPO in men was observed.

In preschool children, physical activity during school time can significantly increase by intensifying locomotor activities during physical education classes

OBJECTIVES

After categorizing preschool children into "active and low active" according to their moderate and vigorous physical activity (MVPA) in PE classes (PE), we compared these two groups within each sex and by sex in: (a) % MVPA and MVPA minutes accrued from each fundamental motor skill (FMS) during PE and (b) % MVPA during school time.

RESULTS

532 children (mean age 5.2 years, 50% girls) were selected from a nationwide program which provides 3 weekly PE. Children wore accelerometers during one school day which included PE. We recorded the type and duration of each activity indicated by the teacher, classifying each one into the corresponding FMS, extracting its MVPA minutes from the accelerometer software. Children were categorized into active and low active. Comparisons used T-tests. In PE, active children accumulate 40 and 36 percentage points (pp) more MVPA minutes (boys and girls respectively), while during school time, 4 pp more in each sex. Girls are significantly less active. Just considering locomotion, active boys and girls accumulate 11 more MVPA minutes during PE. Active boys surpass the MVPA guideline for PE, while active girls almost reach it. Low active children (especially girls) should intensify locomotor activities during PE.

[Prevalence of Barrett's esophagus in patients with colorectal carcinoma]

OBJECTIVE

To determine Barrett's esophagus (BO) prevalence in patients diagnosed with colorectal carcinoma (CC) and feasibility-associated factors in a 10 week period from March 1st to June 15, 1999.

PLACE

Endoscopy Department, Oncology Hospital, Centro Médico Nacional Siglo XXI, IMSS.

METHOD

A prospective, transversal, observational and comparative assay of 48 patients with histologically confirmed diagnosis of colorectal carcinoma in whom high endoscopy with biopsy harvest was performed; otherwise, colonoscopy was performed in eight patients with confirmed BO.

RESULTS

Thirty men and 18 women were studied with an average age of 53 years of age. In 100%, colon cancer was determined as adenocarcinoma and location were rectal in 43.7%. Prevalence of BO was 22.9% in addition to 0.74 to 2% in the general population. This implies an odds ratio calculated at 36.43 (p = 0.00000) and 3.09 p = 0.00007), respectively, for risk to present BO concomitant with CC. There was no statistical significance in relation to age, smoking habit, and/or alcoholism. Among eight patients with BO without CCR, only one had a tubulovellous polypus (12.5%) identified.

CONCLUSIONS

Although the results were not to conclusive to affirm the association of BA with CCR, the high prevalence found justifies the performance of routine endoscopy in CCR carrier patients with reflux symptoms.