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Background: This study aimed to demonstrate the technological means used to offer telerehabilitation and to evaluate the effect of physical exercise on the population affected by COVID-19. Methods: Clinical trials were searched in the electronic databases Cochrane Library, PubMed/MEDLINE, EBSCO (CINAHL), PEDro, and Web of Science from January 16 to 19, 2023. The effect measure was estimated as mean difference (MD) or standard MD (SMD) with 95% confidence intervals (CI). Subgroup analysis was used to study potential moderating factors. Results: Twenty-four articles, describing trials with a total of 1,344 individuals affected by COVID-19, were included in the qualitative synthesis and 14 articles in the meta-analysis. The pooled results revealed that telerehabilitation improves the functional capacity (MD 79.65 [63.57, 95.73]m, p < 0.00001), agility (MD -0.69 [-1.33, -0.04] s, p = 0.04), lower limb strength and endurance (SMD 0.74 [0.52, 0.96], p < 0.00001), forced expiratory volume in 1 s (MD 0.22 [-0.04, 0.49] L, p = 0.10), and dyspnea (SMD -0.94 [-1.64, -0.24], p = 0.009). The dynamic muscular resistance training associated or not with other exercise modalities led to improvements in muscular strength (MD 4.69 [0.44, 8.94] kg, p = 0.03) and fatigue (SMD -0.97 [-1.74, -0.20], p = 0.01). In addition, telerehabilitation showed improvements in the quality of life in the contagious-phase COVID-19 patients. Although this intervention improved inspiratory muscle strength (MD 13.71 [5.41, 22.0] cmH2O, p = 0.001), it did not favor forced vital capacity. Conclusions: Telerehabilitation contributed to improving functional capacity, inspiratory muscle strength, physical fitness, and quality of life, and reducing dyspnea and fatigue in COVID-19 adult survivors.

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AIM: To investigate the associations between 24-h movement behaviours and heart rate variability (HRV) in preschool children. METHODS: A total of 123 preschoolers (4.52 ± 0.25 years old; 62 girls) were assessed for physical activity (PA) and sedentary behaviour (SB) using an accelerometer (Actigraph WGT3x). Sleep duration (SD) was parent-reported. Children were laid down in a supine position for 10 min to assess HRV data. The R-R intervals recorded during the last 5 min of this period were analysed. We conducted compositional analysis in R studio, and the significance level was 95%. All ethical procedures were followed, and the study had the approval of the local ethical board. RESULTS: When considered as a composition, adjusted for age, body mass index and sex, the 24-h movement composition (PA, SB and SD) significantly predicted better parasympathetic modulation (Root mean square of the successive differences [RMSSD] [p = 0.04; r2 = 0.13]), but not high frequency (HF) (nu) (p = 0.51, r2 = 0.01), low frequency (nu) (p = 0.52, r2 = 0.02),or standard deviation (standard deviation of normal-to-normal intervals) (p = 0.55, r2 = 0.02), respectively. CONCLUSION: These results suggest the 24-h movement composition predicted the RMSSD time-domain index related to parasympathetic activity.

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OBJECTIVE: This study aimed to assess the effects of telerehabilitation with multimodal exercise on cardiac remodeling and blood pressure in hypertensive older adults. METHODS: Thirty-two hypertensive older adults (66.7 ± 5.33 years; 29.5 ± 4.22 Kg/m2; 24 female) were randomized into either a telerehabilitation or a control group. Echocardiographic parameters and blood pressure were assessed before and after the 16-week intervention. The exercise program was supervised, individualized, and offered 3×/week via videoconference. RESULTS: Blood pressure significantly decreased after telerehabilitation when compared to the control group, presenting a large effect size. The moderate effect size in relative and posterior wall thickness (g = 0.63; g = 0.61), shortening fraction (g = 0.54), and ejection fraction (g = 0.68). CONCLUSION: As a preliminary study, telerehabilitation is favorable to promote a moderate clinical improvement of some cardiac morphofunctional parameters and reduce blood pressure in hypertensive older adults.

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Introduction: Work-related musculoskeletal disorders result from the overuse of the musculoskeletal system and insufficient time for the structures to recover. They are generally characterized by chronic pain, paresthesia, feeling of heaviness and fatigue, especially in the upper extremities, concomitantly or not, with an insidious onset. Objectives: To characterize musculoskeletal complaints and occupational risks in workers with work-related musculoskeletal disorders. Methods: A cross-sectional observational study of 60 participants in a Workers' Health Reference Center with clinical and imaging diagnosis of work-related musculoskeletal disorders. The instrument used contained 30 questions about individual factors, occupational risks, and musculoskeletal abnormalities. The results were analyzed descriptively, and the chi-square test was used to assess associations with a significance level at p < 0.05. Data analysis was performed using BioEstat 5®. Results: Most participants were men (66.7%) working in the industrial sector. The most common complaint was pain (100%) in the shoulders (43.8%) and lumbar spine (22%), and the most common abnormalities were tendinopathies and intervertebral disc disorders. The following risk factors were identified: 8-hour workday (80%); repetitive gestures (86.7%); twisting (58.3%); bending (61.7%); standing (66.7%); manual work (96.7%); and 10-30 kg of weight handled (35%). Conclusions: A large number of workers exposed to biomechanical and organizational risks report musculoskeletal pain. Employers should check working conditions and adjust them, investing in health promotion and protection actions to effectively reduce the occurrence of these disorders.

Introdução: Os distúrbios osteomusculares relacionados ao trabalho são decorrentes da utilização excessiva do sistema osteomuscular e da falta de tempo para recuperação dessas estruturas. Geralmente, são caracterizados por dor crônica, parestesia, sensação de peso e fadiga, sobretudo em membros superiores, concomitantes ou não, de aparecimento insidioso. Objetivos: Caracterizar as queixas osteomioarticulares e os riscos ocupacionais em trabalhadores portadores de distúrbios osteomusculares relacionados ao trabalho. Métodos: Estudo observacional com análise transversal, realizado com 60 participantes em um Centro de Referência em Saúde do Trabalhador, com diagnóstico clínico e de imagem dos distúrbios osteomusculares relacionados ao trabalho. O instrumento utilizado continha 30 questões sobre fatores individuais, riscos ocupacionais e alterações osteomusculares. Foram realizadas análises descritivas e, para avaliar as associações, foi utilizado o teste qui-quadrado, considerando nível de significância p < 0,05. As análises foram realizadas no programa BioEstat 5®. Resultados: A amostra foi majoritariamente masculina (66,7%) e do setor industrial. A queixa mais relatada foi a dor (100%) nos ombros (43,8%) e região lombar da coluna (22%), e as alterações mais encontradas foram tendinopatias e transtornos nos discos vertebrais. Alguns fatores de risco identificados foram: jornada de trabalho de 8 horas (80%); realizar gestos repetitivos (86,7%); torções (58,3%); deslocamentos (61,7%); adotar a posição bípede (ortostática) do corpo (66,7%); trabalho manual (96,7%); transporte de peso entre 10 e 30 kg (35%). Conclusões: Um grande número de trabalhadores expostos a riscos biomecânicos e organizacionais relata dores musculoesqueléticas. Cabe aos empresários verificar as condições de trabalho e ajustá-las, investindo em ações de promoção e proteção à saúde, para efetivamente reduzir a ocorrência desses distúrbios.

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ABSTRACT: Nakamura, FY, Torres, VBC, da Silva, LS, Gantois, P, Andrade, AD, Ribeiro, ALB, Brasileiro-Santos, MdS, and Batista, GR. Monitoring heart rate variability and perceived well-being in Brazilian elite beach volleyball players: A single-tournament pilot study. J Strength Cond Res 36(6): 1708-1714, 2022-The aim of this study was to monitor the changes in heart rate variability (HRV) and perceptual well-being status after a beach volleyball (BV) tournament day in high-level U17 and senior players. Seventeen BV players (U17 [15-16 years]: n = 08; and senior [19-41 years]: n = 09) competing at national and/or international BV level participated in this study. Resting HRV and perceptual well-being measures were recorded across 4 moments: night 1 (prematches night), morning 1 (prematches morning), night 2 (postmatches night), and morning 2 (postmatches morning). Session rating of perceived exertion was assessed 10 minutes after each match, and accumulated match loads were used for analysis. Senior players presented higher values of natural logarithm of square root of the mean squared differences of successive RR intervals (lnRMSSD) at the 4 observation moments than U17 players (p = 0.006). Within-subjects analysis showed a larger mean difference regarding both lnRMSSD and natural logarithm SD of normal R-R intervals (lnSDNN) between night 1 vs. night 2 in U17 players (effect size = 1.11 and, 0.96, respectively) compared with senior (effect size = 0.40 and 0.32, respectively). Accumulated match loads were negatively correlated with percentage change in lnRMSSD (r = -0.54; p = 0.037). U17 players showed higher well-being variation than senior (group × time; p = 0.02). In conclusion, the lnRMSSD index was able to discriminate the U17 and senior BV players, and maintaining high vagally related HRV indices is an important response to BV training and competition.

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The novel coronavirus disease (COVID-19) has infected millions of people worldwide and generated many sequels in the survivors, such as muscular pain and fatigue. These symptoms have been treated through pharmacological approaches; however, infected people keep presenting physical limitations. Besides, the COVID-19 damage to the central nervous system has also been related to the presence of some physical impairment, so strategies that focus on diverse brain areas should be encouraged. Transcranial Direct Current Stimulation (tDCS) is a non-pharmacological tool that could be associated with pharmacological treatments to improve the central nervous system function and decrease the exacerbation of the immune system response. tDCS targeting pain and fatigue-related areas could provide an increase in neuroplasticity and enhancements in physical functions. Moreover, it can be used in infirmaries and clinical centers to treat COVID-19 patients.

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Oliveira-Dantas, FF, Brasileiro-Santos, MdS, Thomas, SG, Silva, AS, Silva, DC, Browne, RAV, Farias-Junior, LF, Costa, EC, and Santos, AdC. Short-term resistance training improves cardiac autonomic modulation and blood pressure in hypertensive older women: a randomized controlled trial. J Strength Cond Res 34(1): 37-45, 2020-This randomized controlled trial investigated the efficacy of short-term resistance training (RT) on cardiac autonomic modulation and peripheral hemodynamic parameters in hypertensive older women. Twenty-five hypertensive older women who were insufficiently active (64.7 ± 4.7 years) participated in this study. Subjects were randomly allocated to a 10-week RT program (2 d·wk in the first 5 weeks; 3 d·wk in the last 5 weeks) or a nonexercise control group. Linear reverse periodization was used for the RT program. Cardiac autonomic modulation, mean blood pressure (MBP), peripheral vascular resistance (PVR), and resting heart rate (RHR) were measured before and after 10 weeks. The RT group reduced cardiac sympathetic modulation (0V%; B = -6.6; 95% confidence interval [CI]: -12.9 to -0.2; p = 0.045; Cohen's d = 0.88) and showed a trend for increased parasympathetic modulation (2V%; B = 12.5; 95% CI: 0-25; p = 0.050; Cohen's d = 0.87) compared with the control group. The RT group reduced MBP (B = -8.5 mm Hg; 95% CI: -13.6 to -3.4; p = 0.001; Cohen's d = 1.27), PVR (B = -14.1 units; 95% CI: -19.9 to -8.4; p < 0.001; Cohen's d = 1.86), and RHR (B = -8.8 b·min; 95% CI: -14.3 to -3.3; p = 0.002; Cohen's d = 1.20) compared with the control group. In the RT group, the changes in 2V% patterns and low-frequency components showed a correlation with changes in MBP (r = -0.60; p = 0.032) and RHR (r = 0.75; p = 0.0003). In conclusion, 10 weeks of RT improved cardiac autonomic modulation and reduced MBP and PVR in hypertensive older women. These results reinforce the importance of RT for this population.

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Abstract COVID-19 pandemic has required social isolation to prevent the virus from spreading. Initially, the elderly were the most affected by the novel coronavirus. However, the virus spread out worldwide, affecting all age groups. The elderly are commonly affected by several chronic diseases, and as a consequence of social isolation caused by the COVID-19 pandemic, the community-based exercise programs, which usually provide health and well-being to the elderly, have stopped their activities to avoid the virus to spread out; so, the elderly kept taking medicines but stopped exercising, which must impair their health and increase demand from the public health system. In this sense, the physical education professional is essential to providing safe approaches to the elderly who are not able to enroll in community-based exercise programs but need to exercise to improve their health. This article aims to discuss the consequences of not exercising in older adults' health during the social isolation caused by the COVID-19 pandemic; still, we intend to present adjunct strategies to allow the elderly to exercise even socially isolated.

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OBJECTIVE: To evaluate the influence of obesity on pulmonary function and exercise tolerance in women with obstructive sleep apnea (OSA). SUBJECTS AND METHODS: A descriptive analytic cross- sectional study was carried out. Thirty-nine (39) sedentary climacteric women, aged 45 to 60 years, were evaluated and submitted to polysomnography. The participants were divided into 4 groups: a) 'eutrophic non-OSA' (n = 13); b) 'eutrophic OSA' (n = 5); c) 'obese non-OSA' (n = 6); d) 'obese OSA' (n = 15). All subjects underwent clinical and anthropometric evaluation, followed by pulmonary function tests and 6-minute walk test (6MWT). RESULTS: There was a significant difference in the predicted percentage values of FEV1/FVC when comparing 'eutrophic OSA' and 'obese OSA' (97.6% ± 6.1% vs. 105.7% ± 5.7%, respectively; p = 0.025). The other spirometric variables did not show any differences between the studied groups. There was no significant difference in the maximum distance walked when the 'eutrophic non-OSA', 'eutrophic OSA', 'obese non-OSA' and 'obese OSA' groups were compared. CONCLUSION: Considering the results of this study, OSA itself did not influence pulmonary function or functional capacity parameters compared to eutrophic women. However, not only isolated obesity but also obesity associated with OSA can negatively impact sleep quality and lung function.

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