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Background Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. Methods Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. Discussion Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. Trial registration NCT03264443 . Registered on 29 August, 2017. Electronic supplementary material The online version of this article (10.1186/s12889-019-6970-3) contains supplementary material, which is available to authorized users.

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Multimodal physiotherapeutic approach: effects on the temporomandibular disorder diagnosis and severity [I] Abordagem fi sioterapêutica multimodal: efeitos sobre o diagnóstico e a gravidade da disfunção temporomandibular [A] Ariane Bôlla Freire [a] , Angélica Trevisan De Nardi [b] , Jalusa Boufleur [c] , Laís Chiodelli [d] , Fernanda Pasinato [e] , Eliane Castilhos Rodrigues Corrêa [f] [a] Undergraduate Student, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS -Brazil, e-mail:aribfreire@hotmail.com [b] Undergraduate Student, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS -Brazil, e-mail:angelica_denardi@hotmail.com [c] Abstract Introduction: The temporomandibular disorder (TMD) consists of a set of signs and symptoms that affect the masticatory structures, which may cause joint and/or muscular pain. The physiotherapy approach aims at the pain relief and the functional recovery by means of several modalities. Objective: To investigate the effects, short and medium-term, of a multimodal physiotherapeutic approach on TMD diagnosis and severity. Methodology: Individuals with diagnosis of TMD, confirmed by the Axis I of the RDC/TMD, took part in the study. From this evaluation, the Temporomandibular Index (TMI) and its sub-indices were calculated. The participants were treated during ten sessions of physiotherapy, which included therapeutic ultrasound, thermotherapy, manual therapy, stretching and neuromuscular exercises, as well as self-care and home exercises instructions. Assessments were carried out before treatment (AV1), immediately after treatmentFisioter Mov. 2014 abr/jun;27(2):219-27Freire AB, De Nardi AT, Boufleur J, Chiodelli L, Pasinato F, Corrêa ECR. 220 (AV2) and two months after the end of the treatment (AV3). The values of indices and the diagnosis prevalence were compared between the different periods by the t paired test (p < 0.05). Results: The number of diagnoses reduced in all the subgroups and 41.7% of the 24 participants presented no diagnosis after the treatment. A significant decrease in the TMI was observed between AV1 and AV2 (p = 0.000). There was no difference between AV2 and AV3 (p = 0.204) in 13 participants assessed two months after the end of the treatment. Conclusion: The multimodal physiotherapeutic approach resulted in positive effects, short and medium-term, on the symptoms and clinical signs, with deletion of the dysfunction or reduction of its severity in treated patients.[

Conclusions The application appear to offer potential as an engaging and effective way to deliver CBT. The effect sizes should be interpreted cautiously in light of the motivated, self-selected sample. Nevertheless, it may provide a convenient method for accessing support, especially in Russia, where a very low proportion of individuals with depression and anxiety disorders receive adequate care due to a range of obstacles that prevent or limit access to treatment.

ABSTRACT. This study aims to evaluate the effects of TENS at different frequencies on autonomic balance in healthy volunteers. It is a case-control study, and was composed of fourteen healthy volunteers (5 women) with 28 (3.9) years old who underwent low ) and high (100 Hz 200ms -1 ) frequency TENS. The interventions were randomized and applied for 30 minutes in the trajectory brachial nerve plexus from non-dominant member. Intensities were adjusted every 5 minutes and maintained below motor threshold. The autonomic balance was assessed before and after interventions by heart rate variability (HRV). TENS 10 Hz increased 10% sympathetic activity and decreased 10% parasympathetic activity; however, TENS 100 Hz showed opposite effects (p < 0.05). The sympatho-vagal balance increased with low frequency TENS and decreased with high frequency (p < 0.05). It can be concluded that different frequencies of TENS applied in the trajectory brachial nerve plexus modify cardiovascular autonomic responses. High frequency TENS reduces sympathetic activity and increases the parasympathetic, which favors beneficial effects on autonomic balance in healthy volunteers.Keywords: electric stimulation, autonomic nervous system, heart rate.Diferentes frequências da estimulação elétrica nervosa transcutânea no balanço simpatovagal RESUMO. Este estudo objetiva avaliar os efeitos de diferentes frequências da TENS sobre o balanço autonômico em voluntários saudáveis. Estudo caso-controle composto de quatorze voluntários saudáveis (5 mulheres), com 28 (3,9) anos de idade que foram submetidos a baixa (10 Hz 200 ms ) frequências da TENS. As intervenções foram randomizadas e aplicadas por 30 minutos sobre a trajetória do plexo nervoso braquial do membro não dominante. As intensidades foram ajustadas a cada 5 minutos e mantidas abaixo do limiar motor. O balanço autonômico foi avaliado antes e após as intervenções pela variabilidade da frequência cardíaca (VFC). TENS a 10 Hz aumentou 10% da atividade simpática e diminui 10% a atividade parassimpática, mas a TENS a 100 Hz apresentou efeitos opostos (p < 0,05). O balanço simpato-vagal aumentou com a TENS de baixa frequência e diminuiu com a alta frequência (p < 0,05). Conclui-se que as diferentes frequências da TENS aplicadas sobre a trajetória do plexo nervoso braquial modificam as respostas autonômicas cardiovasculares. A alta frequência da TENS reduz a atividade simpática e aumenta a parassimpática, o que favorece aos efeitos benéficos sobre o balanço autonômico em voluntários saudáveis.Palavras-chave: estimulação elétrica, sistema nervoso autônomo, frequência cardíaca.

This is the protocol for development of a COS related to clinical trials with physical activity interventions for overweight or obese children and adolescents, as well as categorize them into specific domains.