Objective: This study aims to compare the effect of intradialytic aerobic exercise with blood flow restriction, without blood flow restriction (conventional) and no exercise (control) on muscle strength and walking endurance among chronic kidney disease patients. Design: Open label and parallel group randomized controlled trial. Subjects: Adult patients with chronic kidney disease on hemodialysis. Intervention: A 12-week intradialytic training with or without blood flow restriction compared with a control group. Main measures: Strength and walking endurance were measured using thoracolumbar dynamometry and a 6-minute walk test, respectively, before and after training. Results: A total of 66 patients were randomized into three groups: blood flow restriction group ( n = 22), conventional exercise group ( n = 22) and control group ( n = 22). There were seven dropouts, and 59 patients were included in the analysis. There was a significant increase in the 6-minute walking distance in the blood flow restriction group (from 412.7 (115.9) to 483.0 (131.0) m, P = 0.007) in comparison with the conventional exercise group (from 426.79 (115.00) to 433.2 (120.42) m, not significant) and the control group (from 428.4 (108.1) to 417.3 (100.2) m, not significant). The change in the walking distance over time was significantly different among groups (intervention group/time, P = 0.02). The simple effects test found a significant time effect only in the blood flow restriction group. There was no significant difference in strength change between the groups. Conclusion: Among chronic kidney disease patients, intradialytic exercise of low/moderate intensity with blood flow restriction was more effective in improving walking endurance than conventional exercise or no exercise.

Objective: To describe the socioeconomic, behavioral, clinical, and health-related characteristics of Brazilian older adults with Alzheimer's disease (AD). Methods: Baseline data from the Brazilian Longitudinal Study of Aging were analyzed. This nationwide survey interviewed 9,412 adults aged at least 50 years. Self-reported medical diagnosis of AD and exposure variables (sociodemographic, clinical, behavioral, and health-related) were assessed by face-to-face questionnaire-based interview. Multivariate analyses accounted for possible confounding factors, and values were reported in prevalence ratio (PR) and 95% confidence interval (95%CI). Results: Participants with AD have important demographic differences compared with older non-AD participants such as low education level and retirement. Clinically, these patients reported more medical appointments, falls, and higher frequency and duration of hospitalizations compared with non-AD participants. These characteristics may be related to worse physical and mental health observed in this population. Indeed, two out of five older adults with AD in Brazil reported always feeling lonely, while two out of three said they felt depressed or sad much of the time. Adjusted analyses showed that patients with AD were 95% (95%CI 1.08 – 3.50) more likely to be hospitalized in a year compared with non-AD older adults. People with AD in Brazil were more likely to be diagnosed with diabetes (PR = 1.83 [95%CI 1.08 – 3.12]), depression (PR = 3.07% [95%CI 1.63 – 5.79]), Parkinson's disease (PR = 17.63 [95%CI 6.99 – 44.51]), and stroke (PR = 3.55 [95%CI 1.90 – 6.67]) compared with non-AD participants. Conclusion: Older adults with AD in Brazil reported impaired physical and mental health compared with the non-AD population.

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Nível de atividade física de coletores de lixo de duas cidades de porte médio do sul do Brasil Physical activity level of garbage collectors from two medium-sized cities in southern BrazilRodrigo Kohn Cardoso Resumo O objetivo do estudo foi verificar os níveis de atividade física (AF) total e nos diferentes domí-nios de coletores de lixo. Este estudo caracterizou-se como observacional descritivo e do tipo censo. A população foi composta por todos os coletores de lixo das cidades de Pelotas e Rio Grande, Rio Grande do Sul. A coleta de dados foi realizada por meio de um questionário contendo questões relativas a variáveis sociodemográficas, econômica, nutricional e comportamentais. O nível de atividade física foi avaliado através do Questionário Internacional de Atividade Física, IPAQ -versão longa. Foi realizada a análise univariada de todas as variáveis coletadas, com cálculo das medidas de tendência central e dispersão para as variáveis contínuas e proporções para as variáveis categóricas. Foram entrevistados todos os 127 coletores de lixo, sendo que a média de AF total relatada pelos trabalhadores foi de 4292,0 minutos por semana (DP 1034,2). Quando verificada a AF ocupacional, o escore médio encontrado foi de 3853,0 minutos por semana (DP 583,4). Os demais domínios, deslocamento, lazer e doméstico, apresentaram médias de AF semanal respectivamente de, 257,9 (DP 237,5), 77,6 (DP 111,5) e 103,5 (DP 101,8) minutos. Concluiu-se que os coletores de lixo estavam expostos a uma carga de AF total e ocupacional extremamente elevadas, podendo haver prejuízo significativo para a saúde se não forem adotadas medidas adequadas de nutrição e recuperação física. Palavras-chaveEpidemiologia, Trabalhadores, Saúde ocupacional, Lixo. AbstractThe aim of the present study was to verify levels of total physical activity (PA) domains, commuting, leisure and domestic had, respectively, means of 257.9 (SD 237.5), 77.6 (SD 111.5) and 103.5 (SD 101.8)

Low-intensity training with blood flow restriction (BFR) has been suggested as an alternative to physical training for older adults. The present study aimed to review the literature regarding the effect of training with BFR for older adults. The search strategyconsisted of experimental studies aimed at verifying the effects of training with BFR on any outcome in older adults. An electronic search in PubMed / Medline, Bireme Scielo, Lilacs and Cochrane Library databases, published until December 2015 was conducted. Experimental studies that considered individuals aged 50 years and over published in English or Portuguese, were included. The Downs & Black scale was used to assess the methodological quality of articles. Of the 60 studies, 12 were included in the review. Training with BFR improved body mass, torque and muscle power; functional capacity; bone health; venous compliance; peak oxygen uptake; and blood flow; balance and overall performance. The methodological quality of studies had mean score of 16.2 points (SD = 1.6). The prescription of low-intensity exercises with BFR may be an alternative of training for older adults. However, future studies should address the methodological quality, especially external validity and power, the main gaps in articles reviewed in this study.

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Introduction: Palletofemoral pain syndrome (PFPS) is anterior knee pain that affects around 25% of the population at some point in their lives. Muscle weakness is one of the main causal factors related to PFPS. Objective: Conduct a quantitative analysis on the effectiveness of strength training at reducing pain in PFPS sufferers. Methods: An electronic search was conducted on the MEDLINE, Pubmed, EMBASE, Lilacs and Scielo databases for studies published between January 2005 and September 2014. The following descriptors were used: "patellofemoral pain syndrome", "patellofemoral pain", "retropatellar pain", "exercise", "exercise therapy", "strength", "rehabilitation". Only randomized controlled trials (RCTs) that compared the effects of strength training to no exercise in terms of reducing pain among PFPS sufferers were included. Data were extracted by two independent authors using predefined quality indicators. Results: A total of 39 RCTs were initially identified in the search. However, only five met the inclusion criteria. Strength training exhibited a positive effect on PFPS (SMD = 0.85, CI: 0.45-1.25). However, high heterogeneity was observed between the studies (p < 0.05; I 2 = 68.3%). Conclusion: Strength training showed a statistically positive response in the treatment of PFPS.