Effects of a multidisciplinary program on autonomic modulation in overweight or obese children and adolescents

Ricci‐Vitor, Ana Laura; Rossi, Fabrí­cio Eduardo; Hirai, Patrícia Miyuki; Silva, Natália Turri da; Vanderlei, Franciele Marques; Haddad, Maria Isabela Ramos; Gonzaga, Luana Almeida; Pastre, Carlos Marcelo; Valenti, Vítor Engrácia; Freitas, Ismael F.; Ferreira, Celso; Vanderlei, Luiz Carlos Marques

doi:10.7322/jhgd.119257

Cited by 5 publications

(9 citation statements)

References 27 publications

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“…Recent literature has reported changes in autonomic activity within obese adolescents, demonstrating this as an important negative condition related to the increased risk of morbidity and mortality. 10,11 In this context, we investigated autonomic responses to exercise in both overweight and obese adolescents in order to determine differences in risk. To accomplish this, heart Figure 1.…”

Section: Discussionmentioning

confidence: 99%

Autonomic responses induced by aerobic submaximal exercise in obese and overweight adolescents

Santana¹,

Kliszczewicz

Vanderlei

et al. 2019

Cardiol Young

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BackgroundGraded exercises tests are performed in adult populations; nonetheless, the use of this type of assessment is greatly understudied in overweight and obese adolescents.ObjectiveTo investigate heart rate autonomic responses to submaximal aerobic exercise in obese and overweight adolescents.MethodsWe recruited 40 adolescents divided into two groups: (1) overweight group comprising 10 boys and 10 girls between Z-score +1 and +2 and (2) obese group comprising 10 boys and 10 girls above Z-score >+2. Heart rate variability was analysed before (T1) and after exercise (T2–T4) on treadmill at a slope of 0%, with 70% of the maximal estimated heart rate (220 – age) for 20 minutes.ResultsHeart rate in the overweight group was: 93.2±10.52 bpm versus 120.8±13.49 bpm versus 94.6±11.65 bpm versus 93.0±9.23 bpm, and in the obese group was: 92.0±15.41 bpm versus 117.6±16.31 bpm versus 92.1±12.9 bpm versus 91.8±14.33 bpm. High frequency in the overweight group was: 640±633.1 ms2 versus 84±174.66 ms2 versus 603.5±655.31 ms2 versus 762.6±807.21 ms2, and in the obese group was: 628.4±779.81 ms2 versus 65.4±119.34 ms2 versus 506.2±482.70 ms2 versus 677.9±939.05 ms2; and root mean square of successive differences in the overweight group was: 37.9±18.81 ms versus 10.9±8.41 ms versus 32.8±24.07 ms versus 36.7±21.86 ms, and in the obese group was: 38.7±23.17 ms versus 11.5±8.62 ms versus 32.3±16.74 ms versus 37.3±24.21 ms. These values significantly changed during exercise compared with resting values in overweight and obese groups. Moreover, we also reported no significant difference of resting parasympathetic control of heart rate between obese and overweight adolescents.ConclusionThere was no significant difference of autonomic responses elicited by submaximal aerobic exercise between overweight and obese adolescents.

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Section: Discussionmentioning

confidence: 99%

Autonomic responses induced by aerobic submaximal exercise in obese and overweight adolescents

Santana¹,

Kliszczewicz

Vanderlei

et al. 2019

Cardiol Young

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“…The studies’ flowchart and inclusion strategy are exemplified in Figure 1 . Amongst the 11 studies [ 3 , 5 , 6 , 17 , 21 , 41 , 42 , 43 , 44 , 45 ], a total of 398 individuals were included as a sample, comprising 176 boys and 222 girls aged 5 to 18 years, as illustrated in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The physical activity programs of the studies included in this review enforced many types of exercise. Other than aerobic training [ 3 , 5 , 6 , 21 , 41 , 42 , 43 , 44 ], the studies involved sports, commonly including soccer practice [ 45 , 46 ], and a solitary research study that assessed resistance training, conducted by Farinatti et al [ 17 ]. Notably, it was revealed that the training time—not only the session time but also the duration time in weeks—is foremost in maintaining the useful effect of exercise, as once the training periods ceased, the indices tended to slowly return to previous values [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other confounders, e.g., dietary control, appear to have not influenced the evaluated studies; in most studies, while no lifestyle or any form of nutritional counseling was provided, positive results were attained. Two studies proposed dietary counseling, yet there was no attempt to reduce energy intake [ 3 , 6 ]; additionally, two studies associated exercise intervention with a dietary restriction [ 21 , 44 ]. If obesity produces an imbalance between dietary intake and energy expenditure, it appears that the latter found positive changes that were enhanced by calorific restriction.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Chronic Exposure to Exercise on Heart Rate Variability in Children and Adolescents Affected by Obesity: A Systematic Review and Meta-Analysis

Dias

Moraes

Dantas

et al. 2021

IJERPH

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Background: Sedentary lifestyles are increasingly common amongst children, and insufficient physical activity is a global epidemic estimated to contribute to future incapacities and potential deaths. Objective: We aimed to increase the amount of evidence concerning the effect of chronic exposure to exercise on heart rate variability in children and adolescents affected by obesity. Methods: A systematic review commenced following the PRISMA guidelines developed by Web of Science, Virtual Health Library, PubMed, Cochrane Library, Embase, Ovid, Medline Complete, and Scopus using keywords obtained from the Descriptors in Health Sciences and Medical Subject Headlines (MeSH) terms. We considered (1) Population: Pediatric individuals affected by obesity; (2) Intervention: Exercise; (3) Control: Pre-intervention and sedentary; (4) Outcomes: Clearly presented primary parameters; and (5) Studies: Clinical trials, case controls, case reports, and case series. Results: 11 articles were involved and predominantly included procedures observed during approximately 12 weeks with a distribution of three sessions per week, each session being 30–60 min of aerobic exercise; additionally, the exercise grades were typically completed at a percentage of subjects’ maximum heart rates. The meta-analyses displayed a significant effect on the domains of time (R-R interval, SDNN, rMSSD), frequency (HF ms2, HF (n.u.), LF/HF), and the non-linear index (SD1). Conclusion: Chronic exposure to exercise influences heart rate variability in children and adolescents affected by obesity by elevating the variability and parasympathetic activity and improving the sympathetic-vagal balance. Exercises should be recommended for the improvement of cardiac autonomic modulation to prevent the likelihood of further chronic diseases.

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“…Studies have sought to describe the mechanisms of neuroendocrine regulation and it's influence on inflammatory diseases 4,8,10,[14][15][16] . The investigations are based on the effect of inflammatory cytokines on sympathetic activity and feedback cycles; existence of correlation between inflammation and HRV markers; an interaction of sympathetic predominance with inflammatory processes or even TNF itself as a direct depressant of HRV, causing an attenuation of beta adrenergic signaling 4,8,17 .…”

Section: Discussionmentioning

confidence: 99%

Cardiac autonomic modulation in juvenile idiopathic arthritis with use of biological medication: case report

Martinelli¹,

Abreu

Silva³

et al. 2020

jhgd

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Introduction: The introduction of biological medication in Juvenile Idiopathic Arthritis (JIA) proposes better therapeutic results with decreased pain and inflammation and consequent reduction in joint damage. The autonomic state can be a predictor for verifying the response to immunomodulation therapy. Thus, measuring heart rate variability can express autonomous behavior and possibly accompany the response to therapy through the expression of the inflammatory condition. Objective: Analysis of heart rate variability in a child with Juvenile Idiopathic Arthritis using the anti-Tumor Necrosis Factor. Methods: This is a clinical case report of an 8-year-old male with a diagnosis of JIA - oligoarticular form, using etanercept, admitted to Clínica Escola de Fisioterapia UNINORTE, Acre, Brazil in 2017. We analyzed laboratory and imaging tests, kinetic-functional evaluation, examination of cardiac autonomic modulation and physiotherapeutic treatment for analgesic, anti-inflammatory purposes, gaining flexibility, strength and postural re-education, according to CARE guidelines, case report guidelines. Results: After medication administration, there was a decrease in pain and normalization of serum creatinine (0.50 mg / dL) and CRP (less than 6 mg / dL) and an increase in erythrocyte sedimentation rate (17 mm3). In the examination of heart rate variability, the linear indices in the time domain showed a predominance of parasympathetic activity (RMSSD: 35ms), with decreased sympathetic control measured through the frequency domain (LF: 27.1 un). However, non-linear methods showed low variability with little dispersion of RR intervals. Conclusion: In the present report, the linear indices showed parasympathetic predominance and in the non-linear analysis a low heart rate variability with abnormal and insufficient adaptation of the autonomic nervous system in a child with juvenile idiopathic arthritis using biological medication.

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Effects of a multidisciplinary program on autonomic modulation in overweight or obese children and adolescents

Cited by 5 publications

References 27 publications

Autonomic responses induced by aerobic submaximal exercise in obese and overweight adolescents

Autonomic responses induced by aerobic submaximal exercise in obese and overweight adolescents

Influence of Chronic Exposure to Exercise on Heart Rate Variability in Children and Adolescents Affected by Obesity: A Systematic Review and Meta-Analysis

Cardiac autonomic modulation in juvenile idiopathic arthritis with use of biological medication: case report

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