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- Obesidade na gravidez: fundamentos básicos para prescrição de exercícioPublication . Bernardo, Diana Filipa Salvador; Carvalho, Carlos Manuel Baptista; Mota, Jorge; Santos, Paula ClaraAs diretrizes internacionais para a atividade física durante a gravidez recomendam unanimemente a prática de pelo menos 150 minutos por semana de atividade física de intensidade moderada para mulheres grávidas sem contraindicações. No entanto, como a obesidade se está a tornar cada vez mais prevalente em mulheres em idade reprodutiva e mulheres grávidas, é importante compreender as alterações anatomofisiológicas e as consequências da obesidade na prescrição de exercício físico durante a gravidez. Este capítulo tem como objetivo descrever e resumir as alterações fisiológicas em grávidas com obesidade, comparar as diretrizes internacionais de exercício físico durante a gravidez em mulheres com obesidade e estabelecer indicações específicas para a prática de exercício físico.
- Developing community partnerships for primary healthcare: An integrative review on management challengesPublication . Alves, Odete Maria Azevedo; Moreira, Joaquim Paulo; Santos, Paula ClaraThe aim of this review was to identify healthcare management barriers, challenges and obstacles in the development of health partnerships in community intervention projects. We conducted an integrative review using the following data sources: PubMed, B-on, Medline and EBSCOhost. The keywords in the search were: Health Partnerships AND Community Health AND Primary Health Care. We grouped results based on six categories: Environment; Membership; Process and structure; Purpose; Communication; Resources.
- Occupational health: does compliance with physical activity recommendations have a preventive effect on musculoskeletal symptoms in computer workers?Publication . Moreira, Sara; Salomé Ferreira, Maria; Begoña Criado, Maria; Machado, Jorge; Mesquita, Cristina; Lopes, Sofia; Santos, Paula ClaraA lack of physical activity in computer workers (CW) can contribute to the development of musculoskeletal symptoms (MSS). Aim: (i) Evaluate MSS over a 12 month and 7 days period, (ii) determine physical activity (PA) levels and compliance with World Health Organization (WHO) PA recommendations, and (iii) assess the relationship between compliance with WHO PA recommendations and MSS. A cross-sectional observational study comprising 119 computer workers. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate the MSS and the International Physical Activity Questionnaire (IPAQ) was used to analyse the perception of the level of PA. MSS occurred in the lumbar region (56.3%), neck (43.7%), and shoulders (39.5%). 44.7% of the participants reported a low level of PA. The percentage of compliance was similar among women and men (62.2% vs. 58.5%, respectively). Negative correlations were found between pain intensity and metabolic equivalent values. The participants who followed the WHO PA recommendations reported a lower frequency of MSS compared to those who did not, but the differences were not statistically significant. It was possible to conclude that computer workers presented a higher frequency of MSS in the lower back, neck, and shoulders. Regarding the level of PA, participants were mostly classified as low. Participants who followed the WHO PA recommendations reported lower MSS than those who did not. This finding could be important in obtaining successful programs that promote health-oriented physical activity in this group of workers.
- Atividade Física na GravidezPublication . Santos, Paula Clara; Mota, Jorge; Félix, José Manuel SousaA atitude perante a atividade física (AF) durante a gravidez mudou radicalmente nos últimos trinta anos (Charlesworth, 2011). Os nossos antepassados tratavam a mulher grávida como se estivesse doente, sendo aconselhada a descansar e a evitar exercícios (Duncombe et al., 2009). A evidência científica suporta cada vez mais a importância da AF para a saúde individual (Duncombe et al., 2009) e comunitária (Beaglehole et al., 2011). Da pesquisa efetuada, não foram encontrados estudos que mostrassem efeitos negativos da AF de moderada intensidade durante o período gravídico (Da Costa, 2003). Atualmente, existem recomendações para a prática da AF durante a gravidez, pelos benefícios demonstrados, tanto para a mulher como para o bebé (Physical activity guidelines for Americans, 2008). O American College of Obstetricians and Gynecologists (ACOG) em 2002, emanou orientações para que as mulheres grávidas, sem complicações obstétricas, adotem as mesmas recomendações de exercício físico que as das mulheres não grávidas. Da mesma forma, o Centers for Disease Control and Prevention (CDC) e o United States Department of Health and Human Services (USDHHS), 2009 também recomendam a AF durante a gravidez. [...]
- The influence of an aquatic exercise program on balance in patients with ankylosing spondylitisPublication . Ferreira, Margarida; Mesquita, Cristina; Santos, Paula Clara; Borges, João; Graça, Maria; Henriques, Ana; Lopes, SofiaAnkylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that leads to a limitation of mobility, which can cause postural deficits and progressive loss of balance. Aquatic exercise improves this health condition. The objetive is to verify the influence of an aquatic exercise program, on balance and functionality, in individuals with AS. Pre-experimental study carried out on 6 individuals with AS. All individuals were assessed at baseline (M0) and 12 weeks after the intervention (M1) using the Bath indices (BASMI, BASFI and BASDAI) and the balance assessment protocol (‘Body Sway’) by the Physiosensing Platform. Data were analyzed using the Statistical Program Statistical Package for the Social Sciences (SPSS), version 26. Were used descriptive statistics and Wilcoxon test to compare M0 and M1. The significance value was 0.05. We verify improvements in BASMI (P = 0.046), BASFI (P = 0.042) and BASDAI (P = 0.027) scores. Through the analysis of the center of pressure variables, there were no statistically significant differences, between moments, in the protocol. However, when assessing balance, in the anteroposterior mean distance in both the protocol (eyes open) and in the protocol (eyes closed), in the root mean square in both protocols and in mediolateral mean velocity, only in the protocol (eyes open), there was a slight decrease in the median value. The present study suggests that the specific aquatic exercise program, may influence balance and improve functionality in a population with AS. Therefore, the Bath indices translate improvements in the symptoms and functionalities of these participants.
- Feasibility, clinical efficacy, and maternal outcomes of a remote exercise program in pregnant women with obesity: The GROB randomized control pilot studyPublication . Bernardo, Diana; Bobadilla-Agouborde, Carolina; Festas, Clarinda; Carvalho, Carlos; Abdalla, Pedro Pugliesi; Amezcua-Prieto, Carmen; Naia-Entonado, Zeltia; Mesquita, Cristina; Mota, Jorge; Santos, Paula ClaraObesity is common in women of reproductive age and increases the risk during pregnancy. Exercising during this period reduces health complications. Home e-health programs are effective in overcoming exercise barriers as pregnant women use technology and the internet for health information. Methods: A single-blind randomized controlled feasibility study with pregnant women with obesity (body mass index [BMI] ≥≥30 kg/m22) was conducted in the University Hospital Center of São João between January and April 2023. Pregnant women were randomized to a control group with standard care and to an experimental group with 8-week remote exercise program using a Phoenix® biofeedback device. Feasibility outcome measures were recruitment rate (≥≥35%), loss to follow-up (≤≤15%), and program fidelity (≥≥1 session/week). Secondary outcomes were evaluated through Pregnancy Physical Activity Questionnaire, Oswestry Index on Disability, and weight assessments at baseline and at the end of the program. Results: Of the 63 eligible participants, 24 (38.1%) were successfully randomized and completed the baseline assessment. Of these, 3 (4.8%) from experimental group did not perform the initial onboarding. The control group had 8.3% of follow-up losses and for the experimental group there were no follow-up losses. Program fidelity (mean ≥≥1 session/week) was fulfilled by 66.7% of successfully randomized participants. Regarding secondary outcomes assessed between baseline and the 8th week, experimental group compared to control group had higher levels of physical activity for sports activities, a lower level of inactivity, and lower disability rates caused by low back pain. Conclusions: Based on the recruitment rate, losses to follow-up, and fidelity rate, the GROB (obesity in pregnancy) study was deemed feasible and worthy of consideration for a larger study. Moreover, the GROB study has the potential to improve maternal outcomes by reducing sedentarism and disability caused by low back pain.
- Avaliação da relação entre o grau de literacia em incontinência urinária e o nível de atividade física em mulheres com idade igual ou superior a 55 anos do norte de PortugalPublication . Carvalho, Camila Garcia de; Araújo, Maíta Poli de; Sartori, Marair Gracio Ferreira; Oliveira, Carla; Santos, Paula ClaraSegundo a Organização Mundial de Saúde (OMS), a população mundial com idade igual ou superior a 65 anos irá passar de 841 milhões para 2 bilhões até 2050, criando novos desafios para a saúde pública global (United Nations, 2019). A sustentabilidade do sistema de saúde passa por uma aposta em programas de promoção da saúde e prevenção da doença. Neste contexto, literacia é uma arma potente para o empoderamento das populações, nomeadamente das mulheres. A incontinência urinária (IU) é uma condição de saúde prevalente em mulheres pós-menoupausa podendo influenciar a prática de atividade física e a qualidade de vida. Avaliar a relação entre o grau de literacia em incontinência urinária(GLIU) e o nível de AF(NAF) em mulheres com idade igual ou superior a 55 anos do norte de Portugal. Realizou-se um estudo transversal numa amostra de conveniencia constituida por sessenta e sete (67) mulheres com idade média de 63.8 (8.2) anos. Estas preencheram os questionários IPAQ-SF (International Physical Activity Questionnaire-Short Form) e Q-IU (Quiz de incontinência urinária). Não foram encontradas diferenças estatisticamente significativas entre GLIU e NAF. Apesar disso, foi visto um baixo GLIU independente do NAF e sem relação entre eles (P>0.005). Não foi encontrada relação entre o GLIU e o NAF. Existem lacunas no conhecimento de mulheres com idade igual ou >55 anos do norte de Portugal sobre IU. Enfatiza-se o baixo nível de conhecimento dessas mulheres sobre a relação entre AF e IU mostrando a importância de mulheres empderadas sobre os fatores de risco para IU.
- Health promotion conceptual evolution and program development: a literature ReviewPublication . Félix, José; Santos, Paula Clara; Baylina, PilarThe World Health Organization defends prevention and health promotion among communities as a driver of economic and social development, where the individual level of health literacy determines health choices such as adopting healthy lifestyles, managing individual healthcare and preventing chronic diseases. Currently, health promotion is guided by a set of values, being these principles essential for identifying needs and priorities, planning, implementing, evaluating and determining the health promotion programs, that can be defined as a set of programmed, integrated and interrelated strategies and actions that aim to promote health, prevent risks, reduce years of life lost due to disability and increase quality of life. There are several models for planning health promotion programs, such as the Precede-Proceed Model, the Multivariate Approach to community Health (MATCH) Model, the Mapped Intervention Model and the Social Marketing Model. A good planning of a health promotion program can effectively reduce the health costs.
- Diástase dos retos abdominais e relação com a prática de Atividade Física – Estudo ObservacionalPublication . Pereira, Sílvia Catarina; Costa, Maria José; Mesquita, Cristina; Lopes, Sofia; Vieira, Ana Isabel; Santos, Paula ClaraA positive correlation has been presented between health literacy and physical activity which assume a central focus in public health issues as well as several benefits, namely for abdominal diastases. Determine the levels of Health Literacy related to Abdominal Diastasis in 18 to 65 years old Portuguese Women, residing in Portugal; verify the relationship between the domains of Literacy and the characteristics of the sample; and analyse the influence of Health Literacy on compliance with the WHO recommendations for the practice of Physical Activity. This is an observational, analytic, and transversal study, where the non-probabilistic sample, by convenience, is composed by 318 participants. For the collection of data, we used two digital self-fill questionnaires (QNLDRA e o IPAQ-short-version). The health literacy presents hit rates between 50%-75% (Sufficient). In addition, they also indicate that functional and interactive literacy appear to be the domains with the lower rates 25%-50% (Problematic). Whereas critical literacy points out to Excellent hit rates (75%-100%). Finally, the results show the absence of correlation between health literacy and the fulfilment of WHO recommendations as far as physical activity is concerned (p>0,005). Moreover, the analysis of the sample demonstrates the existence of sedentary behaviour and high levels of noncompliance of WHO recommendations (approximately 30%). Conclusion: There is a lack of knowledge as far as interactive and functional literacy are concerned, under the premise in study. High levels of noncompliance of WHO recommendations are noted. Finds show that physical activity is not influenced by health literacy.
- Effectiveness of a structured exercise intervention in gestational weight gain in pregnant women with overweight and obesity: A systematic review with meta-analysisPublication . Bernardo, Diana Salvador; Carvalho, Carlos Baptista; Conde, Monserrat; Mota, Jorge Augusto; Santos, Paula ClaraTo assess the effectiveness of exercise interventions during pregnancy in managing gestational weight gain (GWG), excessive GWG, gestational diabetes (GD), hypertensive disorders, 2-h post–oral glucose tolerance test (OGTT), and birth weight in pregnant women with overweight/obesity (OW/OB). The search strategy was conducted in five electronic databases, restricting to articles published within the past 10 years. Randomized controlled trials comparing exercise intervention with usual prenatal care in pregnant women with OW/OB were considered. Two reviewers extracted data and assessed the risk of bias using version 2 of the Cochrane risk-of-bias tool for randomized trials and the quality of studies using Grading of Recommendations Assessment, Development and Evaluation classification. Continuous data were calculated as mean differences (MDs) and dichotomous data as risk ratios (RRs). Seven trials comprising 1648 pregnant women were included. Exercise interventions were associated with lower GWG (MD, −1.19 kg [95% confidence interval, CI, −1.79 to −0.60]) and lower incidence of GD (RR, 0.56 [95% CI, 0.40–0.78]). When analyzing excessive GWG, 2-h post-OGTT, birth weight, and hypertensive disorders, there was no statistically significant difference between the exercise and usual care groups. The strength of evidence was considered moderate. Exercise interventions during pregnancy in women with OW/OB were shown to influence GWG and the incidence of GD.