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- Influence of physical activity in weight gain, blood glucose levels and blood pressure in pregmant womenPublication . Santos, Paula Clara; Leal, I.; Santos, R.; Vale, S.; Alves, O.; Moreira, C.; Marques, AI.; Soares-Miranda, L.; Mota, J.The purpose of our study was to understand the influence of physical activity (PA) in weight gain, blood glucose levels, blood pressure in pregnancy and parity. Cross-sectional evaluation analysis of 100 women, aged between17 to 42, from Santo Antonio General Hospital was done. PA was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ). We found that levels of PA and total weight gain of pregnant women were not associated (p = 0.352), and there was no linear correlation between the total score for PA and blood glucose levels (p = 0.849 for fasting glucose levels and p = 0.438 for blood sugar levels after 50 g glucose). In addition PA and blood pressure values were also not correlated (p = 0.166 for systolic blood pressure; p = 0.233 for diastolic It was found a correlation between PA and parity (multiparous had higher levels of PA: p = 0.020). The statistical tests used were the Spearman’s ρ and chi-square (p<0.05). In this study we did not find associations among PA and the following variables: gain weight, blood glucose and blood pressure. Howev we saw that PA levels were higher in multiparous compared to primiparous.
- 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.
- 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.
- Modelo transteórico de mudança de comportamentos na promoção da actividade física nas grávidasPublication . Silva, Ana; Santos, Paula ClaraDeterminar se o Modelo Transteórico de Mudança de Comportamento (MTMC) é eficaz na promoção da actividade física (AF) nas grávidas. O grupo experimental (GE) participou no projecto “Mães em Movimento” baseado no MTMC. Aplicou-se o Questionário de AF para Gestantes, Escala de Estados de Mudança, Behavioural Regulation in Exercise Questionnaire e Questionário de Conhecimentos. Na 2ª avaliação, no GE, todas as grávidas referiram praticar AF. A motivação intrínseca e os conhecimentos aumentaram. O MTMC revelou-se um modelo eficaz na promoção da AF em grávidas.
- Physical activity and self-esteem during pregnancyPublication . Santos, Paula Clara; Ferreira, Marta Isabel; Teixeira, Ricardo João; Couto, Miriam; Montenegro, Nuno; Mota, JorgeThe aims of this paper are to examine the accomplishment of the recommendations of physical activity (PA) practice in accordance with the recommendations of the American College of Sports Medicine (ACSM); verify if the sociodemographic variables (SDV) influence women’s self-esteem; investigate if there are differences in pregnant women’s self-esteem who practiced or not structured physical activity (SPA) before pregnancy, and of pregnant women who met the recommendations or not during pregnancy. A sample of 44 pregnant women was evaluated in two stages: between the 10th and 13th week of pregnancy (1st trimester- 1T) and between the 20th and 23rd week of gestation (2nd trimester - 2T). The PA was assessed by accelerometry and self-esteem was assessed using the Rosenberg Self-Esteem Scale. Sociodemographic variables and SPA before pregnancy were assessed through a self-administered questionnaire. Over 60% of the sample did not meet recommendations for PA practice in any of the trimester. There were no significant differences between self-esteem for each of the SDV, with the exception of the higher monthly income (1T) and marital status (2T), associated with better self-esteem. There were significant differences in self-esteem among pregnant women or unstructured PA performed before pregnancy (1T and 2T). The completion, or not, of ACSM recommendations did not seem to impact on self-esteem during pregnancy. Most pregnant women did not met the ACSM recommendations for PA practice. It was found that marital status and higher incomes have influenced positively self-esteem, as well as the practice of SPA, before pregnancy.
- Metabolic risk factors, physical activity and physical fitness in azorean adolescents: a cross-sectional studyPublication . Moreira, Carla; Santos, Rute; Júnior, José Cazuza de Farias; Vale, Susana; Santos, Paula Clara; Soares-Miranda, Luísa; Marques, Ana I.; Mota, JorgeThe prevalence of metabolic syndrome has increased over the last few decades in adolescents and has become an important health challenge worldwide. This study analyzed the relationships between metabolic risk factors (MRF) and physical activity (PA) and physical fitness (PF) in a sample of Azorean adolescents. A cross-sectional school-based study was conducted on 417 adolescents (243 girls) aged 15-18 from the Azorean Islands, Portugal. Height, weight, waist circumference, fasting glucose, HDL-cholesterol, triglycerides, and blood pressure were measured. A sum of MRF was computed, and adolescents were classified into three groups: no MRF, one MRF and two or more MRF. PA was assessed by a sealed pedometer. PF was assessed using five tests from the Fitnessgram Test Battery. Dietary intake was obtained using a semi-quantitative food frequency questionnaire. Mean daily steps for girls and boys were 7427 ± 2725 and 7916 ± 3936, respectively. Fifty-nine percent of the adolescents showed at least one MRF and 57.6% were under the healthy zone in the 20 m Shuttle Run Test. Ordinal logistic regression analysis showed that after adjusting for sex, body mass index, socio-economic status and adherence to a Mediterranean diet, adolescents who were in the highest quartile of the pedometer step/counts (≥9423 steps/day) and those who achieved the healthy zone in five tests were less likely to have one or more MRF (OR = 0.56;95%CI:0.33-0.95; OR = 0.55;95%CI:0.31-0.98, respectively). Daily step counts and PF levels were negatively associated with having one or more MRF among Azorean adolescents. Our findings emphasize the importance of promoting and increasing regular PA and PF to reduce the public health burden of chronic diseases associated with a sedentary lifestyle.
- Relationship of milk intake and physical activity to abdominal obesity among adolescentsPublication . Abreu, Sandra; Santos, Rute; Moreira, Carla; Santos, Paula Clara; Vale, Susana; Soares-Miranda, L.; Autran, R.; Mota, Jorge; Moreira, PedroDiet and physical activity (PA) are recognized as important factors to prevent abdominal obesity (AO), which is strongly associated with chronic diseases. Some studies have reported an inverse association between milk consumption and AO. This study examined the association between milk intake, PA and AO in adolescents. A cross-sectional study was conducted with 1209 adolescents, aged 15–18 from the Azorean Archipelago, Portugal in 2008. AO was defined by a waist circumference at or above the 90th percentile. Adolescent food intake was measured using a semi-quantitative food frequency questionnaire, and milk intake was categorized as ‘low milk intake’ (<2 servings per day) or ‘high milk intake’ ( 2 servings per day). PA was assessed via a self-report questionnaire, and participants were divided into active (>10 points) and low-active groups ( 10 points) on the basis of their reported PA. They were then divided into four smaller groups, according to milk intake and PA: (i) low milk intake/low active; (ii) low milk intake/active; (iii) high milk intake/low active and (iv) high milk intake/active. The association between milk intake, PA and AO was evaluated using logistic regression analysis, and the results were adjusted for demographic, body mass index, pubertal stage and dietary confounders. In this study, the majority of adolescents consumed semi-skimmed or skimmed milk (92.3%). The group of adolescents with high level of milk intake and active had a lower proportion of AO than did other groups (low milk intake/low active: 34.2%; low milk intake/active: 26.9%; high milk intake/low active: 25.7%; high milk intake/active: 21.9%, P = 0.008). After adjusting for confounders, low-active and active adolescents with high levels of milk intake were less likely to have AO, compared with low-active adolescents with low milk intake (high milk intake/low active, odds ratio [OR] = 0.412, 95% confidence intervals [CI]: 0.201– 0.845; high milk intake/active adolescents, OR = 0.445, 95% CI: 0.235–0.845).Conclusion: High milk intake seems to have a protective effect on AO, regardless of PA level
- The influence of pre-gestational body mass index and physical activity patterns on maternal, delivery and newborn outcomes in a sample of portuguese pregnant women: a retrospective cohort study.Publication . Bernardo, Diana; Carvalho, Carlos; Mota, Jorge; Ferreira, Margarida; Santos, Paula ClaraThere is a linear association between pregestational body mass index (BMI) and almost all adverse pregnancy outcomes. Pregnancy is “a window of opportunities” in terms of changing behavior and improving awareness of healthy living. The proper assessment of physical activity levels, during pregnancy, determines trends, health benefits, and their effects over time. This study aims to describe maternal physical activity levels, stratified by pregestational BMI, verify the accomplishment of physical activity recommendations in pregnant women, and correlate pregestational BMI and physical activity accomplishment with maternal, delivery, and neonatal parameters. A retrospective cohort study was carried out with 103 pregnant women. Physical activity levels were evaluated using a questionnaire and accelerometry. Pregestational BMI was obtained through the Quetelet formula and used the American College of Sports Medicine’s guidelines were used to determine physical activity accomplishment levels. Continuous data were presented as mean and standard deviation and categorical data as numbers and percentages. The F test was used to examine the differences between groups. Pregnant women in the sample spent 42.9% of their time on household activities, and for pregnant women with obesity, 91.5% of the time was spent on sedentary activities. Women with normative BMI had higher levels of moderate-intensity activities. Only 15.8% of participants with obesity reached the international recommendations for physical activity practice and women who accomplished physical activity recommendations gained less weight during pregnancy. A high percentage of pre-obesity and obese pregnant women exceeded the recommendations for gestational weight gain and the gestational diabetes prevalence was higher in the obesity group (p = 0.03 between groups). Regarding delivery and neonatal parameters (Apgar score 1st, Apgar score 5th, birth weight, length and head circumference), no statistical differences were found when adjusted to a gestational week at birth, between BMI (p = 0.58; p = 0.18; p = 0.60; p = 0.34; p = 0.34, respectively) or physical activity (p = 0.12; p = 0.15; p = 0.83; p = 0.70; p = 0.70, respectively) groups. Pregnant women with obesity, exhibit high levels of sedentary behavior, a high prevalence of gestational diabetes, and exceed recommended gestational weight gain. Healthcare professionals have a crucial role in promoting regular physical activity and lifestyle changes before and during pregnancy.
- Influence of physical activity on anxiety levels in pregnancyPublication . Santos, Paula Clara; Silva, S.; Vale, S.; Santos, R.; Alves, O.; Moreira, C.; Marques, AI.; Soares-Miranda, L.; Mota, J.The aims of this study were twofold. First to evaluate the influence of physical activity (PA) on anxiety levels on pregnancy. Second to analyse the influence of parity and a history of previous miscarriage in PA. In this observational, analytic and cross sectional study, it was used a sample of 100 women, aged 17 to 42 years, from Santo Antonio General Hospital. PA and anxiety were assessed using the Pregnancy Physical Activity Questionnaire (PPAQ) and the Zung Self-Rating Anxiety Scale. It was found that levels of PA were not linearly correlated with the anxiety levels p= 0.144. It was also found an association between PA and parity, whereby multiparous women had higher levels of PA (p=0.020) and between PA and previous miscarriage women with levels of physical activity higher had fewer previous miscarriages (p=0,032). The statistical test used was the Spearman’s ρ and chichisquare. In all tests it was considered a significance level of 0,05. In conclusion, through this study it was not possible to verify that PA during pregnancy is related to anxiety. We concluded that there are only associations between, PA and number of births and PA and a history of previous miscarriage.
- Evaluation of physical activity programmes for the elderly - exploring the lessons from other sectors and examining the general characteristics of the programmes.Publication . Marques, Ana I.; Soares, Pedro; Soares-Miranda, Luísa; Moreira, Carla; Oliveira-Tavares, António; Santos, Paula Clara; Vale, Susana; Santos, Rute; Carvalho, JoanaIn Portugal, there are several physical activity (PA) programmes for elderly people developed by the local government. The importance of these programmes has been increasing since the evidence has shown that this type of health promotion interventions may reduce the deleterious effects of the ageing process. However, no study has already identified the general characteristics of these programmes nor if they use any scheme to assess the quality of the service provided. A widely-used scheme is the EFQM Excellence Model, which will be in the core of our present work. Thus, the main aims of this preliminary study were 1) to identify the general characteristics of the PA programmes developed by the Portuguese Local Public Administration 2) to determine the extent of implementation of quality initiatives in these programmes. Data were collected by an on-line questionnaire sent to all Continental Municipalities (n = 278). Categorical data were expressed as absolute counts and percentages. Continuous data were expressed as the mean and SD. An open-ended question was analysed using qualitative content analysis with QSR NVivo software. Associations between categorical variables were tested by the use of contingency tables and the calculation of chi-square tests. Significance level was set at p ≤ 0.05. Results showed: i) a total of 125 PA programmes were identified in the 18 districts of the Portugal mainland; ii) the main goal of the majority (95.2%) was the participants' health promotion; iii) different characteristics of the programmes were found according to different regions of the country; iv) certain characteristics of the programmes were associated to the existence of other features; v) only one PA programme developed quality initiatives. In conclusion, although there are many PA programmes for elderly people spread throughout the country, aiming at improving the health of participants, the overwhelming majority does not adopt quality control initiatives. Considering that the quality of a service increases customer satisfaction, the continuous quality improvement of the PA programmes for elderly people should therefore be implemented since they can be useful and critical for elderly satisfaction and adherence.