O orientador do trabalho n?o mencionado na lista da folha de aprova??o. / Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-08-06T18:31:52Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) andreza_leticia_gomes.pdf: 1090108 bytes, checksum: 96eed10c887fbcff28a65cbd64874639 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-10-05T19:12:17Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) andreza_leticia_gomes.pdf: 1090108 bytes, checksum: 96eed10c887fbcff28a65cbd64874639 (MD5) / Made available in DSpace on 2018-10-05T19:12:17Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) andreza_leticia_gomes.pdf: 1090108 bytes, checksum: 96eed10c887fbcff28a65cbd64874639 (MD5) Previous issue date: 2018 / O Incremental Shuttle Walking Test (ISWT) vem sendo utilizado na avalia??o da aptid?o cardiorrespirat?ria (ACR) de crian?as e adolescentes com diferentes condi??es de sa?de. N?o se sabe se a resposta cardiorrespirat?ria apresentada por adolescentes saud?veis no ISWT ir? se assemelhar aquela induzida pelo teste de esfor?o cardiopulmonar (TECP). Os objetivos deste estudo foram: (1) Avaliar se o ISWT ? um teste m?ximo para adolescentes assintom?ticos do sexo masculino. (2) Propor uma equa??o matem?tica para predizer o pico do consumo de oxig?nio (VO2 pico) e, (3) testar a confiabilidade dessa equa??o para essa popula??o. M?todos: No primeiro est?gio do estudo, 26 participantes realizaram o ISWT e o TECP. No segundo est?gio 50 participantes realizaram o ISWT duas vezes. Em ambos os est?gios foram avaliados VO2 pico, a frequ?ncia card?aca m?xima (FC m?x.) e o pico da raz?o de troca respirat?ria (R pico). No terceiro est?gio foram comparados os valores do VO2 pico preditos pela equa??o criada e obtidos de forma direta no ISWT. Resultados: N?o houve diferen?a significativa no VO2 pico, R pico e FC m?x. obtidos no ISWT e TECP. Os valores encontrados para o VO2 pico (r = 0,44. p = 0,002) e R pico (r = -0,53, p< 0,01) obtidos no ISWT e TECP apresentaram correla??o moderada e significativa, al?m de concord?ncia na an?lise de Bland-Altman. A velocidade da marcha foi a vari?vel que explicou 48% (R2 = 0,48, p = 0,000) da varia??o no VO2 pico no ISWT. Foi criada a equa??o VO2 previsto = 5,490 + (17,093 x Velocidade da Marcha). Os resultados obtidos pela equa??o foram comparados com os valores obtidos pelo analisador de gases e nenhuma diferen?a significativa foi encontrada entre eles. Conclus?es: Em crian?as e adolescentes do sexo masculino o ISWT ? um teste de esfor?o m?ximo com repercuss?es cardiorrespirat?rias similares ao TECP. A equa??o preditiva proposta ? uma estimativa vi?vel para predi??o do VO2 pico para essa popula??o. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Reabilita??o e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / The Incremental Shuttle Walking Test (ISWT) has been used to evaluate the Cardiorespiratory Fitness (CRF) of children and adolescents with different pathological conditions. It is unknown whether the cardiorespiratory response presented by asymptomatic adolescents in ISWT will be similar to that induced by CardiopulmonaryExerciseStress Test (CEPT). The aims of this study were: (1) To evaluate whether ISWT is a maximum test for asymptomatic male adolescents. (2) To propose a mathematical equation to predict peak oxygen consumption (VO2 peak) and (3) Totest the reliability of this equation on this population. Methods: In the first stage of the study, 26 participants performed the ISWT and the CEPT. In the second stage 33 participants performed the ISWT twice. In both stages, peak VO2, maximal heart rate (HR max) and peak respiratory rate (peak R) were evaluated. In the third stage, the peak VO2 values predicted by the equation created and obtained directly in the ISWT were compared. Results: There was no significant difference in the peak VO2 (p> 0.05), peak R (p> 0.05) and maximum HR obtained in ISWT and CEPT. The values found for the VO2 peak (r = 0.44, p = 0.002) and peak R (r = -0.53, p <0.01) obtained in the ISWT and CEPT presented a moderate correlation and anagreement in the analysis of Bland-Altman analysis. The gait speed was the variable that explained 48% (R2 = 0.48, p = 0.000) of the variation in the peak VO2. The VO2 peak equation = 5.490 + (17.093 x Gait Speed) was created. The results obtained by the equation were compared with the values obtained by the gas analyzer and no significant differences were found between them (p> 0.05). Conclusion: ISWT produced a cardiorespiratory response comparable to CEPT in asymptomatic male adolescents, and the developed equation presented viability to predict peak VO2 in adolescents.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:20:36Z No. of bitstreams: 1 TatianaOnofreGama_TESE.pdf: 3437421 bytes, checksum: bf6e324c913988c9f669375afd319f43 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T23:45:13Z (GMT) No. of bitstreams: 1 TatianaOnofreGama_TESE.pdf: 3437421 bytes, checksum: bf6e324c913988c9f669375afd319f43 (MD5) / Made available in DSpace on 2017-04-20T23:45:13Z (GMT). No. of bitstreams: 1 TatianaOnofreGama_TESE.pdf: 3437421 bytes, checksum: bf6e324c913988c9f669375afd319f43 (MD5) Previous issue date: 2017-02-17 / Introdu??o: O n?mero de indica??es para cirurgia bari?trica (CB) tem crescido mundialmente, demonstrando ser uma medida ?til no tratamento da obesidade severa, promovendo redu??o da morbimortalidade, melhora das altera??es cardiorrespirat?rias/metab?licas e maior qualidade de vida. Programas de reabilita??o ap?s a CB t?m sido estimulados, sendo importante especialmente no controle das comorbidades e do reganho de peso corporal a longo prazo. Apesar disto, existem poucas evid?ncias relacionadas aos efeitos da CB, com ou sem reabilita??o, na aptid?o cardiorrespirat?ria (ACR), medida esta que impacta fortemente na mortalidade e no controle do peso. Nesse contexto, se faz necess?rio o acompanhamento da capacidade funcional e a implementa??o de programas de reabilita??o no p?s-operat?rio (PO) de CB, visto que a perda de peso isolada parece n?o aumentar a ACR em indiv?duos que permanecem sedent?rios ap?s a cirurgia. Objetivos: Avaliar os efeitos da CB e de um programa estruturado de reabilita??o cardiopulmonar e metab?lica (aplicado no PO) na ACR e fun??o pulmonar em mulheres obesas, e compar?-las a um grupo controle. M?todos: A pesquisa foi dividida em duas etapas. Inicialmente, foi realizado um estudo de follow-up constando de avalia??o antropom?trica, espirom?trica e cardiorrespirat?ria/funcional (Teste de Esfor?o Cardiopulmonar-TECP) em 34 obesas antes e ap?s a CB, dos quais resultaram dois artigos. Na segunda etapa, realizamos um ensaio cl?nico n?o randomizado e simples cego, envolvendo 12 mulheres adultas obesas (grau II e III) candidatas ? CB, que foram divididas em grupo controle-GC (n=6) e grupo interven??o-GI (n=6). Todas as pacientes foram avaliadas no pr?-operat?rio, terceiro (3MPO) e sexto m?s de PO (6MPO), quanto aos mesmos par?metros da primeira etapa. O GI participou de um programa espec?fico de reabilita??o supervisionada, que constou de exerc?cios aer?bios e resistidos durante 12 semanas e com in?cio no 3MPO. J? o GC recebeu apenas orienta??es gerais. Assim, foram produzidos no total tr?s artigos cient?ficos, onde a estrat?gia estat?stica variou conforme a metodologia de cada estudo. Foi considerado um n?vel de signific?ncia estabelecido em p<0,05. Resultados: Ap?s a CB, todas as pacientes avaliadas apresentaram redu??o significativa (p<0,001) nas comorbidades (hipertens?o e diabetes) e medidas antropom?tricas, al?m de melhora na fun??o pulmonar (p<0,05). Por?m, apenas as obesas que participaram do protocolo de treinamento f?sico evolu?ram com aumento significativo (p<0,05) no VO2pico e na dura??o total do TECP, de 5,9 ml/kg/min (23,8%) e 4,9 minutos (42,9%), respectivamente. Ap?s um per?odo de 9,4?2,7 meses de PO, houve uma redu??o de 0,398 L/min do VO2pico absoluto (p<0,001) nas pacientes que permaneceram sedent?rias ap?s a CB (n=34), sem diferen?as no VO2pico relativo ao peso corporal (p=0,06). Observamos ainda moderada correla??o (r= -0,52, p<0,05) entre ?VO2pico e ?CP-circunfer?ncia do pesco?o. Conclus?es: A ACR aumentou significativamente apenas no grupo de mulheres obesas que participaram de um programa estruturado de reabilita??o ap?s tr?s meses de CB, apontando que a toler?ncia ao exerc?cio e a capacidade aer?bia podem n?o aumentar nas mulheres que permanecem inativas ap?s a cirurgia. No entanto, independente da pr?tica de exerc?cios, a perda de peso corporal induzida cirurgicamente melhorou a fun??o pulmonar e reduziu comorbidades importantes. / Introduction: The number of indications for bariatric surgery (BS) has increased worldwide, proving to be a useful measure in the treatment of severe obesity, promoting reduction of morbimortality, improvement of cardiorespiratory / metabolic alterations and higher quality of life. Rehabilitation programs after BS have been stimulated, being especially important in controlling comorbidities and regaining body weight in the long term. Despite this, there is little evidence related to the effects of BS, with or without rehabilitation, on cardiorespiratory fitness (CRF), a measure that strongly impacts mortality and weight control. In this context, it is necessary to follow the functional capacity and the implementation of rehabilitation programs in the postoperative period (PO) of BS, since isolated weight loss does not seem to increase the CRF in individuals who remain sedentary after surgery. Objectives: To evaluate the effects of BS and a structured program of cardiopulmonary and metabolic rehabilitation (applied in the PO) on CRF and pulmonary function in obese women, and to compare them to a control group. Methods: The research was divided into two stages. Initially, a follow-up study consisting of anthropometric, spirometric and cardiorespiratory / functional evaluation (Cardiopulmonary Exercise Testing-CPX) was performed in 34 obese women before and after BS, of which two articles resulted. In the second stage, we performed a non-randomized, simple blind trial involving 12 obese adult women (grade II and III) candidates for BS, who were divided into control-CG group (n = 6) and intervention group-IG (n = 6). All patients were evaluated in the preoperative, third (3MPO) and sixth month of PO (6MPO), regarding the same parameters of the first stage. The IG participated in a specific rehabilitation program which consisted of aerobic and resistance exercises for 12 weeks and starting at 3MPO. The CG received only general guidelines. Thus, a total of three scientific articles were produced, where the statistical strategy varied according to the methodology of each study. A significance level was set at p <0.05. Results: After BS, all the patients evaluated had a significant reduction (p <0.001) in comorbidities (hypertension and diabetes) and anthropometric measurements, in addition to an improvement in pulmonary function (p <0.05). However, only those obese who participated in the physical training protocol presented a significant increase (p <0.05) in VO2peak and in the total duration of CPX, of 5.9 ml / kg / min (23.8%) and 4.9 minutes (42.9%), respectively. After a period of 9.4 ? 2.7 months of PO, there was a reduction of absolute VO2peak (p <0.001) in patients who remained sedentary after BS (n = 34), with no differences in relative VO2peak to body weight (p = 0.06). We also observed a moderate correlation (r = -0.52, p <0.05) between ?VO2peak and ?NC-neck circumference. Conclusions: The CRF increased significantly only in the group of obese women who participated in a structured rehabilitation program after three months of CB, indicating that exercise tolerance and aerobic capacity may not increase in women who remain inactive after surgery. However, regardless of exercise practice, weight loss induced surgically improved pulmonary function and reduced major comorbidities.