Orientador: Gil Guerra Júnior / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T19:20:06Z (GMT). No. of bitstreams: 1 Camargo_CristianeTeixeiraAmaral_D.pdf: 5583172 bytes, checksum: eb85b757b3069ac10e27d362a42c3465 (MD5) Previous issue date: 2013 / Resumo: Estrutura da tese: No presente estudo optou-se pelo "Modelo Escandinavo", o qual é chamado de "Modelo Alternativo" no Programa de Pós-Graduação em Saúde da Criança e do Adolescente da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. Dessa forma, a tese foi composta por introdução geral, objetivos, capítulos (1, 2 e 3) e conclusão geral. A introdução apresentou considerações sobre a ginástica rítmica, abordou aspectos sobre o comportamento alimentar, a massa óssea e técnica de sua avaliação por meio da ultrassonografia das falanges. Os capítulos 1 a 3 apresentam os artigos de acordo com as normas específicas de periódicos de circulação internacional. As principais conclusões dos artigos foram apresentadas na conclusão geral. As referências bibliográficas foram apresentadas no final de cada capítulo e da tese. Objetivo: O estudo teve como objetivos: (1) avaliar a composição corporal e a massa óssea com o comportamento alimentar em atletas de elite de ginástica rítmica. (2) analisar o crescimento físico e a composição corporal de atletas de ginástica rítmica em relação à maturação somática e (3) avaliar a massa óssea de atletas de ginástica rítmica em relação à idade cronológica e à maturação somática. Materiais e Métodos: Foram incluídas no estudo 136 atletas do sexo feminino de 23 equipes de ginástica rítmica de 10 estados do Brasil, que participam de campeonatos nacionais de alto nível. A faixa etária do grupo estudado variou de 9 a 16 anos de idade (12,3 ± 1,9). Foram avaliadas as medidas de peso, altura e dobras cutâneas e calculados o índice de massa corporal (IMC), altura tronco-cefálica (altura sentada), massa gorda, massa isenta de gordura e percentual de gordura corporal. O valores de peso e altura foram transformados em z escore segundo o padrão da WHO (2007) e Silva et al. (2012). A maturação somática, denominada pico de velocidade de crescimento (PVC), foi determinada por meio de uma equação de regressão múltipla. A classificação do desenvolvimento puberal foi realizada por meio da auto-avaliação do desenvolvimento das mamas. Para avaliar o comportamento alimentar foi adotado o Eating Attitudes Test (EAT- 26). Foi registrado o número de horas de treinamento e de sessões semanais e a idade da menarca através de um questionário. A massa óssea foi avaliada por meio da ultrassonografia nas falanges utilizando-se a terceira geração do equipamento DBM Sonic BP (IGEA, Carpi, Italy). Realizou-se análise descritiva dos dados, com aplicação dos testes t, Shapiro-Wilk, análise de variância ANOVA, qui-quadrado, teste de Tukey e Mann-Whitney, com um nível de significância de 5%. Resultados: Os resultados monstraram que o comportamento alimentar das ginastas de elite não está relacionado com a faixa etária, puberdade, composição corporal e com a massa óssea. Os escores z do peso foram negativos em todas as idades em relação às referências nacional e internacional e da altura ficaram abaixo em todas as idades em relação à internacional e apenas até 12 anos em relação à nacional. O PVC máximo apresentou-se aos 12,1 anos e até quatro anos após observou-se aumento significativo em peso, altura, altura tronco-cefálica, percentual de gordura, massas gorda e isenta de gordura. Foram observadas diferenças significativas na massa óssea no BTT (Bone Transmission Time em ?/s) apenas no momento do PVC e na AD-SoS (Amplitude Dependent Speed of Sound em m/s) dos 12,1 aos 15,4 anos. O maior aumento na massa óssea ocorreu no momento do PVC. Os valores da massa óssea são ascendentes antes do PVC e estáveis após. Conclusão: O estudo constatou comportamento alimentar inadequado e estado nutricional predominantemente baixo, fatores que não foram preditores de atraso no desenvolvimento puberal e não estiveram associados à massa óssea. As ginastas rítmicas demonstraram diminuição da massa óssea, encontraram-se abaixo das referências internacional e nacional para peso, mas para altura abaixo da referência internacional em todas as idades e referência nacionail até 12 anos de idade. Elas apresentaram PVC e menarca em idades semelhantes às referências internacionais, porém com potencial de ganho de peso e altura vários anos após o PVC, o que pode indicar a maturação tardia / Abstract: Structure of the thesis: In this study we chose the "Scandinavian Model", which is called "Alternative Model" in the Graduate Program in Child and Adolescent Health from the Faculty of Medical Sciences, State University of Campinas. Thus, the thesis consisted of general introduction, objectives, chapters (1, 2 and 3) and a general conclusion. A general introduction presented considerations in rhythmic gymnastics, addressed issues on feeding behavior, bone mass and its evaluation by phalanges ultrasound. Chapters 1-3 present the articles in accordance with the specific rules of international journals. The main conclusions of the papers were presented at the general conclusion. References were presented at the end of each chapter and the thesis. Objective: The study aimed to: (1) evaluate the body composition and bone mass with eating behavior of elite rhythmic gymnasts, (2) analyze the physical growth and body composition of rhythmic gymnastics athletes relative to their level of somatic maturation and (3) assess bone mass in elite athletes of rhythmic gymnastics in relation to chronological age and somatic maturation and compare with literature data of female non-athletes of the same age (12.3 ± 1.9). Materials and Methods: The study included 136 female athletes from 23 Rhythmic Gymnastics teams from 10 states of Brazil, who participate in high-level national championships. The age of the study group ranged from 9 to 16 years of age. The measurements of weight, height and thickness skinfolds were done. It was calculated the body mass index (BMI), height-cephalic trunk (sitting height), fat and lean mass, and body fat percentage. The values of weight and height were transformed in score z according tho WHO (2007) reference. Somatic maturation, called peak of height velocity (PHV), was determined by a multiple regression equation. The evaluation of puberty was performed through selfassessment of breast development. It was adopted the Eating Attitudes Test (EAT-26) to evaluate the feeding behavior. We assessed the number of hours of training and weekly sessions and age at menarche by questionnaires. The bone mass was assessed by ultrasound at the phalanges using the third generation of equipment DBM Sonic BP (IGEA, Carpi, Italy). Descriptive analysis, t-tests, Shapiro-Wilk test, ANOVA, qui-squared, Tukey and Mann-Whitney test, with a significance level of 5%, were applied. Results: The results showed that the eating behavior (EAT-26) of elite gymnasts is not related to age, puberty, body composition and bone mass. The z scores for weight were negative during all ages according to both WHO and a Brazilian references, but for height were also negative for all ages according to WHO reference and only until 12 years old according to a Brazilian reference. The maximum PHV curred at 12.1 years and up to four years after it was observed a significant increase in weight, height, trunk-cephalic height, body fat percentage, fat and lean mass. The average age of menarche was 13.2 years. There were significant differences in bone mass by BTT (Bone Transmission Time in ?/S) only at the time of PHV and by AD-SOS (Amplitude Dependent Speed of Sound in m/s) from 12,1 to 15,4 years. The greatest increase in bone mass occurred at the time of PHV. The values of the bone mass are up before the PHV and stable after. Conclusion: The study found inadequate eating behavior and predominant low nutritional status, factors that were not predictors of delayed pubertal development and were not associated with bone mass. The rhythmic gymnasts showed decreased bone mass, were at below the national and international references for weights but heights below the international reference for all ages and national reference until 12 years of age. PHV and menarche were at similar age of to international references, but with potential for weight and height gain several years after the PHV, which indicates late development / Doutorado / Saude da Criança e do Adolescente / Doutora em Ciências

Text in English / Rhythmic gymnastics is a demanding sport that requires the athlete to not only execute the moves and elements required with perfection, but also demands a very specific lean body type in order to compete and be successful within the sport. This study explores retired gymnasts’ experiences of competing in rhythmic gymnastics at an elite level, as well as, exploring their experiences in relation to personal body image satisfaction and eating habits when they enter into retirement from the sport. The aim of this study is to provide an understanding of the athlete’s experiences as a rhythmic gymnast, as well as aspects of body image satisfaction and eating habits, following retirement from rhythmic gymnastics. The study provided a semi-structured interview to seven retired elite rhythmic gymnasts from Canada that had competed at provincial, national, and international levels. The data for this in-depth phenomenological study was obtained through the means of the semi-structured interviews to allow for the researcher to obtain an understanding of each of the gymnasts own personal experiences in their retired years. The transcription of each interview was then analysed and coded, first manually and then electronically using the qualitative coding software program ATLAS.ti, into various categories as well as themes found within the data. Findings were interpreted utilising the method of phenomenology explored themes relating to negative body image and poor eating habits both during their athletic career and after they had transitioned out of the sport and into retirement. In addition, the themes suggested that most of the former athletes still related to their elite rhythmic gymnastics identity with respect to their body image even after years of being in retirement. Participants seemed to highlight difficulties with lower self-confidence and self-esteem, as well as struggles regarding the acceptance of their body type and body image, themes also spoke to some participants’ dissatisfaction towards their new body post gymnastics. Ethical approval was obtained and all ethical standards were maintained throughout the duration of the research. / Psychology / M.A. (Psychology)