Obesity affects the respiratory system through various mechanisms, including systemic inflammation and direct mechanical hindrance due to fat deposition in the chest and abdomen. In addition, changes in the neural control of respiration and increases in thoracic blood volume can promote abnormalities in lung function. Thus, determining relationships between the distance covered in the 6-min walk test (6MWT) and demographic and lung function variables may help us better understand the mechanisms involved in reduced functional exercise capacity in obesity. To explore the determinants of the 6-min walking distance (6MWD) and evaluate the influence of lung function on the distance covered, 263 obese Brazilian women performed the 6MWT and underwent spirometry and respiratory muscle strength measurement. The mean age was 41.8±11.1 years. The mean body mass index (BMI) was 45±8 kg/m2. The 6MWD showed correlations with height (r=0.319), age (r=-0.281), weight (r=-0.370), BMI (r=-0.561), forced vital capacity (FVC, r=0.443), expiratory peak flow (r=0.278), maximal inspiratory pressure (MIP, r=0.326), and maximal expiratory pressure (r=0.259), all with P<0.0001. In the stepwise forward regression analysis, BMI, FVC, age, and MIP were the independent predictive variables for 6MWD, explaining 41% of its variability. The reference equation including lung function was as follows: 6MWD (m) = 513.6 - (4.439 × BMIkg/m2) + (1.136 × FVC%predicted) - (1.048 × ageyrs) + (0.544 × MIP%predicted). Thus, the inclusion of lung function in a reference equation for 6MWD contributes to a better prediction of the distance covered in this population.

Background. Obesity has several effects on the mechanics of the rib cage that may impair the exercise performance of obese individuals and therefore impact the assessment of surgical risk. This study aimed to establish a reference value for the 6-minute walk distance (6 MWD) in obese Brazilian men in the preoperative period of bariatric surgery that considers the effect of lung function. Methods. This was a cross-sectional study in which 104 obese men underwent the six-minute walk test (6 MWT) before bariatric surgery. They also underwent the spirometry test and respiratory muscle strength measurement before the 6 MWT. Results. The 6 MWD was correlated with age (r = −0.388, ), weight (r = −0.365, ), height (r = 0.285, ), body mass index (BMI) (r = −0.543, ), forced vital capacity (FVC) (r = 0.472, ), peak expiratory flow (r = 0.253, ), and maximal inspiratory pressure (r = 0.313, ). In the stepwise forward regression analysis, BMI, FVC, and age were the only variables that independently predicted the 6 MWD and explained 40% of its variability. The reference equation proposed for obese Brazilian men is 6 MWD (m) = 570.5 − (3.984 × BMI_kg/m2) + (1.093 × FVC_%predicted) − (0.836 × age_yrs). Conclusion. In this sample of obese Brazilian men, lung function contributed to poor performance in the 6 MWT. In these individuals, BMI, FVC, and age were the variables that composed the reference equation for the 6 MWD. Thus, in several clinical settings, such as in the evaluation before bariatric surgery, pulmonary function data are important to determine the reference value for the 6 MWD.

In martial arts, heart rate variability (HRV) measurements can potentially be used to assess injury risk and susceptibility to fatigue. Muay Thai uses the Frequency Speed of Kick Test (FSKT) to measure kick speed, but it is unknown whether better fitness results in improved autonomic function and body composition, which may affect athletic performance and recovery. We aimed to evaluate the correlations between FSKT, HRV, and body composition measures in amateur Muay Thai fighters. This is a cross-sectional study with 37 Muay Thai fighters. They underwent FSKT-10s and multiple FSKT to measure the kick fatigue index (KFI). In addition, body composition was assessed using bioelectrical impedance analysis and HRV using a heart rate monitor. When comparing the values before and during the FSKT-10s, there was a decrease in the percentage of interval differences of consecutive successive NN intervals greater than 50 ms (pNN50), approximate entropy, and parasympathetic nervous system (PNS) index, with an increase in the sympathetic nervous system (SNS) index. The number of kicks assessed by FSKT-10s positively correlated with fat-free mass (FFM) and low frequency (LF) of the HRV assessment. The KFI correlated negatively with the FFM and PNS index, and positively with the LF and SNS index. When amateur Muay Thai fighters perform the FSKT-10s, there is an acute effect on autonomic modulation with increased sympathetic activation and vagal withdrawal. FFM and sympathetic activation are related to performance and susceptibility to fatigue. These results indicate the importance of assessing HRV in Muay Thai fighters to improve performance.

Background. Changes in lifestyle, a carbohydrate-rich diet, and decreased physical activity are part of the context that led to an obesity pandemic. Treating obesity is a task that requires multidisciplinary care; however, in many cases, conventional therapy has no effect, requiring surgical intervention. This, in turn, is not without risks and causes important changes in lung function. Therefore, the aim of this study is to evaluate the effect of electroanalgesia through conventional transcutaneous electrical nerve stimulation (TENS) on the pain and lung function in the postoperative period of bariatric surgery. Methods. This is a controlled and blinded clinical trial with 66 subjects who underwent bariatric surgery. The participants were randomized into 2 groups as follows: an intervention group treated with TENS ( ) and a placebo group ( ). The participants underwent 4 TENS sessions, and the effect on pain was assessed using a visual analogue scale (VAS pain). Lung function was measured by spirometry. Results. There were no differences between the 2 groups regarding time of surgery and time of mechanical ventilation. Compared to placebo, TENS reduced pain in the intervention group ( ). Regarding the effect of electroanalgesia on pulmonary function, the spirometric parameters were similar between the groups. However, regarding muscle strength between the preoperative and postoperative periods, maximal inspiratory pressure (MIP) was maintained in the intervention group and decreased in the placebo group ( ). Compared with that in the intervention group, the respiratory rate in the placebo group increased during the application of TENS ( ). Conclusion. Electroanalgesia reduces pain in patients who underwent bariatric surgery. Importantly, in these patients, the MIP is maintained between the preoperative and postoperative periods. However, electroanalgesia does not contribute to improvements in spirometric data. This trial is registered with NCT04800640.

Covid-19 is caused by the Sars-CoV-2 virus, which presents itself in a systemic, cognitive or physical way. Patients affected by covid may have multisystemic conditions as sequelae, leading to reduced functional capacity and altered pulmonary and cardiac function. Objective: To verify the use of the 6 minute walk test (6MWT) and the short form – 36 (SF-36) as instruments to assess the functional capacity and quality of life of patients infected with covid. Methods: Were included cross-sectional studies, systematic, observational and cross-sectional reviews, clinical trials and data analysis were included in this research, as well as articles containing adult patients infected with covid-19, who entered physical therapy rehabilitation and the 6MWT and SF-36 were evaluated. Thus, being included, covid - 19, Sars-Cov 2, functional capacity tests, 6MWT, coronavirus infection, quality of life and SF-36. The following exclusion criteria were adopted: studies with incomplete data and studies without data from the control group, pediatric rehabilitation. Results: Initially, 43 articles were detected, of which 20 were used for better analysis, of these 14 were considered relevant, but 6 were excluded because they did not present outcomes of interest, due to incomplete data or lack thereof, leaving 8 articles, with a total of 616 volunteers and some systematic review articles. Conclusion: Therefore, it is concluded that the SF 36 detected mainly emotional and physical changes, due to the pathologies already installed in post-covid patients. The 6MWT assists in the assessment and control of functional capacity, assessing physical sequelae and contributing to the prescription of appropriate treatment.

Background and Aims: Proper sagittal alignment and postural control are important for functional independence. This exploratory cross-sectional study evaluated sagittal vertical alignment (SVA) in individuals with axial spondyloarthritis (iwaxSpA) and examined its associations with plantar-pressure-derived postural sway parameters and handgrip strength (HGS). Methods: Twenty-one iwaxSpA and 20 controls underwent whole-spine lateral radiography for SVA measurement, baropodometric assessment, and HGS testing. Results: An SVA ≥50 mm was observed in 9/21 (42.8%) iwaxSpA and 4/20 (20.0%) controls. Median SVA was higher in iwaxSpA than in controls (31 [16–53] vs. 26.5 [9.50–36.7] mm), but the between-group comparison was not statistically significant after correction for multiple testing (adjusted p=0.802). No baropodometric parameter or mean HGS differed significantly between groups after multiplicity correction. Within the iwaxSpA group, SVA showed nominal positive correlations with age (ρ=0.511, unadjusted p=0.017) and maximal mediolateral displacement (ρ=0.452, unadjusted p=0.039), but neither association remained statistically significant after Benjamini–Hochberg adjustment (adjusted p=0.356 and p=0.395, respectively). Conclusions: Although iwSpA exhibit worse postural assessment and balance control values than controls—when measured via spinal radiography and baropodometry, respectively—there are no significant differences after adjusting for multiple comparisons. In iwSpA, the associations between postural assessment (via spinal radiography) and baropodometric parameters or HGS are weak and non-significant. Larger, adequately characterized studies with prespecified outcomes and adjustment for relevant confounders are needed.