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Background: In recent years, there has been a growing use of technological advancements to enhance the rehabilitation of individuals who have suffered from cerebrovascular accidents. Virtual reality rehabilitation programs enable patients to engage in a customized therapy program while interacting with a computer-generated environment. Therefore, our goal was to investigate the effectiveness of virtual reality in occupational therapy for people's rehabilitation after a cerebrovascular accident. Methods: We systematically searched databases (Pubmed/Medline, Scopus, Web of Science, and Science Direct) for randomized controlled trials published within the last 10 years. Studies involving adult stroke survivors undergoing virtual reality-based interventions aimed at improving upper-extremity motor function were included. The quality assessment followed PRISMA guidelines, with the risk of bias assessed using the Cochrane tool (version 6.4) and methodological quality evaluated using GRADEpro. Results: We selected sixteen studies that met the main criteria for the implementation of virtual reality technology. The interventions described in the articles focused mainly on the upper extremities and their fine motor skills. Conclusions: When used in conventional treatments to improve people's motor and cognitive functions after a cerebrovascular accident, virtual reality emerges as a beneficial tool. Additionally, virtual reality encourages adherence to the interventional process of rehabilitation through occupational therapy.

This systematic review aimed to analyze the available studies that identified overweight and/or obesity as a risk factor for mortality, use of respiratory support, and changes in biochemical markers in adults hospitalized with SARS-CoV-2. The PubMed, Web of Science, and Scopus databases were searched using PRISMA guidelines until January 2024. The protocol was registered with PROSPERO (code: CRD42024501551). Of the 473 articles, only 8 met the inclusion criteria (e.g., adult individuals aged 18 or over diagnosed with COVID-19 individuals with overweight and/or obesity). In addition, the Downs and Black tool was used to assess the quality of the studies. The studies analyzed totaled 9782 adults hospitalized for COVID-19, indicating that overweight and obesity are present in more than half of adults. Diseases such as diabetes mellitus and hypertension are more prevalent in adults with obesity. The systematic review also highlighted that a higher incidence of respiratory support is related to a higher incidence of hospitalization in intensive care units and that adults with overweight and obesity have a higher risk of mortality from COVID-19. Biochemical markers such as procalcitinin, C-reactive protein, and interleukin-6 are associated with the severity of COVID-19 infection. This systematic review exposed overweight and/or obesity as a risk factor for worse COVID-19 disease, as well as for the need for intensive care, respiratory support, mortality, and changes in essential blood markers.

This study aimed to analyze the effect of plyometric training (PT) at different frequencies on jump performance, running sprint speed, and service speed in youth male volleyball players. The participants were randomly assigned to one PT session per week (Experimental Group 1, EG1, n = 15), two PT sessions per week (Experimental Group 2, EG2, n = 14), and a control group (CG, n = 13). The total weekly jumping ranged between 98 and 196 jumps (equalized between, EG1 and, EG2). The assessments performed were squat jump (SJ), countermovement jump (CMJ), CMJ-arms, drop jump (DJ), 5-m sprint, 10-m sprint, and service speed. The intragroup comparisons showed that, EG1 significantly ( p < 0.001) improved SJ ( Δ = 12.74%; d = 1.30), CMJ ( Δ = 11.94%; d = 1.71), CMJ-arms ( Δ = 12.02%; d = 1.47), DJ ( Δ = 10.93%; d = 1.30), 5-m sprint ( Δ = -4.61%; d = 0.29), 10-m sprint ( Δ = -3.95%; d = 0.40) and service speed ( Δ = 8.17%; d = 1.53). Similarly, EG2 significantly ( p ˂ 0.001) improved SJ ( Δ = 11.52%; d = 1.25), CMJ ( Δ = 11.29%; d = 1.38), CMJ-arms ( Δ = 11.42%; d = 1.26), DJ ( Δ = 13.90%; d = 2.17), 5-m sprint ( Δ = -3.85%; d = 0.25), 10-m sprint ( Δ = -2.73%; d = 0.25) and service speed ( Δ = 6.77%; d = 1.44). The CG significantly ( p < 0.05) improved SJ ( Δ = 2.68; d = 0.28), CMJ-arms ( Δ = 2.30; d = 0.35), 5-m sprint ( Δ = -1.27; d = 0.10) and service speed ( Δ = 1.42; d = 0.30). Intergroup comparisons revealed significantly greater improvements in all variables ( p < 0.001) in, EG1 and, EG2 concerning to CG. However, no significant differences were found between, EG1 and, EG2. A moderate weekly PT volume, distributed in one or two sessions per week, seems equally effective., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hernandez-Martinez, Guzman-Muñoz, Ramirez-Campillo, Herrera-Valenzuela, Magnani Branco, Avila-Valencia, Luis Carter-Beltran, Aravena-Sagardia, Méndez-Cornejo and Valdés-Badilla.)

This systematic review aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS) on cardiorespiratory fitness (CRF) in the non-athlete population. The methodological quality and certainty of evidence were evaluated using PRISMA, TESTEX, RoB, and GRADE scales. The protocol was registered in PROSPERO (code: CRD42023391433). From 4133 records, six randomized controlled trials were included, involving 855 non-athletes (mean age = 27.2 years old). The TESTEX scale reported all studies with a ≥ 60% (moderate-high quality) score. The GRADE scale indicated moderate to low certainty of evidence. It was only possible to perform a meta-analysis on direct methods to maximum oxygen consumption (VO 2 max). The main results indicated significant differences in favor of OCS compared to active/passive controls in VO 2 max (SMD = 4.61; 95%CI = 1.46 to 7.76; I 2 = 99%; p = 0.004), while the individual results of the studies reported significant improvements in favor of the OCS on the indirect methods of the CRF. OCS improved CRF in a healthy non-athlete population of different ages, specifically showing a significant improvement in VO 2 max with direct tests, such as cardiopulmonary tests. However, moderate to low certainty of evidence is reported, so no definitive recommendations can be established.

Adolescence is a complex period of human development in which young people are susceptible to unhealthy behaviors, such as physical inactivity and an unbalanced diet. This study aimed to analyze the effects of 12 weeks of multi-disciplinary family and individual intervention on cardiometabolic risk parameters in overweight and obese adolescents and compare sub-groups, considering possible differences between sexes (males vs. females vs. intervention approach). Forty-three adolescents (13.73 ± 2.46 years old) of both sexes were divided into two groups: family group (FG) ( n = 21; 14.24 ± 2.61 years old) and individual group (IG) ( n = 22; 13.23 ± 2.27 years old). The following parameters were evaluated: anthropometry (body weight, height, waist circumference (WC), hip circumference (HC), abdominal circumference (AC), calculation of body mass index (BMI), and waist-hip ratio (WHR)), body composition (fat mass (FM), lean mass (LM), fat-free mass (FFM), skeletal muscle mass (SMM), body fat percentage (BF), and visceral fat), biochemical measures (fasting glucose, triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL-c), and high-density lipoproteins (HDL-c)), and the measurement of systolic and diastolic blood pressure (SBP and DBP) before and after the interventions. The multi-disciplinary interventions occurred for 12 weeks (three days a week lasting 1 h and 30 min, in which 30 min were dedicated to theoretical interventions (nutrition: nutritional education and psychology: psychoeducation) and 1 h to physical exercises. A time effect was observed for LM, FFM, SMM, FM, and HDL-c, with higher values after intervention and a significant decrease for FM, BF, visceral fat, fasting glucose, TG, TC, LDL-c, and DBP ( p < 0.05). However, no group, sub-group, or interaction effects were observed when comparing FG, IG, or sexes ( p > 0.05). The responses of the present study show that both multi-disciplinary approaches (family and individual) promoted improvement in the body composition indicators, biochemical markers, and DBP of overweight and obese adolescents independently of the intervention group. Given this finding, health professionals, families, and adolescents could choose the type of intervention based on their preferences.

This study aimed to associate physical activity habits with cardiometabolic variables (blood pressure, fasting glucose, HDL cholesterol, and triglycerides), body composition (body fat percentage and fat-free mass), and physical performance (handgrip strength (HGS), timed up-and-go (TUG), and walking speed) in Chilean older women. An analytical cross-sectional study analyzed 179 older women with a mean age of 75.4 years distributed into physically inactive (PI) older women ( n = 74) and physically active (PA) older women ( n = 105). A logistic regression showed that PI older women presented an increased risk of hyperglycemia (OR = 4.70; p = 0.000), high blood pressure (OR = 3.83; p = 0.000), low HDL cholesterol levels (OR = 2.13; p = 0.03), hypertriglyceridemia (OR = 2.54; p = 0.01), excess body fat percentage (OR = 4.33; p = 0.000), low fat-free mass (OR = 2.22; p = 0.02), low HGS in their dominant hand (OR = 3.37; p = 0.001) and non-dominant hand (OR = 3.60; p = 0.0001), and poor performance in TUG (OR = 5.60; p = 0.000) and walking speed (OR = 5.52; p = 0.000). In conclusion, physical inactivity was associated with increased cardiometabolic risk, excess body fat percentage, lower fat-free mass, and poorer physical performance in Chilean older women. At the same time, PA older women showed a lower cardiometabolic risk, better body composition, and better physical performance than PI older women.

Introduction: The sequelae post-COVID can affect different systems. In this sense, considering the multi-factorial etiology of COVID-19, multi-professional interventions could be a relevant strategy for recovery health indicators. Objective: This study aimed to investigate the effects of multi-professional intervention on body composition, physical fitness, and biomarkers in overweight COVID-19 survivors with different symptomatology. Methodology: A non-randomized parallel group intervention included 69 volunteers (BMI ≥25 kg/m 2 ), divided into three groups according to SARS CoV-2 symptomatology, but only 35 finished the longitudinal protocol [control group ( n = 11); moderate group ( n = 17) and severe group ( n = 7)]. The groups were submitted to a multi-professional program (nutritional intervention, psychoeducation, and physical exercise intervention) for 8 weeks, and the volunteers underwent body composition assessments (primary outcome) and physical and biochemical tests (secondary outcome) in pre- and post-intervention. This study was registered on the Clinical Trials Registration Platform number: RBR-4mxg57b and with the local research ethics committee protocol under number: 4,546,726/2021. Results: After the 8-week multi-professional intervention, the following results were observed for the moderate COVID-19 group: improved dynamic strength of lower- and ( p = 0.003), upper-limbs ( p = 0.008), maximal isometric lumbar-traction strength ( p = 0.04), flexibility ( p = 0.0006), and albumin ( p = 0.0005), as well as a reduction in the C reactive protein (CRP) ( p = 0.003) and fasting glucose ( p = 0.001); for the severe COVID-19 group: an improvement in dynamic lower-body strength ( p = 0.001), higher values of albumin ( p = 0.005) and HDL-c ( p = 0.002), and lower values of CRP ( p = 0.05), and for the control group: an improvement in sit-up repetitions ( p = 0.008), and a reduction of CRP ( p = 0.01), fasting glucose ( p = 0.001) and total cholesterol ( p = 0.04) were identified. All experimental groups reduced triglycerides after intervention ( p < 0.05). Conclusion: Finally, 8 weeks of multiprofessional intervention can be an efficient tool for reversing the inflammatory process and promoting improvements in daily activities and quality of life, although it is believed that the severe COVID-19 group needs longer interventions to improve different health indicators. Clinical Trial Registration: https://ensaiosclinicos.gov.br/, identifier: RBR-4mxg57b., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sordi, Lemos, de Souza Marques, Ryal, Priscila de Paula Silva Lalucci, Marques, Amaro Camilo, De Paula Ramos, Franzói De Moraes, Valdés-Badilla, Mota and Magnani Branco.)

The present study aimed to investigate the effects of a multi-professional intervention model on the mental health of middle-aged, overweight survivors of COVID-19. A clinical trial study with parallel groups and repeated measures was conducted. For eight weeks, multi-professional interventions were conducted (psychoeducation, nutritional intervention, and physical exercises). One hundred and thirty-five overweight or obese patients aged 46.46 ± 12.77 years were distributed into four experimental groups: mild, moderate, severe COVID, and control group. The instruments were used: mental health continuum-MHC, revised impact scale-IES-r, generalized anxiety disorder-GAD-7, and Patient health questionnaire PHQ-9, before and after eight weeks. The main results indicated only a time effect, with a significant increase in global MHC scores, emotional well-being, social well-being, and psychological well-being, as well as detected a significant reduction in global IES-R scores, intrusion, avoidance, and hyperarousal, in addition to a reduction in GAD-7 and PHQ-9 scores ( p < 0.05). In conclusion, it was possible to identify those psychoeducational interventions that effectively reduced anxiety, depression, and post-traumatic stress symptoms in post-COVID-19 patients, regardless of symptomatology, in addition to the control group. However, moderate and severe post-COVID-19 patients need to be monitored continuously since the results of these groups did not follow the response pattern of the mild and control groups.

The present study aimed to evaluate the body composition and cardiorespiratory fitness of overweight or obese people after COVID-19. 171 volunteers of both sexes (men, n = 93 and women, n = 78) between 19 and 65 years old were allocated into three groups according to the severity of their symptoms of COVID-19: non-hospitalized people/mild symptoms ( n = 61), hospitalized ( n = 58), and hospitalized in an intensive care unit-ICU ( n = 52). Two laboratory visits were carried out 24 h apart. First, a medical consultation was carried out, with subsequent measurement of body weight and height (calculation of body mass index) and body composition assessment via electrical bioimpedance. After 24 h, a cardiorespiratory test was performed using the Bruce protocol, with a direct gas exchange analysis. Hospitalized individuals had significantly higher values for fat mass and body fat percentage than non-hospitalized individuals ( p < 0.05). Significantly higher values were found for heart rate (HR) and peak oxygen consumption (VO 2 peak) for individuals who were not hospitalized when compared to those hospitalized in the ICU ( p < 0.05). Significantly higher values for distance, ventilation, and the relationship between respiratory quotient were found for non-hospitalized individuals compared to hospitalized individuals and those in the ICU ( p < 0.05). After the cardiorespiratory test, higher values for peripheral oxygen saturation (SpO 2 ) were observed for non-hospitalized individuals than for all hospitalized individuals ( p < 0.05). Diastolic blood pressure was significantly higher at the tenth and fifteenth minute post-Bruce test in hospitalized than in non-hospitalized participants ( p < 0.05). Based on these results, proposals for cardiopulmonary rehabilitation are indispensable for hospitalized groups considering the responses of blood pressure. Monitoring HR, SpO 2, and blood pressure are necessary during rehabilitation to avoid possible physical complications. Volume and intensity of exercise prescription should respect the physiologic adaptation. Given lower physical conditioning among all the groups, proposals for recovering from health conditions are urgent and indispensable for COVID-19 survivors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lemos, Cavalini, Pugliese Henrique, Perli, de Moraes Marchiori, Marchiori, Sordi, Franzói de Moraes, de Paula Ramos, Valdés-Badilla, Mota and Magnani Branco.)

Purpose: The present study investigated the effects of high-intensity intermittent training (HIIT) on lower- and upper-body graded exercise and high-intensity intermittent exercise (HIIE, four Wingate bouts) performance, and on physiological and muscle damage markers responses in judo athletes., Methods: Thirty-five subjects were randomly allocated to a control group (n = 8) or to one of the following HIIT groups (n = 9 for each) and tested pre- and post-four weeks (2 training d·wk(-1)): (1) lower-body cycle-ergometer; (2) upper-body cycle-ergometer; (3) uchi-komi (judo technique entrance). All HIIT were constituted by two blocks of 10 sets of 20 s of all out effort interspersed by 10 s set intervals and 5-min between blocks., Results: For the upper-body group there was an increase in maximal aerobic power in graded upper-body exercise test (12.3%). The lower-body group increased power at onset blood lactate in graded upper-body exercise test (22.1%). The uchi-komi group increased peak power in upper- (16.7%) and lower-body (8.5%), while the lower-body group increased lower-body mean power (14.2%) during the HIIE. There was a decrease in the delta blood lactate for the uchi-komi training group and in the third and fourth bouts for the upper-body training group. Training induced testosterone-cortisol ratio increased in the lower-body HIIE for the lower-body (14.9%) and uchi-komi (61.4%) training groups., Conclusion: Thus, short-duration low-volume HIIT added to regular judo training was able to increase upper-body aerobic power, lower- and upper-body HIIE performance.

Objectives: The present study aimed to evaluate the effects of using hyperbaric oxygen therapy during post-training recovery in jiu-jitsu athletes., Methods: Eleven experienced Brazilian jiu-jitsu athletes were investigated during and following two training sessions of 1h30min. Using a cross-over design, the athletes were randomly assigned to passive recovery for 2 hours or to hyperbaric oxygen therapy (OHB) for the same duration. After a 7-day period, the interventions were reversed. Before, immediately after, post 2 hours and post 24 hours, blood samples were collected to examine hormone concentrations (cortisol and total testosterone) and cellular damage markers [creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH)]. Moreover, the rating of perceived exertion (RPE) and recovery (RPR) scales were applied., Results: Final lactate [La] values (control: 11.9 ± 1.4 mmol/L, OHB: 10.2 ± 1.4 mmol/L) and RPE [control: 14 (13-17 a.u.), OHB: 18 (17-20 a.u.)] were not significantly different following the training sessions. Furthermore, there was no difference between any time points for blood lactate and RPE in the two experimental conditions (P>0.05). There was no effect of experimental conditions on cortisol (F1,20 = 0.1, P = 0.793, η2 = 0.00, small), total testosterone (F1,20 = 0.03, P = 0.877, η2 = 0.00, small), CK (F1,20 = 0.1, P = 0.759, η2 = 0.01, small), AST (F1,20 = 0.1, P = 0.761, η2 = 0.01, small), ALT (F1,20 = 0.0, P = 0.845, η2 = 0.00, small) or LDH (F1,20 = 0.7, P = 0.413, η2 = 0.03, small). However, there was a difference between the two experimental conditions in RPR with higher values at post 2 h and 24 h in OHB when compared to the control condition (P<0.05)., Conclusions: Thus, it can be concluded that OHB exerts no influence on the recovery of hormonal status or cellular damage markers. Nonetheless, greater perceived recovery, potentially due to the placebo effect, was evident following the OHB condition.

Objectives: The aim of this study was to evaluate the effect of caffeine ingestion on performance and estimated energy system contribution during simulated taekwondo combat and on post-exercise parasympathetic reactivation., Methods: Ten taekwondo athletes completed two experimental sessions separated by at least 48 hours. Athletes consumed a capsule containing either caffeine (5 mg∙kg-1) or placebo (cellulose) one hour before the combat simulation (3 rounds of 2 min separated by 1 min passive recovery), in a double-blind, randomized, repeated-measures crossover design. All simulated combat was filmed to quantify the time spent fighting in each round. Lactate concentration and rating of perceived exertion were measured before and after each round, while heart rate (HR) and the estimated contribution of the oxidative (WAER), ATP-PCr (WPCR), and glycolytic (W[La-]) systems were calculated during the combat simulation. Furthermore, parasympathetic reactivation after the combat simulation was evaluated through 1) taking absolute difference between the final HR observed at the end of third round and the HR recorded 60-s after (HRR60s), 2) taking the time constant of HR decay obtained by fitting the 6-min post-exercise HRR into a first-order exponential decay curve (HRRτ), or by 3) analyzing the first 30-s via logarithmic regression analysis (T30)., Results: Caffeine ingestion increased estimated glycolytic energy contribution in relation to placebo (12.5 ± 1.7 kJ and 8.9 ± 1.2 kJ, P = 0.04). However, caffeine did not improve performance as measured by attack number (CAF: 26. 7 ± 1.9; PLA: 27.3 ± 2.1, P = 0.48) or attack time (CAF: 33.8 ± 1.9 s; PLA: 36.6 ± 4.5 s, P = 0.58). Similarly, RPE (CAF: 11.7 ± 0.4 a.u.; PLA: 11.5 ± 0.3 a.u., P = 0.62), HR (CAF: 170 ± 3.5 bpm; PLA: 174.2 bpm, P = 0.12), oxidative (CAF: 109.3 ± 4.5 kJ; PLA: 107.9 kJ, P = 0.61) and ATP-PCr energy contributions (CAF: 45.3 ± 3.4 kJ; PLA: 46.8 ± 3.6 kJ, P = 0.72) during the combat simulation were unaffected. Furthermore, T30 (CAF: 869.1 ± 323.2 s; PLA: 735.5 ± 232.2 s, P = 0.58), HRR60s (CAF: 34 ± 8 bpm; PLA: 38 ± 9 bpm, P = 0.44), HRRτ (CAF: 182.9 ± 40.5 s, PLA: 160.3 ± 62.2 s, P = 0.23) and HRRamp (CAF: 70.2 ± 17.4 bpm; PLA: 79.2 ± 17.4 bpm, P = 0.16) were not affected by caffeine ingestion., Conclusions: Caffeine ingestion increased the estimated glycolytic contribution during taekwondo combat simulation, but this did not result in any changes in performance, perceived exertion or parasympathetic reactivation.

Purpose: The present study aims at investigating the physiological response and technical-tactical parameters in Brazilian jiu-jitsu competition., Methods: The study included 35 male Brazilian jiu-jitsu athletes (adult category, body mass: 80.2 ± 13.0 kg), graded from white to brown belt, during combats fought at regional level. Twenty-two fights were analyzed in terms of technique and time structure. Blood glucose, lactate and maximal isometric grip strength were determined before and after the fights. The rate of perceived exertion was also assessed after the fight, using the 6-20 Borg rating. The fights were recorded and the following variables were determined: the exertion/pause ratio and subjective intensity of actions, categorized between low and high intensity., Results: The results indicated that during Brazilian jiu-jitsu fights, the glycolytic pathway is only moderately activated (lactate before: 4.4 (4.0 - 4.6) mmol/L, after: 10.1 (8.0 - 11.3) mmol/L; glucose before: 112.4 ± 22.3 mg/dL, after: 130.5 ± 31.0 mg/dL). The exertion during the fight resulted in significant reductions in handgrip strength (right hand grip before: 45.9 ± 10.3 kgf, after: 40.1 ± 9.5 kgf; left hand grip before: 44.2 ± 11.1 kgf, after: 37.0 ± 10.2 kgf). The athletes rated the fight as hard: 15 (13 - 15). Effort/pause ratio was 6:1, while high-intensity actions lasted approximately 4 s, resulting in a low/high intensity? ratio of 8:1., Conclusion: It is recommended that coaches direct the training loads to simulate the energy demand imposed by the competitive matches, activating moderately the glycolytic pathway. Moreover, the time structure of combats can be used to prescribe both physical and technical-tactical training.

Purpose: This study aims to investigate the association between the rating of perceived exertion (RPE), heart rate (HR) and the blood lactate concentration ([La]) in successive judo fight simulations (randori)., Methods: TEN ATHLETES PARTICIPATED IN THE STUDY (AGE: 25.6±2.1 years; stature: 1.75±0.07 m; body mass: 75.6±14.9kg; %BF: 11.5±7.8%; practice: 14.5±6.2 years) and completed 4 judo fight simulations (T1 to T4) with duration of 5 min separated by 5 min passive recovery periods. Before each randori, [La] and HR were collected, and after each randori, the same measures and the RPE (CR-10 scale) were collected., Results: SIGNIFICANT CORRELATIONS WERE OBSERVED BETWEEN: (1) CR-10 and HR (T2: r =0.70; T3: r =0.64; both, P<0.05); (2) ΔCR-10 and Δ[La] (T1-T2: r = .71, P< 0.05; T2-T3: r =0.92, P<0.01; T3-T4: r =0.73, P<0.05). Moreover, significant differences were noted in the behavior of the HR between the 2(nd) (T2) and 3(rd) (T3) judo fight simulations (P<0.05)., Conclusion: The use of CR-10 in the evaluation process, as well as in deciding the load of training in judo, should be done with caution.