Desporto, Saúde e Segurança
Transcription
Desporto, Saúde e Segurança
CONGRESSO DO DESPORTO INSTITUTO DO DESPORTO DE PORTUGAL Desporto, Saúde e Segurança Carlos A. Fontes Ribeiro Faculdades de Medicina e Ciências do Desporto e Educação Física Universidade de Coimbra Coimbra, 14.01.2006 1 Portugal é um país sedentário? ... É um país parado! Coimbra, 14.01.2006 2 1 • Actividade Física • Exercício • Desporto • e Saúde? Recomendações para a actividade física mínima? Desporto Î maior exigência Î melhores resultados... Coimbra, 14.01.2006 3 Medicina Baseada na Evidência • The Cochrane Library (issue 4, 2005): • “Health and Sports” • Cochrane Reviews Î 152 • DARE Î 44 • Trials Î 605 • Methodology Reviews Î 1 Coimbra, 14.01.2006 4 2 Aerobic exercise and resting blood pressure in older adults: a meta-analytic review of randomized controlled trials (Structured abstract) [Abstracts of quality assessed systematic reviews] NHS Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects 2005, Issue 4 Copyright © 2005 University of York. Published by John Wiley & Sons, Ltd. Author's conclusions This study supported the efficacy of aerobic exercise for reducing resting SBP in older adults. However, final conclusions regarding the effectiveness of aerobic exercise for reducing the resting SBP and DBP in older adults cannot be drawn until further studies addressing this issue are conducted. CRD commentary The review question is important. The inclusion criteria were clearly stated but did not mention co-morbidity. All the studies included fitted these criteria. The duration of the exercise intervention was not included and this may be important. No specific search terms were given and no attempt was made to look for unpublished studies. In addition, the papers were limited to English language publications, so some published in non-English languages may have been omitted. Finally, the sources searched were limited and this may have led to the omission of studies. The authors used a scoring system to assess the validity of thestudies, but did not say how they implemented it. Details of the primary data extraction were well presented. However, the number of participants included in the studies was not consistent throughout the paper. The authors discussed the loss to follow-up, which is important in studies of lifestyle interventions and 'intent to treat analysis' and 'analysis by protocol'. All of the included studies used 'analysis by protocol'. The authors' conclusions are consistent with the results. The intensity and duration of the interventions were not considered in the data analysis. Nearly all the participants were American or Japanese, thus the results may not be generalisable. Coimbra, 14.01.2006 5 [ACSM´s Guidelines for Exercise Testing And Prescription, 2000] Coimbra, 14.01.2006 6 3 Coimbra, 14.01.2006 7 Desporto e Saúde • Estímulos repetidos Î adaptações Î alterações estruturais? • Maior produção de radicais livres de oxigénio? • Maior defesa contra os radicais livres? Coimbra, 14.01.2006 8 4 Riscos? Coimbra, 14.01.2006 9 [ACSM´s Guidelines for Exercise Testing And Prescription, 2000] Coimbra, 14.01.2006 10 5 [ACSM´s Guidelines for Exercise Testing And Prescription, 2000] Coimbra, 14.01.2006 11 [ACSM´s Guidelines for Exercise Testing And Prescription, 2000] Coimbra, 14.01.2006 12 6 Desporto e lesões • Desporto Î lesões... • Mas: Treino Î adaptação Î maior resistência a algumas lesões Coimbra, 14.01.2006 13 Dopagem e Desporto • Problema frequente (?) no Desporto... Desporto reflecte a Sociedade... • Necessária formação • Exigência superior? Coimbra, 14.01.2006 14 7 Drogas e Desporto • Desporto Î maior produção de opióides endógenos (eg, encefalinas e beta-endorfinas) Dependência do esforço? Ganhos em Saúde! Substituição das drogas? Coimbra, 14.01.2006 15 Tapete rolante (treadmill): Panlab, model LE8706; programa SeDaCom32 (Versão 1.10) para transferir os dados. Coimbra, 14.01.2006 16 8 (ANFET: 5 mg/Kg, i.p.) 600 s/Treino c/Exerc. agudo [DOPAMINA] (pg/30µl) 500 s/Treino s/Exerc.agudo c/Treino s/Exerc. agudo 400 c/Treino c/Exerc. agudo 300 200 100 0 0 1 2 3 4 5 6 Tempo (h) Coimbra, 14.01.2006 17 • Do mercado de medicamentos (3.000.000.000 €) quanto poderia ser a poupança se houvesse maior investimento na actividade física / exercício / desporto? • E o rendimento profissional, familiar e social? Coimbra, 14.01.2006 18 9