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Objective: We aimed to identify the factors associated with using digital platforms for physical activity during the COVID-19 pandemic among adults living in Southern Brazil. We also compared the trajectory of physical activity between users and non-users and by type of digital platform used. Methods: We analyzed data from the PAMPA (Prospective Study About Mental and Physical Health in Adults) cohort. The study started in June 2020, and tracked participants through three waves (December 2020, June 2021, and June 2022). The exposure variable was usingf digital platforms for physical activity. The outcome measure was minutes per week of physical activity. We employed a generalized linear model with robust variance to explore the interaction between time and the use of digital platforms, adjusting for sociodemographic covariates and the presence of chronic diseases. Results: The proportion of participants using digital platforms for physical activity declined from 36.8% in 2020 to 25.6% in 2021 and further to 13.5% in 2022. Using digital platforms for physical activity was associated with a higher mean daily physical activity during the COVID-19 pandemic. Participants who used digital platforms were more likely to be physically active when compared to their inactive contemparts throughout the entire study period. Notably, social media emerged with greater influence in the physical activity practice among digital platforms. Conclusion: Using these platforms had a positive impact on increasing the level of physical activity among the participants.

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BACKGROUND: Social and economic factors, such as food insecurity, contribute to long coronavirus disease (COVID). During the pandemic, a significant rise in food insecurity was observed, both in Brazil and worldwide. We aimed to investigate the association between food insecurity and long COVID in Brazilian adults. METHODS: Cross-sectional study nested within the Prospective study About Mental and Physical Health in Adults (PAMPA) Cohort. Participants completed an online questionnaire in June 2022. We assessed food insecurity using the Brazilian Scale of Food Insecurity. Long COVID was defined as any post-coronavirus disease 2019 symptoms that persisted for at least 3 months after infection. RESULTS: A total of 956 participants were included (74.0% female, median age 36 (Interquartile Range [IQR] (29-45.7). The prevalence of food insecurity was 29.4%, and 77.8% had long COVID. Food insecurity was associated with an increased probability of long COVID (prevalence ratio [PR]: 1.15, 95% confidence interval [CI]: 1.08-1.22). Participants in food insecurity situations had a higher likelihood of experiencing neurological (PR: 1.19, 95% CI: 1.10-1.28), pulmonary (PR: 1.33, 95% CI: 1.17-1.52) and gastrointestinal (PR: 1.57, 95% CI: 1.31-1.88) symptoms after infection. CONCLUSIONS: Food insecurity was associated with long COVID. Governments must plan public policies to mitigate the effects of long COVID and food insecurity.

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We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.

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Most COVID-19 survivors have reported experiencing persistent symptoms after the infection - these types of cases are known as long COVID. Since Brazil was an epicenter of the COVID-19 pandemic, a high burden of long COVID is expected. This study aimed to identify the prevalence and factors associated with long COVID in adults in Southern Brazil, analyzing data from the PAMPA cohort. Participants filled out a self-reported online questionnaire in June 2022. This study only included subjects who tested positive for COVID-19. Long COVID was defined by any symptoms that persisted for at least three months after the SARS-CoV-2 infection. Poisson's regression models with robust variance were used to identify factors associated with long COVID; and results were reported as prevalence ratios (PR) and respective 95% confidence intervals (95%CI). A total of 1,001 participants (77.4% women, mean age [SD] = 38.3 [11.9] years) were analyzed. The prevalence of long COVID among these patients was 77.4% (95%CI: 74.7; 79.9). The likelihood of long COVID was higher in unvaccinated participants (PR = 1.23, 95%CI: 1.06; 1.42), in those with chronic conditions (PR = 1.13, 95%CI: 1.04; 1.24), and in those who were hospitalized due to the COVID-19 infection (PR = 1.24, 95%CI: 1.16; 1.32). This prevalence was also higher in women (PR = 1.21, 95%CI: 1.09; 1.33) than in men. Physical activity was associated with a reduced likelihood of fatigue, neurological complications, coughing, and headaches as persistent symptoms after a COVID-19 infection. It was found that three out of four adults in Southern Brazil experienced long COVID. Public policies aiming to reduce the burden of long COVID must be prioritized, especially in groups that are at higher risk of developing this harmful condition.

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INTRODUCTION: The number of cases of dementia attributable to physical inactivity remains unclear due to heterogeneity in physical inactivity definitions and statistical approaches used. METHODS: Studies that used population-based samples to estimate the population attributable fraction (PAF) of physical inactivity for dementia were included in this review. Weighted PAFs were adjusted for communality among the risk factors (i.e., inactive persons may also share other risk factors) analyzed. Values were reported as percentage (%) of cases of dementia attributable to physical inactivity. RESULTS: We included 22 studies. The overall impact of physical inactivity, defined by any criteria, on dementia ranged from 6.6% (95% CI: 3.6%, 9.6%; weighted) to 16.6% (95% CI: 14.4%, 18.9%; unweighted). Studies using the WHO criterion for physical inactivity estimated a higher unweighted impact (ß = 7.3%; 95% CI: 2.0%, 12.6%) than studies using other criteria. DISCUSSION: Conservatively, one in 15 cases of dementia may be attributable to physical inactivity, defined by any criteria.

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BACKGROUND: During the COVID-19 pandemic, people with low back pain (LBP) might have avoided seeking care for their pain. We aimed to investigate how the COVID-19 pandemic has affected LBP care seeking behavior among adults. METHODS: Data from four assessments of the PAMPA cohort were analyzed. Participants who reported experiencing LBP during wave one both before and during social restrictions (n = 1,753 and n = 1,712, respectively), wave two (n = 2,009), and wave three (n = 2,482) were included. We asked participants about sociodemographic, behavioral, and health factors and outcomes related to LBP. Poisson regression analyses were conducted, and data are presented as prevalence ratios (PR) and respective 95% confidence interval (95%CI). RESULTS: Overall, care seeking behavior decreased by half in the first months of restrictions, from 51.5% to 25.2%. Although there was an increase in care seeking behavior observed in the other two assessments (nearly 10 and 16 months after restrictions), it was insufficient to reach pre-pandemic levels. In the first months of restrictions, a similar scenario was observed for specific care, such as general practitioner and exercise professional care, with proportions of pre-pandemic levels reached after 10 and 16 months. Women were more likely to seek care for LBP 10 and 16 months after restrictions (PR 1.30 95%CI 1.11; 1.52, PR 1.22 95%CI 1.06; 1.39, respectively). Also, those participants who worked, were physically active, and reported pain-related disability and high pain levels were more likely to seek care at all time points assessed. CONCLUSION: Overall, care-seeking behavior for LBP significantly decreased in the first months of restrictions and increased in the following months; however, this behavior remained lower than pre-pandemic levels.

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Objective To analyze the association of sleep duration and use of sleeping medication with multimorbidity. Materials and Methods We conducted a cross-sectional study using data from the Prospective Study about Mental and Physical Health (PAMPA) cohort. Multimorbidity was defined as the presence of two or more conditions from a list of twelve health problems. Descriptive analyses were performed considering proportion and its 95% confidence interval (95%CI). We performed logistic regression (to obtain odds ratios, ORs) to estimate the associations, including models adjusted for confounding factors. Results In total, 2,936 participants were included, 79,1% of them women, 54.2% aged between 18 and 39 years, and 88.9% with white skin color. Compared with regular sleep (seven to eight hours a day), five hours or less of sleep increased the odds of multimorbidity by 145% (95%CI: 1.90-3.14), and 9 hours or more of sleep increased the odds by 49% (95%CI: 1.14-1.95) for the crude model; the results remained significant even in the adjusted models. Discussion Consumption of sleeping medication was associated with multimorbidity. Short and prolonged sleep duration increased the odds of multimorbidity, regardless of the sociodemographic and behavior characteristics. The regular use of sleeping medication was also associated with multimorbidity. The results of the present study are important but require caution due to reverse causality, and longitudinal studies are needed to confirm the findings.

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Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio ­ HR 1,49; intervalo de confiança ­ IC 95% 1,16­1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06­2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49­2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57­0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

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BACKGROUND: To evaluate the short-term impact of COVID-19 pandemic on low back pain (LBP) outcomes in southern Brazil. METHODS: Data from the PAMPA Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed LBP experience, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]). RESULTS: From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to the first months of pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (ß: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity, and anxiety and depression symptoms, were associated with LBP in the first pandemic months. CONCLUSION: Although the prevalence of LBP did not change at the first months of COVID-19 pandemic, LBP-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic.

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BACKGROUND: Major depressive disorder is the most common type of mental disorder. The biological pathway by which exercise promotes its antidepressant effects remains uncleared. This study aimed to systematically review the chronic effect of exercise on blood biomarkers and its association with changes in depressive symptoms in adults with major depressive disorder. METHODS: Randomized controlled trials (RCT) published until February 2020 were screened in seven databases. Studies were systematically reviewed by two independent reviewers. Random effect meta-analysis was performed and reported as standardized mean differences (SMD) and 95 % confidence interval (CI). The meta- analysis protocol was registered with PROSPERO (CRD42021221177). RESULTS: From 3865 records, 12 studies (N = 757 participants, mean age [SD]: 43.0 [11.0], 66.2 % women) were included in this review. Exercise training resulted in superior increase in circulating BDNF (SMD: 0.44, 95%CI: 0.15, 0.73) and kynurenine (SMD: 0.29, 95%CI: 0.04, 0.54), and decrease depressive symptoms (SMD: -0.72, 95%CI: -1.08, -0.37) in adults with major depression disorder compared to control groups. Multivariate meta-regression analysis showed that improvements in circulating levels of BDNF, kynurenine and interleukyn-6 were associated with decreases in depressive symptoms. LIMITATIONS: Results were not stratified by the type of medication used by participants due to the lack of reporting of the included studies. Few studies provided data on other biomarkers (e.g., TNF-α and IL-10) besides BNDF and kynurenine. CONCLUSIONS: Antidepressant effect of exercise may be triggered by improved circulating levels of BNDF, kynurenine, and interleukine-6 in adults with major depressive disorder.

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BACKGROUND: Police officers are exposed to specific occupational tasks, which require lifting, trunk flexion and rotation, carrying weight, and frequent standing periods, which may be associated with an increased risk of experiencing low back pain (LBP). OBJECTIVE: To describe the prevalence and intensity of chronic LBP (CLBP) in Brazilian Federal Highway Police officers (FHPO) from the Rio Grande do Sul state and evaluate its associated factors. METHODS: A total of 208 FHPOs participated in this study. The participants answered an electronic questionnaire containing sociodemographic, behavioral, and occupational questions, and CLBP history. Data analysis comprises descriptive statistics and Poisson regression models. RESULTS: Most of the FHPO were male, aged 41 or more, lived with a partner and were physically active. Sixty-seven percent of FHPO had CLBP, and the median pain intensity was 3.0 (IQR = 0- 5). Participants who lived with a partner were less likely to report CLBP (PR = 0.80; 95% CI = 0.64; 0.99). On the other hand, those who worked as FHPO for more than 11 years were more likely to report CLPB (PR = 1.32; 95% CI = 1.06; 1.63), and high pain intensity (ß= 0.95; 95% CI = 0.19; 1.71). CONCLUSIONS: The high CLBP prevalence among FHPO from Rio Grande do Sul state indicates a need to highlight the importance for police organizations to promote CLBP prevention and implement workplace management programs.

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Abstract: Most COVID-19 survivors have reported experiencing persistent symptoms after the infection - these types of cases are known as long COVID. Since Brazil was an epicenter of the COVID-19 pandemic, a high burden of long COVID is expected. This study aimed to identify the prevalence and factors associated with long COVID in adults in Southern Brazil, analyzing data from the PAMPA cohort. Participants filled out a self-reported online questionnaire in June 2022. This study only included subjects who tested positive for COVID-19. Long COVID was defined by any symptoms that persisted for at least three months after the SARS-CoV-2 infection. Poisson's regression models with robust variance were used to identify factors associated with long COVID; and results were reported as prevalence ratios (PR) and respective 95% confidence intervals (95%CI). A total of 1,001 participants (77.4% women, mean age [SD] = 38.3 [11.9] years) were analyzed. The prevalence of long COVID among these patients was 77.4% (95%CI: 74.7; 79.9). The likelihood of long COVID was higher in unvaccinated participants (PR = 1.23, 95%CI: 1.06; 1.42), in those with chronic conditions (PR = 1.13, 95%CI: 1.04; 1.24), and in those who were hospitalized due to the COVID-19 infection (PR = 1.24, 95%CI: 1.16; 1.32). This prevalence was also higher in women (PR = 1.21, 95%CI: 1.09; 1.33) than in men. Physical activity was associated with a reduced likelihood of fatigue, neurological complications, coughing, and headaches as persistent symptoms after a COVID-19 infection. It was found that three out of four adults in Southern Brazil experienced long COVID. Public policies aiming to reduce the burden of long COVID must be prioritized, especially in groups that are at higher risk of developing this harmful condition.

Resumo: A maior parte dos sobreviventes da COVID-19 relatou sintomas persistentes após a infecção, também conhecida como COVID longa. O Brasil foi um epicentro da pandemia de COVID-19, logo, espera-se uma alta carga de COVID longa. Este estudo teve como objetivo identificar a prevalência e os fatores associados à COVID longa em adultos no Sul do Brasil. Foram analisados dados da coorte PAMPA. Os participantes preencheram um questionário online autoaplicável em junho de 2022. Foram incluídos apenas os participantes que testaram positivo para COVID-19. A COVID longa foi definida como qualquer sintoma que persistiu por pelo menos três meses após a infecção do SARS-CoV-2. Os modelos de regressão de Poisson com variância robusta foram usados para identificar fatores associados à COVID longa; os resultados foram relatados como razão de prevalência (RP) e seus respectivos intervalos de 95% de confiança (IC95%). Ao todo, 1.001 participantes (77,4% mulheres, idade média [DP] = 38,3 [11,9] anos) foram analisados. A prevalência da COVID longa foi de 77,4% (IC95%: 74,7; 79,9). A probabilidade da COVID longa foi maior em participantes não vacinados (RP = 1,23, IC95%: 1,06; 1,42), pessoas com condições crônicas (RP = 1,13, IC95%: 1,04; 1,24), e pacientes hospitalizados devido à infecção por COVID-19 (RP = 1,24, IC95%: 1,16; 1,32) em comparação com as contrapartes. A prevalência foi maior em mulheres (RP = 1,21, IC95%: 1,09; 1,33) do que em homens. A atividade física foi associada à probabilidade reduzida de fadiga, complicações neurológicas, tosse e dor de cabeça como sintomas persistentes após a infecção por COVID-19. Três em cada quatro adultos no Sul do Brasil tiveram COVID longa. Políticas públicas que visem reduzir a carga da covid longa devem ser priorizadas, especialmente nos grupos de maior risco desta condição.

Resumen: La mayoría de los supervivientes de la COVID-19 relató síntomas persistentes tras la infección, también conocida como COVID largo. Brasil fue un epicentro de la pandemia de COVID-19, así, se espera una alta carga de COVID largo. El objetivo de este estudio fue identificar la prevalencia y los factores asociados con la COVID largo en adultos en el Sur de Brasil. Se analizaron datos de la cohorte PAMPA. Los participantes rellenaron un cuestionario en línea autoadministrado en junio de 2022. Solo se incluyeron los participantes que dieron positivo para COVID-19. La COVID largo fue definida como cualquier síntoma que persistió durante al menos tres meses tras la infección del SARS-CoV-2. Se utilizaron los modelos de regresión de Poisson con varianza robusta para identificar factores asociados con el COVID largo; se relataron los resultados como razón de prevalencia (RP) y sus respectivos intervalos de 95% confianza de 95% (IC95%). En total, se analizaron 1.001 participantes (el 77,4% mujeres, edad media [DP] = 38,3 [11,9] años). La prevalencia del COVID largo fue del 77,4% (IC95%: 74,7; 79,9). La probabilidad del COVID largo fue más alta en participantes no vacunados (RP = 1,23, IC95%: 1,06; 1,42), personas con condiciones crónicas (RP = 1,13, IC95%: 1,04; 1,24) y pacientes hospitalizados debido a la infección por COVID-19 (RP = 1,24, IC95%: 1,16; 1,32) en comparación con sus contrapartes. La prevalencia fue más alta en mujeres (RP = 1,21, IC95%: 1,09; 1,33) que en hombres. La actividad física se asoció con la probabilidad reducida de fatiga, complicaciones neurológicas, tos y dolor de cabeza como síntomas persistentes tras la infección por COVID-19. Tres de cada cuatro adultos en el Sur de Brasil han tenido COVID largo. Se deben priorizar las políticas públicas destinadas a reducir la carga del COVID largo, sobre todo en los grupos de mayor riesgo para esta condición.

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ABSTRACT. Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

RESUMO. Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio — HR 1,49; intervalo de confiança — IC 95% 1,16-1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06-2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49-2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57-0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

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Abstract Background Although gym club instructors are closely linked to health and well-being, this group of workers shows specific characteristics that may favor the involvement in musculoskeletal disorders in their occupational routines. Objective To identify the prevalence of knee, low back, and disabling pain and their association with sociodemographic, nutritional, and occupational variables in instructors from gym clubs in the city of Pelotas, southern Brazil. Method A census-type study was carried out with all professionals working at gym clubs (n=497). Crude and multivariable analyses were performed considering "sex", "age", "income", "occupational physical activity", "time working at the gym clubs" and "modality performed" as exposures. Outcomes were disabling pain, and knee and low back pain. Results The disabling pain affected 20.9% of the workers and was associated with the gym clubs modality performed and with the working longest time in the gym clubs. Half of the professionals related to low back pain in the previous year. This outcome was associated with the age (inversely), of females and Pilates instructors. The knee pains affected, in the last year, 41.5% of the professionals; there was a significant association between age (inversely) and time of work in the gym clubs. Conclusion The instructors had a high prevalence of the three outcomes analyzed. Those who have been working longer time at gym clubs, women, youngers, Pilates, or gymnastic instructors were at an increased risk of presenting the outcomes.

Resumo Introdução Embora os instrutores de academias de ginástica estejam ligados à saúde e ao bem-estar, esse grupo de trabalhadores apresenta características específicas que podem favorecer o surgimento de distúrbios osteomusculares em suas rotinas ocupacionais. Objetivo Verificar a prevalência de dor no joelho, dor lombar e dor incapacitante e sua associação com variáveis sociodemográficas, nutricional e ocupacionais em instrutores de academias de ginástica da cidade de Pelotas, Brasil. Método Censo realizado com todos os profissionais atuantes nas academias da cidade (n=497). Foi realizada análise bruta e ajustada (regressão de Poisson), considerando as variáveis de exposição "sexo", "idade", "renda", "atividade física ocupacional", "anos de trabalho como profissional de academia" e "modalidade ministrada". As variáveis desfecho foram dor no joelho, dor lombar e dor incapacitante. Resultados A dor incapacitante acometeu 20,9% dos profissionais e esteve associada com a função de ministrar aulas de ginástica e com o maior tempo de trabalho em academia. Metade dos entrevistados referiu sentir dor lombar no último ano, sendo associado à idade (inversamente), ao sexo feminino e ministrar aulas de Pilates. A dor no joelho acometeu, no último ano, 41,5% dos profissionais, havendo associação significativa com a idade (inversamente) e o tempo de trabalho em academia. Conclusão Conclui-se que os instrutores das academias de ginástica tiveram uma alta prevalência dos três desfechos analisados. O tempo de trabalho em academia, o sexo feminino, idade, profissionais de Pilates e de ginástica estiveram associados com maiores prevalências das dores investigadas.

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We examined the longitudinal association between physical activity (PA) and the incidence of self-reported diagnosed depression in adults in southern Brazil during the COVID-19 pandemic. Data from the PAMPA (Prospective Study About Mental and Physical Health) cohort was used. Data collection for baseline was carried out on June-July 2020, with two follow-up assessments taking place six months apart. An online, self-reported questionnaire assessed depression and PA. Depression was assessed by asking participants whether they were ever diagnosed with depression. We included 441 participants (women: 75.9%; mean age [SD]: 38.0 [13.5]) in southern Brazil. Over the follow-up, 21.8% (95% confidence interval [CI]: 18.1%-25.9%) were diagnosed with depression. Insufficiently active (<150 min per week of physical activity) (Incidence rate [IR]: 61.9; 95%CI: 39.5-102.4; p = 0.047) and active (≥150 min per week of physical activity) (IR: 50.4; 95%CI: 31.9-84.0; p = 0.015) participants had reduced IR of depression per 1000 persons-year at risk compared to inactive ones (0 min per week of physical activity) (IR: 99.9; 95%CI: 79.7-126.8). In the adjusted analyses, participants in the insufficient active (hazard ratio [HR]: 0.58; 95%CI: 0.34-0.98) and active (HR: 0.53; 95%CI: 0.31-0.93) group had a lower risk of developing depression than the inactive group. PA both at and out of home reduced the risk of incident depression (HR: 0.49; 95%CI: 0.25-0.98) compared to no physical activity. Endurance (HR: 0.52; 95%CI: 0.28-0.97) and endurance plus strengthening (HR: 0.40; 95%CI: 0.17-0.95) PA reduced the risk of incident depression compared to none. Being physically active during pandemic, regardless of the amount of PA practiced, reduced the incidence of depression in adults in southern Brazil.

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ABSTRACT BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, access to healthcare services may have become difficult, which may have led to an increase in chronic diseases and multimorbidity. OBJECTIVES: To assess the incidence of multimorbidity and its associated factors among adults living in the state of Rio Grande do Sul, Brazil. DESIGN AND SETTING: Cohort study conducted in Rio Grande do Sul, Brazil. METHODS: We included data from the two waves of the Prospective Study About Mental and Physical Health (PAMPA). Data were collected via online questionnaires between June and July 2020 (wave 1) and between December 2020 and January 2021 (wave 2). Multimorbidity was defined as the presence of two or more diagnosed medical conditions. RESULTS: In total, 516 individuals were included, among whom 27.1% (95% confidence interval, CI: 23.5-31.1) developed multimorbidity from wave 1 to 2. In adjusted regression models, female sex (hazard ratio, HR: 1.97; 95% CI: 1.19-3.24), middle-aged adults (31-59 years) (HR: 1.78; 95% CI: 1.18-2.70) and older adults (60 or over) (HR: 2.41; 95% CI: 1.25-4.61) showed higher risk of multimorbidity. Back pain (19.4%), high cholesterol (13.3%) and depression (12.2%) were the medical conditions with the highest proportions reported by the participants during wave 2. CONCLUSION: The incidence of multimorbidity during a six-month period during the COVID-19 pandemic was 27.1% in the state of Rio Grande do Sul, Brazil.

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The study aimed to investigate the effect of intradialytic exercise training programmes on the submaximal functional capacity of patients with kidney failure. We searched for randomized clinical trials that assessed submaximal functional capacity using the 6-min walk test (6 MWT) in adult patients on maintenance haemodialysis submitted to intradialytic physical training. The search was performed on 15 October 2021, in different databases. Random-effect, multivariate meta-regression adjusted for multiplicity were performed to examine the relationship between exercise effect and covariates. Intradialytic physical exercise induced greater changes in 6MWT distance (k = 18; n = 1,458; WMD: 37.0; 95% CI 29.3; 50.6 metres) than control groups, with substantial heterogeneity (I2 = 78.3%). Aerobic, strength, and combined exercise promoted an average increase of 48.7 (95%CI 30.9; 66.4 metres), 16.9 (95%CI 7.6; 26.3 metres), and 75.8 (95%CI 55.1; 96.6 metres) metres, respectively. Strength training resulted in inferior gains in 6MWT distance compared to aerobic training (WMD: -25.0; 95%CI: -49.1; -0.9). Intervention length shorter than 11 weeks (WMD: 37.0; 95%CI: -5.4; 79.3 metres) did not induce greater changes in 6MWT compared to control groups. There was a positive response in submaximal functional capacity to intradialytic training in kidney failure patients on maintenance haemodialysis.

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Considering that the hemodynamic safety is a major concern about intradialytic exercise with blood flow restriction, this analysis was performed to compare the blood pressure (BP) behavior during the first two hours of hemodialysis (HD) between sessions with no exercise (control group, CG), low/moderate intensity aerobic exercise with blood flow restriction (BFRE) and conventional aerobic exercise (AE). Adult patients with chronic kidney disease on HD at a university hospital were randomly assigned and submitted to a 12-week intradialytic training with BFRE or AE compared with the CG group. The main outcomes of this report were the change in systolic (SBP) and diastolic (DBP) BP during HD and the frequency of low BP (LBP) and high BP (HBP) episodes. A total of 6,074 BP measurements of 58 patients were analyzed. There was a larger decrease in BP in the exercise sessions compared with the control sessions, but with a similar magnitude in the BFRE and AE groups (effect size 0.49). There was a higher number of LBP in the BFRE group. The frequency of HBP was similar between the BFRE and the CG groups and lower in the AE group. Despite a greater number of mild LBP in BFRE patients, the BP change during the first two hours of HD was similar to that of patients in AE. Intradialytic aerobic exercise with blood flow restriction does not seem to be associated with a higher hemodynamic burden than conventional aerobic exercise.

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BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, access to healthcare services may have become difficult, which may have led to an increase in chronic diseases and multimorbidity. OBJECTIVES: To assess the incidence of multimorbidity and its associated factors among adults living in the state of Rio Grande do Sul, Brazil. DESIGN AND SETTING: Cohort study conducted in Rio Grande do Sul, Brazil. METHODS: We included data from the two waves of the Prospective Study About Mental and Physical Health (PAMPA). Data were collected via online questionnaires between June and July 2020 (wave 1) and between December 2020 and January 2021 (wave 2). Multimorbidity was defined as the presence of two or more diagnosed medical conditions. RESULTS: In total, 516 individuals were included, among whom 27.1% (95% confidence interval, CI: 23.5-31.1) developed multimorbidity from wave 1 to 2. In adjusted regression models, female sex (hazard ratio, HR: 1.97; 95% CI: 1.19-3.24), middle-aged adults (31-59 years) (HR: 1.78; 95% CI: 1.18-2.70) and older adults (60 or over) (HR: 2.41; 95% CI: 1.25-4.61) showed higher risk of multimorbidity. Back pain (19.4%), high cholesterol (13.3%) and depression (12.2%) were the medical conditions with the highest proportions reported by the participants during wave 2. CONCLUSION: The incidence of multimorbidity during a six-month period during the COVID-19 pandemic was 27.1% in the state of Rio Grande do Sul, Brazil.

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