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Virtual reality-based exercise (exergames) improves cognition of the elderly but the neurophysiological effects are poorly understood. The hypothesis herein established is that an ultrafast neurophysiological adaptation occurs in prefrontal cortex of elderly after completion of a single exergames session. To reinforce the aforementioned hypothesis, individuals living in a Long-Term Care Home (LTCH) participated in the study and were randomly allocated into two groups (Virtual Reality Group, VRG, n = 5; and Active Control Group, ACG n = 5). VRG performed six exercises with exergames and ACG performed exercises with the same VRG movements but with no virtual reality. Assessment of frontal cortical activity at rest and during cognitive testing via electroencephalographic activity (EEG) was performed before and immediately after the intervention. Significant decrease in relative power of EEG (RPEEG) Beta brainwave (−29 ± 18%) in the left prefrontal cortex of VRG compared to ACG (4 ± 9%) (p = 0.007). A slight improvement on semantic fluency in VRG (ES=0.21) was noted. An ultrafast prefrontal cortical adaptation may occur as an effect of a single exergames session, causing a small improvement on cognition of institutionalized elderly.

A pandemia causada pela doença do coronavírus 2019 (COVID-19) e as medidas de distanciamento social provocaram reduções nos níveis de atividade física das pessoas. A atividade física está associada a uma melhor saúde física e mental, e manter a população ativa durante a pandemia é essencial. No entanto, ainda não se sabe se exercícios podem, em pessoas infectadas, causar uma potencial exacerbação de sintomas da COVID-19. O presente estudo objetivou traduzir o Pre-exercise screening questionnaire (PESQ) para o Português Brasileiro e de Portugal, para facilitar a sua utilização por profissionais ligados ao exercício físico não fluentes na língua inglesa. O PESQ contém sete perguntas diretas sobre os sintomas mais comuns de COVID-19 mais comumente encontrado em adultos e idosos, para orientação segura para prática de exercício físico. A tradução foi feita em 5 etapas: Tradução inicial, tradução cega, revisão da tradução, adequação da língua Portuguesa e ajustes e finalização. As etapas foram realizadas por pesquisadores experientes, com fluência em língua inglesa e nativos em português Brasileiro e de Portugal. No processo de tradução não houve divergências importantes entre os tradutores. A adaptação transcultural foi importante, pois, o português de Portugal difere-se do brasileiro. O instrumento foi devidamente traduzido e pode ser utilizado como ferramenta de screening para os sintomas da COVID-19 por profissionais do exercício durante a pandemia. No momento, o PESQ é a principal ferramenta disponível para prevenir danos relacionados à COVID-19 e a prática de exercícios.

The last decade has seen a renewed recognition of the interconnection of the mental and physical well-being of people living with anxiety and depression disorders. Research has assessed the impact of exercise and psychological interventions as monotherapy and complementary treatments to usual care and found considerable benefits to reduce psychiatric symptoms and improve better quality of life. There is growing interest in online interventions, and online counseling can be an alternative to traditional face-to-face therapies. Questions remain on the effectiveness and best practices to deliver such interventions. The authors identify and summarize research evaluating online psychotherapy and exercise interventions in individuals with anxiety and depression disorders. They address web-based psychotherapy interventions and web-based exercise interventions for anxiety and depression disorders, followed by combined web-based intervention with psychotherapy and exercise, and discuss strategies to improve adherence to treatments. info:eu-repo/semantics/publishedVersion

Objective: The number of people suffering from depression and/or anxiety has increased steadily due to the coronavirus disease 2019 (COVID-19) pandemic. In this context, web-based exercise interventions have emerged as a potential treatment strategy. The objective of this study was to synthetize evidence from randomized controlled trials regarding the effects of web-based exercise interventions on patients with depressive and/or anxiety disorders. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Six databases were searched (Cochrane Library, EBSCO, PubMed, SciELO, Scopus, and Web of Science), and eligible articles were identified according to a PICOS inclusion-exclusion approach (participants with depressive or anxiety disorders; web-based exercise interventions; active or passive control group; assessment of changes in depressive or anxiety disorders; randomized design). Primary outcomes were depressive and/or anxiety symptoms. The quality of evidence was assessed with Grading of Recommendations Assessment, Development, and Evaluation. Results: Of 7,846 search results, three studies met the inclusion criteria (172 participants between 18 and 65 years of age, 95.9% women). The web-based exercise interventions lasted 8-12 weeks and involved endurance training, yoga, or combined endurance and strength training. The comparators involved non-exercise controls or active controls. Compliance rates were low. Web-based exercise interventions were not superior to controls regarding anxiety symptoms, and only one study found benefits for depressive symptoms (p ≤ 0.05). The quality of the cumulative evidence was low. Conclusion: The available data regarding the effects of web-based exercise interventions on depression and/or anxiety symptoms is scarce, the risk of bias is high, and the quality of the cumulative results is low. Currently, no clear recommendations can be provided. Registration number: PROSPERO CRD42021225938.

Objective and Method: To investigate trends in the scientific evolution of the journal CNS & Neurological Disorders - Drug Targets in the neuroscience scope, we compared the contribution of publications between this journal and others from different geographical regions of the world. To track research output we conducted a bibliometric analysis of neuroscience research based on the SCimago Journal and Country Rank® from 2003 to 2017. Journal rankings were verified according to the following inclusion criteria: journals publishing the neuroscience scope and sub-areas; geographical location and journal trajectory. Additionally, the total number of original, peer-reviewed and conference articles was analyzed using bibliometric tools. Results: Results showed that Europe, North America and the Middle East have been the greatest contributors of neuroscience publications. Nevertheless, there is a huge discrepancy in the number of journals per region. Until 2017, Europe was on top with 85 journals in the neuroscience field. Moreover, research on neuroscience displayed a swift expanding trend, with significant growth in recent years. Conclusion:: In spite of CNS & Neurological Disorders - Drug Targets being a recent journal, it is an international journal emphasizing quality and innovations, and it is a hallmark on the scientific production in neuroscience. Research articles on the scope of the potential role of endocannabinoid systems in central appetite control and in obesity management and the potential of minocycline use in schizophrenia are paramount examples of innovation. Final results will help scientific researchers to know the current interests in neuroscience and provide useful information for further investigation and publication strategies.

Background The effect of pharmacological treatment (PT), exercise treatment (ET), and both in depressive symptoms remains a matter of debate. The present study aimed to clarify (1) the effect of ET as a monotherapy or complementary treatment of pharmacological therapy; (2) changes in the dose-response for different exercise prescription characteristics; and 3) hypothesizing about the gene network model of exercise effects on depression. Methods We sought Randomized Controlled Trials (RCT) addressing the effects of exercise on depressive patients, published in peer-reviewed journals between 2003-2019 in Scopus, Cochrane, Pubmed/Medline, ISI Web of Knowledge and APA PsycNET databases. Standardized mean difference (SMD) was calculated considering the mean difference on depression scales (pre and post-intervention) and pooled standard deviation for each intention-to-treat in each study. For the gene network model of exercise on depression an in silico analyses were used. Results We found 1,165 articles and selected 15 studies to this meta-analysis. RCTs with different ET and PT prescriptions were examined using the delta (pre and post-intervention) of a validated depression scale compared to the control group in different treatment conditions.Standardized mean differences and confidence intervals (SMD, 95% CI) were found for ET with or without PT group (-0.45, -0.62 to -0.29), ET and PT group (-0.70, -1.00 to -0.40), and only ET group (-0.39, -0.57 to -0.21). The subgroup analyses showed a moderate and large SMD in favour of resistance training (-0.67, -1.22 to -0.12), aerobic exercise 60-80% of maximum heart rate intensity (-0.56, -0.89 to -0.23), 20 to 30 minutes (-0.59, -0.88 to -0.31) or 45 to 60 minutes (-0.55, -0.81 to -0.29) duration per session, and seven times per week (-0.75, -1.30 to -0.20). Conclusion ET plus PT showed a better effect on reducing depressive symptoms, and the exercise prescription that shows the best dose-response in subgroup analyses can be the target for ET in depression. Also, the genes network model can withstand the effect of exercise in the depressive symptoms decrease according to an interaction between BDNF and inflammation. More well-designed studies are needed to confirm our findings.

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. Results: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Conclusions: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals., Universidad Pablo de Olavide de Sevilla. Departamento de Deporte e Informática

A randomized controlled trial was conducted to assess the effects of exercise plus pharmacotherapy on monoamine neurotransmitters (dopamine, noradrenaline, adrenaline, serotonin) and cortisol levels. A total of 26 women with clinical depression were randomly assigned to one of the two groups: aerobic exercise plus pharmacotherapy or only pharmacotherapy. The exercise program consisted of aerobic exercise, 45-50 min/session, three times/week, for 16 weeks. The biological parameters were measured before and after the exercise program. Adding exercise to pharmacotherapy had no additional effects on monoamines and cortisol plasma levels. These data are preliminary outcomes from a small sample and should be replicated.

The purpose of this study was to systematically review the effects of supervised resistance training (RT) programs in people diagnosed with depression or depressive symptoms. The following databases were used to search and retrieve the articles: Cochrane Library, EBSCO, PEDro, PubMed, Scopus and Web of Science. The search was conducted in late June 2020. Search protocol required the title to contain the words depression or depressive or dysthymia. Furthermore, the title, abstract or keywords had to contain the words or expressions: “randomized controlled trial”; and “strength training” or “resistance training” or “resisted training” or “weight training”. The screening provided 136 results. After the removal of duplicates, 70 records remained. Further screening of titles and abstracts resulted in the elimination of 57 papers. Therefore, 13 records were eligible for further scrutiny. Of the 13 records, nine were excluded, and the final sample consisted of four articles. Results were highly heterogeneous, with half of the studies showing positive effects of resistance training and half showing no effects. In two of the four combinations, the meta-analysis revealed significant benefits of RT in improving depressive symptoms (p ≤ 0.05). However, considering significant differences with moderate (Effect Size = 0.62) and small (ES = 0.53) effects, the heterogeneity was above 50%, thus suggesting a substantial level. To draw meaningful conclusions, future well-designed randomized controlled trials (RCTs) are needed that focus on understudied RT as a treatment for depression.

Objective:To compare cognitive function among frail and prefrail older adults.Design:Cross-sectional clinical study.Participants:Fifty-one non-institutionalized older individuals participated in this study.Measurements:Cognitive functions were evaluated through Mini-Mental State Examination (Global Cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Verbal Fluency Test (semantic memory/executive function). Data were compared using parametric and non-parametric bivariate tests. Binary logistic regression was used to test a frailty prediction model. Statistical significance was defined as p ≤ 0.01 to compare groups. In the regression model, the p value was set to be ≤0.05.Results:Statistically significant differences were observed in global cognition, and short-term memory between frail and prefrail individuals (p ≤ 0.01). Global cognition explained 14–19% of frailty's model.Conclusion:According to our findings, the evaluation of cognitive functions among older persons with frailty and prefrailty provides important complementary information to better manage frailty and its progression.

Depression is a psychiatric disorder and major contributor to the burden of disease worldwide. The strength of evidence of the benefits of exercise as a therapeutic intervention for patients with depression has expanded in the last 30 years. In fact, the available evidence indicates exercise can not only help manage depressive symptoms, but also effect significant improvements in other health outcomes. Clinical guidelines including such recommendations have been issued by different agencies, namely the UK National Institute for Health and Clinical Excellence (NICE), the American Psychiatric Association (APA), and the Royal Australian and New Zealand College of Psychiatrists (RANZCP). With increasing recognition of the benefits of exercise and shortcomings of healthcare systems, other countries, such as Sweden and Canada, have included exercise in their national guidelines for treating depression. Unfortunately, progress in incorporating exercise guidelines into clinical practice has been slow, and Portugal and Brazil reflect this reality. In this update, we reemphasize the importance of bridging this gap and integrating exercise into clinical practice guidelines as an essential component of depression treatment.

Background: Inflammatory cytokines and acute phase proteins increase with aging, promoting a chronic low-grade inflammation. Studies have shown a positive effect of exercise on inflammatory markers in older persons. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) are the main biomarkers investigated. However, it is unclear if exercise could decrease all these biomarkers. Purpose: The aim was to analyze the effect of chronic exercise on IL-6, TNF-α, and CRP levels in older persons. Methods: Preferred Reporting Items in Systematic Reviews and Meta-analyses guidelines were adopted. Original articles that investigated the effect of chronic exercise on inflammatory profile of the elderly persons were eligible for this review. The databases PubMed, PEDro, EBSCO, and BioMed Central were searched. Three reviewers evaluated each publication for reducing bias. Data about IL-6, TNF-α, and CRP were collected and analyzed. A standardized mean difference based on estimated pooled effect size was calculated considering heterogeneity index (I2) and random effect. Results: Seventy-six studies were retrieved from databases, and 8 of them were analyzed. IL-6 and CRP levels decreased after chronic exercise (overall effect P Conclusion: Regular exercise decreases IL-6 and CRP levels in older persons. The effect of exercise on TNF-α remains unclear.

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Background Catechol-O-methyltransferase (COMT) is a catabolic enzyme involved in the degradation of bioactive molecules including the neurotransmitters epinephrine, norepinephrine, and dopamine. Higher COMT activity in depressive patients in comparison to non-depressed individuals has been reported. The effect of aerobic exercise on depressive patients has been studied and a number of researchers and clinicians believe it to be effective in the treatment of depression and to be involved in several molecular underlying mechanisms. However, the effect of physical exercise on this enzyme activity is unknown, and it remains to be elucidated if chronic exercise changes COMT activity. This randomized control trial evaluates the effects of chronic exercise on peripheral COMT (S-COMT) activity in women with depressive disorder. Methods Fourteen women (aged: 51.4±10.5 years) diagnosed with depression (according to International Classification of Diseases-10) were randomized to one of two groups: pharmacotherapy plus physical exercise (n=7) or only pharmacotherapy (n=7). The aerobic exercise program was supervised, lasting between 45–50 min/session, three times/week for 16 weeks. Erythrocyte soluble COMT were assessed prior to and after the exercise program. Results Exercise group when compared to a control group presented a significant decrease (p=0.02, r=−0.535) in S-COMT activity between baseline and post-intervention. Limitations These data are preliminary outcomes from a small sample and should be replicated. Conclusions Chronic exercise therapy combined with pharmacotherapy leads to significant decrease in S-COMT activity. Our results provide evidence that exercise interferes with S-COMT activity, a molecular mechanism involved in depression.

Objective Physical exercise has been consistently documented as a complementary therapy in the treatment of depressive disorders. However, despite a higher prevalence among women compared to men, the trials developed in women are scarce. In addition, the optimal dosage of exercise capable of producing benefits that reduce depressive symptoms remains unclear. This clinical trial is designed to measure the effect of a structured physical exercise program as a complement to antidepressant medication in the treatment of women with depression. Methods From July 2013 to May 2014, we implemented a randomized controlled trial (HAPPY BRAIN study). A total of 26 women (aged 50.16 ± 12.08) diagnosed with clinical depression were randomized either to a supervised aerobic exercise group (45–50 min/week three times a week for four months) plus pharmacotherapy (intervention group), or only antidepressant medication (control group). Results The exercise group presented a decrease in BDI-II and DASS-21 total score scales. Relatively to DASS-21, it showed a significant decrease in anxiety and stress. The exercise group when compared to a control group showed improvement in relation to physical functioning parameters between baseline and post-intervention. Moreover, anthropometric parameters presented only significant differences between groups in fat mass percentage. Nonetheless, no differences were found between groups in weight, body mass index, waist circumference, and self-esteem. Conclusion Our results showed that supervised structured aerobic exercise training could be an effective adjuvant therapy for treating women with depression, reducing depressive symptomatology and improving physical fitness. A key factor of this improvement included strict control of exercise workload parameters and adjustment to each subject's capacity. In our study, due to the sample size there is an increase in the probability of type II errors.

Background: Active games based on virtual reality have been widely used in the rehabilitation of many clinical conditions. However, studies on the use of Xbox/Kinect are rare, and technology application in stroke treatment is not clear yet. Objective: To verify the outcomes (O) analyzed in randomized controlled trials (C; S) that investigated the use of Xbox/Kinect (I) in patients with stroke (P). Methods: This is a systematic literature review that meets PRISMA standards and the eligibility criteria according to the PICOS strategy. The search procedure was performed by two researchers. The research strategy was repeated in case of divergence. Effect size was calculated by Cohen's formula and Hopkins rank. The risk of individual bias was assessed using PEDro Score and Higgins Classification. Results: The main outcomes were postural balance and activities of daily living, with four studies addressing these variables. However, only one study showed the effect of Xbox/Kinect intervention on balance as large, as in two other studies evaluating manual dexterity and depression, respectively. Conclusion: The greater use of Xbox/Kinect in treating patients after stroke is in recovery of balance and motor function, and the evidence support its application. These findings enable the use of virtual reality technology through Xbox/Kinect in rehabilitation programs, focusing on postural balance and motor skills. However, conclusive results are still not possible. Therefore, caution in the use of this technology is required. RESUMO Introdução: Jogos ativos baseados em realidade virtual têm sido amplamente utilizados na reabilitação de muitas condições clínicas. No entanto, estudos sobre a utilização do Xbox/Kinect são raros, e não está clara a aplicabilidade da tecnologia no tratamento de pacientes que tiveram acidente vascular cerebral. Objetivo: Verificar os desfechos (O) analisados em ensaios clínicos randomizados e controlados (C; S), que investigaram a utilização do Xbox/Kinect (I) em pacientes que tiveram acidente vascular cerebral (P). Métodos: Trata-se de uma revisão sistemática da literatura que atende aos padrões do PRISMA e aos critérios de elegibilidade, de acordo com a estratégia PICOS. O procedimento de busca foi realizado por dois pesquisadores e, em caso de divergência, a estratégia de busca foi repetida. O tamanho do efeito foi calculado por meio da fórmula de Cohen e da escala de Hopkins. O risco de viés individual foi analisado utilizando o escore PEDro e a classificação de Higgins. Resultados: Os principais desfechos foram o equilíbrio postural e as atividades de vida diária, com quatro estudos abordando essas variáveis. No entanto, apenas um estudo mostrou o efeito da intervenção com Xbox/Kinect sobre o equilíbrio como sendo grande, assim como em dois outros artigos que avaliaram destreza manual e depressão, respectivamente. Conclusão: A utilização mais comum do Xbox/Kinect no tratamento de pacientes que tiveram acidente vascular cerebral acontece na recuperação do equilíbrio e da função motora, e as evidências apoiam o seu uso. Esses achados permitem o uso da tecnologia de realidade virtual por meio do Xbox/Kinect em programas de reabilitação, com foco no equilíbrio postural e nas habilidades motoras. Porém, resultados conclusivos ainda não são possíveis, o que exige cautela no uso dessa tecnologia.