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- A Deep Learning Neural Network to Classify Obesity Risk in Portuguese Adolescents Based on Physical Fitness Levels and Body Mass Index Percentiles: Insights for National Health PoliciesPublication . Forte, Pedro; Encarnação, Samuel; Monteiro, A.M.; Teixeira, José Eduardo; Hattabi, Soukaina; Sortwell, Andrew; Branquinho, Luís; Amaro, Bruna; Sampaio, Tatiana; Flores, Pedro Miguel; Silva-Santos, Sandra; Ribeiro, Joana; Batista, Amanda; Ferraz, Ricardo; Rodrigues, FilipeThe increasing prevalence of overweight and obesity among adults is a risk factor for many chronic diseases and death. In addition, obesity among children and adolescents has reached unprecedented levels and studies show that obese children and adolescents are more likely to become obese adults. Therefore, both the prevention and treatment of obesity in adolescents are critical. This study aimed to develop an artificial intelligence (AI) neural network (NNET) model that identifies the risk of obesity in Portuguese adolescents based on their body mass index (BMI) percentiles and levels of physical fitness. Using datasets from the FITescola® project, 654 adolescents aged between 10–19 years old, male: 334 (51%), female: n = 320 (49%), age 13.8 ± 2 years old, were selected to participate in a cross-sectional observational study. Physical fitness variables, age, and sex were used to identify the risk of obesity. The NNET had good accuracy (75%) and performance validation through the Receiver Operating Characteristic using the Area Under the Curve (ROC AUC = 64%) in identifying the risk of obesity in Portuguese adolescents based on the BMI percentiles. Correlations of moderate effect size were perceived for aerobic fitness (AF), upper limbs strength (ULS), and sprint time (ST), showing that some physical fitness variables contributed to the obesity risk of the adolescents. Our NNET presented a good accuracy (75%) and was validated with the K-Folds Cross-Validation (K-Folds CV) with good accuracy (71%) and ROC AUC (66%). According to the NNET, there was an increased risk of obesity linked to low physical fitness in Portuguese teenagers.
- Comparison of Physical Activity Level, Body Composition, Strength, and Flexibility of Teen Basketball Players and Adolescents Non-Practitioners of Sport: An Observational Study with Machine Learning AnalysisPublication . Encarnação, Samuel; Rezende, Vitor Hugo Santos; Gonçalves, Iarni Martins; Prata, Patrícia de Oliveira Ramalho; Mansur, Henrique Novais; Sampaio, Tatiana; Forte, Pedro; Teixeira, José Eduardo; Monteiro, A.M.; Guttierres, Ana Paula MunizIncreasing youths’ physical activity is mandatory to reduce the risk of non-communicable diseases (NCCDs). Basketball is a team sport that is potentially positive in increasing teenagers’ physical performance, health indicators, and well-being. Objective: The objective was to compare the physical activity level (PAL), body composition, strength, and flexibility of teen male basketball players (BG) (n = 15) and adolescent non-practitioners of sport (NS: n = 14). Methodology: All participants were healthy and free from any health disability from a Brazilian high school. A linear regression machine learning algorithm was applied to predict the adolescent´s physical components. In a quasi-experimental analysis, data were extracted by PAL, body fat percentage (BF%), handgrip strength (HG), back extensor muscle’s’ strength (BMS), lower limb power (LLP), and lower limb flexibility (LLF). Parametric (independent T-test) and non-parametric (Mann-Whitney U test) were employed to compare the variable’s average and chi-square was applied to compare categorical data. Results: BG presented an upper number of adolescents classified with high PAL than the NS group (p = 0.0002, large ES, V = 0.73) and a lower number of adolescents classified with low PAL than the NS group (p = 0.0002, V = 0.73), less BF% (p = 0.02, r = 0.85), greater values of HGS (p = 0.005, r = 0.34), greater values of BMSLS (p = 0.005, r = 0.33), greater values of LLP (p = 0.007, r = 0.30), and greater values for LLF (p = 0.02, r = 0.17). Therefore, there was a positive effect of high PAL compared with low PAL in HG, (p = 0.005, r = 0.24) and also for high PAL in LLF, (High PAL: (p = 0.006, r = 0.23). Regarding machine learning analysis, the four models (linear regression, Ridge regression, random forest regression, and Bayesian regression) expressed good generalization performance, with a coefficient of determination (R2) ranging from 0.77 to 0.88, root mean square error (RMSE) from 1.01 to 3.92, with an average mean difference of four points between the predicted and real values. The worst model was random forest regression R2 = 0.77, RMSE = 3.92, and the best model was Bayesian regression (R2 = 0.88, RMSE = 1.01). Conclusion: The BG group presented better results than the NS group for PAL, BF%, HG, BMS, LLP, and LLF. Body fat percentage precisely predicted the player’s’ vertical jump (VJ). In addition to the physical superiority of the BG, this study revealed the importance of managing body composition for both health and performance improvements.
- Asthma prevalence in adolescent students from a Portuguese primary and secondary schoolPublication . Flores, Pedro Miguel; Teixeira, José Eduardo; Leal, Anna Kosmider; Branquinho, Luís; Fonseca, Rui Brito; Silva-Santos, Sandra; Batista, Amanda; Encarnação, Samuel; Monteiro, A.M.; Ribeiro, Joana; Forte, PedroAsthma is one of the most prevalent chronic diseases worldwide, with a considerable increase, especially in children. It is considered the main cause of childhood morbidity, school absenteeism, and limitations in sports practice. The causes are multifactorial, and their prevalence varies from region to region, thus verifying a great disparity in the estimates of the prevalence of asthma. In this sense, the objective of this study is to investigate the prevalence of asthma, its control, as well as the frequency of associated symptoms, in adolescents who attended the 3rd cycle of basic education and secondary education in schools in the municipalities of Paços de Ferreira, Paredes, and Penafiel. The sample consisted of 1222 (587 males and 635 females) (p = 0.17) aged between 12 and 17 years. The instruments used to diagnose asthma-associated symptoms were the standard questionnaire of the “International Study of Asthma and Allergies in Childhood—ISAAC” and to check whether asthma was controlled, the “Test for Asthma Control” questionnaire was used. The results reveal a high prevalence of adolescents with asthma (8.9%) with a significant percentage that did not have the disease under control (38%). There was also a considerable percentage of adolescents who, despite not having asthma, have many symptoms associated with the disease. These results may be associated with environmental factors.
- The effectiveness of pilates training interventions on older adults’ balance: a systematic review and meta-analysis of randomized controlled trialsPublication . Sampaio, Tatiana; Encarnação, Samuel; Santos, Olga Maria; Narciso, Diogo; Oliveira, João P.; Teixeira, José Eduardo; Forte, Pedro; Morais, J.E.; Vasques, Catarina; Monteiro, A.M.Pilates training intervention programs have gained attention as a potential approach to enhancing balance in older adults, thereby reducing the risk of falls. In light of these considerations, this systematic review and meta-analysis aimed to critically evaluate the existing evidence and determine the effect of Pilates training intervention programs on older adults’ balance. Materials and Methods: The literature was searched through the PubMed, Web of Science, and Scopus databases from inception until July 2023. The primary keywords used for the literature search included “elderly” or “older adults” and “pilates training” and “balance”. Results: The systematic review through qualitative analysis showed robust evidence about the efficacy of Pilates intervention programs in improving older adults’ balance. The pooled meta-analysis of static and dynamic balance showed that eight (53%) out of a total fifteen analyzed interventions presented a significant effect of Pilates in improving the participants’ balance, without between-study heterogeneity. In addition, the meta-analysis regarding dynamic balance showed that six (67%) out of nine analyzed interventions presented a significant effect of Pilates in improving the participants’ balance, without heterogeneity between studies. Similarly, the meta-analysis regarding static balance showed that four (50%) out of eight analyzed studies presented significant effects on the older adults’ balance, where moderate between-study heterogeneity was found. Sensitivity analysis showed that three studies reduced the between-study heterogeneity (19, 17.6, and 17%), regressing from moderate to low heterogeneity, p < 0.05. Conclusions: This systematic review and meta-analysis underscores the potential of Pilates training as a valuable intervention to enhance balance in the elderly population
- Influence of multicomponent exercise program or self-selected physical activity on physical, mental, and biochemical health indicators of older womenPublication . Encarnação, Samuel; Fazolo, Sthefany Lemos; Pereira, Felipe Soares Tomaz; Araújo, Daniele Pereira; Miranda, Cíntia Neves de; Pinto, Beatriz Woyames Ferreira; Forte, Pedro; Teixeira, José Eduardo; Barbosa, Tiago M.; Monteiro, A.M.; Moreira, Osvaldo Costa; Carneiro-Júnior, Miguel AraújoThe aim of this study was to compare physical, mental, and biochemical health indicators of 48 older women (67 ± 1 year) who practiced multicomponent exercise program (ME, n = 25) and self-selected physical activity (PA, n = 23) for 6 months. It was an observational study, which aimed to relate a prospective intervention. Displacement speed, lower limb (LL) power, functional capacity, body composition, biochemical profile, physical activity levels (PAL), sedentary behavior (SB), quality of life (QoL), and mental illness risk (MIR) were evaluated. ME presented better values compared to the PA in the gait speed (p = 0.001, large ES), aerobic capacity (p = 0.0001, large ES), agility/dynamic balance (p = 0.0001, large ES), LL flexibility (p = 0.0003, large ES), UL flexibility (p = 0.04, large ES), upper limb (UL) strength (p = 0.07, moderate ES), Total cholesterol (p = 0.009, large ES), triglycerides (p = 0.003, large ES), creatinine (p = 0.007, large ES), glycated hemoglobin (p= 0.007, large ES), and lower mean glucose value (p = 0.008, large ES). ME was more efficient than PA to improve indicators of gait speed, and functional capacity, regulate glycated hemoglobin, blood glucose, and serum creatinine. Thys study also brings practical applications for coaches, which could adapt and use creativity to develop different types of systematized ME, aiming to enhance positive adaptations in the older people at multilevel outcomes.
- The influence of abdominal adiposity and physical fitness on obesity status of portuguese adolescentsPublication . Encarnação, Samuel; Forte, Pedro; Flores, Pedro Miguel; Magalhães, David; Afonso, Gil H.; Pereira, Albino; Fonseca, Rui Brito; Ribeiro, Joana; Silva-Santos, Sandra; Teixeira, José Eduardo; Monteiro, A.M.; Ferraz, Ricardo; Branquinho, LuísThe aim of this study was to verify the relationship between abdominal adiposity and physical fitness in the obesity status of Portuguese adolescents. BMI, abdominal adiposity, and physical fitness tests from the FITescola® were evaluated in a total of 654 Portuguese adolescents, aged 10-19 years old—male: n = 334 (51%), female: n = 320 (49%). For the final model, BMI was positively related with age (β = 0.25), abdominal adiposity (β = 0.313), horizontal jump (β = −0.100), 40 m maximal velocity (β = 0.274), and aerobic fitness (β = −0.250, R2 = 0.75, F = 382.2, and p = 0.0001). We conclude that higher age and abdominal adiposity are positively related with a higher adolescent BMI. Furthermore, lower horizontal jump distances and worse times on the 40 m maximal velocity were inversely related with a higher adolescent BMI, and lower aerobic fitness was inversely related with a higher adolescent BMI.
- Obesity status and physical fitness levels in male and female portuguese adolescents: a two-way multivariate analysisPublication . Encarnação, Samuel; Rodrigues, Filipe; Monteiro, A.M.; Gouili, Hatem; Hattabi, Soukaina; Sortwell, Andrew; Branquinho, Luís; Teixeira, José Eduardo; Ferraz, Ricardo; Flores, Pedro Miguel; Silva-Santos, Sandra; Ribeiro, Joana; Batista, Amanda; Forte, PedroObesity and decreasing fitness levels among the youth are growing concerns in Portugal, similar to other developed countries, with implications for health and psychomotor development. Understanding the influence of health determinants such as sex and age are crucial for developing effective public health strategies. This study aimed to analyze the association between sex and chronological age with obesity status and physical fitness in Portuguese adolescents. A total of 170 adolescents (85 males and 85 females) were evaluated for body mass index, abdominal adiposity, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed in a 40 m sprint using the FITescola® physical fitness battery, a Portuguese government initiative. The general model, analyzed using Pillai’s trace, showed a significant effect of age and sex on body mass index, abdominal circumference, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed (V = 0.99, F (7) = 10,916.4, p < 0.001, partial η2, sex = 0.22; age = 0.43, sex and age interaction = 0.10). Boys had higher physical fitness levels than girls in most tests, but both sex groups had a significantly higher proportion of non-fit adolescents, with boys showing the highest number of participants classified as non-fit.
- The impact of multicomponent exercise protocols order on the maximum voluntary contraction of older womenPublication . Monteiro, A.M.; Rodrigues, Sandra Beatriz; Matos, Sérgio; Encarnação, Samuel; Teixeira, José Eduardo; Barbosa, Tiago M.; Rodrigues, Filipe; Forte, PedroThe aim of this study was to evaluate the impact of exercise order in multicomponent training (MCT) on the maximum voluntary contraction (MVC) of older women. A total of 91 older women, ranging in age from 60 to 85 years, were randomly assigned to either Group A or Group B. Group A performed a warm up followed by aerobic training and resistance training, whereas Group B followed a warm up followed by resistance training and aerobic training. A control group (CG) did not engage in any exercise interventions. Statistical analysis was conducted using one-way ANOVA for between-group comparisons, and ANOVA was used for repeated measures. The results revealed that Group A demonstrated significant increases in MVC for knee extensors (KEs) between M1 and M3 (p < 0.001) and between M2 and M3 (p < 0.001). Similarly, Group A exhibited significant increases in MVC for knee flexors (KFs) between M1 and M3 (p = 0.001) and between M2 and M3 (p < 0.001). Both Group A and Group B demonstrated significant increases in MVC for elbow flexors (EFs) between M1 and M3 (p < 0.001). Furthermore, Group B showed a significant increase in hand grip strength (HGS) between M1 and M3 (p < 0.001). Overall, the findings suggest that initiating MCT with aerobic training followed by resistance training is the most effective approach for improving muscle strength in older women.
- Variações da carga de treino entre titulares e não titulares durante um microciclo padrão em escalões de formação sub-15, sub-17 e sub-19 de uma academia de futebol subelitePublication . Teixeira, José Eduardo; Ribeiro, Joana; Silva-Santos, Sandra; Leal, Miguel; Flores, Pedro Miguel; Encarnação, Samuel; Barbosa, Tiago M.; Monteiro, A.M.; Ferraz, Ricardo; Branquinho, Luís; Forte, PedroO treino complementar tem sido extensamente aplicado para resolver o diferencial da carga de treino semanal entre jogadores titulares e não titulares. Contudo, pouco se sabe da sua aplicação em contextos de futebol de formação subelite. Assim, o objetivo deste estudo foi comparar as variações da carga de treino durante um microciclo padrão em escalões de formação sub-15, sub-17 e sub-19 de uma academia de futebol subelite, tendo em conta o status de titularidade. A carga de treino semanal de sessenta jovens futebolistas foi continuamente monitorizada durante seis semanas, através de sistemas de posicionamento global (GPS), cardiofrequencímetros e escalas de perceção de esforço (RPE) e recuperação (TQR). O status de titularidade considerou os jogadores titulares (iniciam pelo menos 55% dos jogos) e não titulares (suplentes em mais de 55% dos jogos). A distância (D) total percorrida apresentou diferenças significativas entre jogadores titulares e não titulares com um tamanho de efeito moderado (t = -2,38, Δ = -428,03 m, p = 0,018, d = 0,26), tendo-se observado um volume de treino maior nos jogadores não titulares (DTitulares = 5105,53 ± 1684,22 vs. D Não titulares = 5533,56 ± 1549,26 m). De igual modo, verificaram-se efeitos interativos e significativos entre as variáveis de carga de treino acumulada, o status de titularidade, o tempo de jogo e a duração da sessão de treino, considerando-se tanto as comparações intraindividuais (F = 140,46; !2 = 0,85; p <0,001) como as interindividuais (F = 11,63 a 160,70; !2 = 0,05 a 0,76; p <0,001). Deste modo, a titularidade parece influenciar também o volume de treino nos escalões de futebol subelite, sendo recomendável priorizar sessões de treino complementar e/ou individualizado para equalizar a carga de treino semanal e, por conseguinte, proporcionar oportunidades de prática similares a jogadores com menos minutos de competição.
- Barriers and challenges in the prevention, treatment, and rehabilitation of breast cancer patientsPublication . Santos, Ryvia; Encarnação, Roberto Gonçalves; Encarnação, Samuel; Teixeira, José Eduardo; Monteiro, A.M.Breast cancer is the most common female cancer worldwide. This disease represents one of the main points of public health concern today, aggravating the situation due to the numerous barriers to preventing, treating, and rehabilitation patients affected by this health condition. In this way, this letter to the editor aims to discuss the barriers and challenges in preventing, treating, and rehabilitating breast cancer patients.