Table 1.

Characteristic	Whole Sample	Physical Activity Level				Cardiorespiratory Fitness Level, by Quartile
Characteristic	Whole Sample	Inactive	Insufficiently Active	Active	Very Active	1	2	3	4
No. of participants	152	25	31	43	47	32	37	35	27
Sex, %
Female	74	76	80	81	57	71	83	80	63
Male	26	24	19	18	42	28	16	20	37
Age, %, y
40–59	29	28	26	28	28	6	13	40^c	45^c,d
≥60	71	72	74	72	71	94	81	60^c	55^c,d
Self-reported health status, %
Heart disease	11	8	13	14	6	13	16	6	11
Smoker	3	0	0	2	8	0	3	3	7
Weight excess	64	64	61	60	70	63	62	71	74
Central obesity	59	84	81	79	83	66	65	57	67
Hypertension	37	32	42	46	30	53	38	26	48
Hypercholesterolemia	34	28	42	37	25	44	46	29	22
Diabetes	16	16	13	19	15	19	5	20	22

Table 1. Sample Characteristics Assessed in the Preintervention Evaluation in the Whole Sample and in Participants Divided by the Physical Activity Level^a and by the Quartiles of Cardiorespiratory Fitness^b, Data Collected in São Paulo, Brazil, October 2001–October 2015

^a Levels of physical activity were defined as 1) inactive, 0 minutes per week; 2) insufficiently active, 1 to 149 minutes per week; 3) active, 150 to 299 minutes per week; and 4) very active, 300 or more minutes per week ^[6].

^b Cardiorespiratory fitness level was assessed by the 2-minute step-test and classified based on quartiles of the total sample as follows: quartile 1, 87 or fewer steps; quartile 2, 88 to 101 steps; quartile 3, 102 to 114 steps; and quartile 4, 115 steps or more.

^c Significantly different from quartile 1 (P < .05, χ² test).

^d Significantly different from quartile 2 (P < .05, χ² test).

Table 2.

Category	Inactive			Very Active			ANOVA^b P Value
Category	No.	Preintervention, Mean (SD)	Postintervention, Mean (SD)	No.	Preintervention, Mean (SD)	Postintervention, Mean (SD)	Group	Moment	Interaction
CF, no. steps	19	96.9 (20.0)	105.4 (13.0)^c	41	103.1 (16.3)	113.0 (16.5)^c	.27	<.001	.65
BMI^d	22	25.9 (2.4)	25.7 (2.9)^c	45	26.5 (2.7)	26.2 (2.6)^c	.46	.02	.39
WC, cm	23	94.0 (10.3)	91.8 (8.9)^c	45	96.1 (9.1)	95.0 (8.8)^c	.72	.002	.37
Blood glucose, mg/dL	19	98.1 (11.4)	97.4 (10.0)	41	99.4 (11.4)	98.6 (11.1)	.60	.27	.67
TC, mg/dL	18	195.9 (32.2)	189.9 (25.0)	35	189.8 (26.7)	191.2 (26.8)	.84	.16	.88
SBP, mm Hg	23	124.4 (12.7)	119.3 (13.3)^c	44	127.5 (13.6)	125.1 (14.9)^c	.27	.008	.30
DBP, mm Hg	22	77.5 (9.6)	76.3 (6.6)	43	78.0 (8.4)	76.3 (6.8)	.66	.07	.76
Z score	25	0.05 (3.05)	−0.85 (2.29)^c	47	−0.61 (2.38)	−0.26 (2.51)^c	.66	<.001	.89

Table 2. Cardiorespiratory Fitness (CF) and Cardiovascular Risk Assessed Preintervention and Postintervention in Participants Classified as Inactive and Very Active^a, Data Collected in São Paulo, Brazil, October 2001–October 2015

Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference.

^a Inactive, 0 minutes per week; very active, 300 or more minutes per week ^[6].

^b Comparisons by 2-way mixed analysis of variance (ANOVA).

^c Significantly different from preintervention (P < .05).

^d Calculated as weight in kilograms divided by the square of height in meters.

Table 3.

Risk	Quartile 1			Quartile 4			ANCOVA^b P Value
Risk	No.	Preintervention, Mean (SD)	Postintervention, Mean (SD)	No.	Preintervention, Mean (SD)	Postintervention, Mean (SD)	Group	Moment	Interaction
CF, no steps	30	73.8 (8.4)	95.6 (12.5)^c	25	120.6 (5.2)^d	126.2 (10.0)^c,d	<.001	<.001	<.001
Body mass index^e	30	26.2 (2.9)	26.0 (3.1)^c	27	27.7 (3.0)	27.3 (3.2)^c	.27	.008	.25
WC, cm	25	95.6 (8.5)	93.7 (7.6)^c	27	96.7 (9.7)	94.8 (9.6)^c	.95	.008	.66
Blood glucose, mg/dL	25	104.5 (10.6)	102.1 (10.3)	23	98.9 (10.0)^d	97.7 (11.1)^d	.03	.90	.95
TC, mg/dL	18	191.1 (25.5)	180.7 (17.7)	20	194.2 (26.0)	191.8 (30.5)	.45	.23	.37
SBP, mm Hg	32	129.7 (14.1)	125.1 (11.3)	24	118.4 (8.6)^d	116.3 (11.1)^d	.014	.09	.87
DBP, mm Hg	30	77.2 (8.8)	75.9 (7.4)	25	76.4 (8.1)	74.0 (7.4)	.20	.07	.60
Z score	32	0.97 (2.77)	−0.39 (2.34)^c	27	0.07 (2.39)	−0.73 (2.73)^c	.20	.001	.45

Table 3. Cardiorespiratory Fitness (CF) and Cardiovascular Risk Assessed Preintervention and Postintervention in Participants Classified in the First and Fourth Quartiles of CF^a, Data Collected in São Paulo, Brazil, October 2001–October 2015

Abbreviations: CF, cardiorespiratory fitness; DBP, diastolic blood pressure; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference.

^a Cardiorespiratory fitness level was assessed by the 2-minute step-test and classified based on quartiles of the total sample as follows: quartile 1, 87 or fewer steps; quartile 4, 115 steps or more.

^b Comparisons by 2-way mixed analysis of covariance (ANCOVA).

^c Significantly different from preintervention (P < .05).

^d Different from quartile 1 (P < .05).

^e Calculated as weight in kilograms divided by the square of height in meters.

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CME / ABIM MOC

Effects of a Real-Life Park-Based Physical Activity Interventional Program on Cardiovascular Risk and Physical Fitness

Authors: Bruno Temoteo Modesto, MsC; Teresa Bartholomeu; Luciano Basso, PhD; Luiz Augusto Riani Costa, MD; Tais Tinucci, PhD; Cláudia Lúcia de Moraes Forjaz, PhD
CME / ABIM MOC Released: 2/25/2021
THIS ACTIVITY HAS EXPIRED
Valid for credit through: 2/25/2022

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Target Audience and Goal Statement

This activity is intended for primary care physicians, geriatricians, endocrinologists, and other physicians who care for adults.

The goal of this activity is to analyze the effects of a simple exercise intervention on cardiometabolic biomarkers.

Upon completion of this activity, participants will:

Distinguish cardiometabolic markers improved by a simple exercise prescription
Analyze how baseline levels of physical activity affected the response to exercise in the current study
Assess the effects of the exercise intervention in the current study on cardiorespiratory fitness
Analyze how baseline levels of cardiorespiratory fitness affected the response to exercise in the current study

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Faculty

Bruno Temoteo Modesto, MsC

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Bruno Temoteo Modesto, MsC, has disclosed no relevant financial relationships.

Teresa Bartholomeu

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Teresa Bartholomeu has disclosed no relevant financial relationships.

Luciano Basso, PhD

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Luciano Basso, PhD, has disclosed no relevant financial relationships.

Luiz Augusto Riani Costa, MD

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Luiz Augusto Riani Costa, MD, has disclosed no relevant financial relationships.

Tais Tinucci, PhD

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Tais Tinucci, PhD, has disclosed no relevant financial relationships.

Cláudia Lúcia de Moraes Forjaz, PhD

Exercise Hemodynamic Laboratory
School of Physical Education and Sport
University of São Paulo
São Paulo, Brazil

Disclosures

Disclosure: Cláudia Lúcia de Moraes Forjaz, PhD, has disclosed no relevant financial relationships.

CME Author

Charles P. Vega, MD

Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine

Disclosures

Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships:Served as an advisor or consultant for: GlaxoSmithKline

Editor

Caran Wilbanks

Editor
Preventing Chronic Disease

Disclosures

Disclosure: Caran Wilbanks has disclosed the following relevant financial relationships:
Other: Partner is employed by Allscripts, Inc.

CME Reviewer

Esther Nyarko, PharmD

Esther Nyarko, PharmD
Associate Director
Accreditation and Compliance
Medscape, LLC

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Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

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Hazel Dennison, DNP, RN, FNP-BC, CHCP, CPHQ, CNE

Associate Director
Accreditation and Compliance
Medscape, LLC

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From Preventing Chronic Disease

CME / ABIM MOC

Effects of a Real-Life Park-Based Physical Activity Interventional Program on Cardiovascular Risk and Physical Fitness

Authors: Bruno Temoteo Modesto, MsC; Teresa Bartholomeu; Luciano Basso, PhD; Luiz Augusto Riani Costa, MD; Tais Tinucci, PhD; Cláudia Lúcia de Moraes Forjaz, PhDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED

CME / ABIM MOC Released: 2/25/2021

Valid for credit through: 2/25/2022

processing....

Abstract

Introduction

Regular physical activity (PA) practice is a way to combat cardiovascular disease, and a PA interventional program, including individualized prescription of walking with limited supervision of execution, may be a strategy to be applied in public parks. Thus, our study tested the effects of a real-world program like this on cardiovascular risk and cardiorespiratory fitness (CF) of the users of a public park.

Methods

Data came from the Exercise and Heart Project, a real-life park-based PA interventional program. The study phases were 1) a preintervention evaluation; 2) the individualized prescription of PA; 3) the supervision of the first practice sessions; 4) the unsupervised execution of the prescription; and 5) a postintervention evaluation.

Results

Data from 152 participants (mainly women and aged 40 to 80 years) were analyzed. The intervention significantly increased CF (mean [standard deviation], 99 [19] steps vs 110 [21] steps, P < .001) and reduced body mass index, waist circumference, and systolic blood pressure, decreasing global cardiovascular risk (mean [standard deviation], 0.15 [2.84] vs −0.52 [2.60]; P < .001). The effects of intervention on cardiovascular risk were not different between the participants with low and high initial CF or PA levels.

Conclusion

The proposed real-life park-based PA interventional program decreased cardiovascular risk of the participants independently of their initial PA or CF levels.

Page 1 of 5

Introduction

CME / ABIM MOC Information

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Table 1.

Table 2.

Table 3.

References

Faculty and Disclosures

Faculty

Bruno Temoteo Modesto, MsC

Teresa Bartholomeu

Luciano Basso, PhD

Luiz Augusto Riani Costa, MD

Tais Tinucci, PhD

Cláudia Lúcia de Moraes Forjaz, PhD

CME Author

Charles P. Vega, MD

Editor

Caran Wilbanks

CME Reviewer

Esther Nyarko, PharmD

CE Reviewer

Hazel Dennison, DNP, RN, FNP-BC, CHCP, CPHQ, CNE

CME / ABIM MOC

Effects of a Real-Life Park-Based Physical Activity Interventional Program on Cardiovascular Risk and Physical Fitness

Target Audience and Goal Statement

Disclosures

Faculty

Bruno Temoteo Modesto, MsC

Teresa Bartholomeu

Luciano Basso, PhD

Luiz Augusto Riani Costa, MD

Tais Tinucci, PhD

Cláudia Lúcia de Moraes Forjaz, PhD

CME Author

Charles P. Vega, MD

Editor

Caran Wilbanks

CME Reviewer

Esther Nyarko, PharmD

CE Reviewer

Hazel Dennison, DNP, RN, FNP-BC, CHCP, CPHQ, CNE

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Effects of a Real-Life Park-Based Physical Activity Interventional Program on Cardiovascular Risk and Physical Fitness

Abstract

Introduction

Methods

Results

Conclusion

Table of Contents