Efeitos da inserção de exercícios respiratórios diafragmáticos, cardiorrespiratórios e de força, e de atividades esportivas cooperativas durante aulas de Educação Física nos sintomas de ansiedade em adolescentes

Abstract

Introduction: Anxiety is the body's reaction to some situation or anticipation of danger or greater attention. When intensified, it is projected in a dysfunctional way, becoming a mental health problem, affecting people of all age groups. In this context, school, including the subject of Physical Education, becomes a privileged space in combating symptoms that are linked to adolescents. Physical activities and sports act as a protective factor for mental health. Objectives: The main objective of this thesis was, through a scientific article, to evaluate the effects of inserting diaphragmatic breathing exercises (GI-1), cardiorespiratory and strength physical exercises (GI-2) and cooperative sports activities (GI- 3), in addition to the comparator group (CG), using part of the Physical Education classes, on the anxiety symptoms of high school students, also verifying the effects according to the volume of weekly practice and the stratification of the age group. As secondary objectives of the thesis, we sought to write a systematic review identifying and summarizing studies that analyzed the effects of interventions that used diaphragmatic breathing exercises, one of the proposed protocols, on anxiety symptoms in adolescents. Furthermore, a protocol article was proposed that described the step-by-step execution of the randomized clinical trial and aimed to evaluate the effects of the three interventions already mentioned during Physical Education (PE) classes on the mental health of adolescents. Methodology and results: The main production of the thesis was a randomized clinical trial (RCT), parallel, with four arms developed with 326 high school students (14 to 20 years old) integrated from two campuses, in the cities of Bagé and Pelotas, from the Instituto Federal Sul-rio-grandense (IFSul) between the months of February and July 2023. The intervention protocols were applied over twelve weeks. At the Bagé Campus, two weekly sessions were held (24 sessions in total) and at the Pelotas Campus, three weekly sessions (36 sessions in total). The interventions lasted 15 minutes in groups GI-1 and GI-2, and 20 minutes in group GI-3, in addition to the participation of the comparator group (CG) who practiced PE classes as usual, without changing their configuration. Anxiety symptoms were assessed by the General Anxiety Disorder-7 (GAD-7). The groups were compared regarding the characteristics collected at baseline and after the 12th week of intervention. The analyzes were carried out using the Generalized Estimation Equation (GEE), by intention to treat, which indicated a significant group*moment interaction (p=0.018) in the age group between 18 and 20 years old, where participants in the GI cardiorespiratory and strength physical exercises showed a reduction in anxiety symptoms from pre-to post-intervention (p=0.008). In relation to the volume of weekly classes, no intervention effect was observed (p>0.05) although the group with 36 sessions presented a borderline group*moment interaction (p=0.086), thus concluding that more intervention studies during classes of Physical Education can and need to be tested and improved as an option in this space. The systematic review article, already published, registered on the PROSPERO platform, (CRD42022328536) followed the PRISMA methodology. The search was carried out between the months of July and August 2022 in the databases MedLine/PubMed, PsycINFO, CINAHL, SPORTDiscus, EMBASE, Scielo, Web of Science and Scopus. Descriptors were used considering the population (adolescents), type of intervention (diaphragmatic breathing exercise), outcome (anxiety symptoms) and study design (experimental studies and their subclassifications and quasi-experimental studies) combining boolean operators. Methodological quality was determined using the PEDro scale. As a final conclusion, the findings indicated positive effects of this practice on anxiety symptoms in adolescents, highlighting its easy application, low cost, as well as the possibility of carrying it out in different locations. Some reservations such as the small number of studies found and methodological weaknesses were highlighted. And finally, the protocol study, also already published, described in detail the randomized clinical trial carried out, and sought to identify positive effects of the three protocols, facilitating their adaptation to the different contents and moments of a school Physical Education class. In this way, the teacher is presented with the choice of the opportune moment, according to the availability of the subject's syllabus, thus expanding their pedagogical resources related to improving mental health, enabling preventive work associated with anxiety symptoms. Conclusion: The thesis was composed of three scientific articles, each of which contributed in its own way and according to its characteristics to the construction of the answer to the research problem of the work. The main production highlights that the Physical Education discipline can also be configured as a space for identifying and combating problems related to mental health. This theme requires increasingly more care and attention and studies like this should be encouraged to also be carried out within the school environment and in different educational spheres.