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N
utritional
therapy
assessment
– O
utpatient
mobility
monitoring
(MAM)
R
ev
A
ssoc
M
ed
B
ras
2016; 62(9):811-815
811
GUIDELINES IN FOCUS
Nutritional therapy assessment – Outpatient mobility monitoring (MAM)
A
valiação
nutrológica
– M
onitorização
ambulatorial
da mobilidade
(MAM)
Authorship:
Associação Brasileira de Nutrologia (Abran)
Participants:
Ribas DF
1
, Simões RS
2
, Buzzini RF
2
, Kelman G
2
, Bernardo WM
2
Final draft:
March 11, 2016
1
Sociedade Brasileira de Nutrologia (Abran)
2
Programa Diretrizes, Brazilian Medical Association (AMB)
http://dx.doi.org/10.1590/1806-9282.62.09.811E
vidence
collection method
This policy followed the pattern of a systematic review
with retrieval of evidence based on the principles of evi-
dence-based medicine (EBM), according to which clinical
experience is integrated with the ability to critically ana-
lyze and rationally apply scientific information, thus
improving the quality of medical care. EBM uses existing
scientific evidence available at the time, with good inter-
nal and external validity, applying its results to the clini-
cal practice.
1,2
(
D
)
Systematic reviews are considered today as level I
evidence for any clinical question as systematically sum-
marize information on a particular topic based on pri-
mary studies (clinical trials, cohort studies, case-control
or cross-sectional studies). The method used for this is
reproducible, and integrates information on effectiveness,
efficiency, efficacy and safety.
1,2
(
D
)
We use a structured way to ask the question, sum-
marized by the acronym PICO, where P is the patient or
population, I intervention or indicator, C comparison or
control, and O is the outcome. Based on structured ques-
tion, the keywords or descriptors that will form the basis
of the search for evidence in the various available data-
bases are identified (Annex I).
1,2
(
D
)
C
linical
question
What is the role of outpatient mobility monitoring (MAM)
in the monitoring of physical activity and energy expen-
diture in children, adolescents or adults?
G
rade
of
recommendation
and
strength
of
evidence
A: Experimental or observational studies of higher con-
sistency.
B: Experimental or observational studies of lower consis-
tency.
C: Case reports/non-controlled studies.
D: Opinions without critical evaluation, based on con-
sensus, physiological studies, or animal models.
O
bjective
To determine the role of outpatient nutritional therapy
assessment in the monitoring of physical activity and
energy expenditure of children, adolescents and adults.
C
onflict
of
interest
No conflict of interest was declared by the participants
in the development of this guideline.
I
ntroduction
Physical activity is an important health indicator and
regular practice provides a broad spectrum of benefits,
impacting on the prevention of cardiovascular risk factors
and the development of chronic diseases such as obesity,
type 2
diabetes mellitus
, dyslipidemia and hypertension.
3
(
D
) Epidemiological studies have unequivocally demon-
strated that mortality from any cause is lower among
physically active individuals in contrast to that observed
in inactive individuals, respecting the parameters of age,
gender, and co-morbidities.
4,5
(
B
) Furthermore, it has been
noted that the adequacy of the lifestyle, including the
practice of physical activity, is related to a reduction of
all causes of mortality, showing unique importance in
maintaining functional independence and good quality
of life in the elderly population.
6
(
B
) Physical activity as
a form of therapeutic exercise is also important in reha-
bilitation programs for cardiovascular, neuromuscular,
motor control and cortical plasticity aspects.
7
(
B
) Thus,
with the measurement of physical activity becoming more
common in clinical practice, it is imperative to search for
simple, practical and non-invasive tools that are suitable
for assessing the level of physical activity and energy ex-
penditure.
W
hat
are
the
assessment methods
for
phys
-
ical
activity
and
energy
expenditure
?
Although individuals are able to describe their daily phys-
ical activity habits in general terms, detailed and accurate
measurement is an extremely difficult task because it is