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1.
J Sport Health Sci ; 11(3): 319-329, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34098176

RESUMEN

PURPOSE: This study used downhill running as a model to investigate the repeated bout effect (RBE) on neuromuscular performance, running biomechanics, and metabolic cost of running. METHODS: Ten healthy recreational male runners performed two 30-min bouts of downhill running (DR1 and DR2) at a -20% slope and 2.8 m/s 3 weeks apart. Neuromuscular fatigue, level running biomechanics during slow and fast running, and running economy parameters were recorded immediately before and after the downhill bouts, and at 24 h, 48 h, 72 h, 96 h, and 168 h thereafter (i.e., follow-up days). RESULTS: An RBE was confirmed by attenuated muscle soreness and serum creatine kinase rise after DR2 compared to DR1. An RBE was also observed in maximum voluntary contraction (MVC) force loss and voluntary activation where DR2 resulted in attenuated MVC force loss and voluntary activation immediately after the run and during follow-up days. The downhill running protocol significantly influenced level running biomechanics; an RBE was observed in which center of mass excursion and, therefore, lower-extremity compliance were greater during follow-up days after DR1 compared to DR2. The observed changes in level running biomechanics did not influence the energy cost of running. CONCLUSION: This study demonstrated evidence of adaptation in neural drive as well as biomechanical changes with the RBE after DR. The higher neural drive resulted in attenuated MVC force loss after the second bout. It can be concluded that the RBE after downhill running manifests as changes to global and central fatigue parameters and running biomechanics without substantially altering the energy cost of running.


Asunto(s)
Músculo Esquelético , Mialgia , Adaptación Fisiológica , Fenómenos Biomecánicos , Humanos , Extremidad Inferior , Masculino , Músculo Esquelético/fisiología
2.
Trials ; 22(1): 394, 2021 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-34127029

RESUMEN

BACKGROUND: There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist 1 year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support programme (at 18 months). METHODS: We will recruit 264 participants (aged 50-80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months, whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either 1 year of ongoing telephone behavioural support or no telephone support. The primary aim is to determine the independent effect of aerobic exercise on a cognitive composite score in participants allocated to this intervention compared to participants allocated to the stretching-toning group. The secondary aims are to examine the effects of aerobic exercise on a number of secondary outcomes and determine whether aerobic exercise-related changes persist after a 1-year behavioural support programme (at 18 months). DISCUSSION: This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining the potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with ageing. TRIAL REGISTRATION: ClinicalTrials.gov NCT03035851 . Registered on 30 January 2017.


Asunto(s)
Demencia , Terapia por Ejercicio , Anciano , Encéfalo , Cognición , Demencia/prevención & control , Ejercicio Físico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
3.
J Neurophysiol ; 124(4): 1131-1143, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32877296

RESUMEN

It is unclear whether motor fatigability and perceived fatigue share a common pathophysiology in people with multiple sclerosis (PwMS). This cross-sectional investigation explored the relationship between the mechanisms of motor fatigability from cycling and fatigue severity in PwMS. Thirteen highly fatigued (HF) and thirteen nonfatigued (LF) PwMS and thirteen healthy controls (CON) completed a step test until volitional exhaustion on an innovative cycle ergometer. Neuromuscular evaluations involving femoral nerve electrical stimulation and transcranial magnetic stimulation were performed every 3 min throughout cycling. One-way ANOVA at baseline and exhaustion uncovered evidence of consistently smaller motor evoked potential (MEP) amplitudes (P = 0.011) and prolonged MEP latencies (P = 0.041) in HF as well as a greater decline in maximal voluntary contraction force (HF: 63 ± 13%; LF: 75 ± 13%; CON: 73 ± 11% of pre; P = 0.037) and potentiated twitch force (HF: 35 ± 13%; LF: 50 ± 16%; CON: 47 ± 17% of pre; P = 0.049) in HF at volitional exhaustion. Hierarchical regression determined that fatigue severity on the Fatigue Severity Scale was predicted by prolonged MEP latencies (change in r2 = 0.389), elevated peripheral muscle fatigability (change in r2 = 0.183), and depressive symptoms (change in r2 = 0.213). These findings indicate that MS-related fatigue is distinguished by disrupted corticospinal responsiveness, which could suggest progressive pathology, but fatigability from whole body exercise and depressive symptoms also influence perceptions of fatigue in PwMS.NEW & NOTEWORTHY The etiology of fatigability from whole body exercise was examined for the first time to accurately elucidate the relationship between fatigue and fatigability in multiple sclerosis (MS). Compromised corticospinal responsiveness predicted fatigue severity, providing a novel, objective indicator of fatigue in MS. Although the impaired corticomotor transmission did not aggravate muscle activation in this group of people with multiple sclerosis (PwMS) of lower disability, heightened muscle fatigability was seen to contribute to perceptions of fatigue in PwMS.


Asunto(s)
Ejercicio Físico , Esclerosis Múltiple/fisiopatología , Fatiga Muscular , Tractos Piramidales/fisiopatología , Adulto , Potenciales Evocados Motores , Femenino , Nervio Femoral/fisiopatología , Humanos , Contracción Isométrica , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Tiempo de Reacción
4.
Eur J Appl Physiol ; 120(11): 2455-2466, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32816143

RESUMEN

PURPOSE: Lower limbs' neuromuscular force capabilities can only be determined during single sprints if the test provides a good fit of the data in the torque-velocity (T-V) and power-velocity (P-V) relationships. This study compared the goodness of fit of single sprints performed against traditional (7.5% of the body mass) vs. optimal load (calculated based on the force production capacity and ergometer specificities), and examined if reducing the load in fatigued state enhances T-V and P-V relationship goodness of fit. METHODS: Thirteen individuals performed sprints before (PRE) and after (POST) a fatiguing task against different loads: (1) TRAD: traditional, (2) OPT: optimal, and (3) LOW-OPT: optimal load reduced according to fatigue levels. RESULTS: At PRE, OPT sprints presented a higher R2 of the T-V relationship (0.92 ± 0.06) and lower time to reach maximal power (Pmax) (48 ± 9%) when compared with TRAD sprints (0.89 ± 0.06 and 66 ± 22%, respectively, p < 0.01). At POST, the range of velocity spectrum was greater in the LOW-OPT (33 ± 4%) vs. TRAD (24 ± 3%) and OPT (26 ± 8%, p < 0.007). Similarly, the time to reach Pmax was lower in the LOW-OPT (46 ± 12%) vs. TRAD (76 ± 24%) and OPT (70 ± 24%, p < 0.006). CONCLUSION: Sprints performed against an OPT load and reducing the OPT load after fatigue improve the fit of data in the T-V and P-V curves. Sprints load assignment should consider force production capacities rather than body mass.


Asunto(s)
Prueba de Esfuerzo/métodos , Ejercicio Físico , Torque , Aceleración , Adulto , Fenómenos Biomecánicos , Prueba de Esfuerzo/normas , Femenino , Humanos , Pierna/fisiología , Masculino , Fatiga Muscular , Músculo Esquelético/fisiología
5.
J Neurophysiol ; 124(3): 763-773, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32755359

RESUMEN

Data from studies of elbow-flexor (EF) or knee-extensor (KE) muscles suggest that a fatigue-related decrease in motoneuron excitability only occurs in EF. It is unknown how motoneuron excitability changes after sustained fatiguing maximal voluntary isometric contractions (MVICs) in EF and KE in the same participants. In two sessions, eight healthy men performed a 2-min MVIC of EF or KE to induce fatigue with brief MVICs before and six times after the 2-min MVIC. Electromyographic responses elicited by corticospinal tract stimulation at the transmastoid [cervicomedullary motor-evoked potential (CMEP)] or thoracic [thoracic motor-evoked potential (TMEP)] level were recorded from EF and KE, respectively. To account for muscle excitability, CMEPs and TMEPs were normalized to maximal M-wave (Mmax) elicited by peripheral nerve stimulation during each brief MVIC. Immediately after the 2-min MVIC, biceps brachii and brachioradialis CMEP/Mmax were 88% (SD 11%) (P = 0.026) and 87% (SD 12%) (P = 0.029) of pre-MVIC (PRE) values, respectively, and remained lower than PRE after 5 s of recovery [91% (SD 8%), P = 0.036 and 87% (SD 13%), P = 0.046, respectively]. No subsequent time points differed from PRE (all P ≥ 0.253). TMEP/Mmax for rectus femoris and vastus lateralis were not different from PRE at any time during the recovery period (all P > 0.050). A different recovery pattern in motoneuron excitability occurred in EF as it recovered by 60 s whereas KE motoneurons were unaffected by the fatiguing task. The present findings may contribute to better understand muscle-specific neurophysiological differences in spinal excitability.NEW & NOTEWORTHY By comparing the changes in motoneuron excitability in elbow-flexor and knee-extensor muscles after sustained fatiguing maximal voluntary contractions, this study shows that motoneuron recovery behavior depends on the muscle performing the exercise. A different recovery pattern in motoneuron excitability occurs in elbow flexors as it recovered by 60 s whereas knee extensors were unaffected by fatigue. This finding can help to increase understanding of the effect of a fatigue and subsequent recovery on neural processes.


Asunto(s)
Codo/fisiología , Potenciales Evocados Motores/fisiología , Contracción Isométrica/fisiología , Rodilla/fisiología , Neuronas Motoras/fisiología , Fatiga Muscular/fisiología , Músculo Esquelético/fisiología , Tractos Piramidales/fisiología , Adulto , Estimulación Eléctrica , Electromiografía , Humanos , Adulto Joven
6.
Exp Gerontol ; 133: 110877, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32068090

RESUMEN

Studies have suggested that older individuals are more fatigable than young adults when power loss, measured during single-joint contractions, is considered the fatigue index; however, age-related differences in fatigue considering power measurements during multi-joint movements (e.g., cycling) have not been fully elucidated yet. This study examined age-related differences in dynamic and isometric measures of fatigue in response to three cycling exercises. Ten young (27 ±â€¯4 years) and ten old (74 ±â€¯4 years) men performed exercises on different days, 30-s Wingate, 10-min at severe-intensity, and 90-min at moderate-intensity. Dynamic measures-maximal power, torque, and velocity-were assessed after cycling and during recovery (1-8 min post-exercise) through 7-s cycling sprints and isometric force and fatigue etiology (central and peripheral components) through isometric contractions. There were no age-related differences in the relative reduction of dynamic and isometric measures following the Wingate and moderate-intensity tasks. Maximal power, isometric force, and indices of peripheral function (e.g., high-frequency doublet) decreased more in young compared with older individuals after the severe-intensity exercise (all p < .05). The only observed age-related difference in the recovery of NM fatigue was a slower recovery of power and torque from 1 to 8 min (p < .05) and at 4 min (p = .015), respectively, in younger males after the Wingate. Age-related fatigue and recovery depend on the fatiguing exercise intensity and duration and on the fatigue assessment mode. This study provides novel information on age-related neuromuscular fatigue responses to multi-joint dynamic exercises performed at different intensities and durations.


Asunto(s)
Fatiga Muscular , Músculo Esquelético , Electromiografía , Ejercicio Físico , Humanos , Contracción Isométrica , Masculino , Torque
7.
Neuroscience ; 422: 88-98, 2019 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-31682821

RESUMEN

This study compared the effects of fatigue on corticospinal responsiveness in the upper- and lower-limb muscles of the same participants. Seven healthy males performed a 2-min maximal voluntary isometric contraction of the elbow flexors or knee extensors on four separate days. Electromyographic responses were elicited by nerve stimulation (maximal M-wave) in all sessions and by transcranial magnetic stimulation (motor-evoked potential; silent period) and spinal tract stimulation (cervicomedullary or thoracic motor-evoked potentials; silent period) in one session each per limb. During sustained maximal voluntary contractions, motor-evoked potential area normalised to M-waves increased from baseline in biceps brachii (155 ±â€¯55%) and rectus femoris (151 ±â€¯44%) (both p ≤ 0.045). At the end of maximal voluntary contractions, spinal tract motor-evoked potential area normalised to M-waves was smaller than baseline in biceps brachii (74 ±â€¯23%; p = 0.012) but not rectus femoris (108 ±â€¯40%; p = 0.999). The ratio of motor-evoked potential to spinal tract-evoked potential areas increased dramatically from 90 to 115 s in biceps brachii (p = 0.001) but not in rectus femoris (p = 0.999). Silent period durations increased similarly in both muscles (p ≤ 0.008) after transcranial and spinal stimulation. Sustained maximal contractions elicit different neurophysiological adjustments in upper- and lower-limb muscles. Specifically, motoneuronal excitability was reduced in biceps brachii, but not in rectus femoris, and this reduction required greater compensatory adjustments from the motor cortex. Therefore, changes in cortical and spinal excitability during sustained maximal exercise are likely specific to the muscle performing the task.


Asunto(s)
Contracción Isométrica/fisiología , Extremidad Inferior/fisiología , Fatiga Muscular/fisiología , Extremidad Superior/fisiología , Adulto , Codo/fisiología , Estimulación Eléctrica , Ejercicio Físico/fisiología , Humanos , Rodilla/fisiología , Masculino , Corteza Motora/fisiología , Neuronas Motoras/fisiología , Músculo Esquelético/fisiología , Tractos Piramidales/fisiología , Músculo Cuádriceps/fisiología , Estimulación Magnética Transcraneal
8.
Appl Physiol Nutr Metab ; 44(12): 1320-1328, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31082324

RESUMEN

The majority of studies have routinely measured neuromuscular (NM) fatigue with a delay (∼1-3 min) after cycling exercises. This is problematic since NM fatigue can massively recover within the first 1-2 min after exercise. This study investigated the etiology of knee extensors (KE) NM fatigue and recovery kinetics in response to cycling exercises by assessing NM function as early as 10 s following cycling and up to 8 min of recovery. Ten young males performed different cycling exercises on different days: a Wingate (WING), a 10-min task at severe-intensity (SEV), and a 90-min task at moderate-intensity (MOD). Electrically evoked and isometric maximal voluntary contractions (IMVC) of KE were assessed before, after, and during recovery. SEV induced the highest decrease in IMVC. Peak twitch (Pt) was more reduced in WING and SEV than in MOD (p < 0.001), whereas voluntary activation decreased more after MOD than WING (p = 0.043). Regarding Pt and the ratio between low- and high-frequency doublet (i.e., low-frequency fatigue), recovery was faster for WING, whereas IMVC and high-frequency doublet recovered slower during MOD (p < 0.05). Our results confirm that peripheral fatigue is greater after WING and SEV, while central fatigue is greater following MOD. Peripheral fatigue can substantially recover within minutes after a supramaximal exercise while NM function recovered slower after prolonged, moderate-intensity exercise. This study provides an accurate estimation of NM fatigue and recovery kinetics because of dynamic exercise with large muscle mass by significantly shortening the delay for postexercise measurements.


Asunto(s)
Ciclismo/fisiología , Ergometría , Fatiga Muscular , Adulto , Electromiografía , Humanos , Contracción Isométrica , Cinética , Masculino , Adulto Joven
9.
J Exp Biol ; 222(Pt 9)2019 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-30890621

RESUMEN

Although fatigue can be defined as an exercise-related decrease in maximal power or isometric force, most studies have assessed only isometric force. The main purpose of this experiment was to compare dynamic measures of fatigue [maximal torque (Tmax), maximal velocity (Vmax) and maximal power (Pmax)] with measures associated with maximal isometric force [isometric maximal voluntary contraction (IMVC) and maximal rate of force development (MRFD)] 10 s after different fatiguing exercises and during the recovery period (1-8 min after). Ten young men completed six experimental sessions (3 fatiguing exercises×2 types of fatigue measurements). The fatiguing exercises were: 30 s all-out intensity (AI), 10 min at severe intensity (SI) and 90 min at moderate intensity (MI). Relative Pmax decreased more than IMVC after AI exercise (P=0.005) while the opposite was found after SI (P=0.005) and MI tasks (P<0.001). There was no difference between the decrease in IMVC and Tmax after the AI exercise, but IMVC decreased more than Tmax immediately following and during the recovery from the SI (P=0.042) and MI exercises (P<0.001). Depression of MRFD was greater than Vmax after all fatiguing exercises and during recovery (all P<0.05). Despite the general definition of fatigue, isometric assessment of fatigue is not interchangeable with dynamic assessment following dynamic exercises with large muscle mass of different intensities, i.e. the results from isometric function cannot be used to estimate dynamic function and vice versa. This implies different physiological mechanisms for the various measures of fatigue.


Asunto(s)
Ejercicio Físico/fisiología , Contracción Isométrica/fisiología , Fatiga Muscular/fisiología , Adulto , Humanos , Masculino , Adulto Joven
10.
Med Sci Sports Exerc ; 50(10): 2132-2144, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29787475

RESUMEN

PURPOSE: The assessment of power changes after fatiguing exercise provides important additional information about neuromuscular function compared with traditional isometric measurements, especially when exploring age-related changes in fatigability. Therefore, the aim of this review was to explore the effects of age on neuromuscular fatigue (NMF) when measured in isometric compared with dynamic contractions. The importance of central and peripheral mechanisms contributing to age-related NMF was discussed. METHODS: Medline, EMBASE, Cochrane Central Register of Controlled Trials, and SPORT Discus databases were searched. The combination of terms related to the intervention (fatiguing exercise), population (old people) and outcomes (isometric force and power) were used. This meta-analysis was registered on PROSPERO (CRD42016048389). RESULTS: Thirty-one studies were included. The meta-analyses revealed that force decrease was greater (there was more NMF) in young subjects than their older counterparts when fatigue was induced by isometric tasks (effect size [ES], 0.913; confidence interval [CI], 0.435-1.391; P < 0.001), but not when the fatiguing exercise was performed in dynamic mode (ES, 0.322; CI, -0.039 to 0.682; P = 0.08). Older individuals demonstrated a greater reduction in power after fatigue induced by either dynamic or isometric tasks (ES, -0.891; CI, -1.657 to -0.125; P = 0.023). CONCLUSIONS: There is no difference in the isometric force loss between young and old people when fatigue is induced by dynamic tasks. However, maximal power is more decreased after fatigue tasks in older adults. Thus, the assessment of fatigue (isometric force vs power) must be considered in identifying age-related NMF mechanisms.


Asunto(s)
Factores de Edad , Ejercicio Físico , Fatiga Muscular , Adolescente , Adulto , Anciano , Humanos , Contracción Isométrica , Adulto Joven
11.
J Strength Cond Res ; 32(5): 1422-1430, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-28486335

RESUMEN

Farinha, JB, Macedo, CEO, Rodrigues-Krause, J, Krüger, RL, Boeno, FP, Macedo, RCO, Queiroz, JN, Teixeira, BC, and Reischak-Oliveira, A. Effects of two combined exercise designs associated with high-fat meal consumption on postprandial lipemia, insulinemia, and oxidative stress. J Strength Cond Res 32(5): 1422-1430, 2018-Impaired postprandial lipemia (PPL) response after the consumption of a high-fat meal (HFM) is linked to diabetes, oxidative stress, and cardiovascular events. The aim of this study was to investigate lipid and glucose metabolism and oxidative stress responses of 2 different combined exercise designs associated with HFM consumption. Eleven healthy and physically active men (27.36 ± 5.04 years) participated in this study. After the pretrial visits, participants were randomly assigned to perform 2-day trials in 3 different conditions (interspaced by at least 1 week): resting (REST), circuit combined exercise (CIRC), or traditional combined exercise (COMB), on the evening of day 1. On the morning of day 2, an HFM was provided and blood samples were obtained before and after 1, 3, and 5 hours of HFM consumption. No differences were found with respect to glucose, thiobarbituric acid-reactive substances, or total thiol levels in between time points or conditions. One-way analysis of variance demonstrated a difference between REST and CIRC (p = 0.029; reduction of 35.29%) and between REST and COMB (p = 0.041; reduction of 33.41%) conditions with incremental area under the curve (iAUC) for triacylglycerol levels. A difference between REST and CIRC (p = 0.03; reduction of 34.22%) conditions in terms of iAUC for insulin was also found. Both CIRC and COMB exercise designs can reduce PPL associated with HFM consumption. Moreover, CIRC reduces the iAUC for insulin, suggesting additional benefits for prescribing this type of exercise.


Asunto(s)
Grasas de la Dieta/metabolismo , Ejercicio Físico/fisiología , Insulina/sangre , Lípidos/sangre , Estrés Oxidativo/fisiología , Periodo Posprandial/fisiología , Adulto , Metabolismo de los Hidratos de Carbono , Glucosa , Humanos , Masculino , Sustancias Reactivas al Ácido Tiobarbitúrico , Triglicéridos/sangre , Adulto Joven
12.
Lasers Med Sci ; 33(3): 453-460, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29119418

RESUMEN

Some evidence supports that low-level laser therapy (LLLT) reduces neuromuscular fatigue, so incrementing sports performance. A previous randomized controlled trial of our group showed increased exercise tolerance in male competitive cyclists treated with three different LLLT doses (3, 6, and 9 J/diode; or 135, 270, and 405 J/thigh) before time-to-exhaustion cycling tests. Now, the present study was designed to evaluate the effects of these LLLT doses on the VO2 kinetics of athletes during cycling tests. Twenty male competitive cyclists (29 years) participated in a crossover, randomized, double-blind, and placebo-controlled trial. On the first day, the participants performed an incremental cycling test to exhaustion to determine maximal oxygen uptake (VO2MAX) and maximal power output (POMAX), as well as a familiarization with the time-to-exhaustion test. In the following days (2 to 5), all participants performed time-to-exhaustion tests at POMAX. Before the exhaustion test, different doses of LLLT (3, 6, and 9 J/diode; or 135, 270, and 405 J/thigh, respectively) or placebo were applied bilaterally to the quadriceps muscle. All exhaustion tests were monitored online by an open-circuit spirometry system in order to analyze the VO2 amplitude, VO2 delay time, time constant (tau), and O2 deficit. Tau and O2 deficit were decreased with LLLT applications compared to the placebo condition (p < 0.05). No differences (p > 0.05) were found between the experimental conditions for VO2 amplitude and VO2 delay time. In conclusion, LLLT decreases tau and O2 deficit during time-to-exhaustion tests in competitive cyclists, and these changes in VO2 kinetics response can be one of the possible mechanisms to explain the ergogenic effect induced by LLLT.


Asunto(s)
Ciclismo , Terapia por Luz de Baja Intensidad/métodos , Consumo de Oxígeno , Adulto , Estudios Cruzados , Método Doble Ciego , Ejercicio Físico/fisiología , Prueba de Esfuerzo , Humanos , Cinética , Masculino
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