Aerobic exercise ameliorates survival, clinical score, lung inflammation, DNA and protein damage in septic mice.

BACKGROUND AND OBJECTIVE: Sepsis is a potentially deadly organic dysfunction, and one of the main causes of mortality in intensive care units (ICU). Aerobic exercise (AE) is a preventive intervention in the establishment of inflammatory conditions, such as chronic lung diseases, but its effects on sepsis remain unclear. Therefore, this study aimed to evaluate the effects of AE on health condition, mortality, inflammation, and oxidative damage in an experimental model of pneumosepsis induced by Klebsiella pneumoniae (K.p). METHODS: Animals were randomly allocated to Control; Exercise (EXE); Pneumosepsis (PS) or Exercise + Pneumosepsis (EPS) groups. Exercised animals were submitted to treadmill exercise for 2 weeks, 30 min/day, prior to pneumosepsis induced by K.p tracheal instillation. RESULTS: PS produced a striking decrease in the health condition leading to massive death (85%). AE protected mice, as evidenced by better clinical scores and increased survival (70%). AE alleviated sickness behavior in EPS mice as evaluated in the open field test, and inflammation (nitrite + nitrate, TNF-α and IL-1ß levels) in broncoalveolar fluid. Catalase activity, oxidative damage to proteins and DNA was increased by sepsis and prevented by exercise. CONCLUSION: Overall, the beneficial effects of exercise in septic animals encompassed a markedly improved clinical score and decreased mortality, along with lower inflammation markers, less DNA and protein damage, as well as preserved antioxidant enzyme activity. Neural network risk analysis revealed exercise had a considerable effect on the overall health condition of septic mice.

The practice of physical activity and cryotherapy in rheumatoid arthritis: systematic review.

INTRODUCTION: Rheumatoid arthritis (RA) is an autoimmune, chronic and inflammatory disease, which the affected patients present a higher cardiovascular mortality rate. Physical activities have been identified as the most important strategy to prevent cardiovascular diseases. However, the articular damage and the chronic pain caused by RA challenges its regular practice. Moreover, persons with RA tend to avoid PA due to the fear of exacerbating the inflammatory potential and pain. One alternative to avoid the collateral effects of the PA could be the cryotherapy. Therefore, this study aimed to review studies focused on the use of both PA and cryotherapy in RA patients and to identify evidences that both therapies could be combined in order to optimize the symptomatic treatment. EVIDENCE ACQUISITION: Four databases (MEDLINE, CINAHL, Elsevier and PEDro) were searched to identify publications regarding RA patients, PA and cryotherapy intervention by the terms and operators (rheumatoid arthritis AND exercise OR physical activity OR activity OR training OR reconditioning OR cryotherapy OR cold OR immersion). The selected studies should at least present one measure of the aerobic capacity, disease activity or pain relief. Among 19 studies with RA patients identified, only 4 studies used PA combined with cryotherapy. The other 13 studies used physical activities and 2 studies used cryotherapy intervention. EVIDENCE SYNTHESIS: The results of the physical activities combined with cryotherapy studies showed an improvement in the disease activity and pain relief, however without details of the physical activities intervention and an aerobic capacity. Among the physical activities studies, evidence was found suggesting that aerobic exercises and multiactivity exercises with high intensity are the more effective for improve the aerobic capacity. CONCLUSIONS: Even if few studies on cryotherapy were found, there are enough evidences in the literature that demonstrate the benefits of this intervention on pain relief and disease activity. In summary, neither study found associated physical activities to improve aerobic capacity with cryotherapy to improve disease activity and pain relief. This may be an innovative therapeutic strategy to improve the aerobic capacity in arthritis patients and consequently reduce their cardiovascular risk while minimizing pain and disease activity.

Avaliação do equilíbrio corporal de pacientes com artrite reumatoide / Evaluation of body balance in rheumatoid arthritis patients / Evaluación del equilibrio corporal de pacientes con artritis reumatoidea

Controle postural, estabilidade nos movimentos voluntários, reação às perturbações externas e propriocepção constituem elementos básicos para a manutenção do equilíbrio. Pessoas com Artrite Reumatoide (AR) têm dificuldade em manter o controle postural, prejudicando o equilíbrio nas Atividades de Vida Diárias (AVD's), tornando-se um importante fator de risco para quedas. O presente estudo teve por objetivo avaliar o equilíbrio corporal de indivíduos com AR, em função do nível de atividade da doença. Foram avaliados 24 indivíduos com 54,66±9,52 anos. Todos foram submetidos à aplicação de questionário de identificação e história clínica, avaliações antropométricas, coleta de amostra sanguínea para análise de Proteína C-Reativa (PCR), determinação do nível de atividade da doença por meio do Disease Activity Score (DAS-28) e avaliação do equilíbrio através dos testes: Escala de Equilíbrio de Berg (EEB) e Timed Up and Go (TUG). Os pacientes foram divididos em três grupos: baixa, moderada e alta atividade da doença. Os resultados dos testes de equilíbrio demonstraram que, embora a amostra tenha apresentado baixo risco para quedas, o grupo em alta atividade da doença apresentou maior distribuição de frequência (57,2%) nos escores entre 48-52 na EEB, em comparação ao grupo moderada atividade, cuja distribuição de frequência predominou nos escores entre 53 e 56 (92,3%-p<0,05). Também foi verificada diferença no tempo de execução do TUG, entre os grupos alta (11,86±4,62s) e moderada (9,71±0,90s) atividade da doença (p<0,05). Estes dados evidenciam que o nível de atividade da doença pode influenciar na realização dos testes EEB e TUG, sugerindo um aumento do risco de quedas ou até mesmo uma dependência na realização de suas AVD's em função do aumento do nível de atividade da doença...

Postural control, stability in voluntary movements in response to external disturbances and proprioception are basic elements for maintaining balance. People with Rheumatoid Arthritis (RA) have difficulty maintaining postural control, undermining the balance in the Activities of Daily Living (ADL's), making it an important risk factor for falls. The present study aimed to evaluate the body balance of individuals with RA, according to the level of disease activity. We evaluated 24 individuals with 54.66±9.52 years. All underwent a questionnaire identification and medical history, anthropometric measurements, blood sampling for analysis of C-Reactive Protein (CRP), determining the level of disease activity using the DAS-28 and equilibrium through tests: Berg Balance Scale (BBS) and TUG. Patients were divided into three groups: low, moderate and high disease activity. The results of equilibrium tests showed that, although the sample has presented low risk for falls, the group in high disease activity had higher frequency distribution (57.2%) in scores between 48-52 in the BBS compared to the moderate activity group, whose frequency distribution prevailed in the scores between 53 and 56 (92.3%-p<0.05). It was also observed differences in the time of the TUG execution between groups high (11.86±4.62 s) and moderate (9.71±0.90 s) disease activity (p<0.05). These data show that the level of disease activity can influence the achievement of the BBS and TUG tests, suggesting an increased risk of falls or even a dependency in performing their ADL's due to the increased level of disease activity...

Control postural, estabilidad en los movimientos voluntarios, reacción a las perturbaciones externas y propiocepción constituyen elementos básicos para la manutención del equilibrio. Personas con Artritis Reumatoidea (AR) tienen dificultad en mantener el control postural, perjudicando el equilibrio en las Actividades de Vida Diarias (AVD's), volviéndose un importante factor de riesgo de caídas. El presente estudio tuvo por objetivo evaluar el equilibrio corporal de individuos con AR, en función del nivel de actividad de la enfermedad. Fueron evaluados 24 individuos con 54,66±9,52 años. Todos fueron sometidos a la aplicación de cuestionario de identificación e historia clínica, evaluaciones antropométricas, colecta de muestra sanguínea para análisis de Proteína C-Reactiva (PCR), determinación del nivel de actividad de la enfermedad por medio del Disease Activity Score (DAS-28) y evaluación del equilibrio a través de los tests: Escala de Equilibrio de Berg (EEB) y Timed Up and Go (TUG). Los pacientes fueron divididos en tres grupos: baja, moderada y alta actividad de la enfermedad. Los resultados de los tests de equilibrio demostraron que, aunque la muestra haya presentado bajo riesgo de caídas, el grupo en alta actividad de la enfermedad presentó mayor distribución de frecuencia (57,2%) en los escores entre 48-52 en la EEB, en comparación con el grupo moderada actividad, cuya distribución de frecuencia predominó en los escores entre 53 y 56 (92,3%-p<0,05). También fue verificada diferencia en el tiempo de ejecución del TUG, entre los grupos alta (11,86±4,62s) y moderada (9,71±0,90s) actividad de la enfermedad (p<0,05). Estos datos evidencian que el nivel de actividad de la enfermedad puede influenciar en la realización de los tests EEB y TUG, sugiriendo un aumento del riesgo de caídas o aun una dependencia en la realización de sus AVD's en función del aumento del nivel de actividades de la enfermedad...