Effects of a combined aerobic and strength training program in youth patients with acute lymphoblastic leukemia.

Cure rates of youth with Acute Lymphoblastic Leukemia (ALL) have increased in the past decades, but survivor's quality of life and physical fitness has become a growing concern. Although previous reports showed that resistance training is feasible and effective, we hypothesized that a more intense exercise program would also be feasible, but more beneficial than low- to moderate-intensity training programs. We aimed to examine the effects of an exercise program combining high-intensity resistance exercises and moderate-intensity aerobic exercises in young patients undergoing treatment for ALL. A quasi-experimental study was conducted. The patients (n = 6; 5-16 years of age) underwent a 12-week intra-hospital training program involving high-intensity strength exercises and aerobic exercise at 70% of the peak oxygen consumption. At baseline and after 12 weeks, we assessed sub-maximal strength (10 repetition-maximum), quality of life and possible adverse effects. A significant improvement was observed in the sub maximal strength for bench press (71%), lat pull down (50%), leg press (73%) and leg extension (64%) as a result of the training (p < 0.01). The parents' evaluations of their children's quality of life revealed an improvement in fatigue and general quality of life, but the children's self-reported quality of life was not changed. No adverse effects occurred. A 12-week in-hospital training program including high-intensity resistance exercises promotes marked strength improvements in patients during the maintenance phase of the treatment for Acute Lymphoblastic Leukemia without side-effects. Parents' evaluations of their children revealed an improvement in the quality of life. Key pointsPatients with ALL present low muscle strength and poor quality of life.High-intensity resistance exercises combined with moderate-intensity aerobic exercise improved muscle strength and quality of life during the maintenance phase of ALL treatment.The exercise training program seemed to be tolerable and safe in ALL patients.

Dinamometria isocinética de tronco em nadadores de diferentes estilos / Isokinetic trunk dynamometry in diferent swimming strokes

OBJETIVOS: Comparar a atividade muscular dos músculos flexores e extensores de tronco entre estilos de nado assimétrico e nado simétrico. MÉTODO: Catorze nadadores da elite, velocistas e especialistas em um dos quatro estilos da natação sem história prévia de lesões.. Divididos em dois grupos de sete atletas: 1. Grupo nado assimétrico (GNA): constituído por cinco atletas que nadam o estilo crawl e dois atletas que nadam o estilo costas. 2. Grupo nado simétrico (GNS) formado por sete atletas: quatro atletas nadadores no estilo peito e três nadadores no estilo borboleta. Todos foram avaliados no dinamômetro isocinético Cybex 6000. RESULTADOS: O tempo de aceleração na velocidade de 120º/ s do grupo flexor do tronco foi maior no GNS (p=0,054). A potência do grupo extensor nas velocidades de 90 e 120º/ segundo foi maior no GNA que no GNS (p=0,053 e 0,052) respectivamente. Não houve diferença estatística significante nas demais variáveis analisadas. CONCLUSÃO: Os nados assimétricos (crawl e costas) proporcionam uma resposta muscular (recrutamento) mais eficiente nos grupo dos flexores do tronco, possivelmente pela manutenção constante da contração isométrica dos músculos abdominais.

OBJECTIVE: To compare the effect of asymmetric and symmetric swimming strokes on muscle activity of the trunk flexor and extensor muscles. METHODS: Fourteen elite speed swimmers, specialists in one of four swimming styles, all without any history of spinal cord injury, were divided in two groups: 1) asymmetric group, consisting of five athletes specializing in the freestyle stroke and three in the backstroke; and 2) symmetric group, consisting of four athletes specializing in the butterfly stroke and three in the breaststroke. All the swimmers were assessed using a Cybex 6000 isokinetic dynamometer. RESULTS: The acceleration time for the trunk flexor group at a speed of 120º per second was greater in the symmetric group (p=0.054). The power of the extensor group at speeds of 90º and 120º per second were greater in the asymmetric than in symmetric group (p=0.053 and 0.052) respectively. There was no significant statistical difference for any of the other variables assessed. CONCLUSION: The asymmetric strokes (crawl and backstroke) provided a more efficient muscular response (recruitment) in the trunk flexor muscles, which may be due to the constant maintenance of isometric contraction of the abdominal muscles.

Avaliação isocinética em nadador amputado de membro superior: relato de caso / Isokinetic evaluation in a swimmer with upper limb amputation: a case study

A natação é um dos principais esportes de estudo, mas a natação em atletas com deficiência física abre um ramo de pesquisa. Objetivo: Analisar através da dinamometria isocinética os grupos musculares: abdutores e adutores, flexores e extensores de ombro de um nadador da elite brasileira com amputação do terço proximal do rádio. Métodos: Paciente do gênero masculino com 18 anos de idade, sendo, nove deles competindo. Foi avaliado clinicamente e através do questionário funcional DASH e pelo questionário EROE quanto à atividade esportiva. Na avaliação no dinamômetro isocinético Biodex System 3 com o protocolo de 5 repetições a 60º/segundo e 20 repetições a 180º e 240º/segundo quanto aos movimentos abdução/adução e flexão/extensão. Resultados: Nos questionários não se observou dor ou outra alteração da avaliação clínica. No questionário DASH, o atleta referiu dificuldade grau médio. Seu desempenho na escala EROE foi excelente. Na avaliação isocinética o atleta apresentou diferenças no lado amputado comparado em relação ao sadio. Conclusão: A avaliação isocinética é um bom parâmetro para estudo da força mesmo em nadadores com deficiência física, mostrando que estes atletas necessitam de um treinamento específico.

Swimming is one of the most popular sports studied, but swimming by athletes with physical disabilities suggests a new branch of research. Objective: To analyze muscle groups by isokinetic dynamometry: the adductor and abductor and the shoulder flexor and extensor of an elite Brazilian swimmer with an amputation at the level of the proximal third of the radius. Methods: The male patient was 18 years old, and had spent nine of those years competing. He was clinically evaluated via the functional DASH questionnaire and the EROE questionnaire on sports. The Biodex System 3 isokinetic dynamometer was used with the protocol of 5 repetitions at 60º / second, 20 repetitions at 180º and 240º / second as the movement of abduction / adduction and flexion / extension. Results: In the questionnaires there was no indication of pain or any other change in clinical evaluation. In the DASH questionnaire, the athlete reported a medium level of difficulty. His performance was excellent on the EROE scale. In isokinetic evaluation the athlete showed differences between the amputated side and the healthy side. Conclusion: Isokinetic evaluation is a good parameter to study the strength even in swimmers with physical disabilities, showing that these athletes need specific training.