Isotemporal Substitution of Sedentary Behavior by Different Physical Activity Intensities on Pain and Disability of Patients With Chronic Low Back Pain: A Cross-Sectional Study.

OBJECTIVE: To investigate the association of isotemporal substitution modeling (ISM) of time spent in sedentary activities with physical activity in different intensities on pain and disability of patients with chronic low back pain (LBP). DESIGN: Observational and cross-sectional study. Device-measured physical activity levels were assessed using an actigraph. Pain intensity was measured using the 11-point numeric rating scale, and disability was measured using the Roland Morris Disability Questionnaire. The ISM was used to estimate the theoretical substitution association of reallocating time from 1 exposure variable to an equal amount of time in another exposure variable while holding total activity time constant. SETTINGS: Outpatient physical therapy clinic. PARTICIPANTS: This study included data from 358 patients (N=358) with chronic LBP aged between 18 and 60 years. MAIN OUTCOME MEASURES: Pain and disability. RESULTS: Our results suggest that replacing 60 minutes of sedentary behavior with 60 minutes of vigorous activity in a week is significantly associated with a decrease in pain (ß=-1.67; 95% confidence interval [CI], -3.18 to -0.15). Additionally, replacing 60 minutes of light physical activity (ß=-1.67; 95% CI, -3.18 to -0.16) or moderate activity (ß=-1.67; 95% CI, -3.21 to -0.13) with the same amount of time of vigorous activity per week may also favorable reductions in pain. For the analysis of disability, no significant associations (P>.05) for disability in any of the isotemporal models were found. CONCLUSIONS: Our results showed that replacing 60 minutes of sedentary behavior with equal amounts of vigorous activity per week was associated with reductions in pain intensity. Similarly, replacing a light or moderate activities with vigorous activity was also associated with reductions in pain intensity. Finally, no significant associations were observed between time spent in sedentary activities with physical activity in different intensities for disability.

Analysis of Autonomic Modulation in Response to a Session of Aerobic Exercise at Different Intensities in Patients With Moderate and Severe COPD.

Despite the many benefits of performing physical exercise in patients with chronic obstructive pulmonary disease (COPD), information on the response of acute cardiac autonomic modulation in subjects with moderate and severe COPD during and after an aerobic exercise session at different intensities is unknown. The aim of this study was to evaluate the response of cardiac autonomic modulation in patients with moderate and severe COPD during and after an aerobic exercise session at different intensities. Twenty-seven patients with COPD, divided into: Moderate Group and Severe Group, underwent an aerobic exercise sessions with intensities equivalent to 60% and 90% of velocity corresponding to peak oxygen consumption. The heart rate variability (HRV) indices were analyzed in the time and frequency domains at the following times: at rest, during exercise, immediately after, and 5, 10, and 15 minutes after exercise. In the comparison analysis between the two groups, no differences were observed in any of the HRV indices at different intensities applied. However, it was observed that the exercise caused autonomic changes when the groups were analyzed separately. Sessions of aerobic exercise influence the autonomic modulation in patients with COPD. However, COPD severity did not influence the autonomic nervous system response to exercise and recovery moments; and there was no difference between the exercise intensities.

Reporting of confidence intervals, achievement of intended sample size, and adjustment for multiple primary outcomes in randomised trials of physical therapy interventions: an analysis of 100 representatively sampled trials.

BACKGROUND: The physical therapy profession has made efforts to increase the use of confidence intervals due to the valuable information they provide for clinical decision-making. Confidence intervals indicate the precision of the results and describe the strength and direction of a treatment effect measure. OBJECTIVES: To determine the prevalence of reporting of confidence intervals, achievement of intended sample size, and adjustment for multiple primary outcomes in randomised trials of physical therapy interventions. METHODS: We randomly selected 100 trials published in 2021 and indexed on the Physiotherapy Evidence Database. Two independent reviewers extracted the number of participants, any sample size calculation, and any adjustments for multiple primary outcomes. We extracted whether at least one between-group comparison was reported with a 95 % confidence interval and whether any confidence intervals were interpreted. RESULTS: The prevalence of use of confidence intervals was 47 % (95 % CI 38, 57). Only 6 % of trials (95 % CI: 3, 12) both reported and interpreted a confidence interval. Among the 100 trials, 59 (95 % CI: 49, 68) calculated and achieved the required sample size. Among the 100 trials, 19 % (95 % CI: 13, 28) had a problem with unadjusted multiplicity on the primary outcomes. CONCLUSIONS: Around half of trials of physical therapy interventions published in 2021 reported confidence intervals around between-group differences. This represents an increase of 5 % from five years earlier. Very few trials interpreted the confidence intervals. Most trials reported a sample size calculation, and among these most achieved that sample size. There is still a need to increase the use of adjustment for multiple comparisons.

Autonomic Function Recovery and Physical Activity Levels in Post-COVID-19 Young Adults after Immunization: An Observational Follow-Up Case-Control Study.

Coronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = -24.67--3.26; SNS index: p = 0.0068, CI = -2.50--0.32) and increase in parasympathetic (PNS) activity (mean RR: p = 0.0097, CI = 33.72-225.51; PNS index: p = 0.0091, CI = -0.20-1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.

Mild to moderate post-COVID-19 alters markers of lymphocyte activation, exhaustion, and immunometabolic responses that can be partially associated by physical activity level- an observational sub-analysis fit- COVID study.

Aim: This study aimed to evaluate if physical activity is associated with systemic and cellular immunometabolic responses, in young adults after mild-to-moderate COVID-19 infection. Methods: Mild- to- moderate post-COVID-19 patients (70.50 ± 43.10 days of diagnosis; age: 29.4 (21.9- 34.9) years; BMI: 25.5 ± 4.3 kg m2 n = 20) and healthy age-matched controls (age: 29.3 (21.2 - 32.6) years; BMI: 25.4 ± 4.7 kg m2; n = 20) were evaluated. Physical activity levels (PAL), body composition, dietary habits, muscular and pulmonary function, mental health, sleep quality, metabolic parameters, immune phenotypic characterization, stimulated whole blood and PBMC culture (cytokine production), mRNA, and mitochondrial respiration in PBMCs were evaluated. Results: The post-COVID-19 group exhibited lower levels of moderate to vigorous physical activity (MVPA) (p = 0.038); therefore, all study comparisons were performed with adjustment for MVPA. Post-COVID-19 impacted the pulmonary function (FEV1, FEV1%pred, FVC, and FVC %pred) compared with the control (p adjusted by MVPA (p adj) <0.05). Post-COVID-19 exhibited lower levels of serum IL-6 (p adj <0.01), whereas it showed higher serum IL-10, triglyceride, leptin, IgG, ACE activity, TNFRSF1A, and PGE2 (p adj <0.05) levels compared with controls. Post-COVID-19 presented a lower percentage of Treg cells (p adj = 0.03) and altered markers of lymphocyte activation and exhaustion (lower CD28 expression in CD8+ T cells (p adj = 0.014), whereas CD4+T cells showed higher PD1 expression (p adj = 0.037)) compared with the control group. Finally, post- COVID-19 presented an increased LPS-stimulated whole- blood IL-10 concentration (p adj <0.01). When exploring mitochondrial respiration and gene expression in PBMCs, we observed a higher LEAK state value (p adj <0.01), lower OXPHOS activity (complex I) (p adj = 0.04), and expression of the Rev-Erb-α clock mRNA after LPS stimulation in the post-COVID-19 patients than in the control (p adj <0.01). Mainly, PAL was associated with changes in IL-10, triglyceride, and leptin levels in the plasma of post-COVID-19 patients. PAL was also associated with modulation of the peripheral frequency of Treg cells and the expression of PD-1 in CD8+ T cells, although it abrogated the statistical effect in the analysis of TNF-α and IL-6 production by LPS- and PMA-stimulated PBMC of post-COVID-19 patients. Conclusion: Young adults after mild-to-moderate SARS-CoV-2 infection appeared to have lower physical activity levels, which can be associated with clinical and immunometabolic responses in a complex manner.

Resistance training using different elastic components offers similar gains on muscle strength to weight machine equipment in Individuals with COPD: A randomized controlled trial.

Purpose: To compare the effects of three modalities of resistance training, two using elastic components and one using conventional weight machine on peripheral muscle strength in Individuals with chronic obstructive pulmonary disease (COPD). Effects on exercise capacity, impact of disease on health status, body composition and daily level of physical activity were investigated as secondary endpoints.Methods: Forty-eight participants were randomly allocated (Trials Registry #RBR-6V9SJJ) into Elastic band group (Theraband®) (EBG), Elastic tubes training using Lemgruber® (ETG), and Conventional training with weight machine equipment (CG). Participants were evaluated before and after 12 weeks of training regarding peripheral muscle strength by dynamometry; impact of disease on health status via COPD Assessment Test, CAT; exercise capacity by 6-min walk test, 6MWT; body composition by bioelectrical impedance; and daily level of physical activities via accelerometry.Results: Inter-group comparison of training effects did not elucidate significant differences between the modalities in muscle strength (p ≥ .2). Likewise, all training modalities showed similar effects on CAT, body composition and daily physical activity variables with no statistical significance observed (p ≥ .15).Conclusions: Modalities of resistance training using elastic components presented similar effects on muscle strength, health status, exercise capacity, body composition and daily level of physical activity in individuals with COPD. The effects of elastic resistance were similar to conventional resistance training.

Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study.

The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p < 0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p < 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p < 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight/obesity and physical activity levels.

Body image in COPD and its relation with physical activity levels, lung function and body composition: An observational study.

INTRODUCTION: Body image has been previously defined as the mental figure we have of the contours and shape of our body; and the feelings concerning these characteristics. A change in body perception can influence one's feelings of self-worth and compromise functional abilities. Thus, the detection of distortions in body image could be important data for clinical evaluation of subjects with COPD. OBJECTIVES: To assess the body image perception of subjects with COPD. Also, to investigate the association between body image and levels of physical activity in these subjects. MATERIALS AND METHODS: 109 subjects were recruited and divided into the COPD group and control subjects without any pulmonary conditions. For this cross-sectional study, we performed an initial evaluation and participants were evaluated regarding physical activity level, body image (silhouette scale) and determination of body mass index (BMI). Finally, we performed the evaluation of lung function (spirometry) and body composition analysis (bioelectrical impedance). RESULTS: BothCOPD and control subjects presented alterations in body image. Both groups desired significantly lower BMI and weight measures, according to the silhouette scale, demonstrating body dissatisfaction (P < .05). No differences in the level body dissatisfaction were found between Control and COPD groups (P > .05). No associations between physical activity levels and body image were observed (P > .05; r = -0.24 to 0.14). CONCLUSION: In conclusion, patients with COPD present significant body dissatisfaction, similar to control individuals. Furthermore, body image perception in COPD is related to body composition measurements but not to physical activity levels.

Analysis of the heart rate deflection point as a tool for exercise prescription in subjects with COPD - a cross-sectional study.

Background: Prescription of exercise training in subjects with chronic obstructive pulmonary disease (COPD) remains a challenge in clinical practice. The heart rate deflection point (HRDP) is an option to reduce costs, reflects the anaerobic threshold and it is noninvasive; however its applicability in COPD is still unknown. Aim: To compare HRDP with gas exchange threshold values (GET) in subjects with COPD. Methods: Thirty-one subjects were evaluated in this cross-sectional study, diagnosed with COPD. The subjects performed an incremental exercise test on a treadmill to determine the GET, peak oxygen consumption (VO2PEAK), speed corresponding to VO2PEAK (sVO2PEAK), and peak values of heart rate (HRPEAK). To determine HRDP the heart rate values observed were plotted as a function of intensity. Results: The HRDP was visible in 96.77% of subjects. There was no difference between HRDP and GET (p = 0.07) and a moderate intraclass correlation coefficient (ICC): 0.74 [0.52-0.87] and high limits of agreements were presented (±1.1 km·h-1). Conclusion: The HRDP cannot be used to determine the limits between the physiological domains of these subjects. Thus, although significant correlation was found between HRDP and GET, their application for training prescription and monitoring in subjects with COPD proved to be limited.

Use of 95% confidence intervals in the reporting of between-group differences in randomized controlled trials: analysis of a representative sample of 200 physical therapy trials.

OBJECTIVES: To assess the prevalence of the use of 95% confidence intervals in the reporting of between-group differences in randomized controlled trials of physical therapy interventions and to determine if the prevalence is changing over time. METHODS: Observational study, including an analysis of 200 trials from the Physiotherapy Evidence Database: 50 from each of the years 1986, 1996, 2006, and 2016. The primary outcome used was the prevalence of the between-group difference presented with 95% confidence intervals. We also extracted trial characteristics for descriptive purposes (i.e., number of participants, number of sites involved in recruitment, country(ies) of data collection, funding, subdiscipline of physical therapy, publication language and total Physiotherapy Evidence Database score). RESULTS: Most commonly, the trials were published in English (89%) and classified in the musculoskeletal subdiscipline (23%). The overall prevalence of use of confidence intervals was 29% and there was a consistent increase in reporting between 1986 and 2016, with peak usage in the 2016 cohort (42%). Confidence intervals were more likely to be used in trials that had received funding, were conducted in Europe and Oceania, and in trials with a Physiotherapy Evidence Database score of at least 6/10. CONCLUSIONS: Most trials of physical therapy interventions do not report confidence intervals around between-group differences. However, use of confidence intervals is increasing steadily, especially among high-quality trials. Physical therapists must understand confidence intervals so that they can understand a growing number of trials in physical therapy.

Burnt sugarcane harvesting is associated with rhinitis symptoms and inflammatory markers.

INTRODUCTION: Burnt sugarcane harvesting requires intense physical exertion in an environment of high temperature and exposure to particulate matter. OBJECTIVE: To evaluate the effects of burnt sugarcane harvesting on rhinitis symptoms and inflammatory markers in sugarcane workers. METHODS: A total of 32 male sugarcane workers were evaluated with questionnaire for rhinitis symptoms, and for inflammatory markers on peripheral blood and nasal lavage, in the non-harvesting, and 3 and 6 months into the sugarcane harvesting period. Weather data and particulate matter fine concentrations were measured in the same day. RESULTS: The particulate matter concentrations in sugarcane harvesting were 27 (23-33µg/m3), 112 (96-122µg/m3), and 63 (17-263µg/m3); 24h temperatures were 32.6 (25.4-37.4°C), 32.3 (26.7-36.7°C) and 29.7 (24.1-34.0°C) and relative humidities were 45.4 (35.0-59.7%), 47.9 (39.1-63.0%), and 59.9 (34.7-63.2%) in the non-harvesting period, three and 6 months of the harvesting period. The age was 37.4±10.9 years. The prevalence of rhinitis symptoms was significantly higher at 3 months of the harvesting period (53.4%), compared to non-harvesting period (26.7%; p=0.039) and at 6 months into the harvesting period (20%; p=0.006). Concentrations of interleukin 6 (IL-6) in nasal lavage increased after 3 months of the harvesting period compared to the non-harvesting period (p=0.012). The presence of rhinitis symptoms, after 3 months of the harvesting period, was directly associated with blood eosinophils and inversely associated with neutrophils. CONCLUSIONS: After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.

Elastic resistance training improved glycemic homeostasis, strength, and functionality in sarcopenic older adults: a pilot study.

The purpose of this study was to verify the effects of 12 weeks of elastic resistance training on the glucose homeostasis, strength and functionally in sarcopenic older adults. Seven sarcopenic subjects (age, 70.71± 8.0 years; body mass index, 22.75±3.1 kg/m2) participated of training protocol with 12 weeks of elastic resistance training. The oral glucose tolerance test, handgrip strength, sit-to-stand test, 4-m walk test, and coordination test were measured at baseline and after training. According to the results, baseline values of area under the curve of glucose and homeostatic model assessment-insulin resistance were significantly lower than after 12 weeks, respectively (808.2±185.0 mmol/L vs. 706.6±114.8 mmol/L, P=0.049; 1.44±0.48 vs. 0.73±0.32, P=0.040). There were a significant improve of HGS (24.3±5.7 kg vs. 27.3±7.3 kg, P=0.01), 4-m walking test (3.64±0.4 sec vs. 3.23±0.3 sec, P=0.04), and STS (10.2±2.3 sec vs. 9.0±1.9 sec, P=0.04) compared with baseline. In conclusion, these findings suggest that elastic resistance training improved glucose homeostasis, strength, and functionality in sarcopenic older adults.

Critical Velocity Determined by a Non-Exhaustive Method in Subjects With COPD.

BACKGROUND: Exercise training is an effective and low-cost tool for COPD rehabilitation. Thus, validating a non-exhaustive method to determine a patient's anaerobic threshold would be a very interesting tool in practical settings. We aimed to test the reproducibility of critical velocity values determined in a non-exhaustive manner (CVNE) and tolerance for exercise performed at this physiological marker in subjects with COPD. METHODS: Twelve subjects with COPD were evaluated in this cross-sectional study. The study was divided into 2 phases: Phase A consisted of reproducibility of CVNE for subjects with COPD, and Phase B determined the tolerance for exercise tests performed at this physiological marker. RESULTS: The proposed protocol for determining CVNE presented fair reproducibility according to blood lactate concentrations (intraclass correlation coefficient = 0.58). However, we cannot consider that the tests were reproducible due to the wide CI (0.03-0.85). Furthermore, moderate and strong correlations were observed between the CVNE determined by lactate concentration, by oxygen consumption (V̇O2 ) (r = 0.66), and by heart rate (r = 0.88). However, a high limit of agreement was observed ±1.45 km/h and ±1.55 km/h, respectively. In the tolerance for exercise test, none of the subjects presented lactate destabilization, whereas 3 tests were interrupted by oxygen saturation decline and 1 test was interrupted by hemodynamic instability. CONCLUSIONS: Although most of the subjects presented good tolerance for exercise at CVNE, fair levels of reproducibility were observed in subjects with COPD, even using lactate. Thus, the use of CVNE determined through double 3-min efforts should be considered with caution.

The quality of clinical practice guidelines for chronic respiratory diseases and the reliability of the AGREE II: an observational study.

OBJECTIVES: To survey the quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy practice using the Appraisal of Guidelines for Research and Evaluation version II instrument (AGREE II) and to evaluate the inter-rater reliability of AGREE II. DESIGN: Observational survey. PROCEDURES: Guidelines indexed in the Physiotherapy Evidence Database (PEDro) on chronic respiratory diseases were evaluated by four assessors using AGREE II. MAIN OUTCOME MEASURES: The six domains and two global items of AGREE II. RESULTS: Thirty-three guidelines were evaluated (58% were published in the last 5 years and 36% were for chronic obstructive pulmonary disease). The domains with the highest scores were scope and purpose (79%, SD 10%) and clarity of presentation (79%, SD 10%). The domain with the lowest score was applicability (37%, SD 23%). Mean overall quality was five out of seven (SD 1). Intraclass correlation coefficients ranged from 0.66 to 0.93 for the six domains and first global item, suggesting good to excellent reliability. The second global item had very poor reliability (Kappa 0.097). CONCLUSION: The quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy could be improved, particularly in consideration with applicability. The number of assessors for AGREE II could be reduced because of the good inter-rater reliability.

Comparação da resposta hemodinâmica entre terapia convencional e realidade virtual em pacientes com insuficiência cardíaca internados na unidade de emergência / Comparación de la respuesta hemodinámica entre la terapia convencional y la realidad virtual en pacientes con insuficiencia cardiaca ingresados en urgencias / Comparison of hemodynamic responses between conventional and virtual reality therapies in patients with heart failure admitted to an emergency room

RESUMO O objetivo deste estudo foi avaliar e comparar a resposta aguda de parâmetros hemodinâmicos de acordo com o uso de realidade virtual (RV) semi-imersiva e terapia convencional (TC) em indivíduos internados no serviço hospitalar de emergência por insuficiência cardíaca (IC). Trata-se de estudo de viabilidade com 11 indivíduos submetidos a sessões de terapia com e sem o uso da RV. Na TC, os participantes realizaram alongamentos, exercícios ativos ou ativo-assistidos e inspiração fracionada. Já na terapia com realidade virtual (TRV) utilizou-se os óculos VR box - virtual reality glasses aplicando VR relax associado à TC. Os parâmetros hemodinâmicos avaliados foram: frequência cardíaca, pressão arterial sistólica e diastólica e saturação de oxigênio. Para análise, foram utilizados os testes t de Student e de Mann-Whitney (p<0,05). Ao avaliar os parâmetros hemodinâmicos basal e final em ambos os grupos, não foi verificada diferença significativa entre os momentos (p>0,05). Com relação à comparação das variações absolutas entre a TC e a TRV, não foi observada diferença significativa entre as respostas hemodinâmicas (p>0,05). Os resultados demonstraram que a implementação da TRV e da TC promoveram alterações fisiológicas nas respostas dos parâmetros hemodinâmicos em indivíduos com IC hospitalizados em uma unidade de emergência, não havendo diferenças significativas entre as duas intervenções. O estudo sugere que a RV é um método hemodinamicamente seguro para aplicação em unidade de emergência.

RESUMEN El objetivo de este estudio fue evaluar y comparar la respuesta aguda de los parámetros hemodinámicos según el uso de realidad virtual (RV) semiinmersiva y terapia convencional (TC) en individuos ingresados por insuficiencia cardiaca (IC) en el servicio de urgencias de un hospital. Este es un estudio de factibilidad con la participación de 11 personas, quienes se sometieron a sesiones de terapia con el uso de RV y sin este. En la TC, los participantes realizaron estiramientos, ejercicios activos o activos-asistidos e inspiración fraccionada. En la terapia de realidad virtual (TRV), utilizaron gafas VR box virtual reality glasses aplicando realidad virtual VR relax asociada a la TC. Los parámetros hemodinámicos que se evaluaron fueron los siguientes: frecuencia cardiaca, presión arterial sistólica y diastólica, y saturación de oxígeno. El análisis de datos utilizó las pruebas t de Student y de Mann-Whitney (p<0,05). Al evaluar los parámetros hemodinámicos basales y finales en ambos grupos, se observó que no hubo diferencia significativa entre los momentos (p>0,05). En cuanto a la comparación de las variaciones absolutas entre TC y TRV, no se observó diferencia significativa entre las respuestas hemodinámicas (p>0,05). Los resultados mostraron que la implementación de la TRV y la TC posibilitó cambios fisiológicos en las respuestas de los parámetros hemodinámicos en individuos con IC hospitalizados en una unidad de urgencias, sin diferencias significativas entre las dos intervenciones. El estudio apunta que la RV es un método hemodinámico seguro para aplicarse en la unidad de urgencias.

ABSTRACT This study aimed to evaluate and to compare the acute response, due to semi-immersive virtual reality (VR) and conventional therapies (CT), of hemodynamic parameters in hospitalized individuals admitted to an emergency unity for heart failure (HF). This is a viability study with 11 individuals subjected to sessions with and without VR. At CT, stretching, active or active-assisted exercises, and fractional inspiration were performed. In VR therapy (VRT), VR box glasses were used to promote VR relaxation associated with CT. The hemodynamic parameters evaluated were heart rate, systolic and diastolic blood pressure, oxygen saturation, and double product. To analyze them, Student's t- and Mann Whitney tests were used (p<0.05). Comparing baseline and final evaluations showed no significant differences in the hemodynamic parameters of both groups (p>0.05). Comparing absolute variations between CT and VRT also produced no significant differences between hemodynamic responses (p>0.05). Results showed that administering VRT and CT promoted physiological changes in the responses of hemodynamic parameters in individuals with HF hospitalized in an emergency unit without significant differences between the two interventions. This study suggests that VRT is a hemodynamically safe method for treating patients in emergency units.

Effects of Growth Hormone on Cardiac Remodeling During Resistance Training in Rats.

BACKGROUND: Although the beneficial effects of resistance training (RT) on the cardiovascular system are well established, few studies have investigated the effects of the chronic growth hormone (GH) administration on cardiac remodeling during an RT program. OBJECTIVE: To evaluate the effects of GH on the morphological features of cardiac remodeling and Ca2+ transport gene expression in rats submitted to RT. METHODS: Male Wistar rats were divided into 4 groups (n = 7 per group): control (CT), GH, RT and RT with GH (RTGH). The dose of GH was 0.2 IU/kg every other day for 30 days. The RT model used was the vertical jump in water (4 sets of 10 jumps, 3 bouts/wk) for 30 consecutive days. After the experimental period, the following variables were analyzed: final body weight (FBW), left ventricular weight (LVW), LVW/FBW ratio, cardiomyocyte cross-sectional area (CSA), collagen fraction, creatine kinase muscle-brain fraction (CK-MB) and gene expressions of SERCA2a, phospholamban (PLB) and ryanodine (RyR). RESULTS: There was no significant (p > 0.05) difference among groups for FBW, LVW, LVW/FBW ratio, cardiomyocyte CSA, and SERCA2a, PLB and RyR gene expressions. The RT group showed a significant (p < 0.05) increase in collagen fraction compared to the other groups. Additionally, the trained groups (RT and RTGH) had greater CK-MB levels compared to the untrained groups (CT and GH). CONCLUSION: GH may attenuate the negative effects of RT on cardiac remodeling by counteracting the increased collagen synthesis, without affecting the gene expression that regulates cardiac Ca2+ transport.

Influence of Smoking Consumption and Nicotine Dependence Degree in Cardiac Autonomic Modulation.

BACKGROUND: Smoking consumption alters cardiac autonomic function. OBJECTIVE: Assess the influence of the intensity of smoking and the nicotine dependence degree in cardiac autonomic modulation evaluated through index of heart rate variability (HRV). METHODS: 83 smokers, of both genders, between 50 and 70 years of age and with normal lung function were divided according to the intensity of smoking consumption (moderate and severe) and the nicotine dependency degree (mild, moderate and severe). The indexes of HRV were analyzed in rest condition, in linear methods in the time domain (TD), the frequency domain (FD) and through the Poincaré plot. For the comparison of smoking consumption, unpaired t test or Mann-Whitney was employed. For the analysis between the nicotine dependency degrees, we used the One-way ANOVA test, followed by Tukey's post test or Kruskal-Wallis followed by Dunn's test. The significance level was p < 0,05. RESULTS: Differences were only found when compared to the different intensities of smoking consumption in the indexes in the FD. LFun (62.89 ± 15.24 vs 75.45 ± 10.28), which corresponds to low frequency spectrum component in normalized units; HFun (37.11 ± 15.24 vs 24.55 ± 10.28), which corresponds to high frequency spectrum component in normalized units and in the LF/HF ratio (2.21 ± 1.47 vs 4.07 ± 2.94). However, in the evaluation of nicotine dependency, significant differences were not observed (p > 0.05). CONCLUSION: Only the intensity of smoking consumption had an influence over the cardiac autonomic modulation of the assessed tobacco smokers. Tobacco smokers with severe intensity of smoking consumption presented a lower autonomic modulation than those with moderate intensity.

Short-Term Effects of a Resistance Training Program Using Elastic Tubing in Patients with Heart Disease

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)