Effectiveness of a resistance exercise program for lower limbs in chronic renal patients on hemodialysis: A randomized controlled trial.

INTRODUCTION: Physical inactivity in hemodialysis patients is associated with increased mortality. The objective of this study was evaluated the effect of an intradialytic resistance exercise program on chronic kidney disease (CKD) patients on hemodialysis. METHODS: One hundred seven patients were included in the study. They were aged 18-60 years, of both sexes, had undergone hemodialysis treatment for at least 1 year, sedentary. Patients were randomly divided into two groups: stretching (STG) and resistance exercise (REG). Intervention programs were performed for 8 weeks, three times a week. The evaluations were performed before and after the training programs. The primary outcome was functional capacity using the 6-minute walk test (6MWT). Secondary outcomes were peripheral muscle strength, respiratory muscle strength, spirometric respiratory function, and laboratory data. FINDINGS: Comparisons between groups revealed the following clinically relevant results in favor of REG: lower limb muscle strength (mean difference [MD] = -1.99, 95% confidence interval [CI] = -2.77 to -1.21; d = -0.53), distance walked in the 6MWT (MD = -26.27, 95% CI = -45.40 to -7.14; d = -0.46), creatinine (MD = -1.52, 95% CI = -2.49 to -0.54; d = -0.66), and calcium (MD = -0.44, 95% CI = -0.78 to -0.10; d = -0.49). DISCUSSION: CKD patients on hemodialysis have reduced functional capacity compared to healthy sedentary individuals. In turn, this reduction appears to be associated with a lower survival rate and affects the performance of their daily living activities. Thus, resistance exercise performed in the intradialytic phase is an effective therapeutic strategy for CKD patients, mainly because it increases functional capacity and lower limb muscle strength.

Inspiratory muscle training improves autonomic modulation and exercise tolerance in chronic obstructive pulmonary disease subjects: A randomized-controlled trial.

OBJECTIVES: We aimed to evaluate the effect a regular inspiratory muscle training program on autonomic modulation measured by heart rate variability, exercise capacity and respiratory function in chronic obstructive pulmonary disease subjects (COPD). DESIGN: Single-center controlled study, with balanced randomization (1:1 for two arms). SETTING: A COPD reference hospital localized in Sao Luís, Brazil. PARTICIPANTS: 22 COPD subjects joined the study. INTERVENTIONS: Three times a week for four weeks inspiratory muscle training (IMT) at 30% of PImax. MAIN OUTCOME MEASURES: Pulmonary capacities and inspiratory pressure, total six-minute walk test and, cardiac autonomic modulation. RESULTS: The intervention group showed improvements in the cardiac autonomic modulation, with increased vagal modulation (total variability and HF [ms2; adjusted p < 0.05]); increased expiratory and inspiratory capacities and, increased distance in the 6-min walk test. CONCLUSION: 12 weeks of IMT at 30% of the maximal inspiratory pressure increased cardiac autonomic modulation, expiratory and inspiratory and exercise capacity in COPD subjects.

Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly.

The association of old age and chronic conditions, such as hypertension and obesity, can lead to larger decreases in the physical capacities of elderly, compared with their healthy counterparts. Physical exercise has been demonstrated to be efficient in postponing this phenomenon, mainly strength training. However, little is known about the effect of aerobic training on this condition. The aim of this work was to investigate the impact of 12 weeks of moderate-intensity aerobic training on the physical capacities of hypertensive obese older women. Aerobic power, lower limb muscle power, upper limb muscle strength, endurance, and flexibility of 19 hypertensive obese elders were evaluated. Afterward, patients were blindly randomized into control group (CG) and exercise group (EG). EG underwent three sessions/week of 60 min of moderate-intensity aerobic training, during 12 weeks. EG showed increases in VO2max compared with CG (p = .03) and increases in flexibility compared with basal moment (+21.6%; p = .01) after 12 weeks, whereas CG did not show any significant alterations. Moderate aerobic training is capable of inducing increases in maximal aerobic power and flexibility in hypertensive obese elderly. However, other essential physical capacities associated with independence in elderly people (i.e., muscle power and strength) were not responsive to this kind of protocol.

Involvement of peripheral TRPV1 in TMJ hyperalgesia induced by ethanol withdrawal.

Ethanol withdrawal increases nociception after the injection of formalin into the rat's temporomandibular joint (TMJ). Little is known about the neurological basis for hyperalgesia induced by ethanol withdrawal, but it has been reported that ethanol can potentiate the response of transient receptor potential vanilloid receptor-1 (TRPV1) in superficial tissues. The present study was designed to test the hypothesis that peripheral TRPV1 could be involved on nociceptive behavioral responses induced by the injection of formalin into the TMJ region of rats exposed to chronic ethanol administration and ethanol withdrawal. Behavioral hyperalgesia was verified 12 h after ethanol withdrawal in rats that drank an ethanol solution (6.5%) for 10 days. In another group submitted to the same ethanol regimen, the selective vanilloid receptor antagonist capsazepine (300, 600 or 1200 microg/25 microl) or an equal volume of vehicle were injected into the TMJ regions 30 min before the TMJ formalin test. The local injections of capsazepine reduced the increased nociceptive responses induced by ethanol withdrawal. The effect of capsazepine on rats that did not drink ethanol was not significant. These results indicate that the peripheral TRPV1 can contribute to the hyperalgesia induced by ethanol withdrawal on deep pain conditions.

Resistance training associated with the administration of anabolic-androgenic steroids improves insulin sensitivity in ovariectomized rats.

The aim of the present study was to investigate the effects of anabolic-androgenic steroids and resistance training (RT) on insulin sensitivity in ovariectomized rats. Adult female Wistar rats were divided into ten experimental groups (n = 5 animals per group): (1) sedentary (Sed-Intact); (2) sedentary ovariectomized (Sed-Ovx); (3) sedentary nandrolone (Sed-Intact-ND); (4) sedentary ovariectomized plus nandrolone (Sed-Ovx-ND); (5) trained (TR-Intact); (6) trained nandrolone (TR-Intact-ND); (7) trained ovariectomized (TR-Ovx); (8) trained ovariectomized plus nandrolone; (9) trained sham; and (10) trained ovariectomized plus sham. Four sessions of RT were used, during which the animals climbed a 1.1 m vertical ladder with weights attached to their tails. The sessions were performed once every 3 days, with between four and nine climbs and with eight to twelve dynamic movements per climb. To test the sensitivity of insulin in the pancreas, glucose and insulin tolerance tests were performed. For insulin sensitivity, there was a statistically significant interaction for the TR-Ovx group, which presented higher sensitivity than the Sed-Intact, Sed-Ovx, and TR-Intact groups. Sed-Intact-ND and TR-Intact-ND groups exhibited higher values of insulin sensitivity than the Sed-Intact group. Except for the TR-Intact group, sensitivity was greater in trained groups than in the Sed-Intact group. There was higher insulin sensitivity in the TR-Intact-ND group than in the Sed-Intact and Sed-Intact-ND groups (P < 0.05). In conclusion, ovariectomy and short-term RT alone induced no change on insulin action. Administration of nandrolone decanoate improved insulin action, mainly when it was associated with RT.

Variáveis objetivas e subjetivas para monitoramento de diferentes ciclos de temporada em jogadores de basquete / Objective and subjective variables for monitoring of different season cycles in basketball players

O presente estudo teve o objetivo de avaliar, comparar e relacionar carga e cansaço causado por treinamento durante um ciclo de periodização em jogadores de basquete. Oito atletas profissionais masculinos com idade de 21,9 ± 3,4 anos, todos participantes do Campeonato Paulista de Basquete, divisão especial, foram sujeitos deste estudo. O macrociclo analisado incluiu 19 semanas divididas nos seguintes períodos: preparatório, competitivo I e competitivo II (tendo 4,6 e nove semanas, respectivamente). Os autores avaliaram os atletas diariamente quanto à percepção subjetiva de cansaço e carga de treinamento e monitoraram a potência de membro superior dos atletas através da quantificação de sua capacidade de lançar uma bola medicinal. Os atletas apresentaram menos fadiga (p < 0,005) no período preparatório (13,71 ± 1,30) em comparação com os períodos competitivo I (14,68 ± 1,51) e competitivo II (14,63 ± 1,22). Sua habilidade de lançar a bola medicinal diminuiu (p < 0,005) no período competitivo II (3,59 ± 0,30) em comparação com os períodos preparatório (3,80 ± 0,36) e competitivo I (3,86 ± 0,26). Sua monotonia diminuiu (p < 0,001) no período competitivo II (1,18 ± 0,43) em comparação com o preparatório (2,50 ± 2,01) e competitivo I (2,10 ± 1,61). Os resultados revelaram a efetividade na monitoração da carga e cansaço dos atletas através do método proposto para auxiliar na organização do treinamento durante um macrociclo.

The present study aimed to evaluate, compare and relate load and training tiredness during a periodization cycle in basketball players. Eight professional male athletes aged 21.9 ± 3.4 years, all of whom participated in the São Paulo basketball championship, special division, took part in this study. The macrocycle analyzed encompassed 19 weeks divided into the following periods: Preparatory, Competitive I, and Competitive II (having 4, 6, and 9 weeks, respectively). The authors daily evaluated the athletes on subjective perception of tiredness and training load and monitored the athletes' upper limb power by quantifying their ability to throw a medicine ball. Athletes presented less fatigue (p <0.005) in the Preparatory period (13.71 ± 1.30) compared with the Competitive I (14.68 ± 1.51) and Competitive II (14.63 ± 1.22) periods. Their ability to throw the medicine ball decreased (p <0.005) in the Competitive period II (3.59 ± 0.30) compared with the Preparatory (3.80 ± 0.36) and Competitive I (3.86 ± 0.26) periods. Their monotony decreased (p <0.001) in the Competitive period II (1.18 ± 0.43) compared with the Preparatory (2.50 ± 2.01) and Competitive I (2.10 ± 1.61) periods. The results revealed the effectiveness of monitoring load and tiredness of athletes by means of the proposed method to assist in training organization during a macrocycle.

Avaliação da potência anaeróbia e sua aplicabilidade no treinamento de atletas de basquetebol / Assessment of power anaerobia and its application in the athletes training of basketball

O basquetebol se caracteriza pela alternância de períodos de atividades de curta duração e alta intensidade intercalada com momentos de recuperação. Quanto ao metabolismo parece que em desportos coletivos o anaeróbio é considerado predominante, porém seu grau de solicitação depende da distribuição das ações realizadas ao longo da partida. Nesse sentido, o objetivo da presente pesquisa foi avaliar a efetividade de um teste de potência anaeróbia em atletas de basquetebol. Para isso, foram avaliadas 10 atletas do sexo feminino (23±2,7 anos; 1,76±0,08 m; 72,3±11,8 kg), pelo protocolo de Forward-Backward. As seis repetições do teste apresentadas em tempo e potência, foram comparadas pelo AnovaOne Way seguido do post hoc de Tukey (p<0,05). As atletas apresentaram uma tendência de diminuição do desempenho ao longo das seis repetições, sendo a quinta e sexta repetições menores estatisticamente comparadas com a primeira e segunda, tanto em forma de tempo (segundos) quanto de potência (watts). Desta forma, conclui-se que o protocolo de avaliação utilizado expressa a atividade anaeróbia intermitente e atende as especificidades do jogo de basquetebol.

Basketball is characterized by alternating periods of activities of short duration and high intensity interspersed with moments of recovery. Regarding metabolism seems that the anaerobic incollective sports is considered predominant, but their degree of application depends on the distribution ofactions taken during the game. In this sense, the objective of this study was to evaluate the effectiveness of a test of anaerobic power in basketball players. Thus, we evaluated 10 female athletes (23 ± 2.7 years, 1.76 ± 0.08 m, 72.3 ± 11.8 kg), the protocol of Forward-Backward. The six repetitions of the test delivered on time and power, were compared by One Way Anova followed by post hoc Tukey (p <0.05). The athletes showed a trend of decreasing performance over the six replicates, and the fifth and sixth repetitionsstatistically lower compared with the first and second both in the form of time (seconds) and power (watts). Thus, we conclude that the evaluation protocol used to express intermittent anaerobic activity and meets the specifics of the game of basketball.

Respostas hormonais, imunológicas e enzimáticas agudas a uma partida de basquetebol / Acute hormonal, immunological and enzymatic responses to a basketball game

O objetivo do estudo foi analisar as respostas hormonais, imunológicas e enzimáticas agudas a uma partida de basquetebol em jogadores profissionais desta modalidade. A amostra foi composta de oito atletas de basquetebol, praticantes a pelo menos quatro anos. Foi realizada uma partida de duração total de 40 minutos com simulação real, sendo dividida por dois tempos de 20 minutos e um intervalo de 10 minutos entre os tempos. As amostras sanguíneas foram colhidas antes e imediatamente após a partida (20 ml pelo sistema de tubos a vácuo). As variáveis analisadas foram: hormônios testosterona e cortisol, leucócitos totais, neutrófilos, linfócitos, monócitos e as enzimas creatina kinase (CK) e lactato desidrogenase (LDH). Para análise estatística, foi utilizada estatística descritiva e Teste t de Student pareado com p≤0,05. A concentração pré (13,34 nmol/L e 301,97 nmol/L) e pós (17,34 nmol/L e 395,91 nmol/L) de testosterona e cortisol foram estatisticamente diferentes, com maiores valores após o jogo para ambos os hormônios respectivamente. A contagem das células imunes apresentou diferença significante nos leucócitos totais (6393,75 nmol/L e 9158,75 nmol/L) e neutrófilos (3532,5 nmol/L e 6392,62 nmol/L) com maiores valores após a partida. As variáveis enzimáticas analisadas não apresentaram diferenças significativas. Portanto, dos marcadores analisados, testosterona e cortisol mostraram aumento acentuado após a partida, o mesmo comportamento foi verificado para os leucócitos totais e neutrófilos.

The objective of the present study was to analyze the acute hormonal, immunological and enzymatic responses of professional basketball players to a basketball game. The sample was composed of eight basketball athletes, with a minimum of 4 years’ experience in basketball. A real game was simulated with a total duration of 40 minutes, divided into two halves of 20 minutes each and an interval of 10 minutes between halves. Blood samples were collected before and immediately after the game (20 ml, vacuum tube system). The variables analyzed were: testosterone and cortisol hormones, total leukocytes, neutrophils, lymphocytes, monocytes and the enzymes creatine kinase (CK) and lactate dehydrogenase (LDH). Statistical analysis was with descriptive statistics and the Student’s t test for paired samples to p≤0.05. The pre (13.34 nmol/L and 301.97 nmol/L) and post game (17.34 nmol/L and 395.91 nmol/L) levels of testosterone and cortisol were statistically different, with higher levels after the game for both hormones. The immune cell counts exhibited significant differences for total leukocytes (6393.75 nmol/L and 9158.75 nmol/L) and neutrophils (3532.5 nmol/L and 6392.62 nmol/L), with levels being higher after the game. No statistical differences were observed for the enzymatic variables. Therefore, based on the markers analyzed, testosterone and cortisol exhibited pronounced increases after the game and the same behavior was observed for total leukocytes and neutrophils.

Características antropométricas de jovens nadadores brasileiros do sexo masculino e feminino em diferentes categorias competitivas / Anthropometric characteristics of brazilian young swimmers in different competitive categories

O objetivo deste estudo foi verificar o perfil e as diferenças nas características antropométricas de jovens nadadores brasileiros, de distintas categorias, em ambos os gêneros. Foram avaliados 90 nadadores do sexo masculino e 70 do sexo feminino das categorias Infantil (12-13 anos), juvenil (14-15 anos) e junior (16-18 anos). As variáveis antropométricas mensuradas foram: massa corporal (Kg), estatura (m), IMC (Kg/m2), massa magra (kg), massa gorda (kg) e envergadura (m). O percentual de gordura (%G) foi obtido através da equação de Lohman. Na estatística, foi utilizado o teste Anova two way seguido de post hoc Tukey, com p<0,05. No gênero masculino, a categoria junior apresentou maior massa corporal, estatura, envergadura e massa magra em relação aos grupos infantil e juvenil. Para o gênero feminino, a massa corporal foi superior na categoria junior comparada à infantil e a juvenil. Foram observadas estatura, envergadura, massa magra e massa gorda maiores na categoria junior, quando comparadas à infantil. No sexo feminino, a categoria juvenil apresentou maior massa corporal e massa magra em relação ao grupo infantil. Na categoria infantil, os meninos apresentaram maior massa corporal e massa magra em relação às meninas. Na categoria juvenil, o masculino teve maior massa corporal, estatura, envergadura e massa magra em relação ao feminino, que teve maior %G. Na categoria junior, os meninos apresentaram maior massa corporal, estatura, envergadura e massa magra em relação às meninas, que apresentaram maior %G. Conclui-se que, existem diferenças nas variáveis antropométricas entre as categorias, em ambos os gêneros, entretanto, para o grupo feminino as diferenças antropométricas entre as categorias infantil e juvenil são menos evidentes, provavelmente, devido às alterações orgânicas e hormonais que ocorrem prematuramente em meninas.

The objective of this study was to establish the profi le as well as the differences in anthropometric characteristics of Brazilian young swimmers of different categories in both sexes. Ninety male and 70 female swimmers were measured in the following categories: 1 (12-13 years), 2 (14-15 years) and 3 (16-18 years). Anthropometric variables analyzed were: body mass (Kg), stature (m), BMI (Kg/m2), fat free mass (LBM, kg), fat mass (kg) and arm span (m). The percent of body fat (% fat) was estimated using the Lohman equation. Two-way ANOVA was used followed by the TukeyÆs post-hoc test, with p< 0.05. For males, the category 3 presented higher body mass, stature, arm span and LBM in relation to the other categories. For females, body mass was higher in category 3 when compared to categories 1 and 2. It was observed higher stature, arm span, LBM andfat mass for category 3 when compared to 1. Category 2 presented higher body mass and LBM than category 1. Comparing to girls, boys in the category 2 had higher BMI and LBM than girls. For both categories 2 and 3, males showed higher body mass, stature, arm span and LBM than females, which, in turn, had higher % fat. It was concluded that anthropometric variables are different between categories for both sexes, however, among girls differences between categories 1 and 2 were less evident, probably because of early maturation changes in females.