Determining factors of functioning in hemodialysis patients using the international classification of functioning, disability and health.

BACKGROUND: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. METHODS: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function - handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity - short physical performance battery (SPPB); and Participation - participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. RESULTS: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS (R2 = 0.558); HAP and PTH were associated with 5-STS (R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS (R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB (R2 = 0.689). Finally, only HAP was associated with the participation scale (R2 = 0.067). CONCLUSION: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Miconia albicans and Curcuma longa herbal medicines positively modulate joint pain, function and inflammation in patients with osteoarthritis: a clinical study.

This study aims to evaluate the analgesic and modulating effect of Curcuma longa and Miconia albicans herbal medicines in knee's osteoarthritis (OA) treatment. This longitudinal study evaluated 24 patients with OA. The patients were divided into three groups: ibuprofen (1200 mg/day), C. longa (1000 mg/day) and M. albicans (1000 mg/day). The medications were applied orally for 30 days. The synovial fluid of the knee joint was collect at the first (day 0) and the last medical (day 30) consultation. The groups treated with herbal medicines presented the same results when compared to Ibuprofen. The comparison of the means of Total WOMAC for M. albicans before and after treatment presented a statistically significant difference (mean day 0 = 57.19; mean day 30 = 31.02) as well as variation of Total WOMAC for C. longa (mean day 0 = 54.79; mean day 30 = 37.08). The WOMAC Total and the VASP were compared, it was found that there was a significant decrease in the means in the C. longa and M. albicans groups, as well as in the Ibuprofen group after treatment. The study demonstrated that the treatment of knee OA with C. longa or M. albicans positively interferes with patients pain and functionality, decreased WOMAC and VASP scores, leading to functional improvement of these patients. This is the first clinical study demonstrating the analgesic and anti-inflammatory effect on knee osteoarthritis from M. albicans comparable to Ibuprofen drug.

Decreased percentage of CD4+ lymphocytes expressing chemokine receptors in bipolar disorder.

OBJECTIVE: Although accumulating evidence supports the hypothesis that immune/inflammatory mechanisms are associated with the pathophysiology of bipolar disorder (BD), data about the profile of chemokines (chemotactic cytokines) and chemokine receptors are still scarce. The current study was designed to evaluate the expression of chemokine receptors on lymphocytes of patients with BD in comparison with controls. METHODS: Thirty-three patients with type I BD (N = 21 in euthymia; N = 6 in mania/hypomania; N = 6 in depression) and 22 age- and sex-matched controls were subjected to clinical evaluation and peripheral blood draw. The expression of chemokine receptors CCR3, CCR5, CXCR4, and CXCR3 on CD4+ and CD8+ lymphocytes was assessed by flow cytometry. RESULTS: Patients with BD had decreased percentage of CD4+CXCR3+ (p = 0.024), CD4+CCR3+ (p = 0.042), and CD4+CCR5+ (0.013) lymphocytes in comparison with controls. The percentage of both CD4+ and CD8+ lymphocytes expressing the chemokine receptor CXCR4 was similar in patients with BD and controls. Likewise, the percentages of CD8+CXCR3+, CD8+CCR3+, and CD8+CCR5+ lymphocytes were similar in patients with BD and controls. CONCLUSION: Our findings reinforce the hypothesis that immune pathways, especially involving CD4+ lymphocytes, are involved in the physiopathology of BD.

Comparison between whole-body vibration, light-emitting diode, and cycling warm-up on high-intensity physical performance during sprint bicycle exercise.

The purpose of this study was to compare the effects of light-emitting diode (LED) irradiation and whole-body vibration (WBV) delivered either in isolation or combination (LED + WBV), warm-up (WU), and a control (C) treatment on performance during a sprint bicycle exercise. Ten cyclists performed a 30-second sprint cycle test under these conditions. The LED light was applied at 4 points bilaterally. Whole-body vibration consisted of 5 minutes of squats associated with WBV. LED + WBV consisted of WBV followed by LED therapy. Warm-up consisted of 17 minutes of moderate-intensity bicycle exercise. Control consisted of 10 minutes at rest. Blood lactate (BL) and ammonia (BA) levels and skin temperature (ST) were determined. Peak power (842 ± 117 vs. 800 ± 106 vs. 809 ± 128 W [p = 0.02 and p = 0.01]), relative power (12.1 ± 1.0 vs. 11.5 ± 0.9 vs. 11.6 ± 1.0 W·kg [p = 0.02 and p = 0.02]), and relative work (277 ± 23 vs. 263 ± 24 vs. 260 ± 23 J·kg [p = 0.02 and p = 0.003]) were higher in the WU group compared with the control and LED groups. In the LED + WBV group, peak (833 ± 115 vs. 800 ± 106 W [p = 0.02]) and relative (11.9 ± 0.9 vs. 11.5 ± 0.9 W·kg [p = 0.02]) power were higher than those in the control group, and relative work (272 ± 22 vs. 260 ± 23 J·kg [p = 0.02]) were improved compared with the LED group. There were no differences for BL, BA, and ST. The findings of this study confirmed the effectiveness of a warm-up as a preparatory activity and demonstrated that LED + WBV and WBV were as effective as WU in improving cyclist performance during a sprint bicycle exercise.

Effect of exercise on the plasma BDNF levels in elderly women with knee osteoarthritis.

Knee osteoarthritis is a common disease in the elderly population worldwide. The alleviation of the symptoms associated with this disease can be achieved with physical exercise that induces a cascade of molecular and cellular processes. Of the neurotrophins, brain-derived neurotrophic factor (BDNF) appears to be the most affected by physical activity. Moreover, BDNF seems to have a negative modulatory role in inflammation, and its production by skeletal muscle cells or by cells of the immune system drives the immunoprotective role of physical activity in situations of chronic inflammation. Therefore, the aim of this study was to evaluate plasma BDNF concentrations in elderly individuals presenting with knee osteoarthritis. To accomplish this, sixteen volunteers (mean age 67 ± 4.41 years) presenting with clinically and radiographically diagnosed knee osteoarthritis were evaluated during acute exercise (1 session of 20 min on a treadmill) and after chronic exercise (12 weeks of aerobic training, consisting of a 50-min walk 3 times per week). Additionally, both a functional assessment (during a 6-min walk) and a pain perception assessment were performed at the start and at the end of physical exercises (training). The plasma BDNF concentrations were measured by ELISA. For the population studied, acute exercise increased the levels of BDNF only before the 12-week training period (p < 0.001). Moreover, the training augmented the plasma concentrations of BDNF (p < 0.0001) and improved clinical parameters (functional p < 0.001; pain perception p < 0.01).

Evidence of Use of Whole-Body Vibration in Individuals with Metabolic Syndrome: A Systematic Review and Meta-Analysis.

(1) Background: Metabolic syndrome (MSy) is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease. This systematic review with meta-analysis was conducted to assess the effects of whole-body vibration exercise (WBVE) in metabolic syndrome (MSy) individuals. (2) Methods: An electronic search in Pubmed, Embase, Scopus, Web of Science, ScienceDirect, PEDro, and CINAHL databases in December 2022 was performed. Data regarding the included studies were extracted. The level of evidence, the methodological quality, and the risk of bias of each selected publication were individually evaluated. (3) Results: Eight studies were included in the systematic review and four studies in the meta-analysis, with a mean methodological quality score on the Physiotherapy Evidence Database (PEDro scale) of 5.6, considered "fair" quality. The qualitative results suggested positive effects of the systemic vibration therapy in relevant outcomes, such as quality of life, functionality, pain level, trunk flexibility, cardiovascular responses (blood pressure and heart rate), neuromuscular activation, range of motion of the knees, rating of perceived exertion, and body composition. The quantitative results, with weighted mean differences, standard mean differences, and 95% confidence intervals (CIs), were calculated. Conclusions: WBVE may be an alternative capable of interfering with physical-mainly for flexibility with weighted mean differences (1.70; 95% CI 0.15, 3.25; n = 39)-functional, psychosocial, neuromuscular, emotional parameters, and consequently contribute to improvements in metabolic health and reduce the cardiovascular risk factor in MSy individuals. Nevertheless, further additional studies are required to understand the long-term effects of WBVE on MSy and its complications in a better way. Protocol study registration was as follows: PROSPERO (CRD 42020187319).

Effects of Whole-Body Vibration Exercise on Athletes with Ankle Instability: A Systematic Review.

OBJECTIVE: Chronic Ankle Instability (CAI) or Functional Ankle Instability (FAI) is a condition characterized by laxity and mechanical instability in the ankle joint. This instability interferes with the activities and physical-functional parameters of athletes, which leads to repetitive ankle sprains. The current systematic review was carried out to identify the effects of whole-body vibration exercise (WBVE) in athletes with CAI. METHODS: We conducted electronic searches in Pubmed, the Cochrane Library, Embase, Web of Science, Scopus, Science Direct, Allied Health Literature (CINAHL) and Academic Search Premier (ASP) (EBSCO) databases on 26 February 2022. Registers were identified, and studies were selected for inclusion according to the eligibility criteria. The methodological quality was assessed by the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Seven studies were included with a mean methodological quality score of 5.85, considered 'regular' quality on the PEDro scale. WBVE interventions in athletes with CAI showed that this exercise contributes to a better response on parameters of neuromuscular performance, muscle strength and consequently in balance and postural control, variables that are for the management of CAI. CONCLUSION: WBVE interventions in sports modalities promote physiological responses that may lead to positive effects in several parameters. The protocols proposed in each modality can be carried out in practice and are considered effective additional exercise and training methods beyond traditional types of training for athletes. However, more studies are needed on athletes with this condition, with specific protocols, to highlight the possible physiological and physical-functional responses. Protocol study registration: PROSPERO (CRD42020204434).

Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis.

OBJECTIVE: To investigate the effects of squat exercises combined with whole-body vibration on the plasma concentration of inflammatory markers and the functional performance of elderly individuals with knee osteoarthritis (OA). DESIGN: Clinical, prospective, randomized, single-blinded study. SETTING: Exercise physiology laboratory. PARTICIPANTS: Elderly subjects with knee OA (N=32) were divided into 3 groups: (1) squat exercises on a vibratory platform (platform group, n=11); (2) squat exercises without vibration (squat group, n=10); and (3) the control group (n=11). INTERVENTIONS: The structured program of squat exercises in the platform and squat groups was conducted 3 times per week, on alternate days, for 12 weeks. MAIN OUTCOME MEASURES: Plasma soluble tumor necrosis factor-α receptors 1 (sTNFR1) and 2 (sTNFR2) were measured using immunoassays (the enzyme-linked immunosorbent assay method). The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire was used to evaluate self-reported physical function, pain, and stiffness. The 6-minute walk test, the Berg Balance Scale, and gait speed were used to evaluate physical function. RESULTS: In the platform group, there were significant reductions in the plasma concentrations of the inflammatory markers sTNFR1 and sTNFR2 (P<.001 and P<.05, respectively) and self-reported pain (P<.05) compared with the control group, and there was an increase in balance (P<.05) and speed and distance walked (P<.05 and P<.001, respectively). In addition, the platform group walked faster than the squat group (P<.01). CONCLUSIONS: The results suggest that whole-body vibration training improves self-perception of pain, balance, gait quality, and inflammatory markers in elderly subjects with knee OA.

Fibromyalgia in social media: content and quality of the information analysis of videos on the YouTube platform.

To evaluate the fibromyalgia (FM) content in YouTube videos and verify if American College of Rheumatology (ACR) guidelines are being met. The videos were searched with the keyword "Fibromyalgia." Two independent researchers evaluated and coded specific characteristics of the videos. The popularity of the videos, the presentation properties, and content related to FM according to the ACR criteria were analyzed. Of the 200 videos included, the majority were presented by health professionals, 61.5%. Most videos covered more than one subject, 38.5%. The videos presented by health professionals were the most viewed. Following the ACR guidelines, 38% defined FM, 24% described the etiology, 19.5% described the diagnostic criteria and 52% presented recommended management strategies. The results indicate that users mainly watch videos published by health professionals. Most of the published videos do not follow the information recommended by the ACR guidelines. Therefore, videos should be interpreted with caution, not being the most appropriate resource for health education for patients with FM. Most of the videos published on YouTube about FM do not meet the ACR guidelines for FM.

Impact of Two Whole-Body Vibration Exercise Protocols on Body Composition of Patients with Metabolic Syndrome: A Randomized Controlled Trial.

(1) Background: This study investigated the effects of two 6-week whole-body vibration exercise (WBVE) protocols on body composition in patients with metabolic syndrome (MSy). Thirty-three patients were allocated to either the Fixed Frequency WBVE Group (FFG-WBVE) or the Variable Frequency WBVE Group (VFG-WBVE). (2) Methods: A side-alternating vibration platform was used and the patients remained in the semi-squat position on this platform. In the FFG-WBVE (n = 12; median age = 50.50 years) and (body mass index BMI = 31.95 kg/m2), patients were exposed to 10 s of mechanical vibration at a fixed frequency of 5 Hz, followed by 50 s without vibration. In the VFG-WBVE (n = 10; median age = 57.50 years) and (BMI = 32.50 kg/m2), the patients performed 60 s of mechanical vibration at different frequencies from 5 to 16 Hz). Body composition evaluated through (bioelectrical impedance analysis and anthropometric measurements) were was evaluated before and after the all the interventions in each group. (3) Results: The VFG-WBVE decreased waist circumference, p = 0.01 and segmental fat mass [left arm, p = 0.01; right arm, p = 0.02 and trunk, p = 0.03]. Bone content increased, p = 0.01. No significant changes were observed in the FFG- WBVE. (4) Conclusions: In conclusion, this study demonstrated that 6 weeks of WBVE with a protocol with variable frequency can positively modify the body composition of MSY patients. These findings might contribute to improvements in the metabolic health of these patients.

Maximal inspiratory pressure is associated with health-related quality of life and is a reliable method for evaluation of patients on hemodialysis.

OBJECTIVE: To evaluate the association between Maximal Inspiratory Pressure (MIP) and health-related quality of life (HRQoL) and to verify the reliability of the MIP in patients on hemodialysis. METHODS: In a repeated-measures design, patients on hemodialysis performed MIP and specific HRQoL questionnaire (trial 1). The MIP was repeated after 6 to 8 weeks (trial 2) and reliability was assessed using Intra-class Correlation Coefficient. Standard Error of Measurement and Minimal Detectable Change scores were calculated. RESULTS: Sixty-one individuals (68.9% men) were evaluated in trial 1. MIP was associated with specific domains "Symptoms" (r = 0.45; R2 adjusted = 0.192) and the kidney disease component summary (r = 0.38; R2 adjusted = 0.138). Regarding generic domains, the MIP was associated with "Physical Functioning" (r = 0.57; R2 adjusted = 0.375) and Physical component summary (r = 0.47; R2 adjusted = 0.258). Thirty-three patients were randomly selected to perform a second MIP test (trial 2). The Intra-class Correlation Coefficient was 0.94 (95%CI 0.88-0.97). By Bland-Altman analysis, the bias was 3.2 cmH2O, which represents a difference of 3.7%. The Standard Error of Measurement and Minimal Detectable Change for MIP were 5.9 cmH2O and 13.8 cmH2O, respectively. CONCLUSION: The MIP is a reliable test, associated with physical domains of HRQoL in patients on hemodialysis. Thus, it is a useful method for respiratory evaluation in this population.

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations.

To investigate the efficacy of hip strengthening on pain, disability, and hip abductor strength in musculoskeletal conditions of the trunk and lower limbs, we searched eight databases for randomized controlled trials up to 8 March 2022 with no date or language restrictions. Random-effect models estimated mean differences (MDs) with 95% confidence intervals (CIs), and the quality of evidence was assessed using the GRADE approach. Very low quality evidence suggested short-term effects (≤3 months) of hip strengthening on pain intensity (MD of 4.1, 95% CI: 2.1 to 6.2; two trials, n = 48 participants) and on hip strength (MD = 3.9 N, 95% CI: 2.8 to 5.1; two trials, n = 48 participants) in patellofemoral pain when compared with no intervention. Uncertain evidence suggested that hip strengthening enhances the short-term effect of the other active interventions on pain intensity and disability in low back pain (MD = -0.6 points, 95% CI: 0.1 to 1.2; five trials, n = 349 participants; MD = 6.2 points, 95% CI: 2.6 to 9.8; six trials, n = 389 participants, respectively). Scarce evidence does not provide reliable evidence of the efficacy of hip strengthening in musculoskeletal conditions of the trunk and lower limbs.

Assessment of functional performance in Chagas heart disease by Human Activity Profile questionnaire.

PURPOSE: To verify the association between Human Activity Profile and functional capacity, functional class and systolic function of the patients with Chagas heart disease (CHD). METHODS: Sixty-two patients with CHD were evaluated by echocardiography, maximal exercise testing and Human Activity Profile questionnaire. The sample was stratified, according to the values of peak oxygen uptake (low or normal), functional class (symptomatic or asymptomatic), and left ventricular ejection fraction (preserved or systolic dysfunction). Linear regression and two-group comparisons analyses were used. Receiver-operating characteristic analysis was used to determine different cutoff values of the Human Activity Profile for low peak oxygen uptake prediction. RESULTS: Peak oxygen uptake was an independent predictor of Human Activity Profile (R2-adjusted = 0.27). Patients with low peak oxygen uptake had lower scores in Human Activity Profile [difference of 6.9 (95%CI 2.5-11.4)] than those with normal peak oxygen uptake. Symptomatic patients also showed lower scores when compared to the asymptomatic [difference of 6.2 (95%CI 1.7-10.8)]. There was no difference between left ventricular ejection fraction classes. The Human Activity Profile score of 76.5 was the optimal cut point value in predicting low peak oxygen uptake (sensitivity = 66.0% and specificity = 71.8%). CONCLUSION: The Human Activity Profile questionnaire is associated with functional capacity of patients with CHD and is able to identify individuals with low peak oxygen uptake.Implications for rehabilitationFunctional impairment is one of the most common clinical findings in all stages and is an important predictor of poor prognosis of the Chagas heart disease;A patient-derived measure of functional capacity is potentially useful in the setting of the Chagas heart disease;The Human Activity Profile questionnaire is effective in the identification of patients with Chagas heart disease with functional impairment and may be a valid method for functional evaluation.

Inflammatory and oxidative biomarkers as determinants of functional capacity in patients with COPD assessed by 6-min walk test-derived outcomes.

INTRODUCTION: Reduction in functional capacity is a negative clinical outcome of chronic obstructive pulmonary disease (COPD). Studies have shown association between inflammatory and oxidative stress biomarkers and functional capacity. However, it is unclear whether these biomarkers are associated with outcomes of functional capacity. Therefore, the aim of this study was to evaluate whether plasma biomarkers of inflammation and oxidative stress are predictors of the 6-min walking test (6MWT)-derived outcomes. METHODS: Twenty COPD patients were assessed on three consecutive days with different clinical measures, including functional capacity, and blood sampling. Plasma concentrations of IL-6, IL-8, TNF-ɑ, IL-10 and soluble TNF-ɑ receptors (sTNFR1 and sTNFR2) were determined by immunoassays. Oxidative stress was evaluated by determining lipid peroxidation products based on the enzymatic activity of superoxide dismutase (SOD) and catalase, and total antioxidant capacity of plasma. Functional capacity was assessed considering the six-minute walking distance (6MWD) and the estimate of six-minute walking work (6MWW). The association between biomarkers (i.e. inflammation and oxidative stress) and functional exercise capacity was investigated through the Pearson's correlation coefficient. To identify the determinants of the 6MWT, multiple linear stepwise regression analyses were performed with adjustment for age, sex and GOLD classification. RESULTS: Patients were predominantly male (65%), with mean age of 64 years and moderate airflow obstruction and impaired functional capacity. There were positive correlations between SOD activity and 6MWD (r = 0.520; p = 0.02) and 6MWW (r = 0.554; p = 0.01), as well as a negative correlation between sTNF-R1 and 6MWD (r = -0.437; p = 0.05). SOD was an independent determinant of the functional capacity, explaining 23% of the variability of 6MWD (p = 0.019) and 27% of the variability of 6MWW (p = 0.011). sTNF-R1 levels were associated with 6MWD and, together with SOD explained 40% of variability in 6MWD (p = 0.005). CONCLUSION: SOD activity was an independent determinant of performance in the 6MWT, and together with sTNFR1 explained 40% of the variations in walking distance in COPD patients. SOD activity and sTNFR1 levels might be seen as potential biomarkers of the functional capacity in patients with COPD.

Efficacy of Whole-Body Vibration Training on Brain-Derived Neurotrophic Factor, Clinical and Functional Outcomes, and Quality of Life in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial.

This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels (p=0.045), a higher number of repetitions on the STS test (p=0.011), and increased walking distance on the 6MWT (p=0.010), compared to CG. Moreover, there was a reduction in the scores of the FIQ (p=0.001), the PSQI (p=0.001), the BDI (p=0.017), and pain assessed using VAS (p=0.008) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).

Efficacy of conservative therapy in older people with nonspecific low back pain: A systematic review with meta-analysis and GRADE recommendations.

PURPOSE: This systematic review aimed to investigate the effectiveness of conservative therapy in older people with nonspecific low back pain. MATERIALS AND METHODS: Searches were conducted on Medline, Amed, Embase, Cochrane, Psycinfo and Pedro databases up to 2020. Risk of bias were assessed using the 0-10 PEDro scale. Weighted mean differences (WMDs) or mean differences (MDs) with 95 % confidence intervals (CIs) were reported for each conservative therapy, and strength of the current evidence was assessed using the GRADE approach. RESULTS: Eleven original trials were included investigating effects on disability, pain, coping, quality of life, strength, balance, depression, falls, sleep quality, mobility, body mass index, percentage body fat, trunk muscle mass and waist-to-hip ratio. Moderate quality evidence showed short-term effects of trigger point acupuncture on disability (WMD = 5.0 points [95 % CI 3.5-6.4] on a 25-point scale) and pain (WMD = 35.9 points [95 % CI 22.2-49.7] on a 101-point scale), and of exercise on disability (WMD = 1.7 points [95 % CI 0.3-3.0]) when compared with control (placebo, sham, waiting list or no intervention). Moderate quality evidence showed no short-term effect of exercise on coping (95 % CI -5.0 to 14.6). Moreover, evidence for other important outcomes in older people is scarce and we did not find any trial investigating pharmacological therapies. CONCLUSION: Findings support partially exercise and trigger point acupuncture to improve disability and/or pain. Future trials with appropriate sample sizes are likely to impact on the estimates and need to clarify medium- and long-term effects.

Whole-Body Vibration Exercise in Different Postures on Handgrip Strength in Healthy Women: A Cross-Over Study.

OBJECTIVE: To compare the effect of Whole-Body Vibration Exercise (WBVE) applied in push-up modified and half-squat positions, on handgrip strength (HS) and on the electromyography registry (EMGrms) of the flexor digitorum superficialis muscle (FDSM) of the dominant hand. METHODS: Nineteen healthy women (age 23.40 ± 4.03 years, bodyweight: 58.89 ± 9.87 kg), performed in a randomized order five different tests: (S1) Control; (S2) Push-up modified; (S3) Push-up placebo; (S4); Half-squatting; (S5) Half-squatting placebo. The HS and the EMGrms were assessed at baseline and immediately after the tests. ANOVA two-way design mixed test, with Tukey post hoc, was used to evaluate the HS, EMGrms and the ratio between EMGrms and HS, i.e., neural ratio (NR). Thus, the lower NR represents the greater neuromuscular modifications. The statistical significance level was set up at p < 0.05. RESULTS: WBVE on S2 increased HS compared to the stimulus applied to the S4 (p = 0.0001). The increase in HS was associated with a reduction in the EMGrms of the FDSM (p < 0.001) and a lower NR (p < 0.0001), i.e., greater neuromuscular modifications, in the S2 compared to the S4 after the tests. CONCLUSION: The distance of the stimulus and the positioning on the vibratory platform influence the maximum muscular strength due to neuromuscular modifications of hands in healthy women.

Cardiorespiratory responses in different types of squats and frequencies of whole body vibration in patients with chronic obstructive pulmonary disease.

This study aims to investigate the cardiorespiratory responses to different vibration frequencies to characterize the intensity of exercise, as well as to compare the effect of two types of squatting exercises (static and dynamic) on the whole body vibration (WBV) exercise in individuals with chronic obstructive pulmonary disease (COPD). Twenty-six subjects were divided and paired into healthy and COPD groups that performed static squatting associated with WBV (frequencies: 30, 35, and 40 Hz; amplitude: 2 mm) and dynamic squatting associated with WBV (frequency: 35 Hz; amplitude 2 mm) on a vertical vibration platform. Oxygen consumption (V̇o2), heart rate (HR), minute ventilation (V̇e), ratio of minute ventilation to oxygen production (V̇e/V̇o2), ratio of minute ventilation to carbon dioxide production (V̇e/V̇co2), oxygen saturation (SpO2), and rating of perceived exertion were measured. For both groups, there was a decrease in V̇e/V̇o2 and V̇e/V̇co2 ratios during static and dynamic squats, as well as an increase in other cardiorespiratory parameters, and no significant difference existed between them. There was an effect of the type of squat on the HR variation; the values in the static squat were higher than those of the dynamic squat in both groups. There was a significant difference with a reduction in SpO2 at 40 Hz frequency when compared with 30 Hz in the COPD group. The other variables behaved similarly between the frequencies. The WBV exercise, regardless of the frequencies used, represented a mild effort that promoted cardiorespiratory response in COPD, with greater responses in the static squat and no adverse effect. NEW & NOTEWORTHY This study showed that an acute session of light exercise of whole body vibration (WBV) can increase the cardiorespiratory responses in patients with chronic obstructive pulmonary disease (COPD), reaching values similar to that of the control group. The results might contribute, therefore, to the elaboration of exercise protocols with WBV for the treatment of patients with COPD during rehabilitation. Thus, future studies referring to training on the vibratory platform could use these exercise parameters and demonstrate possible long-term benefits.

Cardiorespiratory and metabolic responses and reference equation validation to predict peak oxygen uptake for the incremental shuttle waking test in adolescent boys.

BACKGROUND: Previous studies speculated that the Incremental Shuttle Walking Test (ISWT) is a maximal test in children and adolescents, however comparison between ISWT with cardiopulmonary exercise test has not yet performed. Furthermore, there is no regression equation available in the current literature to predict oxygen peak consumption (VO2 peak) in this population. This study aimed to assesses and correlate the cardiorespiratory responses of the ISWT with the cardiopulmonary exercise (CEPT) and to develop and validate a regression equation to predict VO2 peak in healthy sedentary adolescent boys. METHODS: Forty-one participants were included in the study. In the first stage, the VO2 peak, respiratory exchange ratio (R peak), heart rate max (HR max) and percentage of predicted HR max (% predicted HR max) were evaluated in CEPT and ISWT (n = 26). Second, an equation was developed (n = 29) to predict VO2 peak. In both phases, the VO2 peak, respiratory exchange ratio R and hearth rate (HR) were evaluated. In the third stage, the validation equation was performed by another 12 participants. RESULTS: Similar results in VO2 peak (P>0.05), R peak (P>0.05) and predicted maximum HR (P>0.05) were obtained between the ISWT and CEPT. Both tests showed moderate significant correlations of VO2 peak (r = 0.44, P = 0.002) e R peak (r = -0.53, P < 0.01), as well as the agreement of these measurements by Bland-Altman analysis (VO2 peak, bias = -0.13; R peak, bias = 0.0). Distance walked was the variable that explained 42.5% (R2 = 0.425, p = 0.0001) of the variance in VO2 peak. The equation was VO2 peak (predicted) = 20.94 + (0.02 x distance walked). The results obtained by the equation were not significantly different compared to the values obtained by the gas analyzer and the Bland-Altman analysis showed agreement (bias = 1.6). CONCLUSION: The ISWT produced maximal cardiorespiratory responses comparable to the CEPT, and the developed equation showed viability for the prediction of VO2 peak in healthy sedentary adolescent boys.

Correction: Cardiorespiratory and metabolic responses and reference equation validation to predict peak oxygen uptake for the incremental shuttle waking test in adolescent boys.

[This corrects the article DOI: 10.1371/journal.pone.0206867.].