Current Technologies and Practices to Assess External Training Load in Paralympic Sport: A Systematic Review.

CONTEXT: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. OBJECTIVES: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. EVIDENCE ACQUISITION: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. EVIDENCE SYNTHESIS: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). CONCLUSIONS: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.

The Sleep Parameters of Paralympic Athletes: Characteristics and Assessment Instruments.

CONTEXT: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. OBJECTIVES: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. EVIDENCE ACQUISITION: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. EVIDENCE SYNTHESIS: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). CONCLUSIONS: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.

Active warm-up and time-of-day effects on repeated-sprint performance and post-exercise recovery.

PURPOSE: This study investigated the effects of both an active warm-up and the time-of-day variation on repeated-sprint performance. A second objective was to compare the post-exercise recovery between the experimental conditions. METHODS: Eleven male participants performed ten maximal cycling sprints (6 s each, with a 30-s interval between them) in the morning and late afternoon, either after a warm-up or control condition. The warm-up consisted of cycling for 10 min at 50% of the peak aerobic power. RESULTS: Rest measurements of rectal, muscle, and skin temperatures were higher in the afternoon compared to the morning (p < 0.05), with no significant differences in heart rate (p = 0.079) and blood lactate concentration (p = 0.300). Warm-up increased muscle temperature, heart rate, and lactate, and reduced skin temperature (all p < 0.001), though no significant differences were observed for rectal temperature (p = 0.410). The number of revolutions (p = 0.034, ηp2 = 0.375), peak (p = 0.034, ηp2 = 0.375), and mean (p = 0.037, ηp2 = 0.365) power of the first sprint (not the average of ten sprints) were higher in the afternoon compared to the morning, regardless of warm-up. However, beneficial performance effects of warming up were evident for the first (p < 0.001) and the average of ten sprints (p < 0.05), regardless of time of day. More remarkable changes during the 60-min post-exercise were observed for rectal temperature (p = 0.005) and heart rate (p = 0.010) in the afternoon than in the morning. CONCLUSION: Warming-up and time-of-day effects in enhancing muscular power are independent. Although warm-up ensured further beneficial effects on performance than the time-of-day variation, a faster post-exercise recovery was observed in the late afternoon.

The effect of aerobic plus resistance training associated with a long-term interdisciplinary weight loss program on visceral fat and isokinetic parameters in adolescents with obesity.

BACKGROUND: Obesity can lead to a number of alterations in biomechanical structures. We aimed to assess the effect of aerobic plus resistance training associated with an interdisciplinary approach on visceral fat and isokinetic parameters in a long-term weight loss therapy program. METHODS: Forty-four postpubertal obese adolescents were involved in the 1-year interdisciplinary weight loss therapy program (clinical, nutritional, psychological and physical training). Body composition, and visceral and subcutaneous fat were measured by DXA absorptiometry and ultrasonography, respectively. Peak torque was analyzed using an isokinetic dynamometer. Statistical analysis was performed using t-tests to assess the effect of the intervention. RESULTS: There was a significant reduction in body fat with an inverse increase in lean mass. Positive correlations were observed between peak torque and lean body mass and negative correlations with visceral fat, gynoid fat mass, arm fat mass and subcutaneous fat. CONCLUSIONS: An interdisciplinary weight loss program can reduce body fat and increase peak torque and improve muscle strength. The results reinforce the importance of this kind of approach to treat obesity and improve the quality of life in this population.

Poor Sleep Quality's Association With Soccer Injuries: Preliminary Data.

PURPOSE: To investigate the relationship between sleep quality and quantity and injuries in elite soccer players and to compare sleep-wake variables and injury characteristics. METHODS: The current investigation was a prospective cohort study of 23 elite male soccer players competing for 2 teams over 6 mo in the highest-level Brazilian competition. The players' sleep behavior was monitored for 10 d in the preseason using self-reporting sleep diaries and wrist activity monitors to determine sleep duration and quality. Furthermore, injuries were recorded by the respective club's medical teams into a specific database. Details of injuries recorded included the type, location, and severity of each injury. The results were expressed as descriptive statistics, and the significance level was set at 5%. The Mann-Whitney U test was performed to compare the sleep variables between groups. Spearman correlation coefficient and linear-regression analysis were used. RESULTS: The results indicated a moderate negative correlation between sleep efficiency and particular injury characteristics, including absence time, injury severity, and amount of injuries. The linear-regression analysis indicated that 44% of the total variance in the number of injuries can be explained by sleep efficiency, 24% of the total variance in the absence time after injury (days) can be explained by sleep efficiency, and 47% of the total variance in the injury severity can be explained by sleep efficiency. CONCLUSIONS: Soccer players who exhibit lower sleep quality or nonrestorative sleep show associations with increased number and severity of musculoskeletal injuries.

Nutrient intake is a predictor of lung function in obese asthmatic adolescents undergoing interdisciplinary therapy.

Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (ß = -0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (ß = -0·06) and cholesterol were negative predictors (ß = -0·05) in FEV1:FVC. However, the consumption of Ca (ß = 0·01), fibres (ß = 1·34) and vitamin A (ß = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.

Effects of resistance exercise training and stretching on chronic insomnia

Objective: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. Methods: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. Results: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. Conclusion: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. Clinical trial registration: NCT01571115

Effects of resistance exercise training and stretching on chronic insomnia.

OBJECTIVE: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. METHODS: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. RESULTS: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. CONCLUSION: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. CLINICAL TRIAL REGISTRATION: NCT01571115.

Cardiovascular Responses During Resistance Exercise in Patients With Parkinson Disease.

BACKGROUND: Patients with Parkinson disease (PD) present cardiovascular autonomic dysfunction that impairs blood pressure control. However, cardiovascular responses during resistance exercise are unknown in these patients. OBJECTIVE: To investigate cardiovascular responses during resistance exercise performed with different muscle masses in patients with PD. DESIGN: Prospective, repeated-measures. SETTING: Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo. PARTICIPANTS: Thirteen patients with PD (4 women, 62.7 ± 1.3 years, stages 2-3 of the modified Hoehn and Yahr scale; "on" state of medication) and 13 paired control patients without PD (7 women, 66.2 ± 2.0 years). INTERVENTIONS: Both groups performed, in a random order, bilateral and unilateral knee extension exercises (2 sets, 10-12 maximal repetition, 2-minute intervals). MAIN OUTCOME MEASUREMENTS: Systolic blood pressure (SBP) and heart rate (HR) were assessed before (pre) and during the exercises. RESULTS: Independent of set and exercise type, SBP and HR increases were significantly lower in PD than the control group (combined values: +45 ± 2 versus +73 ± 4 mm Hg and +18 ± 1 versus +31 ± 2 bpm, P = .003 and .007, respectively). Independently of group and set, the SBP increase was greater in the bilateral than the unilateral exercise (combined values: +63 ± 4 versus +54 ± 3 mm Hg, P = .002), whereas the HR increase was similar. In addition, independently of group and exercise type, the SBP increase was greater in the second than the first set (combined values: +56 ± 4 versus +61 ± 4 mm Hg, P = .04), whereas the HR increases were similar. CONCLUSIONS: Patients with PD present attenuated increases in SBP and HR during resistance exercise in comparison with healthy subjects. These results support that resistance exercise is safe and well tolerated for patients with PD from a cardiovascular point of view supporting its recommendation for this population. LEVEL OF EVIDENCE: II.

High-Intensity Interval Training Attenuates Insulin Resistance Induced by Sleep Deprivation in Healthy Males.

Introduction: Sleep deprivation can impair several physiological systems and recently, new evidence has pointed to the relationship between a lack of sleep and carbohydrate metabolism, consequently resulting in insulin resistance. To minimize this effect, High-Intensity Interval Training (HIIT) is emerging as a potential strategy. Objective: The aim of this study was to investigate the effects of HIIT on insulin resistance induced by sleep deprivation. Method: Eleven healthy male volunteers were recruited, aged 18-35 years, who declared taking 7-8 h sleep per night. All volunteers were submitted to four different conditions: a single night of regular sleep (RS condition), 24 h of total sleep deprivation (SD condition), HIIT training followed by regular sleep (HIIT+RS condition), and HIIT training followed by 24 h of total sleep deprivation (HIIT+SD condition). They performed six training sessions over 2 weeks and each session consisted of 8-12 × 60 s intervals at 100% of peak power output. In each experimental condition, tests for glucose, insulin, cortisol, free fatty acids, and insulin sensitivity, measured by oral glucose tolerance test (OGTT), were performed. Results: Sleep deprivation increased glycaemia and insulin levels, as well as the area under the curve. Furthermore, an increase in free fatty acids concentrations and basal metabolism was observed. There were no differences in the concentrations of cortisol. However, HIIT before 24 h of sleep deprivation attenuated the increase of glucose, insulin, and free fatty acids. Conclusion: Twenty-four hours of sleep deprivation resulted in acute insulin resistance. However, HIIT is an effective strategy to minimize the deleterious effects promoted by this condition.

Effects of Progressive Resistance Training on Cardiovascular Autonomic Regulation in Patients With Parkinson Disease: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the effects of a progressive resistance training (RT) on cardiac autonomic modulation and on cardiovascular responses to autonomic stress tests in patients with Parkinson disease (PD). DESIGN: Randomized clinical trial. SETTING: The Brazil Parkinson Association. PARTICIPANTS: Patients (N=30) with PD (modified Hoehn & Yahr stages 2-3) were randomly divided into 2 groups: a progressive RT group (PD training [PDT] group) and a control group (PD control [PDC] group). In addition, a group of paired healthy control (HC) subjects without PD was evaluated. INTERVENTIONS: The PDT group performed 5 resistance exercises, 2 to 4 sets, 12 to 6 repetitions maximum per set. Individuals in the PDC group maintained their usual lifestyle. MAIN OUTCOME MEASURES: The PDT and PDC groups were evaluated before and after 12 weeks. The HC group was evaluated once. Autonomic function was assessed by spectral analysis of heart rate variability and cardiovascular responses to autonomic stress tests (deep breathing, Valsalva maneuver, orthostatic stress). RESULTS: Compared with baseline, the normalized low-frequency component of heart rate variability decreased significantly after 12 weeks in the PDT group only (PDT: 61±17 normalized units [nu] vs 47±20nu; PDC: 60±14nu vs 63±10nu; interaction P<.05). A similar result was observed for systolic blood pressure fall during orthostatic stress that also was reduced only in the PDT group (PDT: -14±11mmHg vs -6±10mmHg; PDC: -12±10mmHg vs -11±10mmHg; interaction P<.05). In addition, after 12 weeks, these parameters in the PDT group achieved values similar to those in the HC group. CONCLUSIONS: In patients with PD, progressive RT improved cardiovascular autonomic dysfunction.

Chronotype and anxiety are associated in patients with chronic primary insomnia

Objective: To assess the interaction of chronotype with anxiety in patients with chronic primary insomnia. Methods: Sixty-four patients (50 women) with mean age 43.9±8.1 years were investigated with the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) and State-Trait Anxiety Inventory (STAI). Results: Significant negative correlations of chronotype-MEQ score with STAI state-anxiety (r = -0.40, p < 0.05), STAI trait-anxiety (r = -0.40, p < 0.05), and STAI pre-sleep state anxiety (r = -0.30, p < 0.05) were observed. Eveningness preference was associated with higher trait, state, and pre-sleep state anxiety. Conclusions: These results suggest that chronotype may be an important parameter to identifying the origin and significance of a vicious anxiety-insomnia-depression cycle in patients with chronic primary insomnia.

Chronotype and anxiety are associated in patients with chronic primary insomnia.

OBJECTIVE:: To assess the interaction of chronotype with anxiety in patients with chronic primary insomnia. METHODS:: Sixty-four patients (50 women) with mean age 43.9±8.1 years were investigated with the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) and State-Trait Anxiety Inventory (STAI). RESULTS:: Significant negative correlations of chronotype-MEQ score with STAI state-anxiety (r = -0.40, p < 0.05), STAI trait-anxiety (r = -0.40, p < 0.05), and STAI pre-sleep state anxiety (r = -0.30, p < 0.05) were observed. Eveningness preference was associated with higher trait, state, and pre-sleep state anxiety. CONCLUSIONS:: These results suggest that chronotype may be an important parameter to identifying the origin and significance of a vicious anxiety-insomnia-depression cycle in patients with chronic primary insomnia.

Physiological and cytokine response to acute exercise under hypoxic conditions: a pilot study.

BACKGROUND: Studies have demonstrated that exercise in hypoxia situations induces a cytotoxicity effects. However, the cytokines participation in this condition is remaining unknown. Thus, the aim the present study was to evaluate physiological parameters and inflammatory profiles in response to acute exercise after five hours of hypoxic conditions. METHODS: Fourteen healthy men were distributed randomly into two groups: normoxic exercise (N.=7) and hypoxic exercise (N.=7). All volunteers were blinded to the protocol. Initially, all subjects were submitted to chamber normobaric in a room fitted for altitude simulations of up to 4500 m, equivalent to a barometric pressure of 433 mmHg. All analyses began at 7:00 a.m. and was maintained for 5 hours; the fraction of inspired oxygen (FiO2) was 13.5%. The groups began a 60-minute session of physical exercise starting at 11:00 a.m., at 50% of peak VO2 (50% VO2peak). Blood was collected for cytokine analysis in the morning upon waking, before the 60-minute exercise session and immediately thereafter. RESULTS: The heart rate during 60 minutes' exercise training was significantly increased in both exercise groups (P<0.05), and the oxygen saturation was reduced under hypoxic conditions during exercise (P<0.05). After exercise, significant increases were found for IL-1ra and IL-10 under hypoxic conditions (P<0.05) and for IL-6 for both groups (P<0.05). TNF-α was not altered under either environmental condition. CONCLUSIONS: Our data demonstrate that acute exercise performance in hypoxic conditions can promotes early inflammatory response, leads for immunosuppression state.

The quantification of game-induced muscle fatigue in amputee soccer players.

BACKGROUND: This study quantified the degree of game-induced muscular fatigue in amputee soccer players. METHODS: Thirty-three male amputee soccer players performed muscular tests (Push Up Test [PUT], Countermovement Jump Test [CMJ] and medicine-ball throw [MBT]) before and after a competitive match. Five players served as a control group. The rating of perceived exertion was recorded after each battery. RESULTS: Control group demonstrated no differences between the two testing batteries (P>0.05, effect size [ES]: 0.1-0.4). However, match group illustrated markedly lower performances for PUT (-17%, P<0.01, ES: 0.9) with less pronounced declines in MBT (-8%, P<0.01, ES: 0.7) and CMJ (-5%, P<0.01, ES: 0.3) compared to pre-match values. The rating of perceived exertion were higher after the match compared to baseline values (+60%, P<0.01, ES: 2.4). CONCLUSIONS: The data demonstrate that the fatigue experienced after amputee soccer matches causes impairments in muscular performance and this could be different to able-bodied players.

Homeostasis Model Assessment-Adiponectin: the role of different types of physical exercise in obese adolescents.

BACKGROUND: Homeostasis Model Assessment-Adiponectin (HOMA-AD) is suggesting a new biomarker of insulin resistance in obese population. In this way, the purpose of this study was to investigate the effects of different kinds of exercise in the sensitive index predictor of insulin resistance. METHODS: A total of 148 obese adolescents were enrolled in the program. They aged 15-19 y, with Body Mass Index (BMI) ≥P95th and were submitted to 1 year of interdisciplinary weight loss therapy, randomized in two groups, aerobic training (AT) (N.=51) and aerobic plus resistance training (N.=97). Blood samples were collected to analyze adiponectin, glucose and insulin concentrations. The insulin resistance was measured by HOMA-AD and Homeostasis Model Assessment Insulin Resistance Index (HOMA-IR). RESULTS: Both kinds of exercise training promoted a decrease in body mass, body mass index, fat mass, visceral and subcutaneous fat. However, only aerobic plus resistance training was effective to reduce HOMA-AD, insulin and glucose concentration; and increase insulin sensibility and adiponectin concentration. CONCLUSIONS: The aerobic plus resistance training was more effective than AT alone to improve the HOMA-AD, suggesting clinical application on obesity, diabetes, atherosclerosis and metabolic syndrome control in the pediatric population.

Resistance Training Improves Sleep Quality in Subjects With Moderate Parkinson's Disease.

Silva-Batista, C, de Brito, LC, Corcos, DM, Roschel, H, de Mello, MT, Piemonte, MEP, Tricoli, V, and Ugrinowitsch, C. Resistance training improves sleep quality in subjects with moderate Parkinson's disease. J Strength Cond Res 31(8): 2270-2277, 2017-The objectives of this study were to test if 12 weeks of progressive resistance training (RT) improves sleep quality and muscle strength in subjects with moderate Parkinson's disease (PD) and if sleep quality values of subjects with moderate PD are closer to those of age-matched healthy controls (HC) at posttraining. This was a randomized controlled trial conducted between March 2013 and September 2014. Twenty-two subjects with moderate PD were randomly assigned to a nonexercising control group (n = 11) or an RT group (n = 11). Thirty-one HC were not randomized to any group. The RT group performed a RT program twice a week for 12 weeks, whereas the control group made no change to their weekly routine. For subjects with PD, sleep quality (i.e., Pittsburgh Sleep Quality Index [PSQI]) and knee-extensor peak torque were assessed before and after 12 weeks of intervention; for HC, these outcomes were assessed at pretest only. There were differences between RT and control groups in PSQI scores, PSQI subscores(i.e., subjective sleep quality and daytime dysfunction), and knee-extensor peak torque at posttraining (p ≤ 0.05). After RT, the average subjects with PD showed lower (i.e., improved) PSQI scores than the average HC (p ≤ 0.05). A negative association was observed between changes in PSQI scores and changes in knee-extensor peak torque at posttraining (r = -0.58, p = 0.028). No adverse events were reported. The RT is recommended as an adjunct therapeutic method for improving sleep quality of subjects with moderate PD and moving these levels to those observed in HC.

Assessment of Body Composition and Sport Performance of Brazilian Paralympic Swim Team Athletes.

CONTEXT: Body-composition assessments of high-performance athletes are very important for identifying physical performance potential. Although the relationship between the kinanthropometric characteristics and performance abilities of Olympic swimmers is extremely important, this subject is not completely understood for Paralympic swimmers. OBJECTIVE: To investigate the relationship between body composition and sport performance in Brazilian Paralympic swimmers 6 mo after training. DESIGN: Experimental pre/posttest design. SETTING: Research laboratory and field evaluations of swimming were conducted to verify the 50-m freestyle time of each athlete. PARTICIPANTS: 17 Brazilian Paralympic swim team athletes (12 men, 5 women). MAIN OUTCOME MEASURES: Body-composition assessments were performed using a BOD POD, and swimming performance was assessed using the 50-m freestyle, which was performed twice: before and after 6 mo of training. RESULTS: Increased lean mass and significantly reduced relative fat mass and swimming time (P < .05) were observed 6 mo after training. Furthermore, a positive correlation between body-fat percentage and performance (r = .66, P < .05) was observed, but there was no significant correlation between body density and performance (r = -.14, P > .05). CONCLUSIONS: After a 6-mo training period, Paralympic swimmers presented reduced fat mass and increased lean body mass associated with performance, as measured by 50-m freestyle time. These data suggest that reduced fat-mass percentage was significantly correlated with improved swimming performance in Paralympic athletes.

Blunted Maximal and Submaximal Responses to Cardiopulmonary Exercise Tests in Patients With Parkinson Disease.

OBJECTIVE: To investigate submaximal and maximal responses during maximal cardiopulmonary exercise tests in subjects with Parkinson disease (PD). DESIGN: Cross-sectional. SETTING: A PD association. PARTICIPANTS: A sample (N=68) of subjects with PD (n=48; mean age, 66±8y; modified Hoehn and Yahr stage between 2 and 3; "on" state of medication) and age-matched controls without PD (n=20; mean age, 64±9y). INTERVENTIONS: Maximal cardiopulmonary exercise test on a cycle ergometer. MAIN OUTCOME MEASURES: Oxygen uptake (V˙o2), systolic blood pressure (SBP), and heart rate assessed at rest, submaximal intensities (ie, anaerobic threshold [AT] and respiratory compensation point), and maximal intensity (peak exercise). RESULTS: Compared with control subjects, subjects with PD had lower V˙o2, heart rate, and SBP at respiratory compensation point and peak exercise (V˙o2: 14.6±3.6mL⋅kg⋅min vs 17.9±5.5mL⋅kg⋅min and 17.7±4.8mL⋅kg⋅min vs 21.5±6.6mL⋅kg⋅min; heart rate: 119±17beats/min vs 139±12beats/min and 132±20beats/min vs 158±13beats/min; SBP: 151±17mmHg vs 172±20mmHg and 166±21mmHg vs 187±24mmHg; P≤.05). They also had lower heart rate at AT (102±14beats/min vs 110±13beats/min; P≤.05), whereas V˙o2 and SBP at this intensity were similar to those of control subjects. CONCLUSIONS: Subjects with PD demonstrated blunted metabolic and cardiovascular responses to submaximal and maximal exercise tests, especially at intensities above AT, which are in line with autonomic disturbances present in patients with PD. Future studies need to determine how this affects performance, participation, and responses of these patients to exercise training at different intensities.

Incremental exercise test for the evaluation of peak oxygen consumption in paralympic swimmers.

BACKGROUND: Peak oxygen consumption (VO2peak) is a fundamental parameter used to evaluate physical capacity. The objective of this study was to explore two types of incremental exercise tests used to determine VO2peak in four Paralympic swimmers: arm ergometer testing in the laboratory and testing in the swimming pool. METHODS: On two different days, the VO2peak values of the four athletes were measured in a swimming pool and by a cycle ergometer. The protocols identified the VO2peak by progressive loading until the volitional exhaustion maximum was reached. The results were analyzed using the paired Student's t-test, Cohen's d effect sizes and a linear regression. RESULTS: The results showed that the VO2peak values obtained using the swimming pool protocol were higher (P=0.02) than those obtained by the arm ergometer (45.8±19.2 vs. 30.4±15.5; P=0.02), with a large effect size (d=3.20). When analyzing swimmers 1, 2, 3 and 4 individually, differences of 22.4%, 33.8%, 60.1% and 27.1% were observed, respectively. CONCLUSIONS: Field tests similar to the competitive setting are a more accurate way to determine the aerobic capacity of Paralympic swimmers. This approach provides more sensitive data that enable better direction of training, consequently facilitating improved performance.