Pilates method in the treatment of patients with Chikungunya fever: a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the effects of the Pilates method on the reduction of pain, improvement of joint function, and quality of life of patients with chronic Chikungunya fever. DESIGN: This is a randomized, controlled, blind trial for the evaluators. SETTING: The study was conducted at the Advanced Laboratory in Physical Education and Health at Federal University of Pernambuco, Brazil. SUBJECTS: A total of 51 patients were allocated randomly and divided into 2 groups: a Pilates group (26 patients) and a control group (25 patients). After 12 weeks, 4 patients in the Pilates group and 5 in the control group were lost to follow-up. INTERVENTION: The Pilates group performed 24 Pilates method intervention sessions; the control group continued to receive standard clinical treatment at the outpatient clinic. MAIN MEASURES: The main measures were as follows: visual analogue scale (VAS) for pain, functional capacity evaluated by Health Assessment Questionaire (HAQ), quality of life measured by the 12-Item Short-Form Health Survey (SF-12), and range of joint motion by goniometry. RESULTS: After 12 weeks, patients in the Pilates group presented lower VAS (P < 0.001), lower HAQ scores (P < 0.001), and higher quality-of-life scores (P < 0.001) compared with the control group. We found statistically significant results for the Pilates group in the range of movement for shoulder, knee, ankle, and lumbar spine (P < 0.001). In the intragroup analysis, there was a significant improvement in all outcomes evaluated. CONCLUSION: In this study, patients undertaking Pilates method for 12 weeks had less pain, better function and quality of life, and increased range of joint movement.

Prevalence of Perceived Barriers to Physical Activity Among Pre- and Post-Metabolic and Bariatric Surgery Patients: A Cross-Sectional Study.

OBJECTIVE: This study aims to describe and compare the prevalence of perceived barriers to physical activity (PBPA) in pre- and post-metabolic and bariatric surgery (MBS) patients and assess the association of these barriers with their physical activity levels. METHODS: A cross-sectional study included pre-operative (n = 63) and post-operative (n = 119) groups. Sociodemographic characteristics, leisure-time physical activity levels, and PBPA data were collected. Descriptive statistics, chi-square, and Fisher's exact tests, and binomial logistic regression analyses were used for comparisons and associations. RESULTS: Compared to the pre-operative group, the post-operative group had a lower prevalence of barriers in the physical domain (p = 0.036) and the behavioral domain (p = 0.004). However, there were no significant differences in the environmental (p = 0.531) or social (p = 0.597) domains. Pre-MBS patients were more likely to be physically inactive when perceiving barriers in the environmental (p = 0.048) and behavioral (p = 0.048) domains. In contrast, post-surgical patients were more likely to be physically inactive when perceiving barriers in the environmental (p = 0.027), social (p = 0.020), and behavioral (p = 0.037) domains. CONCLUSION: The results show that individuals who underwent metabolic and bariatric surgery have a lower prevalence of behavioral and physical PBPA compared to those awaiting the procedure. The perception of barriers to physical activity in the environmental and behavioral domains increases the likelihood of physical inactivity in both pre- and post-MBS patients, while in the social domain, it was only associated with physical activity in post-MBS patients.

The impact of supervised physical exercise on chemokines and cytokines in recovered COVID-19 patients.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which induces a high release of pro-inflammatory chemokines and cytokines, leading to severe systemic disorders. Further, evidence has shown that recovered COVID-19 patients still have some symptoms and disorders from COVID-19. Physical exercise can have many health benefits. It is known to be a potent regulator of the immune system, which includes frequency, intensity, duration, and supervised by a professional. Given the confinement and social isolation or hospitalization of COVID-19 patients, the population became sedentary or opted for physical exercise at home, assuming the guarantee of the beneficial effects of physical exercise and reducing exposure to SARS-CoV-2. This study aimed to investigate the effects of a supervised exercise protocol and a home-based unsupervised exercise protocol on chemokine and cytokine serum levels in recovered COVID-19 patients. This study was a prospective, parallel, two-arm clinical trial. Twenty-four patients who had moderate to severe COVID-19 concluded the intervention protocols of this study. Participants were submitted to either supervised exercise protocol at the Clinical Hospital of the Federal University of Pernambuco or home-based unsupervised exercise for 12 weeks. We analyzed serum levels of chemokines (CXCL8/IL-8, CCL5/RANTES, CXCL9/MIG, CCL2/MCP-1, and CXCL10/IP-10) and cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, and IFN-γ). Before the interventions, no significant differences were observed in the serum levels of chemokines and cytokines between the supervised and home-based unsupervised exercise groups. The CXCL8/IL-8 (p = 0.04), CCL2/MCP-1 (p = 0.03), and IFN-γ (p = 0.004) levels decreased after 12 weeks of supervised exercise. In parallel, an increase in IL-2 (p = 0.02), IL-6 (p = 0.03), IL-4 (p = 0.006), and IL-10 (p = 0.04) was observed after the supervised protocol compared to pre-intervention levels. No significant differences in all the chemokines and cytokines were found after 12 weeks of the home-based unsupervised exercise protocol. Given the results, the present study observed that supervised exercise was able to modulate the immune response in individuals with post-COVID-19, suggesting that supervised exercise can mitigate the inflammatory process associated with COVID-19 and its disorders. Clinical trial registration: https://ensaiosclinicos.gov.br/rg/RBR-7z3kxjk, identifier U1111-1272-4730.

Sarcopenia in Non-Dialysis Chronic Kidney Disease Patients: Prevalence and Associated Factors.

Background: Sarcopenia is related to morbidity and mortality in non-dialysis Chronic Kidney Disease (ND-CKD) patients; however, the pathophysiology of sarcopenia remains unclear. The study aimed to assess the prevalence and factors associated with sarcopenia in ND-CKD individuals. Methods: We cross-sectionally evaluated 139 prevalent ND-CKD patients attending our outpatient clinic at Hospital das Clínicas of the Federal University of Pernambuco, between April and October 2019. Patients older than 18 years old and at G3-G5 CKD stages were included. Hand grip strength, Muscle Mass appendicular Index, and Gait Speed (GS) were defined by the standards of the European Working Group on Sarcopenia in Older People 2 guideline. Results: Sarcopenia prevalence was 20.9% and severe sarcopenia 2.9%. Sarcopenic were mostly found in elderly ones (64.8 ± 13.5 years vs. 54.9 ± 12.8 years, p < 0.001), revealing lower body mass index [26.1 (6.8) vs. 28.6 (6.2), p = 0.023], lower phase angle (PhA) [4.50 (1.10) vs. 5.60 (1.20), p < 0.001] and lower GS [1.00 (0.50) vs. 1.40 (0.4), p < 0.001]. They also presented lower serum creatinine levels [2.40 (1.50) vs. 3.0 (1.8), p = 0.032], lower Albumin-to-Creatinine Ratio [72.60 (1008.30) vs. 342.30 (1172.1), p = 0.039] and Hemoglobin levels [11.45 (1.8) vs. 12.60 (2.40), p = 0.003], and higher levels of C-reactive protein [0.2 (0.80) vs. 0.03 (0.3), p = 0.045] compared to non-sarcopenic. Under Poisson Multivariate Model, PhA [Relative precision (RP): 0.364, Confidence Interval (CI) (95%):0.259-0.511, p < 0.001], Interleukin six (IL-6) [RP: 1.006, CI (95%):1.001-1.01, p = 0.02] and serum creatinine levels [RP: 0.788, CI (95%): 0.641-0.969, p = 0.024] were associated with sarcopenia. Conclusions: Sarcopenia predominance was identified in our ND-CKD population, and was associated with lower PhA values, higher IL-6 levels, and lower serum creatinine levels.

The influence of overweight on postural balance and mobility of candidates for bariatric surgery / Influência do excesso de peso sobre o equilíbrio postural e a mobilidade de candidatos à cirurgia bariátrica

Abstract Obesity is considered a risk factor to health and besides generating metabolic and cardiovascular alterations, it is related to mechanical complications. Since stability may be altered due to anthropometric and biomechanical factors, studies investigating the relationship of excess weight on the mobility and balance of obese adults are still scarce. The research aimed to evaluate the postural balance and mobility of obese individuals who are waiting for bariatric surgery. This is a cross-sectional and descriptive study, conducted at the Hospital das Clínicas of the Universidade Federal de Pernambuco. The sample consisted of 97 individuals, 81 women, 16 men, age 38.39 ± 10.60 years and body mass index 47.5 ± 6.9 kg/m2. The Timed Up and Go test, which evaluates the mobility, resulted in 7.6 ± 1.7 seconds as the average of the longest times spent to perform the test. Regarding the evaluation of dynamic balance and mobility, it was found that the domains of anticipatory postural adjustments, necessary to prevent postural disturbances (median 5, 95%CI 5-6) and the domain of dynamic movement, which corresponds to the balance necessary to walk (median 8, 95%CI 7-9) are the most impaired in the subjects with obesity. Positive correlations were found between weight and dynamic balance. The findings indicate that excess body fat interferes with dynamic balance.

Resumo A obesidade é considerada fator de risco à saúde e além de gerar alterações metabólicas e cardiovasculares, está relacionada a complicações mecânicas. Uma vez que a estabilidade pode estar alterada em função de fatores antropométricos e biomecânicos, ainda são escassos os estudos que investigam a relação do excesso de peso sobre a modilidade e equilíbrio dos adultos obesos. A pesquisa teve como objetivo avaliar o equilíbrio postural e a mobilidade dos indivíduos com obesidade que estão aguardando a realização da Cirurgia Bariátrica. Trata-se de um estudo transversal e descritivo, realizado no Hospital das Clínicas da Universidade Federal de Pernambuco. A amostra foi composta por 97 indivíduos, sendo 81 mulheres, 16 homens, idade 38,39 ± 10,60 anos e índice de massa corporal 47,5 ± 6,9 kg/m2. O teste Timed Up and Go, que avalia a mobilidade, teve como resultado 7,6 ± 1,7 segundos como a média dos maiores tempos gastos para a execução do teste. A respeito da avaliação do equilíbrio dinâmico e da mobilidade, verificou-se que os domínios de ajustes posturais antecipatórios, necessários para prevenir perturbações posturais (mediana 5, IC95% 5-6) e o domínio de movimentação dinâmica, que corresponde ao equilíbrio necessário para a realização da marcha (mediana 8; IC95% 7-9) são os mais prejudicados nos sujeitos com obesidade avaliados. Foram constatadas correlações positiva entre peso e equilíbrio dinâmico. Os achados indicam que o excesso de gordura corporal interfere no equilíbrio dinâmico.

Kinetics of Hypotension during 50 Sessions of Resistance and Aerobic Training in Hypertensive Patients: a Randomized Clinical Trial.

Background: Resistance and aerobic training are recommended as an adjunctive treatment for hypertension. However, the number of sessions required until the hypotensive effect of the exercise has stabilized has not been clearly established. Objective: To establish the adaptive kinetics of the blood pressure (BP) responses as a function of time and type of training in hypertensive patients. Methods: We recruited 69 patients with a mean age of 63.4 ± 2.1 years, randomized into one group of resistance training (n = 32) and another of aerobic training (n = 32). Anthropometric measurements were obtained, and one repetition maximum (1RM) testing was performed. BP was measured before each training session with a digital BP arm monitor. The 50 training sessions were categorized into quintiles. To compare the effect of BP reduction with both training methods, we used two-way analysis of covariance (ANCOVA) adjusted for the BP values obtained before the interventions. The differences between the moments were established by one-way analysis of variance (ANOVA). Results: The reductions in systolic (SBP) and diastolic BP (DBP) were 6.9 mmHg and 5.3 mmHg, respectively, with resistance training and 16.5 mmHg and 11.6 mmHg, respectively, with aerobic training. The kinetics of the hypotensive response of the SBP showed significant reductions until the 20th session in both groups. Stabilization of the DBP occurred in the 20th session of resistance training and in the 10th session of aerobic training. Conclusion: A total of 20 sessions of resistance or aerobic training are required to achieve the maximum benefits of BP reduction. The methods investigated yielded distinct adaptive kinetic patterns along the 50 sessions.

Fundamento: Os treinamentos de força e aeróbio são indicados para o tratamento adjuvante da hipertensão. Entretanto, o número de sessões necessárias até estabilização do efeito hipotensor com o exercício ainda não está claramente estabelecido. Objetivo: Estabelecer a cinética adaptativa das respostas tensionais em função do tempo e do tipo de treinamento em hipertensos. Métodos: Foram recrutados 69 hipertensos com idade média de 63,4 ± 2,1 anos, randomizados em um grupo de treinamento de força (n = 32) e outro de treinamento aeróbio (n = 32). Foram realizadas medidas antropométricas e testes de uma repetição máxima (1RM). A pressão arterial (PA) foi medida antes de cada sessão de treinamento com um aparelho de pressão digital de braço. As 50 sessões de treinamento foram categorizadas em quintis. Para comparar o efeito da redução da PA entre os métodos de treinamentos (between), utilizamos análise de covariância (ANCOVA) bifatorial ajustada para os valores de PA pré-intervenção. As diferenças entre os momentos foram estabelecidas por análise de variância (ANOVA) unifatorial. Resultados: As reduções na PA sistólica (PAS) e diastólica (PAD) foram de 6,9 mmHg e 5,3 mmHg, respectivamente, com o treinamento de força e 16,5 mmHg e 11,6 mmHg, respectivamente, com o treinamento aeróbio. A cinética hipotensiva da PAS apresentou reduções significativas até a 20ª sessão em ambos os grupos. Observou-se estabilização da PAD na 20ª sessão com o treinamento de força e na 10ª sessão com o aeróbio. Conclusão: São necessárias 20 sessões de treinamento de força ou aeróbio para alcance dos benefícios máximos de redução da PA. Os métodos investigados proporcionaram padrões cinéticos adaptativos distintos ao longo das 50 sessões.

Estratégias e ações de cuidado no programa Academia da Cidade durante a pandemia de covid-19: relato de experiência / Care strategies and actions at the Academia da Cidade program during the COVID-19 pandemic: experience report / Estrategias y acciones de cuidado en la Academia de la Ciudad durante la pandemia: reporte de experiencia

Perante um contexto de rápida disseminação do novo coronavírus, inúmeras secretarias municipais e estaduais de saúde adotaram medidas cautelares para diminuir a contaminação. Tais medidas ocasionaram o fechamento de espaços públicos e, igualmente, os ambientes típicos de prática de atividade física foram limitados. Além disso, o isolamento ressoou na população, acarretando diferentes sentimentos que provocaram medos e incertezas, que, adicionado a um frequente estado de luto, atingiram a saúde mental da população. Desse modo, diferentes estratégias e ações intersetoriais foram utilizadas nesse período, visando amenizar os efeitos prejudiciais do isolamento e superar as barreiras para a manutenção de um estilo de vida saudável. Assim, o objetivo desta pesquisa é relatar uma experiência de desenvolvimento de estratégias e ações de cuidado realizadas com usuários de um programa de promoção à saúde com ajuda das práticas corporais em Recife, Pernambuco.

Faced with a context of rapid spread of the new coronavirus, numerous municipal and state health departments have adopted precautionary measures to reduce contamination. Such measures resulted in the closing of public spaces and the typical environments for physical activity were limited as well. In addition, isolation resonated with the population, resulting in different feelings that caused fears and uncertainties, which, added to a frequent state of mourning, affected the mental health of the population. Thus, different intersectoral strategies and actions were used in this period, aiming to mitigate the harmful effects of isolation and overcome barriers to maintaining a healthy lifestyle. Thus, the objective of this research is to report an experience of developing strategies and care actions carried out with users of a health promotion program with the help of body practices in Recife, Pernambuco.

Ante un contexto de rápida propagación del nuevo coronavirus, muchas secretarías de salud municipales y estaduales han adoptado medidas de precaución para reducir la contaminación. Tales medidas dieron como resultado el cierre de espacios públicos y limitaron los ambientes para la actividad física. Además, el aislamiento tuvo impacto en la población al generar diferentes sentimientos relacionados a temores e incertidumbres, a lo cual se sumó a un estado de duelo frecuente, afectándole su salud mental. Así, en este período se utilizaron diferentes estrategias y acciones intersectoriales, con el objetivo de mitigar los efectos nocivos del aislamiento y superar las barreras para mantener un estilo de vida saludable. Por lo tanto, el objetivo de este estudio es relatar una experiencia de desarrollo de estrategias y acciones de cuidado realizadas con usuarios de un programa de promoción de la salud de prácticas corporales en Recife, Pernambuco (Brasil).

Acute effects of different intensities resistance training on inflammatory markers of women with severe obesity / Efeitos agudos de treinamento de força com diferentes intensidades sobre marcadores inflamatórios de mulheres com obesidade severa

ABSTRACT This study objective to compare the acute effects between one resistance training bout with high versus moderate intensities on inflammatory markers in women with severe obesity. Experimental crossover study, performed with adult women with severe obesity (BMI ≥ 40.0 kg/m²; age ≥ 18 years old). Each participant performed a high and moderate intensity resistance training (HIRT and MIRT, respectively) with an interval of 7 days between bouts. Four exercises were performed in the both protocols, with total training volume equalized. MIRT consisted of 3 sets of 8 repetitions each, with an intensity of 75% of 1RM, while HIRT consisted of 2 sets of 6 repetitions, followed by a 20-second rest, with a new performance of 2 to 3 repetitions, with one more rest of 20s and finishing with 2 to 3 more repetitions, at an intensity of 85% of 1RM. Blood samples were collected before, 15 minutes after and 24 hours after both training protocols. The inflammatory markers analyzed were IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ. Nine participants have completed the intervention (n=9; 35.2 ± 10.93 years old; BMI = 48.3 ± 5.06 kg/m²). The Mann-Whitney U test showed that there was no significant difference between the HIRT and MIRT in the concentration of markers. Friedman's test did not report significant differences between intragroup measures for the HIRT as well as MIRT. This research suggests that a single session of high or moderate intensity resistance training does not change the inflammatory status of women with severe obesity.

RESUMO Este estudo objetivou comparar os efeitos agudos entre uma sessão de treinamento de força de alta versus moderada intensidade sobre marcadores inflamatórios em mulheres com obesidade severa. Estudo experimental do tipo cross-over, realizado com mulheres adultas com obesidade severa (IMC ≥ 40,0 kg/m²; idade ≥ 18 anos). Cada participante realizou uma sessão de treinamento de força de alta e de moderada intensidade (HIRT e MIRT, respectivamente) com intervalo de 7 dias entre as sessões. Quatro exercícios foram realizados em ambos os protocolos, com volume total de treino equalizado. O MIRT consistiu em 3 séries de 8 repetições cada, com intensidade de 75% de 1RM, enquanto o HIRT consistiu em 2 séries de 6 repetições, seguidas de um descanso de 20 segundos, com nova execução de 2 a 3 repetições, com mais um descanso de 20s e finalização com mais 2 a 3 repetições, com intensidade de 85% de 1RM. Amostras de sangue foram coletadas antes, 15 minutos após e 24 horas após ambos os protocolos de treino. Os marcadores inflamatórios analisados foram IL-2, IL-4, IL-6, IL-10, TNF-α e IFN-γ. Nove participantes completaram a intervenção (n=9; 35,2 ± 10,93 anos; IMC = 48,3 ± 5,06 kg/m²). O teste U de Mann-Whitney mostrou que não houve diferença significativa entre HIRT e MIRT na concentração dos marcadores. O teste de Friedman não mostrou diferenças significativas entre as medidas intragrupo para HIRT e MIRT. Esta pesquisa sugere que uma única sessão de treinamento de força de alta ou moderada intensidade não altera o estado inflamatório de mulheres com obesidade severa.

Effect of the aerobic component of combined training on the blood pressure of hypertensive elderly women / Efeito do componente aeróbico no treinamento combinado sobre a pressão arterial de idosas hipertensas / Efecto del componente aeróbico en el entrenamiento combinado sobre la presión arterial de mujeres de tercera edad hipertensas

ABSTRACT Introduction Aerobic (AT), strength (ST) and combined (CT) training are already well referenced as a method for the treatment and control of arterial hypertension (AH) inducing positive changes in blood pressure (BP) reduction, a phenomenon known as post-exercise hypotension (PEH). However, the correct order of combined training to promote PEH is still unclear. Objective To verify the effect of the order of the aerobic component in combined training on PEH among hypertensive elderly women. Methods Randomized clinical trial of 24 elderly hypertensive women allocated to three training groups: Group 1 - Aerobic + Strength Training (AT + ST), Group 2 - Strength + Aerobic Training (ST + AT) and Group 3 - Aerobic + Strength + Aerobic Training (AT + ST + AT). Participants underwent AT at 60% heart rate reserve intensity for 30 minutes and ST with four exercises in three sets of 12 repetitions at 60% of one-repetition maximum (1RM) also for 30 minutes. The training involved 24 sessions (three times a week).Systolic (SBP) and diastolic blood pressure (DBP) were measured in all groups at time points before and after each session, and the mean BP (MBP) was calculated. Results The variables analyzed did not differ significantly between groups in either the pre- or post-training period. MBP showed a significant reduction only in G1. However, G3 had a greater effect on all the variables analyzed. Conclusion Combined training with an aerobic component (G3) generated a significant post-exercise hypotensive effect over 24 sessions, and is indicated for elderly hypertensive women. Level of evidence II; Therapeutic studies.

RESUMO Introdução O treinamento aeróbico (TA), de força (TF) e combinado (TC) já são bem conhecidos como método de tratamento e controle da hipertensão arterial (HA), levando a alterações positivas na redução da pressão arterial (PA), fenômeno denominado hipotensão pós-exercício (HPE). Porém, persistem dúvidas quanto à ordem do treinamento combinado para promoção da HPE. Objetivo Verificar o efeito da ordem do componente aeróbico no treinamento combinado na HPE em idosas hipertensas. Métodos Ensaio clínico randomizado composto por 24 idosas hipertensas, distribuídas em três grupos de treinamento: Grupo 1 - Treinamento Aeróbico + Força (TA+TF), Grupo 2 - Treinamento de Força + Aeróbico (TF+TA) e Grupo 3 - Treinamento Aeróbico + Força + Aeróbico (TA+TF+TA). As participantes foram submetidas ao TA com intensidade de 60% da frequência cardíaca de reserva durante 30 minutos e ao TF com quatro exercícios, em três séries de 12 repetições, a 60% de uma repetição máxima (1RM) também de 30 minutos. Os treinamentos foram realizados ao longo de 24 sessões (três vezes por semana), sendo aferidas a pressão arterial sistólica (PAS) e diastólica (PAD) em todos os grupos, nos períodos antes e após cada sessão, e calculada a PA média (PAM). Resultados As variáveis analisadas não diferiram significativamente entre os grupos, nem no período pré-, nem no pós-treino. A PAM apresentou redução significativa apenas no G1. Porém, o G3 teve efeito maior sobre todas as variáveis analisadas. Conclusão O treinamento combinado com aeróbico fracionado (G3) gerou grande efeito hipotensor pós-exercício ao longo das 24 sessões, sendo indicado para o público de idosas hipertensas. Nível de evidência II; Estudos terapêuticos.

RESUMEN Introducción El entrenamiento aeróbico (EA), de fuerza (EF) y combinado (EC) ya están bien referenciados como forma de tratamiento y control de la hipertensión arterial (HA) llevando a alteraciones positivas en la reducción de la presión arterial (PA), fenómeno denominado hipotensión post-ejercicio (HPE). Sin embargo, persisten dudas cuanto al orden del entrenamiento combinado para promoción de la HPE. Objetivo Verificar el efecto del orden del componente aeróbico en el entrenamiento conjunto en la HPE de mujeres de tercera edad hipertensas. Métodos Ensayo clínico aleatorizado compuesto por 24 mujeres de tercera edad hipertensas, distribuidas en tres grupos de entrenamiento: Grupo 1 - Entrenamiento Aeróbico + Fuerza (EA+EF), Grupo 2 - Entrenamiento de Fuerza + Aeróbico (EF+EA) y Grupo 3 - Entrenamiento Aeróbico + Fuerza + Aeróbico (EA+EF+EA). Las participantes fueron sometidas al EA con intensidad del 60% de la frecuencia cardíaca de reserva durante 30 minutos y al EF con cuatro ejercicios, en tres series de 12 repeticiones, al 60% de una repetición máxima (1RM) también de 30 minutos. Los entrenamientos fueron realizados a lo largo de 24 sesiones (tres veces por semana), siendo medidas la presión arterial sistólica (PAS) y diastólica (PAD) en todos los grupos, en los períodos antes y después de cada sesión, y se calculó la PA media (PAM). Resultados Las variables analizadas no difirieron significativamente entre los grupos, ni en el momento pre, ni post entrenamiento. La PAM presentó reducción significativa sólo en el G1. Sin embargo, el G3 tuvo efecto mayor sobre todas las variables analizadas. Conclusión El entrenamiento combinado con aeróbico fraccionado (G3) generó gran efecto hipotensor post ejercicio a lo largo de 24 sesiones, siendo indicado para el público de mujeres de tercera edad hipertensas. Nivel de evidencia II; Estudios terapéuticos.

Kinetics of Hypotension during 50 Sessions of Resistance and Aerobic Training in Hypertensive Patients: a Randomized Clinical Trial / Cinética Hipotensiva durante 50 Sessões de Treinamento de Força e Aeróbio em Hipertensos: Ensaio Clínico Randomizado

Abstract Background: Resistance and aerobic training are recommended as an adjunctive treatment for hypertension. However, the number of sessions required until the hypotensive effect of the exercise has stabilized has not been clearly established. Objective: To establish the adaptive kinetics of the blood pressure (BP) responses as a function of time and type of training in hypertensive patients. Methods: We recruited 69 patients with a mean age of 63.4 ± 2.1 years, randomized into one group of resistance training (n = 32) and another of aerobic training (n = 32). Anthropometric measurements were obtained, and one repetition maximum (1RM) testing was performed. BP was measured before each training session with a digital BP arm monitor. The 50 training sessions were categorized into quintiles. To compare the effect of BP reduction with both training methods, we used two-way analysis of covariance (ANCOVA) adjusted for the BP values obtained before the interventions. The differences between the moments were established by one-way analysis of variance (ANOVA). Results: The reductions in systolic (SBP) and diastolic BP (DBP) were 6.9 mmHg and 5.3 mmHg, respectively, with resistance training and 16.5 mmHg and 11.6 mmHg, respectively, with aerobic training. The kinetics of the hypotensive response of the SBP showed significant reductions until the 20th session in both groups. Stabilization of the DBP occurred in the 20th session of resistance training and in the 10th session of aerobic training. Conclusion: A total of 20 sessions of resistance or aerobic training are required to achieve the maximum benefits of BP reduction. The methods investigated yielded distinct adaptive kinetic patterns along the 50 sessions.

Resumo Fundamento: Os treinamentos de força e aeróbio são indicados para o tratamento adjuvante da hipertensão. Entretanto, o número de sessões necessárias até estabilização do efeito hipotensor com o exercício ainda não está claramente estabelecido. Objetivo: Estabelecer a cinética adaptativa das respostas tensionais em função do tempo e do tipo de treinamento em hipertensos. Métodos: Foram recrutados 69 hipertensos com idade média de 63,4 ± 2,1 anos, randomizados em um grupo de treinamento de força (n = 32) e outro de treinamento aeróbio (n = 32). Foram realizadas medidas antropométricas e testes de uma repetição máxima (1RM). A pressão arterial (PA) foi medida antes de cada sessão de treinamento com um aparelho de pressão digital de braço. As 50 sessões de treinamento foram categorizadas em quintis. Para comparar o efeito da redução da PA entre os métodos de treinamentos (between), utilizamos análise de covariância (ANCOVA) bifatorial ajustada para os valores de PA pré-intervenção. As diferenças entre os momentos foram estabelecidas por análise de variância (ANOVA) unifatorial. Resultados: As reduções na PA sistólica (PAS) e diastólica (PAD) foram de 6,9 mmHg e 5,3 mmHg, respectivamente, com o treinamento de força e 16,5 mmHg e 11,6 mmHg, respectivamente, com o treinamento aeróbio. A cinética hipotensiva da PAS apresentou reduções significativas até a 20ª sessão em ambos os grupos. Observou-se estabilização da PAD na 20ª sessão com o treinamento de força e na 10ª sessão com o aeróbio. Conclusão: São necessárias 20 sessões de treinamento de força ou aeróbio para alcance dos benefícios máximos de redução da PA. Os métodos investigados proporcionaram padrões cinéticos adaptativos distintos ao longo das 50 sessões.