Lower limb ice application alters ground reaction force during gait initiation

BACKGROUND: Cryotherapy is a widely used technique in physical therapy clinics and sports. However, the effects of cryotherapy on dynamic neuromuscular control are incompletely explained. OBJECTIVES: To evaluate the effects of cryotherapy applied to the calf, ankle and sole of the foot in healthy young adults on ground reaction forces during gait initiation. METHOD: This study evaluated the gait initiation forces, maximum propulsion, braking forces and impulses of 21 women volunteers through a force platform, which provided maximum and minimum ground reaction force values. To assess the effects of cooling, the task - gait initiation - was performed before ice application, immediately after and 30 minutes after removal of the ice pack. Ice was randomly applied on separate days to the calf, ankle and sole of the foot of the participants. RESULTS: It was demonstrated that ice application for 30 minutes to the sole of the foot and calf resulted in significant changes in the vertical force variables, which returned to their pre-application values 30 minutes after the removal of the ice pack. Ice application to the ankle only reduced propulsion impulse. CONCLUSIONS: These results suggest that although caution is necessary when performing activities that require good gait control, the application of ice to the ankle, sole of the foot or calf in 30-minute intervals may be safe even preceding such activities. .

Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

Objectives: To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method: Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results: There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions: Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably ...

Stabilometric response during single-leg stance after lower limb muscle fatigue / Resposta estabilometrica durante apoio unipodal apos fadiga muscular de membros inferiores

OBJECTIVE: This study sought to analyze the effect of muscle fatigue induced by active isotonic resistance training at a moderate intensity by measuring the knee extension motion during the stabilometric response in a single-leg stance among healthy university students who perform resistance training on a regular basis. METHOD: Eleven healthy university students were subjected to a one-repetition maximum (1RM) test. In addition, stabilometric assessment was performed before and after the intervention and consisted of a muscle fatiguing protocol, in which knee extension was selected as the fatiguing task. The Shapiro-Wilk test was used to investigate the normality of the data, and the Wilcoxon test was used to compare the stabilometric parameters before and after induction of muscle fatigue, at a significance level of p≤0.05. Descriptive statistics were used in the analysis of the volunteers' age, height, body mass, and body mass index (BMI). RESULTS: The sample population was 23.1±2.7 years of age, averaged 1.79.2±0.07 m in height and 75.6±8.0 Kg in weight, and had a BMI of 23.27±3.71 Kg.m-2. The volunteers performed exercises 3.36±1.12 days/week and achieved a load of 124.54±22.07 Kg on 1RM and 74.72±13.24 Kg on 60% 1RM. The center of pressure (CoP) oscillation on the mediolateral plane before and after fatigue induction was 2.89±0.89 mm and 4.09±0.59 mm, respectively, while the corresponding values on the anteroposterior plane were 2.5±2.2 mm and 4.09±2.26 mm, respectively. The CoP oscillation amplitude on the anteroposterior and mediolateral planes exhibited a significant difference before and after fatigue induction (p=0.04 and p=0.05, respectively). CONCLUSIONS: The present study showed that muscle fatigue affects postural control, particularly with the mediolateral and anteroposterior CoP excursion. .

OBJETIVO: Analisar o efeito da fadiga muscular induzida por exercício isotônico ativo-resistido de extensão de joelhos em intensidade moderada na resposta estabilométrica em apoio unipodal em universitários saudáveis, praticantes de treinamento resistido. MÉTODO: Para tanto, 11 jovens universitários saudáveis foram submetidos ao teste de 1-RM, avaliação estabilométrica pré e pós-intervenção e protocolo de indução à fadiga muscular utilizando a extensão do joelho como tarefa fatigante. Utilizou-se o teste de Shapiro-Wilk para verificação da normalidade dos dados e o teste de Wilcoxon para as comparações entre os parâmetros estabilométricos pré e pós-indução à fadiga muscular com nível de significância estipulado em p≤0,05, enquanto a estatística descritiva foi aplicada para caracterizar a idade, estatura, massa corporal e o índice de massa corporal (IMC). RESULTADOS: O grupo apresentou 23,1±2,7 anos; 1,79,2±0,07 m; 75,6±8,0 Kg; 23,27±3,71 Kg.m-2; 3,36±1,12 número de dias de atividade/semana; 1RM: 124,54± 22,07 kg; 60% de 1-RM: 74,72±13,24 Kg. A oscilação do centro de pressão (CP) médio-lateral pré e pós-fadiga, respectivamente, foi de 2,89±0,89 mm e 4,09±0,59 mm, enquanto a oscilação ântero-posterior foi de 2,5±2,2 mm e 4,09±2,26 mm. Encontrou-se diferença na largura de oscilação do CP nas direções ântero-posterior e médio-lateral entre as condições pré e pós-fadiga, p=0,04 e p=0,05, respectivamente. CONCLUSÕES: Portanto, o estudo demonstrou que a fadiga muscular altera o controle postural, especialmente na excursão médio-lateral e ântero-posterior do CP. .

The effects of one-half of a soccer match on the postural stability and functional capacity of the lower limbs in young soccer players

OBJECTIVE: Most injuries occur during the final 15 minutes of each half of a soccer match, suggesting that physical exertion may influence changes in neuromuscular control and the body's ability to stabilize the joints of the lower extremities. The aim of this study was to analyze the effects of one-half of a soccer match on the functional capacity and stability of the lower limbs in young soccer players. METHODS: We analyzed 27 soccer players by evaluating the functional capacity of their lower limbs using the hop test protocol and their level of postural stability using the Biodex Stability System. The evaluations were performed before and after 45 minutes of game time. RESULTS: After the match, there was a decrease in the overall stability index (OSI) (F(1,23) = 5.64, p = 0.026) and the anterior-posterior stability index (APSI) (F(1,23) = 5.24,p = 0.032). In the single and triple hop tests, there was a higher functional capacity in the dominant limb compared to the non dominant limb in the pre- and post-game comparisons. CONCLUSION: The results of this study show that there is a decrease in the stability of the lower limbs in young soccer players after a 45 minutes soccer match, but the same result was not found for the functional capacity.

Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients

The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ≤ 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis.

The influence of lower-limb dominance on postural balance / A influência da dominância dos membros inferiores no equilíbrio postural

CONTEXT AND OBJECTIVE: Maintainance of postural balance requires detection of body movements, integration of sensory information in the central nervous system and an appropriate motor response. The purpose of this study was to evaluate whether lower-limb dominance has an influence on postural balance. DESIGN AND SETTING: This was a cross-sectional study conducted at Faculdade de Medicina da Universidade de São Paulo (FMUSP) and at Hospital do Coração (HCor). METHODS: Forty healthy sedentary males aged 20 to 40 years, without any injuries, were evaluated. A single-foot balance test was carried out using the Biodex Balance System equipment, comparing the dominant leg with the nondominant leg of the same individual. The instability protocols used were level 8 (more stable) and level 2 (less stable), and three instability indices were calculated: anteroposterior, mediolateral and general. RESULTS: The volunteers' mean age was 26 ± 5 years (range: 20-38), mean weight 72.3 ± 11 kg (range: 46-107) and mean height 176 ± 6 cm (range: 169-186). Thirty-four of them (85 percent) presented right-leg dominance (defined according to which leg they used for kicking) and six (15 percent) had left-leg dominance. There were no significant differences between the dominant and nondominant legs at the two levels of stability (eight and two), for any of the instability indices (general, anteroposterior and mediolateral). CONCLUSION: The lower-limb dominance did not influence single-foot balance among sedentary males.

CONTEXTO E OBJETIVO: A manutenção do equilíbrio postural exige a detecção dos movimentos do corpo, a integração das informações sensoriais no sistema nervoso central e uma resposta motora apropriada. O objetivo deste estudo foi avaliar se a dominância dos membros inferiores influencia o equilíbrio postural. TIPO DE ESTUDO E LOCAL: Este é um estudo transversal realizado na Faculdade de Medicina da Universidade de São Paulo (FMUSP) e no Hospital do Coração (HCor). MÉTODOS: Foram avaliados 40 indivíduos sedentários e saudáveis, do sexo masculino de 20 a 40 anos, sem lesões. O teste do equilíbrio unipodal foi realizado no equipamento Biodex Balance System, comparando membro dominante com não dominante do mesmo indivíduo. Os protocolos de instabilidade utilizados foram: nível 8 (mais estável) e nível 2 (menos estável) e três índices de instabilidade foram calculados: anteroposterior, medial/lateral e geral. RESULTADOS: A idade média foi de 26 ± 5 anos (20-38), massa corporal 72.3 ± 11 kg (46-107) e estatura 176 ± 6 cm (169-186). 34 voluntários (85 por cento) tinham o membro direito como dominante (determinado pelo membro que chuta) e seis (15 por cento), o membro esquerdo. Não houve diferenças significantes entre os membros dominantes e não dominantes nos dois níveis de estabilidade (oito e dois) em nenhum índice de instabilidade (geral, ântero-posterior e medial/lateral). CONCLUSÃO: A dominância dos membros inferiores não influencia o equilíbrio unipodal em indivíduos sedentários do sexo masculino.

Efetividade do treinamento de resistência à fadiga dos músculos dos membros inferiores dentro e fora d'água no equilíbrio estático e dinâmico de idosos / Effectiveness of aquatic and non-aquatic lower limb muscle endurance training in the static and dynamic balance of elderly people

CONTEXTUALIZAÇÃO: O envelhecimento compromete a habilidade do sistema nervoso central (SNC) de realizar a manutenção do equilíbrio corporal bem como diminui a capacidade das reações adaptativas. Para prevenir as quedas, é necessário aprimorar as condições de recepção de informações sensoriais. OBJETIVOS: Comparar o impacto de um programa estruturado de exercícios de resistência muscular dos membros inferiores dentro e fora d'água no equilíbrio estático e dinâmico em idosos. MÉTODOS: Trata-se de um estudo clínico, prospectivo, aleatório, em que as variáveis utilizadas foram avaliadas antes e após o programa de treinamento. Foram avaliados 36 idosos por meio de quatro testes: Escala de Equilíbrio de Berg, Dynamic Gait Index, velocidade da marcha, Marcha Tandem. Posteriormente, houve a alocação dos voluntários em três grupos: grupo de exercício na piscina terapêutica, grupo de exercício no solo e grupo controle. Os grupos de exercícios foram submetidos a um programa de resistência muscular dos membros inferiores aplicado durante seis semanas, duas sessões semanais com 40 minutos de duração. Os voluntários foram reavaliados após seis semanas. Os dados foram analisados estatisticamente pelo teste ANOVA univariada para comparação entre os três grupos antes e após a intervenção. RESULTADOS: O programa de resistência muscular dos membros inferiores promoveu aumento significativo do equilíbrio dos idosos (p<0,05) nos testes avaliados após o programa de treinamento. CONCLUSÃO: O programa de resistência muscular proporcionou uma melhora significativa no equilíbrio estático e dinâmico de idosos comunitários. Foi possível inferir também que essa melhora ocorreu independentemente do meio em que o programa foi realizado, ou seja, se dentro ou fora d'água.

BACKGROUND: Aging compromises the ability of the central nervous system to maintain body balance and reduces the capacity for adaptive reactions. To prevent falls, the reception conditions for sensory information need to be improved. OBJECTIVES: To evaluate the impact of a structured aquatic and a non-aquatic exercise program for lower-limb muscle endurance on the static and dynamic balance of elderly people. METHODS: This was a prospective randomized clinical study in which the variables were assessed before and after the training program. Thirty-six elderly people were evaluated using four tests: the Berg Balance Scale, Dynamic Gait Index, gait speed and tandem gait. The participants were randomized into three groups: aquatic exercise group, non-aquatic exercise group and control group. The exercise groups underwent a program for lower-limb muscle endurance that consisted of 40-minute sessions twice a week for six weeks. The participants were reevaluated after six weeks. The data were analyzed statistically using the univariate ANOVA test for comparisons between the groups before and after the intervention. RESULTS: The program for lower-limb muscle endurance significantly increased balance (p<0.05) in the evaluation tests after the training program. CONCLUSION: The muscle endurance program provided a significant improvement in static and dynamic balance among community-dwelling elderly people. It was also possible to infer that this improvement occurred regardless of the environment, i.e. aquatic or non-aquatic.

Relação da função muscular respiratória e de membros inferiores de idosos comunitários com a capacidade funcional avaliada por teste de caminhada / Relationship between functional capacity assessed by walking test and respiratory and lower limb muscle function in community-dwelling elders

CONTEXTUALIZAÇÃO: A sarcopenia é considerada o fator mais significativo na redução da força muscular periférica e respiratória e pode ocasionar incapacidades progressivas, perda de independência e interferir na capacidade funcional dos idosos. OBJETIVOS: Caracterizar a força dos músculos respiratórios (pressão inspiratória máxima - PImax e pressão expiratória máxima - PEmax) e de membros inferiores (MMII), bem como as possíveis correlações existentes com a capacidade funcional dos idosos. MÉTODOS: Sessenta e cinco idosos, com 71,7±4,9 anos; foram avaliados por dinamometria isocinética para flexores e extensores dos joelhos, manovacuometria analógica para os músculos respiratórios pelo teste de caminhada de 6 minutos para capacidade funcional. Foram utilizados os testes Mann-Whitney e t de Student para comparação entre os gêneros. As correlações foram calculadas pelo coeficiente de correlação de Pearson. Para todos os testes foi considerado p<0,05. RESULTADOS: As variáveis isocinéticas, de força respiratória e distância caminhada apresentaram valores médios maiores para os homens em relação às mulheres (p<0,05). Foram encontradas correlações moderadas e significativas entre essas variáveis (p<0,001), sendo as de maior valor entre a média do pico de torque (MPT) extensor direito e PImax (r=0,587), MPT flexor esquerdo e PEmax (r=0,638), assim como da distância caminhada com a potência média extensora esquerda (r=0,614) e flexora direita (r=0,539) e com PImax (r=0,508) e PEmax (r=0,541). CONCLUSÕES: A associação entre força muscular respiratória e de MMII com a distância caminhada encontrada neste estudo sugere que a otimização dessas funções pode contribuir para manter e/ou melhorar a capacidade funcional da população idosa.

BACKGROUND: Sarcopenia is the most significant factor in the decline of peripheral and respiratory muscle strength. It can lead to progressive disability, loss of independence and impaired functional capacity. OBJECTIVES: To determine the strength of respiratory muscles (maximal inspiratory pressure - MIP and maximal expiratory pressure - MEP) and lower limb muscles, and to explore the possible relationships between these variables and the functional capacity of the elderly. METHODS: Sixty-five elderly patients (71.7±4.9 years old) took part in the study. Isokinetic dynamometry was used to assess the knee flexors and extensors, an analog vacuum manometer was used to assess the respiratory muscles, and the six-minute walking test was used as an outcome of functional capacity. The Mann-Whitney test and Student's t-test were used for gender comparison. The relationships were investigated using Pearson's correlation. The significance level was p<0.05. RESULTS: The lower limb and respiratory muscle strength variables and the walking distance variables were higher in men than women (p<0.05). Moderate and significant correlations were found between these variables (p<0.001). The higher values were between right knee extensor average peak torque (APT) and MIP (r=0.587), left knee flexor APT and MEP (r=0.638), as well as between walking distance and left knee extensor average power (AP; r=0.614), right knee flexor AP (r=0.539), MIP (r=0.508) and MEP (r=0.541) respectively. CONCLUSIONS: The relationship between walking distance and respiratory and lower limb muscle strength found in this study suggests that optimizing these functions may contribute to maintaining and improving functional capacity in the elderly.

Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC / Influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD

OBJETIVO: A massa magra corporal (MMC) tem sido associada à mortalidade em pacientes com DPOC, mas seu impacto na limitação funcional é pouco conhecido. O objetivo deste trabalho foi analisar as variáveis cardiopulmonares em pacientes com DPOC, com ou sem depleção da MMC, antes e após a realização do teste de caminhada de seis minutos (TC6). MÉTODOS: Foram avaliados pacientes com DPOC, 36 sem depleção de MMC e 32 com depleção de MMC. Todos os pacientes foram submetidos à avaliação clínica, espirometria, avaliação da composição da massa corpórea e TC6 e responderam a questionários de qualidade de vida e de percepção de dispnéia. RESULTADOS: Não foram observadas diferenças significativas na gravidade de obstrução das vias aéreas, na percepção da dispnéia e na qualidade de vida entre os grupos. A distância percorrida no TC6 foi similar nos pacientes com DPOC com e sem depleção de MMC (470,3 ± 68,5 m vs. 448,2 ± 89,2 m). Entretanto, durante a realização do teste, os pacientes com depleção de MMC apresentaram aumento significativamente maior na diferença entre os valores final e basal da frequência cardíaca e do índice da escala de Borg para cansaço dos membros inferiores. A distância percorrida no TC6 apresentou correlação significativa positiva com o VEF1 (r = 0,381; p = 0,01). CONCLUSÕES: Não houve influência da depleção da MMC na capacidade funcional de exercício e na qualidade de vida dos pacientes estudados. Entretanto, os pacientes com depleção de MMC apresentam sintomas de fadiga dos membros inferiores mais acentuados durante o TC6, o que reforça a importância da avaliação e tratamento das manifestações sistêmicas da DPOC.

OBJECTIVE: Although lean body mass (LBM) has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM depletion, prior to and after the six-minute walk test (6MWT). METHODS: We evaluated COPD patients, 32 with LBM depletion and 36 without. All patients underwent clinical evaluation, spirometry, evaluation of body mass composition and 6MWT, as well as completing questionnaires related to quality of life and perception of dyspnea. RESULTS: No significant differences in the severity of airway obstruction, perception of dyspnea and quality of life scores were found between the groups. The distance covered on the 6MWT was similar in COPD patients with and without LBM depletion (470.3 ± 68.5 m vs. 448.2 ± 89.2 m). However, patients with LBM depletion presented significantly greater differences between baseline and final values in terms of heart rate and Borg scale index for lower limb fatigue. There was a significant positive correlation between distance covered on the 6MWT and FEV1 (r = 0.381, p = 0.01). CONCLUSIONS: In the patients studied, functional exercise tolerance and quality of life were unaffected by LBM depletion. However, the patients with LBM depletion presented more pronounced lower limb fatigue during the 6MWT, which underscores the importance of the evaluation and treatment of systemic manifestations in COPD patients.

Non-invasive assessment of oxidative capacity in young Indian men and women: a 31P magnetic resonance spectroscopy study.

It is generally assumed that men display greater strength and muscle capacity than women. However, previous biochemical and histological studies have shown that men have greater capacity for anaerobic metabolism and women have higher or similar oxidative metabolism. Therefore, in the present study, we estimated oxidative capacity of gastrocnemius muscle and compared in Indian men and women using non-invasive in vivo 31P magnetic resonance spectroscopy (MRS). Healthy subjects (8 young males and 9 females, age-matched) performed plantar flexion exercise within a magnet and MRS measurements of inorganic phosphate (Pi), phosphocreatine (PCr), ADP, and pH of the calf muscles were carried out using a 1.5 T whole-body MRI system. PCr values during recovery were fitted to an exponential curve, and oxidative capacity was calculated using rate constant (k(PCr)), as an index of oxidative phosphorylation. When men and women were compared for different metabolic ratios, ADP, pH, k(PCr) and oxidative capacity, all parameters turned out to be statistically insignificant. The results showed no gender effect on skeletal muscle oxidative metabolism. The study demonstrated the usefulness of such non-invasive method to indirectly measure the oxidative capacity of the muscle based on PCr recovery.

Lower Extremity Edema and Pain of Nurses and the Effect of Self Leg Massage / 간호학회지

PURPOSE: This study was done to compare edema and pain after completing a nurse's daily shift and to examine the effects of self leg massage which was usually used for reducing nurses' lower extremity edema and pain after their shift. METHODS: The research design was a nonequivalent control group pretest-posttest design. Study subjects wer 81 nurses who took a self leg massage program created by the researcher. Self leg massage was done 15 times during 3 weeks. Data were collected from September 21 to October 31, 2007. The level of lower extremity edema was measured by ankle and calf circumference by a tapeline in cm and the pain score was measured by using a subjective numbering rating scale. Data were analyzed with the SPSS 12.0 program using statistics of repeated measures ANOVA. RESULTS: There was a statistically significant difference in pain according to the department. There was a statistically significant difference in lower extremity edema and pain in nurses after their shift and self leg massage. CONCLUSION: Self leg massage was effective for relieving nurses' lower extremity edema and pain. Therefore, it is proposed that standardized self leg massage should be applied as a method for nurses' lower extremity edema and pain.

Determinação de perfil de repetições máximas no exercício de extensão de pernas e supino reto com diferentes percentuais de força / Determination of the profile of maximum repetitions in the leg extension exercise and straight supino with different percentages of strength

Os objetives desse estudo foram verificar se tabelas de força padrões são praticáveis, se há diferença entre o número de repetições máximas (RM) intra-exercício e entre grupamentos musculares, para a mesma intensidade. A amostra compõe-se de 20 indivíduos do sexo masculino, entre 17 e 30 anos. Foram aplicados testes de carga, máxima e RM, para o grupo muscular peitoral e quadríceps. A análise estatística foi realizada ao nível de significância de até P=0,05. Os resultados do exercício supino reto (SR) comparados a cadeira extensora (CE), apresentou diferença estatística para a intensidade 80% (P<0,05). Os resultados da CE foram superiores aos do SR, exceto para intensidade de 50%. A análise intra-exercício apresentou diferença estatística (P<0,05) no supino reto em diferentes percentuais de força. Para a CE não houve diferença estatística para as intensidades 60-70 % e 70-80 %. As tabelas analisadas se mostraram sem padronização de valores, com enormes variações de valores entre as diversas tabelas e no número de repetições entre membro superior e inferior. Concluise que diferentes faixas de força proporcionam diferenças no número de RM, entre indivíduos e entre grupamento muscular. As limitações destas tabelas padrões evidenciam a importância de programas de treinamento de força de forma individualizada.

The objectives of this study was to verify if the standard force tables are practicable, if there is difference between the number of maximum repetitions (RM) intra-exercise and between muscular groups, for the same intensity. The sample is composed by 20 individuals of the masculine sex, between 17 and 30 years. Load tests, maximum and RM were applied, for the pectoral muscular group and quadriceps. The statistics analysis was carried through to the level of significance P=0,05. The straight supine year-end results (MR.) compared the extensive chair (CE), presented statistic difference for intensity 80% (P<0,05). The results of the CE were superior to the ones of MR., except for 50% intensity. The intra-exercise analysis presented statistic difference (P<0,05) in the straight supine in different percentages of strength. For the CE there was not statistic difference for the intensities 60-70% and 70-80%. The analyzed tables were shown without standardization of values, with enormous variations of values between diverse tables and the number of repetitions between upper/lower member. One concludes that different bands of strength pr vide differences in the RM number, between individuals andmuscular grouping. The limitations of these standard tables evidence the importance of individualized strength programs.

Reliability of center of pressure distance and area sway measurement during one-legged stance in a normal population.

OBJECTIVE: The objective of this study was to assess the reliability of center ofpressure distance and area sway during one-legged stance. MATERIAL AND METHOD: One hundred and sixteen participants aged 40-60 years old were recruited. Fifty nine subjects were males and fifty seven subjects were females. Subjects were excluded in cases of abnormal lower extremity structures, neurological deficits related to balance disorder, and inability of right leg stance for more than 30 seconds. All subjects were evaluated with 4 trials ofone-legged stance, each 2 of normal and fast lifting leg conditions. Center of pressure and kinematic data were synchronously collected. RESULTS: Intraclass correlation coefficients (ICC) of the distance sway was between 0.69 and 0.83, while ICC of the area sway was between 0.06 and 0.25. CONCLUSION: Distance sway provides higher reliability than area sway for static balance assessment. Subjective leg lifting speed was satisfactory.

Existe déficit bilateral na realização de 10RM em exercícios de braços e pernas? / Is there bilateral deficit in the practice of 10RM in arm and leg exercises?

Os exercícios resistidos (ER) podem ser realizados de forma uni e bilateral. Dependendo da forma pela qual o movimento é conduzido, verifica-se a presença do déficit bilateral. Os estudos de déficit bilateral concentraram seus esforços na investigação do fenômeno em exercícios realizados com uma repetição máxima e pouco se sabe sobre o seu comportamento em exercícios com várias repetições. O presente estudo teve como objetivos: a) comparar a carga obtida em 10 repetições máximas (10RM) nos diferentes dimídios corporais em exercícios de braços e pernas; b) comparar a soma das ações unilaterais com os resultados obtidos bilateralmente nos mesmos exercícios. Foram avaliadas 20 mulheres treinadas com idade entre 18 e 30 anos (24 ± 6 anos) no teste de 10RM de forma uni e bilateral nos exercícios selecionados. A análise estatística foi realizada pelo teste t de Student pareado, para verificar a existência de diferença entre os membros, bem como no somatório dos dois membros separadamente em relação ao trabalho realizado bilateralmente. Para todos os procedimentos considerou-se um nível de significância de p < 0,05. Não foram verificadas diferenças para as cargas manipuladas nos dois seguimentos em ambos os exercícios, o mesmo não ocorrendo com a soma das cargas nos trabalhos unilaterais com as obtidas bilateralmente. Isso demonstra que a realização do trabalho bilateral em situações habituais de treinamento envolvendo 10RM promove maior manipulação de carga em relação ao trabalho unilateral, diferentemente do que é evidenciado em relação ao déficit bilateral para 1RM. Em conclusão, ao menos nos exercícios selecionados, não se evidenciou ocorrência de déficit bilateral. Futuros estudos devem ser conduzidos para melhor entender o fenômeno do déficit bilateral nas situações habituais de treinamento.

Resistance exercises can be done uni or bilaterally. Depending on the way by which the movement is conducted, the presence of bilateral deficit (BD) is observed. BD studies have concentrated their effort on the investigation of the phenomenon in exercises done with one single maximum repetition and little is known about their behavior in exercises with many repetitions. The aims of this study were: a) to compare the load in 10 repetition maximum (10RM) in the different sides of the body in exercises done with arms and legs. b) To compare the sum of the unilateral actions with the bilateral results in the same exercises. Twenty trained women between 18 and 30 years old (24 ± 6) were evaluated in uni and bilateral 10RM test in the selected exercises. The statistics analysis was t-test paired, to verify the difference between limbs and the sum of the two limbs separately in relation to bilateral load. Significance level was p < 0.05 for all procedures. No difference was found in the manipulated loads in both members, the same not occurring with the sum of unilateral load compared to bilateral. This demonstrates that the practice of bilateral work in routine situation of training involving 10RM promotes a greater manipulation of load in relation to unilateral work, differently from what is seen in BD in 1RM. In conclusion, at least in the selected exercises, BD was not found. Future studies should be done for better understanding of the BD phenomenon during training routine.

Los ejercicios resistidos (ER) pueden ser realizados de forma unilateral y bilateral. Dependiendo de la forma como el movimiento es conducido, se verifica la presencia de déficit bilateral. Los estudios de déficit bilateral concentraron sus esfuerzos en la investigación del fenómeno en ejercicios realizados con repetición máxima y poco se sabe sobre su comportamiento en ejercicios con varias repeticiones. El presente estudio tuvo como objetivos: a) comparar la carga obtenida en 10 repeticiones máximas (10RM) en los diferentes segmentos corporales en ejercicios de brazos y piernas; b) comparar la suma de las acciones unilaterales con los resultados obtenidos bilateralmente en los mismos ejercicios. Fueron evaluadas 20 mujeres preparadas con edades entre 18 y 30 años (24 ± 6 años) en el test de 10RM de forma uni e bilateral en los ejercicios seleccionados. El análisis estadístico fue realizado por el test t-Student pareado, para verificar la existencia de diferencia entre los miembros, bien como la suma de los dos miembros por separado en relación al trabajo realizado bilateralmente. Para todos los procedimientos se consideró como grado de significancia p < 0,05. No se verificaron diferencias para las cargas manipuladas en los dos seguimientos en ambos ejercicios, lo que no ocurrió con la suma de las cargas en los trabajos unilaterales respecto a las obtenidas bilateralmente. Eso muestra que la realización de trabajo bilateral en situaciones habituales de entrenamiento envolviendo 10RM promueve una mayor manipulación de carga en relación al trabajo unilateral, en contraste a lo que es verificado en relación al déficit bilateral para 1RM. En conclusión, al menos en los ejercicios seleccionados, no se constató ocurrencia de déficit bilateral. Futuros estudios deben ser conducidos para entender mejor el fenómeno del déficit bilateral en situaciones habituales de entrenamiento.

A functional electric orthesis on the paretic leg improves quality of life of stroke patients

CONTEXTO: A hemiparesia altera a qualidade de vida de pacientes com acidente vascular encefálico (AVE) dificultando uma vida normal. OBJETIVO: Avaliar o efeito da Órtese Elétrica Funcional (OEF) colocada na perna parética, sobre a qualidade de vida de pacientes com AVE. MÉTODO: A qualidade de vida de 50 pacientes da AACD foi avaliada pelo questionário SF-36 antes e após o tratamento com OEF. Os dados foram analisados segundo sexo e lado do corpo acometido pelo AVE. RESULTADOS: As médias em todas as categorias do SF-36 foram significantemente maiores após tratamento com OEF (p<0,001). Pacientes do sexo feminino apresentaram resultados superiores aos do sexo masculino nos Aspectos Emocionais (p=0,04) e apresentaram tendência a melhora em Dor e Aspectos Sociais. Pacientes com hemiparesia direita obtiveram resultados superiores aos com hemiparesia esquerda nos Aspectos Emocionais (p=0,02). CONCLUSÃO: A utilização da OEF na perna parética por AVE é eficaz em melhorar a qualidade de vida dos pacientes.

Freqüência cardíaca máxima em testes de exercício em esteira rolante e em cicloergômetro de membros inferiores / Maximal heart rate in exercise tests on treadmill and in a cycloergometer of lower limbs

OBJETIVO: Comparar, retrospectivamente, os valores de freqüência cardíaca máxima (FCM) e o descenso da freqüência cardíaca no primeiro minuto da recuperacão (dFC), obtidos em teste de exercício (TE) realizados em dois ergômetros e momentos distintos. MÉTODOS: Sessenta indivíduos (29 a 80 anos de idade), submetidos a TE cardiopulmonar em ciclo de membros inferiores (CMI) em nosso laboratório e que possuíam TE prévio (até 36 meses) em esteira (EST) em outros laboratórios, nas condicões idênticas de medicacões de acão cronotrópica negativa. RESULTADOS: FCM foi semelhante no CMI: 156n3 e EST: 154n2 bpm (p=0,125), enquanto o dFC foi maior em CMI: 33n2, EST: 26n3 bpm (média n erro padrão da média) (p<0,001). Nas variáveis hemodinâmicas estudadas, a pressão arterial sistólica e o duplo produto foram maiores no TE-CMI (p<0,001). O eletrocardiograma (ECG) foi semelhante nos dois TEs, exceto por arritmias supraventriculares mais freqüentes no CMI. CONCLUSAO: a) É possível, com empenho do examinador e conhecimento prévio do resultado de FCM em um TE anterior, obter níveis altos de FCM em um TE-CMI; b) interromper o TE baseado em FCM prevista por equacões tende a levar a esforcos submáximos; c) o dFC difere nas recuperacões ativa e passiva; d) novas formas de analisar o comportamento da FC no exercício, que não apenas o valor da FCM, são necessárias para caracterizar um TE como máximo.

Variation of lower extremity venous function in normal individuals

The change in venous function during the course of the day was studied non-invasively in 50 normal lower extremities of 25 physically active normal subjects. Venous refilling time, measured by photoplethysmography, was significantly shorter [p < 0.0001], and venous capacitance, measured by impedance plethysmography, was significantly reduced [p < 0.04] after 5 hours or more of daily activities performed in the upright position. Abnormally short venous refilling time [less than 18 seconds] developed in 21% of the extremities, which had a normal venous refilling time earlier in the same day. Lower extremity symptoms of ache, pain, or swelling were reported more frequently in extremities that developed an abnormal venous refilling time. There was a trend toward. a greater change in venous refilling time during the day in symptomatic lower extremities than in asymptomatic limbs [p = 0.07]

Characterization of gait parameters in patients with Charcot-Marie-Tooth disease.

The gait of five patients with Charcot-Marie-Tooth(CMT) disease was analyzed using light-emitting diodes and a force plate. The flexion-extension motions of the hips, knees, and ankles, as well as their moments (vector sums of forces acting at the joints) in the flexion-extension and abduction-adduction planes, were quantified. The gait of the CMT patients showed abnormalities consistent with both distal weakness (ankle dorsi- and plantar-flexors) and weakness of the hip abductor muscles. The latter weakness appeared to produce asymmetric hip moments and truncal instability in the mediolateral plane during ambulation. However, the extent to which the gait was abnormal appeared not to be exclusively related to the severity of the sensorimotor conduction deficits in the peripheral nerves. In the four patients for whom nerve conduction velocity studies were available, decrease in the lower-extremity distal conduction velocities and evoked motor amplitude potentials did not correlate with the severity and extent of the gait abnormalities.

Entrenamiento muscular en la enfermedad pulmonar obstructiva cronica severa: estudio comparativo del entrenamiento aerobico de miembros inferiores vs. combinación con miembros superiores / Exercise training in chronic obstructive pulmonary disease. Comparative study aerobic training of lower limbs vs. combination with upper limbs

Se realizó un estudio prospectivo, randomizado y controlado en 28 pacientes con EPOC severa, entrenándose a un grupo de 14 pacientes los miembros inferiores (MI), mientras otro grupo similar (14 enfermos) efectuó entrenamiento adicional de miembros superiores (MS). Los resultados demonstraron mejoría en ambos grupos de la prueba de tolerancia para MI, escalas de disnea, eficiencia y capacidad de trabajo muscular. Se observó un aumento significativo en el consumo de oxigeno al umbral anaeróbico, hecho que sugiere un efecto entrenamiento, expresado con una mejoría en la tolerancia al ejercicio. Sólo en el grupo que entrenó los MS se observó una mejoría en la escala de disnea, prueba de tolerancia y en las presiones buscales estáticas máximas, demonstrando una mayor capacidad intrínseca de trabajo y participación de los músculos de los MS en la generalación de esas maniobras. Al finalizar el entrenamiento se objetivó una mejoría en la calidad de vida y disminución de la hospitalización para ambos grupos. En base a estos hallazgos se sugiere en pacientes con EPOC severa incluidos en programas de entrenamiento muscular, adicionar ejercicios de MS a los habituales de MI.