Effects of Manual Therapies and Resistance Exercise on Postexercise Hypotension in Women With Normal Blood Pressure.

ABSTRACT: Monteiro, ER, Pescatello, LS, Winchester, JB, Corrêa Neto, VG, Brown, AF, Budde, H, Marchetti, PH, Silva, JG, Vianna, JM, and Novaes, JdS. Effects of manual therapies and resistance exercise on postexercise hypotension in women with normal blood pressure. J Strength Cond Res 36(4): 948-954, 2022-The purpose of this investigation was to examine the acute effects of resistance exercise (RE) and different manual therapies (static stretching and manual massage [MM]) performed separately or combined on blood pressure (BP) responses during recovery in women with normal BP. Sixteen recreationally strength-trained women (age: 25.1 ± 2.9 years; height: 158.9 ± 4.1 cm; body mass: 59.5 ± 4.9 kg; body mass index: 23.5 ± 1.9 kg·m-2; baseline systolic BP median: 128 mm Hg; and baseline diastolic BP median: 78 mm Hg) were recruited. All subjects performed 6 experiments in a randomized order: (a) rest control (CON), (b) RE only (RE), (c) static-stretching exercise only (SS), (d) MM only, (e) RE immediately followed by SS (RE + SS), and (f) RE immediately followed by MM (RE + MM). RE consisted of 3 sets of bilateral bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. Static stretching and MM were applied unilaterally in 2 sets of 120 seconds to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic BP were measured before (rest) and every 10 minutes for 60 minutes following (Post 10-60) each intervention. There were significant intragroup differences for RE in Post-50 (p = 0.038; d = -2.24; ∆ = -4.0 mm Hg). Similarly, SBP intragroup differences were found for the SS protocol in Post-50 (p = 0.021; d = -2.67; ∆ = -5.0 mm Hg) and Post-60 (p = 0.008; d = -2.88; ∆ = -5.0 mm Hg). Still, SBP intragroup differences were found for the MM protocol in Post-50 (p = 0.011; d = -2.61; ∆ = -4.0 mm Hg) and Post-60 (p = 0.011; d = -2.74; ∆ = -4.0 mm Hg). Finally, a single SBP intragroup difference was found for the RE + SS protocol in Post-60 (p = 0.024; d = -3.12; ∆ = -5.0 mm Hg). Practitioners should be aware that SS and MM have the potential to influence BP responses in addition to RE or by themselves and therefore should be taken into consideration for persons who are hypertensive or hypotensive.

Limited cardiopulmonary capacity in patients with liver cirrhosis when compared to healthy subjects.

OBJECTIVES: The present study compared cardiorespiratory capacity between cirrhotic patients and healthy subjects. METHODS: Nineteen cirrhotic patients and 19 healthy subjects, paired by age and gender, participated in the study. Volunteers performed an incremental cardiopulmonary test with a ramp protocol, a ventilatory and metabolic variables were obtained and analyzed. The recovery was analyzed by calculating the time needed for 50% of oxygen consumption (VO2) recovery to occur as the median between the peak of the exercise and the end of recovery on the VO2 curve (T1/2). The VE/VCO2 slope were performed by the linear regression of ventilation (VE) and carbon dioxide production (VCO2) data. RESULTS: During resting condition, cirrhotic patients presented significantly higher levels of VO2 compared to healthy subjects. The VE/ VO2 and VE/ VCO2 values were significantly higher in the control group at the anaerobic threshold and at the peak of the test compared to cirrhotic patients. Time under effort was significantly higher for healthy subjects. CONCLUSIONS: Based on these findings, it is possible to conclude that liver cirrhosis can compromise the patients' quality of life, mainly by inducing metabolic alterations which can impair functional capacity and lead to a sedentary lifestyle.

Limited cardiopulmonary capacity in patients with liver cirrhosis when compared to healthy subjects

SUMMARY OBJECTIVES: The present study compared cardiorespiratory capacity between cirrhotic patients and healthy subjects. METHODS: Nineteen cirrhotic patients and 19 healthy subjects, paired by age and gender, participated in the study. Volunteers performed an incremental cardiopulmonary test with a ramp protocol, a ventilatory and metabolic variables were obtained and analyzed. The recovery was analyzed by calculating the time needed for 50% of oxygen consumption (VO2) recovery to occur as the median between the peak of the exercise and the end of recovery on the VO2 curve (T1/2). The VE/VCO2 slope were performed by the linear regression of ventilation (VE) and carbon dioxide production (VCO2) data. RESULTS: During resting condition, cirrhotic patients presented significantly higher levels of VO2 compared to healthy subjects. The VE/ VO2 and VE/ VCO2 values were significantly higher in the control group at the anaerobic threshold and at the peak of the test compared to cirrhotic patients. Time under effort was significantly higher for healthy subjects. CONCLUSIONS: Based on these findings, it is possible to conclude that liver cirrhosis can compromise the patients' quality of life, mainly by inducing metabolic alterations which can impair functional capacity and lead to a sedentary lifestyle.

Effects of Cardiovascular Interval Training in Healthy Elderly Subjects: A Systematic Review.

The aim of this review is to demonstrate the effects of cardiovascular interval training (IT) on healthy elderly subjects. We used the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The following variables were observed: resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MBP), heart rate variability (HRV), baroreflex activity (BA), and maximal oxygen uptake (VO2max). Studies were searched for in the MedLine, PubMed, and Sport Discus databases considering publications between 1990 and 2019. To find the studies, the keywords used were "Interval and Elderly Training" or "Interval Training and Baroreflex Sensing" or "Interval Training and Aging and Pressure Arterial and Blood Pressure Training" or "Interval Training and Variation in Aging and Heart Rate" or "Interval Training and Sensitivity to the Elderly and Baroreflex" or "Interval Training and Variability in the Elderly and Heart Rate." The systematic search identified 1,140 hits. The analysis of the study was performed through a critical review of the content. One thousand one hundred forty articles were identified. Of these, 1,108 articles were excluded by checking the articles and abstracts. Finally, 32 studies were selected for full reading while 26 studies were eliminated because they did not contain a methodology according to the purpose of this review. Thus, six studies were included for the final analysis. The PEDro score was used for analyzing the study quality and found 4,8 ± 1,3 points (range: 3-6). Positive results were found with the different IT protocols in the observed variables. Results show that IT protocols can be an efficient method for functional improvement of cardiovascular and cardiorespiratory variables in the healthy elderly, especially HR, SBP, DBP, MAP, HRV, BA, and VO2max. However, this method can be included in the prescription of aerobic training for the elderly to obtain conditional improvements in the cardiovascular system, thus being an important clinical intervention for the public.

Men exhibit greater fatigue resistance than women in alternated bench press and leg press exercises.

BACKGROUND: The purpose of this study was to evaluate the influence of sex, exercise order, and rest interval on neuromuscular fatigue resistance for an alternated strength training sequence of bench press (BP) and leg press (LP) exercises. METHODS: Twelve women and 16 men, both recreationally trained, performed four sessions in a random order: 1) BP followed by LP with three-minutes rest (BP+LP with rest); 2) LP followed by BP with three-minutes rest (LP+BP with rest); 3) BP followed by LP without rest interval (BP+LP no rest), and 4) LP followed by BP without rest interval (LP+BP no rest). Participants performed four sets with 100% of 10RM load to concentric failure with the goal of completing the maximum number of repetitions in both exercises. The FI was analyzed from the first and last sets of each exercise bout. RESULTS: A main effect for sex showed that women exhibited 25.5% (P=0.001) and 24.5% (P=0.001) greater BP and LP fatigue than men respectively when performing 10RM. Men exhibited greater BP (P<0.0001; 34.1%) and LP (P<0.0001; 30.5%) fatigue resistance when a rest period was provided. Men did not show an exercise order effect for BP fatigue and exhibited greater (P=0.0003; 14.5%) LP fatigue resistance when BP was performed first. CONCLUSIONS: The present study demonstrated the greater fatigue resistance of men when performing 10RM BP and LP exercises. Since men tend to experience less fatigue with the second exercise in the exercise pairing, women's training programs should be adjusted to ensure they do not parallel men's resistance training programs.

The influence of exercise order on strength performance in post menopause women / A influência da ordem dos exercícios sobre o desempenho da força muscular em mulheres na pós-menopausa

OBJECTIVE: Verify the influence of different exercise orders on the performance of the number of maximal repetitions in older women. METHODS: Twelve older women (65.7 ± 5.6 years, 66.9 ± 9.5 kg, 1.56 ± 0.67 m, 27.4 ± 3.6 kg/m2) underwent four nonconsecutive visits and two different orders of Resistance Training. At the first visit, the volunteers were submitted to anamnesis, anthropometric evaluation and a 10RM test. On the second visit, a re-test of 10RM was performed. On the third and fourth visits, the volunteers performed two exercise sequences: sequence A: bench press, latissimus pulldown close grip, biceps curl, triceps extension; for sequence B the order was inverted. Performance was measured by the number of repetitions in each exercise. To determine differences in performance for sequence A vs. sequence B, repeated measures were performed by two-way ANOVA followed by the Tuckey post-hoc test. RESULTS: The number of repetitions of each exercise varied significantly for the bench press, biceps curl and triceps extension between the exercise sequences. CONCLUSIONS: The order of the exercises performed in a resistance training session can affect the performance in the number of repetitions in older women.

OBJETIVO: Verificar a influência de diferentes sequências de exercícios no desempenho do número de repetições máximas em mulheres idosas. MÉTODOS: Doze mulheres idosas (65,7 ± 5,6 anos, 66,9 ± 9,5 kg, 1,56 ± 0,67 m; 27,4 ± 3,6 kg/m2) foram submetidas a diferentes sequências de exercícios no Treinamento Resistido. Na primeira visita, as voluntárias foram submetidas à anamnese, avaliação antropométrica e teste de 10 RM. Na segunda visita, foi feito um re-teste de 10RM. Na terceira e quarta visita, as voluntárias realizaram as duas sequências: SEQ A - supino horizontal, puxador alto fechado, rosca bíceps e rosca tríceps e, SEQ B - a ordem foi inversa. O desempenho foi medido pelo número de repetições em cada exercício. A fim de verificar as diferenças nos dados obtidos no desempenho em diferentes sequências e séries, foram realizadas medidas repetidas pela ANOVA two-way seguido do teste post-hoc de Tuckey. RESULTADOS: Os resultados demonstraram que o número de repetições de cada exercício variou significativamente entre as sequências nos exercícios de supino horizontal, rosca bíceps e rosca tríceps. CONCLUSÕES: A ordem dos exercícios realizada em uma sessão de treinamento resistido pode afetar o desempenho no número de repetições em mulheres idosas.

Efeito do treinamento de força na potência muscular de membros inferiores de idosos coronariopatas / Effect of resistance training on muscular power of lower limbs of elderly with coronary artery disease

Introdução: A força e a potência muscular têm relação direta com a capacidade funcional de idosos. Objetivo: Verificar o efeito absoluto e relativo da potência muscular de membros inferiores em idosos portadores de doença arterial coronariana. Métodos: Dez homens sedentários participaram de 24 sessões de treinamento de força compostas por 2 séries de 6 a 8 repetições máximas e 1 minuto de intervalo. No início, os exercícios foram: meio agachamento, step, flexão plantar. E após: extensão e flexão dos joelhos, adução e abdução do quadril sentado. A potência muscular foi mensurada nos momentos: pré, após 12 e 24 sessões. Resultados: Após 24 sessões de treinamento de força foram encontrados aumentos na potência muscular absoluta (p< 0.0001) e relativa (p<0.0001; p<0.0001) em relação à condição pré-treinamento, respectivamente. Conclusão: Vinte e quatro sessões de treinamento de força parecem ser suficientes para aumentar a PM absoluta e relativa de idosos coronariopatas. (AU)

Introduction: Strength and muscle power have a direct relationship with functional capacity in elderly people. Objective: Verify absolute and relative gains in muscle power of lower limbs in elderly people with coronary artery disease. Methods: Ten untrained men subjects participated of 24 sessions of resistance training composed by 2 sets of 6 to 8 maximum repetitions and 1 minute rest interval. Initially, the exercises were: half squat, step up and plantar flexion. And after: leg extension, leg curl, seated hip adduction and seated hip abduction. The muscle power was measured at times: pre, post 12 and 24 sessions. Results: After 24 sessions of resistance training were found increases in absolute muscle power (p< 0.0001) and relative (p< 0.0001) regarding the condition pre-training, respectively. Conclusion: Twenty four sessions of resistance training appear to be sufficient to increase absolute and relative muscle power in elderly people with coronary artery disease. (AU)

MAXIMUM REPETITION PERFORMANCE AFTER DIFFERENT ANTAGONIST FOAM ROLLING VOLUMES IN THE INTER-SET REST PERIOD.

BACKGROUND: Foam rollers, or other similar devices, are a method for acutely increasing range of motion, but in contrast to static stretching, do not appear to have detrimental effects on neuromuscular performance. PURPOSE: The purpose of this study was to investigate the effects of different volumes (60 and 120 seconds) of foam rolling of the hamstrings during the inter-set rest period on repetition performance of the knee extension exercise. METHODS: Twenty-five recreationally active females were recruited for the study (27.8 ± 3.6 years, 168.4 ± 7.2 cm, 69.1 ± 10.2 kg, 27.2 ± 2.1 m2/kg). Initially, subjects underwent a ten-repetition maximum testing and retesting, respectively. Thereafter, the experiment involved three sets of knee extensions with a pre-determined 10 RM load to concentric failure with the goal of completing the maximum number of repetitions. During the inter-set rest period, either passive rest or foam rolling of different durations (60 and 120 seconds) in a randomized order was employed. RESULTS: Ninety-five percent confidence intervals revealed dose-dependent, detrimental effects, with more time spent foam rolling resulting in fewer repetitions (Cohen's d of 2.0 and 1.2 for 120 and 60 seconds, respectively, in comparison with passive rest). CONCLUSION: The results of the present study suggest that more inter-set foam rolling applied to the antagonist muscle group is detrimental to the ability to continually produce force. The finding that inter-set foam rolling of the antagonist muscle group decreases maximum repetition performance has implications for foam rolling prescription and implementation, in both rehabilitation and athletic populations. LEVEL OF EVIDENCE: 2b.

ACUTE EFFECTS OF DIFFERENT SELF-MASSAGE VOLUMES ON THE FMS™ OVERHEAD DEEP SQUAT PERFORMANCE.

BACKGROUND: The Functional Movement Screen (FMS™) is a battery of tests designed to assess movement competency; the overhead deep squat test, specifically, has been shown to be an accurate predictor of overall FMS™ scores. Self-massage (SM) is a ubiquitous warm-up utilized to increase joint range of motion and, therefore, may be effective for improving performance of the overhead deep squat test. PURPOSE: To examine how different doses (30, 60, 90, and 120 seconds) of SM of different areas of the body (plantar fascia, latissimus dorsi, and lateral thigh) affects the score obtained on an overhead deep squat test. METHODS: Twenty recreationally active females were recruited to be tested on four occasions: sessions one and two consisted of baseline testing, session three consisted of SM applied to the lateral thigh, and session four consisted of SM applied to the lateral torso and plantar fascia. RESULTS: In all SM conditions, at least 90 seconds was required for a change in deep squat score from baseline; therefore, it is concluded that SM the lateral torso, plantar fascia, and lateral thigh for 90 seconds or more are effective interventions for acutely improving overhead deep squat scores. CONCLUSION: Self-massage appears to be an effective modality for inducing acute improvements in the performance of the FMS™ overhead deep squat in all conditions tested. LEVEL OF EVIDENCE: 2b.

Acute effects of different foam rolling volumes in the interset rest period on maximum repetition performance.

BACKGROUND: Foam rolling (FR) is a ubiquitous intervention utilised for the purpose of acutely increasing the range of motion without subsequent decreases in performance. Thus, it is commonly used during the periworkout period-that is, prior to, during, or after an athlete's workout. OBJECTIVE: This study investigated how different FR durations applied to the quadriceps during the interset rest periods affects the numbers of repetitions in the knee extension exercise. METHODS: Twenty-five females completed four sets of knee extensions with 10 repetitions of maximum load to concentric failure on four occasions. Between each set, a 4-minute rest interval was implemented in which participants either passively rested or performed FR for different durations (60 seconds, 90 seconds, and 120 seconds). The 95% confidence intervals revealed a dose-dependent relationship in which longer durations of FR resulted in fewer completed repetitions. RESULTS: On average, the number of repetitions with PR was 13.8% greater than that in FR120, 8.6% greater than that in FR90, and 9.1% greater than that in FR60. CONCLUSION: For the purposes of performance and likely adaptation, interset FR seems to be detrimental to a person's ability to continually produce force, and should not be applied to the agonist muscle group between sets of knee extensions.

Predicting Cellular Rejection With a Cell-Based Assay: Preclinical Evaluation in Children.

BACKGROUND: Allospecific CD154+T-cytotoxic memory cells (CD154+TcM) predict acute cellular rejection after liver transplantation (LTx) or intestine transplantation (ITx) in small cohorts of children and can enhance immunosuppression management, but await validation and clinical implementation. METHODS: To establish safety and probable benefit, CD154+TcM were measured in cryopreserved samples from 214 children younger than 21 years (National Clinical Trial 1163578). Training set samples (n = 158) were tested with research-grade reagents and 122 independent validation set samples were tested with current good manufacturing practices-manufactured reagents after assay standardization and reproducibility testing. Recipient CD154+TcM induced by stimulation with donor cells were expressed as a fraction of those induced by HLA nonidentical cells in parallel cultures. The resulting immunoreactivity index (IR) if greater than 1 implies increased rejection-risk. RESULTS: Training and validation set subjects were demographically similar. Mean coefficient of test variation was less than 10% under several conditions. Logistic regression incorporating several confounding variables identified separate pretransplant and posttransplant IR thresholds for prediction of rejection in the respective training set samples. An IR of 1.1 or greater in posttransplant training samples and IR of 1.23 or greater in pretransplant training samples predicted LTx or ITx rejection in corresponding validation set samples in the 60-day postsampling period with sensitivity, specificity, positive, and negative predictive values of 84%, 80%, 64%, and 92%, respectively (area under the receiver operator characteristic curve, 0.792), and 57%, 89%, 78%, and 74%, respectively (area under the receiver operator characteristic curve, 0.848). No adverse events were encountered due to phlebotomy. CONCLUSIONS: Allospecific CD154+T-cytotoxic memory cells predict acute cellular rejection after LTx or ITx in children. Adjunctive use can enhance clinical outcomes.

Effects of resistance training with blood flow restriction on haemodynamics: a systematic review.

This study systematically reviewed the available scientific evidence on the changes promoted by low-intensity (LI) resistance training (RT) combined with blood flow restriction (BFR) on blood pressure (BP), heart rate (HR) and rate-pressure product (RPP). Searches were performed in databases (PubMed, Web of Science™ , Scopus and Google Scholar), for the period from January 1990 to May 2015. The study analysis was conducted through a critical review of contents. Of the 1 112 articles identified, 1 091 were excluded and 21 met the selection criteria, including 16 articles evaluating BP, 19 articles evaluating HR and four articles evaluating RPP. Divergent results were found when comparing the LI protocols with BFR versus LI versus high intensity (HI) on BP, HR and RPP. The evidence shows that the protocols using continuous BFR following a LIRT session apparently raise HR, BP and RPP compared with LI protocols without BFR, although increases significantly in BP seem to exist between the HI protocols when compared to LI protocols. Haemodynamic changes (HR, SBP, DBP, MBP, RPP) promoted by LIRT with BFR do not seem to differ between ages and body segments (upper or lower), although they are apparently affected by the width of the cuff and are higher with continuous BFR. However, these changes are within the normal range, rendering this method safe and feasible for special populations.

Acute effects of different stretching techniques on the number of repetitions in a single lower body resistance training session.

This study aimed to investigate the acute effects of passive static and ballistic stretching on maximal repetition performance during a resistance training session (RTS). Nine male subjects underwent three experimental conditions: ballistic stretching (BS); passive static stretching (PSS); and a specific warm-up (SW). The RTS was composed of three sets of 12RM for the following exercises: leg press 45 (LP), leg extension (LE), leg curl (LC), and plantar flexors (PF). Performance of six sessions was assessed 48 hours apart. The first visit consisted of a familiarization session including stretching methods and exercises used in the RTS. On the second and third visit, a strength test and retest were performed. During the fourth to the sixth visit, the volunteers randomly performed the following protocols: BS+RTS; PSS+RTS; or SW+RTS. For the sum of the RM number of each three-set exercise, significant differences were found between PSS vs. SW for the LP (p = 0.001); LE (p = 0.005); MF (p = 0.001); and PF (p = 0.038). For the comparison between the methods of stretching PSS vs. BS, significant differences were found only for the FP (p = 0.019). When analyzing the method of stretching BS vs. SW, significant differences were found for the LP (p = 0.014) and MF (p = 0.002). For the total sum of the RM number of three sets of the four exercises that composed the RTS, significant differences were observed (p < 0.05) in the following comparisons: PPS vs. SW (p = 0.001), PPS vs. BS (p = 0.008), and BS vs. SW (p = 0.002). Accordingly, the methods of passive static and ballistic stretching should not be recommended before a RTS.