Efectos de un programa de ejercicio físico multicomponente en la funcionalidad de personas con la enfermedad de Parkinson / Effects of a Multicomponent Physical Exercise Program on the Physiological Functions of People With Parkinson's Disease / Efeitos de um programa de exercícios físicos multicomponentes sobre a funcionalidade das pessoas com o mal de Parkinson

Resumen: Introducción: La enfermedad de Parkinson (EP) es un trastorno neurológico y progresivo caracterizado por síntomas motores y no motores que influyen en el deterioro de la calidad de vida. Objetivo: Esta investigación tiene como objetivo analizar los efectos de un programa de intervención multicomponente basado en la actividad física y el deporte en la funcionalidad de personas con EP, tanto con alta como con baja afectación. Metodología: Para ello, 16 personas (13 hombres y 3 mujeres) con EP participaron en este estudio, dividiéndose en 2 grupos según su nivel de afectación, el de baja (GBA, n = 12) y el de alta (GAA, n = 4). Se realizó una intervención de un programa de ejercicio físico multicomponente a todos los participantes durante 4 semanas (2 sesiones de 50 minutos, por semana). Se realizó una batería de test funcionales (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) y The five times sitto-stand Chair (FTSTS)) una semana antes (T1) y una semana después de la intervención (T2). Resultados: El total de la muestra mejoró significativamente en el test SLS (P < 0.05; d > 0.56, moderado). Sin embargo, analizando cada grupo, de conformidad con su nivel de afectación, el grupo GBA obtuvo mejoras significativas en SLS y 5STS (d= 0.44 - 0.68, p < 0.05), mientras que no se observaron diferencias significativas en el grupo GAA en ninguna variable analizada. Conclusiones: Los resultados del presente estudio muestran la necesidad de realizar más estudios con programas de larga duración y más frecuencia semanal.

Abstract: Introduction: Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms that influence the impairment of quality of life. Objective: This research aims to analyze the effects of a multicomponent intervention program based on physical exercise and sport on the physiological functions of people with PD, both with high and low impairment. Methodology: For this purpose, sixteen people (13 men and 3 women) with PD participated in this study, divided into two groups according to their level of impairment, low (GBA, n = 12) and high (GAA, n = 4). A multicomponent physical exercise program intervention was administered to all participants for 4 weeks (2 sessions of 50 minutes per week). A battery of functional tests (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) and The five times sit-to-stand Chair (FTSTS)) was performed one week before (T1) and one week after the intervention (T2). Results: The total sample improved significantly on the SLS test (P < 0.05; d > 0.56, moderate). However, analyzing each group according to their level of impairment, the GBA group obtained significant improvements in SLS and 5STS (d= 0.44 - 0.68, P < 0.05), while no significant differences were observed in the GAA group in any of the variables analyzed. Conclusion: The results of the present study show the need for further studies with longer duration and more frequent weekly programs.

Resumo: Introdução: A doença de Parkinson (DP) é um distúrbio neurológico progressivo, caracterizado por sintomas motores e não motores que influenciam a deterioração da qualidade de vida. Objetivo: Esta pesquisa visa analisar os efeitos de um programa de intervenção multicomponente baseado na atividade física e no esporte sobre a funcionalidade das pessoas com DP, tanto com deficiência alta quanto baixa. Metodologia: Para este fim, 16 pessoas (13 homens e 3 mulheres) com DP participaram deste estudo, divididos em dois grupos de acordo com seu nível de afecção, o baixo (GBA, n = 12) e o alto (GAA, n = 4). Uma intervenção de um programa de exercícios físicos multicomponentes foi realizada com todos os participantes durante 4 semanas (2 sessões de 50 minutos por semana). Uma bateria de testes funcionais (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) y The five times sit-to-stand Chair (FTSTS)) foi realizada uma semana antes (T1) e uma semana após a intervenção (T2). Resultados: A amostra total melhorou significativamente no teste SLS (P < 0,05; d > 0,56, moderado). Não obstante, analisando cada grupo de acordo com seu nível de deficiência, o grupo GBA obteve melhorias significativas no SLS e 5STS (d= 0,44 - 0,68, p < 0,05), mas não se observaram diferenças significativas no grupo GAA em nenhuma variável analisada. Conclusões: Os resultados do presente estudo mostram a necessidade de mais estudos com programas de maior duração e mais frequência semanal.

Neuromuscular Fatigue after Small-Sided Games in Wheelchair Basketball Players with and without Spinal Cord Injury.

Purpose: The aim was to analyze the differences between wheelchair basketball players with Spinal Cord Injury (SCI) and without Spinal Cord injury (Non-SCI) in psycho-physiological response and neuromuscular fatigue in a series of small-sided games (SSG). Methods: Thirteen high-level wheelchair basketball male players (age 28.8 ± 9.2 years, body mass 75.9 ± 11.3 kg) participated in four versus four SSG once a week for five consecutive weeks. Absolute and relative heart rate (HR) during SSG and muscular and respiratory perceived exertion (RPEmus and RPEres), tympanic temperature, and acceleration capacity were recorded at the end of each SSG. Results: No significant differences were observed between SCI and non-SCI players in relative HR variables in SSG series. However, the SCI group had a lower absolute HR (mean HR and peak HR) (p < .05 or p < .01, ES = 0.73-1.39) and higher perceived muscular load (RPEmusTL) (p < .01, ES = 0.75-0.82) during SSG. Regarding the evolution of the physiological response, no differences were observed between the four bouts in the SCI group. However, the Non-SCI group showed an increase in the absolute and relative variables of HR and RPEres and RPEmus (p < .05 or p < .01, ES = 0.45-1.06). On the contrary, only the SCI group showed a loss of acceleration capacity between the four series (p < .05, ES = 0.28-0.35). Conclusion: The results of this study show that there are differences between SCI and non-SCI wheelchair basketball players in their physiological response and acceleration capacity during SSG tasks.

Targeted delivery of autoantigen to dendritic cells prevents development of spontaneous uveitis.

Restoration of immunological tolerance to self antigens has been a major drive in understanding the mechanisms of, and developing new treatments for, autoimmune and autoinflammatory disease. Sessile dendritic cells (DC) are considered the main instruments underpinning immunological tolerance particularly the CD205+ (DEC205+) cDC1 subset in contrast to DCIR2+ cDC2 which mediate immunogenicity. Targeting DC using autoantigen peptide-antibody fusion proteins has been a well explored methodology for inducing tolerance. Here we show that subcutaneous (s.c.) inoculation of hen-egg lysozyme (HEL)-DEC205 Ig fusion prevents the development of spontaneous uveoretinitis (experimental autoimmune uveoretinitis, EAU) in a transgenic mouse model generated by crossing interphotoreceptor retinol binding protein (IRBP)-HEL (sTg HEL) with HEL specific TCR (sTg TCR) mice. Prolonged suppression of EAU required injections of HEL-DEC205 Ig once weekly, reflecting the half life of s.c. DC. Interestingly, HEL-DCIR2 Ig also had a suppressive effect on development of EAU but less so than DEC205 Ig while it had minimal effect on preventing the retinal atrophy associated with EAU. In addition, HEL-DEC205 Ig was only effective when administered s.c. rather than systemically and had no effect on EAU induced by adoptive transfer of HEL-activated T cells. These data demonstrate the importance of systemic (lymph node) rather than local (eye) antigen presentation in the development of EAU as well as suggest a potential therapeutic approach to controlling sight-threatening immune-mediated uveitis provided relevant antigen(s) can be identified.

Analysis of the Barriers and Motives for Practicing Physical Activity and Sport for People with a Disability: Differences According to Gender and Type of Disability.

The aim of the study was to analyse the perception of the barriers and motives for the practice of physical activity (PA) in people with a disability, according to gender and type of disability. The participants in this investigation were 103 people with a disability (33.25 ± 11.86 years) who were habitual users of PA or sports programmes. They completed the questionnaire Motives and Barriers for Physical Activity and Sport (MBAFD). The results showed that personal barriers were more important than environmental ones and that the most outstanding motives were those related to leisure, enjoyment or social aspects. Regarding gender, women perceived more barriers than men. For the people with physical (PD) and intellectual (ID) disabilities, the most common barriers were of an intrinsic nature, and for those with a visual disability (VD), barriers of an environmental nature. With respect to the motives, people with PD gave higher scores to the items related to aspects of physical improvement and rehabilitation. In contrast, people with ID and VD placed more importance on reasons of leisure, enjoyment and social relations. Knowledge of these findings can be a tool to help increase the provision of PA for people with a disability.

Fat Oxidation during Exercise in People with Spinal Cord Injury, and Protocols Used: A Systematic Review.

BACKGROUND: The aim of this study was to summarize evidence on energy metabolism through peak fat oxidation (PFO) and maximum fat oxidation (Fatmax), as well as to analyze the protocols used in people with spinal cord injury (SCI) and to examine the main factors related to fat oxidation ability (i.e., age, sex, level of physical activity, and level and degree of injury). METHODS: Studies to determine PFO and Fatmax using indirect calorimetry with an arm exercise protocol for SCI patients were included after a systematic search. Other endpoints included study design, sample size, control group, demographic data, level of injury, physical condition, protocol, outcomes measured, and statistical findings. RESULTS: Eight studies (n = 560) were included. The mean value of VO2peak was 1.86 L∙min-1 (range 0.75-2.60 L∙min-1) (lowest value in the tetraplegic subjects). The PFO ranged between 0.06 and 0.30 g∙min-1 (lowest rates: the non-trained subjects with cervical SCI; highest: the tetraplegic subjects). Two types of exercise protocol were found: arm cycle ergometer, and wheelchair propulsion with a computerized ergometer. Five studies used an incremental protocol (2-3 min/stage, different load increments); the rest performed tests of 20 min/stage at three intensities. CONCLUSION: There are few existing studies measuring fat oxidation in SCI, many of which used small and heterogeneous samples. PFO was lower in SCI subjects when compared with non-injured people performing lower-limb exercise; however, comparing upper-limb exercise, people with SCI showed higher values.

Increased Fat Oxidation During Arm Cycling Exercise in Adult Men With Spinal Cord Injury Compared With Noninjured Controls.

People with spinal cord injury (SCI) tend to be more sedentary and increase fat accumulation, which could have a negative influence on metabolic flexibility. The aim of this study was to investigate the capacity to oxidize fat in a homogenous sample of men with thoracic SCI compared with healthy noninjured men during an arm cycling incremental test. Forty-one men, 21 with SCI and 20 noninjured controls, performed an incremental arm cycling test to determine peak fat oxidation (PFO) and the intensity of exercise that elicits PFO (Fatmax). PFO was expressed in absolute values (g/min) and relative to whole-body and upper-body lean mass ([mg·min-1]·kg-1) through three different models (adjusting by cardiorespiratory fitness and fat mass). Gross mechanical efficiency was also calculated. PFO was higher in SCI than in noninjured men (0.27 ± 0.07 vs. 0.17 ± 0.07 g/min; 5.39 ± 1.30 vs. 3.29 ± 1.31 [mg·min-1]·kg-1 whole-body lean mass; 8.28 ± 2.11 vs. 5.08 ± 2.12 [mg·min-1]·kg-1 upper-body lean mass). Fatmax was found at a significantly higher percentage of VO2peak in men with SCI (33.6% ± 8.2% vs. 23.6% ± 6.4%). Differences persisted and even increased in the fully adjustment model and at any intensity. Men with SCI showed significantly higher gross mechanical efficiency at 35 and 65 W than the noninjured group. Men with SCI showed higher fat oxidation when compared with noninjured men at any intensity, even increased after full adjustment for lean mass, fat mass, and cardiorespiratory fitness. These findings suggest that SCI men could improve their metabolic flexibility and muscle mass for greater efficiency, not being affected by their fat accumulation.

Load-Velocity Relationship in Bench Press and Effects of a Strength-Training Program in Wheelchair Basketball Players: A Team Study.

Performance in wheelchair basketball is determined by capabilities, such as strength and power. The study has two aims: first, to analyze the association between speed and acceleration variables (collected in the bench press (BP) exercise) and the distinct percentages of one-repetition maximum (1RM); second, to analyze the effect of a strength training protocol on wheelchair basketball (WB) players according to their functional impairments. Ten Spanish male WB players volunteered to participate in the study. The players did a pretest and posttest (1RM in bench press) with 6-week muscle strength intervention program. The results showed a high association between the %1RM and the mean propulsive velocity (MPV) and the maximum velocity (Vmax), both in the total of the participants, and in each separate group of athletes. After implementing the strength training program, both the players of the IWBF (International Wheelchair Basketball Federation) < 2.5 group and those of IWBF > 2.5 group improved their 1RM (p < 0.01, ES = 0.20 to 0.23). However, the program produced positive effects at submaximal intensities in the MPV reached with 30, 40, 70, and 80 kg and in time to maximum velocity (TVmax) with 30, 40, and 70 kg (ES = -3.24 to 1.32) only in players with greater functional impairments. The high association between %1RM and MPV and Vmax can allow for determination the %1RM of the WB players in the BP using the MPV and the Vmax. The training program was effective in improving 1RM in both groups, while improvements in submaximal values only occurred in the IWBF < 2.5 group.

Sex differences in competitive surfers' generic and specific strength capacity.

To compare the pop-up and counter movement jump (CMJ) and to analyse the relationships among the variables between sexes and different ages [under (U16), over (O16) 16 years] in male and female competitive surfers. Eighty-three surfers were divided according to sex, male (n = 55) and female (n = 28), and to age, U16 (n = 47) and O16 (n = 36). Vertical jump and pop-up movements were measured through the vertical ground reaction force with a force plate. CMJ demonstrated that the O16 male group exhibited significantly greater force compared to females in the concentric phase of the jump (CMJFMAX) (p < 0.01, ES = 1.82, large). Female U16 and O16 groups presented increased unloading rates in the eccentric phase compared to male surfers (CMJULR) (p < 0.05, ES = 0.73, moderate and p < 0.05, ES = 0.12, trivial, respectively). O16 males obtained significantly greater values than O16 females in the push-up phase (POPPUSH) (p < 0.05, ES = 0.76, moderate). Moderate correlations were found between lower-body power capacity and the pop-up (r = 0.32; ± 0.16 CL, p < 0.01, 98.1/1.9/0, very likely, moderate). General and skill-specific strengths are different in competitive male and female surfers, dependent upon their age range. The moderate association between CMJ and pop-up suggests that the pop-up might be influenced by other factors such as coordination or upper-body strength. Therefore, competitive surfers should also train the upper body strength and overall coordination in order to improve the performance of the pop-up movement.

Velocity and Power-Load Association of Bench Press Exercise in Wheelchair Basketball Players and Their Relationships With Field-Test Performance.

PURPOSE: This study analyzes the relationship between mean propulsive velocity (MPV) of the bar and relative load (%1RM) in the bench press exercise, as well as determining the relationship of power variables (i.e. Mean Power (MP), Mean Propulsive Power (MPP) and Peak Power (PP)) in change of direction ability (CODA), linear sprint and RSA performance. METHODS: Nine Spanish First Division wheelchair basketball (WB) players participated in the study. All participants performed an isoinertial bench press (BP) test in free execution mode, 505 change of direction ability test (505 CODA), linear sprint test (20 m), and Repeated Sprint Ability Test (RSA). RESULTS: A nearly perfect and inverse relationship was observed for the BP exercise between the %1RM and MPV (r = -.97; R2 = .945; P < 0.001). The maximum loads for MP, MPP and PP were obtained between 48.1 - 59.4% of the 1RM. However, no significant correlations were observed between strength and wheelchair performance. CONCLUSIONS: WB players with different functional impairments showed a nearly perfect and inverse relationship for the BP exercise between the %1RM and MPV, thus the MPV could be used to estimate the %1RM. This finding has important practical applications for velocity-based resistance training in which coaches would be able to prescribe and monitor training load. Conversely, the absence of association between BP performance and field tests might be due to other factors such as wheelchair-user interface, trunk muscular activity or propulsion technique apart from strength variables.

Anthropometric characteristics of top-class Olympic race walkers.

BACKGROUND: Typical training programmes in elite race walkers involve high training volumes at low and moderate intensities, which have been reported to induce functional and structural adaptations at an anthropometric level. Since anthropometrical variables are closely related to movement efficiency and performance in endurance events, the aim of this study was to describe the anthropometric profile of world-class race walkers. METHODS: Twenty-nine world-class race walkers (21 men and 8 women) participated in this study. Anthropometric characteristics, including height, body mass, eight skinfolds, five girths and four bone breadths were measured. Body composition, somatotype, somatotype dispersion mean, somatotype attitudinal mean and height to weight ratio, as well as skinfolds extremity to trunk ratio were also calculated. RESULTS: Mean height, body mass and body mass index were 177.1±7.1 cm, 66.4±5.8 kg, and 21.2±1.3 kg·m2 for men and 165.6±4.5 cm, 53.6±3.7 kg, and 19.6±1.6 kg· m2 for women, respectively. Women presented greater body fat content (6.7±0.6 vs. 12.2±0.8%; very large effect), less muscle mass (65.6±4.6 vs. 61.6±2.6 kg; large effect), and were more endomorphic (large effect) than men. Men specialists in 20-km showed greater muscle mass (66.7±4.9 vs. 64.4±4.3 kg; moderate effect), and slightly higher skinfolds, girths, body fat content and were more mesomorphic than 50-km specialists (moderate effect). CONCLUSIONS: The present study expands the limited knowledge on the anthropometric characteristics and somatotype elements of elite top-class race walkers. The characterisation of the morphology of elite race walkers provides coaches a reference values to control the training development of the race walker, as well as providing reference values to improve talent identification.