Effects of photobiomodulation therapy (PBMT) over endothelial function in healthy individuals: a preliminary crossover clinical trial.

Photobiomodulation therapy (PBMT) causes stimulatory effects that raise cell metabolism. The study aimed to evaluate the effects of PBMT on the endothelial function of healthy individuals. It was a controlled, randomized, crossover, triple-blind trial with 22 healthy volunteers (female: 77.3%), aged 25.45 years which were randomly divided into three groups. PBMT with gallium-aluminum-arsenide (GaAlAs) diode laser (810 nm, continuous-wave mode, 1000 mW, 0.28 cm2) was applied over the radial and ulnar artery regions in two parallel spots: group 1-30 J (n = 22, 107 J/cm2) per spot; group 2-60 J (n = 22, 214 J/cm2) per spot; and group 3-placebo (n = 22, sham). The endothelial function was measured before and immediately after PBMT by the flow-mediated dilation technique (%FMD) with high-resolution ultrasound. Statistical analysis was made with ANOVA for repeated measures, the effect size was measured by Cohen's d, and results are presented as mean and standard error (or 95% confidence intervals). A p-value < 0.05 was considered statistically significant. The %FMD increases 10.4% with 60 J (mean difference = 0.496 mm, 95% CI = 0.42 to 0.57, p < 0.001), 7.3% with 30 J (mean difference = 0.518 mm, 95% CI = 0.44 to 0.59, p < 0.001), and 4.7% with placebo (mean difference = 0.560 mm, 95% CI = 0.48 to 0.63, p < 0.001). We found a small effect size (p = 0.702; d de Cohen = 0.24) without statistical difference between interventions. PBMT with the energy density of 60 J and 30 J did not improve endothelial function.Trial registration number: NCT03252184 (01/09/2017).

The effects of exercise on circulating endocannabinoid levels-a protocol for a systematic review and meta-analysis.

BACKGROUND: Increased circulating endocannabinoids levels are typically associated with aerobic exercise. This phenomenon is associated with a "runner's high," a state of euphoria and well-being experienced after a long exercise. We will provide in this review a transparent and standardized methodology following the PRISMA-P and Cochrane Handbook for Systematic Reviews of Interventions for conducting a systematic review and meta-analysis for synthesizing the available evidence about the effects of physical activity on the circulating levels of AEA and 2-AG endocannabinoids in healthy subjects. METHODS: A multi-disciplinary team with basic and clinical expertise in exercise science developed this protocol. PubMed, EMBASE, Web of Science, CINAHL, SPORTDiscus, and Scopus will be the databases. A health sciences librarian was consulted in the development of the research. Search strategies will combine MeSH terms and free text words, including "exercise," "exercise, physical," "exercise training," "physical activity," "endocannabinoids," "2-arachidonoyl-glycerol," "glyceryl 2-arachidonate," "2-AG," "anandamide," "AEA," "n-arachidonoylethanolamide," "adult," "young adult," and "middle-aged." We will select experimental or quasi-experimental studies published through December 2021. The selection of studies, data extraction, assessment of the risk of bias, and the quality of evidence will be carried out in a paired and independent manner, and the consistency will be assessed using the statistics of Cohen Kappa. Methodological quality will be assessed using the Revised Cochrane risk of bias tool for randomized trials (RoB 2) and the Risk Of Bias In Nonrandomized Studies of Interventions (ROBINS-I) risk tool. We will use the Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of the evidence, χ2 and I2 tests for heterogeneity, funnel plots, and the Egger test for publication bias. A meta-analysis for each data comparison will be performed whenever possible to determine the effect of physical activity on endocannabinoids' circulating levels. DISCUSSION: This systematic review and meta-analysis will provide an overview of the evidence about physical activity over AEA and 2-AG endocannabinoids, including comparability of variables between studies, critical interpretation of results, and use of accurate statistical techniques. The endocannabinoid is molecules by which muscles communicate with other tissues and organs, mediating the beneficial effects of exercise on health and performance, including increased glucose uptake, improved insulin action, and mitochondrial biogenesis. They are essential to exercise. Thus, this study will review the acute effect of physical exercise on circulating levels of endocannabinoids in healthy individuals. The results of this study will potentially be transferred to doctors, health professionals, and legislators to guide their decision making, as well as will improve future research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020202886 .

Effects of aerobic exercise using cycle ergometry on balance and functional capacity in post-stroke patients: a systematic review and meta-analysis of randomised clinical trials.

BACKGROUND: Previous studies have shown that aerobic exercise with cycle ergometer improves motor control. PURPOSE: The objective of this systematic review and meta-analysis are to evaluate evidence about the effects of aerobic exercise with cycle ergometer on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS), and functional capacity, evaluated by the maximal oxygen intake and six-minute walk test (6MWT). METHODS: The research was conducted on MEDLINE, LILACS, Cochrane Library, EMBASE, Physiotherapy Evidence Database, and Google Scholar until March 2018 (CRD42015020146). Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was balance assessed by the Berg scale and the secondary outcome was functional capacity of the maximal oxygen intake and the 6MWT. Meta-analysis was conducted using a random-effects method, and mean pre-post intervention difference with a 95% confidence interval (95%CI). RESULTS: The review included 5 papers and a total of 258 patients. It was observed that the cycle ergometer did not improve balance in this population (0.03 [-0.57 to 0.64] p = 0.91) or functional capacity in maximal oxygen intake (2.40 [-0.24 to 5.04] p = 0.07) and 6MWT (-40.49 [-131.70 to 50.72] p = 0.38). CONCLUSIONS: The cycle ergometer aerobic exercise did not seem to improve balance or functional capacity in post-stroke patients.IMPLICATIONS FOR REHABILITATIONAerobic exercise with cycle ergometer does not improve balance in patients after chronic stroke, but the results for functional capacity are more promising.Beneficial changes in functional capacity can be seen after 12-4 weeks of training, and are dependent on the initial level of physical fitness of each individual.The use of the cycle-ergometer to improve balance and functional capacity was not superior when compared to conventional physiotherapy; therefore, a combination of therapeutic modalities would be ideal for rehabilitation and post-stroke patients.

Effects of transcutaneous electrical nerve stimulation alone or as additional therapy on chronic post-stroke spasticity: systematic review and meta-analysis of randomized controlled trials.

Purpose: To evaluate the effects and to compare transcutaneous electrical nerve stimulation protocols, alone or as additional therapy in chronic post-stroke spasticity through a systematic review and meta-analysis of randomized clinical trials.Methods: Search was conducted in MEDLINE, Cochrane Library, EMBASE and Physiotherapy Evidence Database through November 2017 (CRD42015020146). Two independent reviewers performed articles selection, data extraction and methodological quality assessment using the Cochrane Collaboration's risk of bias tool. The main outcome was spasticity assessed with Modified Ashworth Scale or other valid scale. Meta-analysis was conducted using random effects method, and pooled-effect results are mean difference with 95% confidence interval.Results: Of 6506 articles identified, 10 studies with 360 subjects were included in the review. Transcutaneous electrical nerve stimulation alone or as additional therapy is superior to placebo TENS to reduce post-stroke spasticity assessed with Modified Ashworth Scale (-0.52 [-0.74 to -0.30] p < 0.0001, 6 studies), especially in lower limbs (-0.58 [-0.82 to -0.34] p < 0.0001, 5 studies), which is in accordance with the studies that used other scales. Low frequency TENS showed a slightly larger improvement than high-frequency, but without significant difference between subgroups. Most studies present low or unclear risk of bias.Conclusion: Transcutaneous electrical nerve stimulation can provide additional reduction in chronic post-stroke spasticity, mainly as additional therapy to physical interventions. Studies with better methodological quality and larger sample are needed to increase evidence power.Implications for RehabilitationTranscutaneous electrical nerve stimulation as additional treatment to physical interventions can lead to additional reduction in chronic post-stroke spasticity.High and low frequency transcutaneous electrical nerve stimulation showed similar results, with a smaller numerical superiority of low frequency TENS.More studies are needed to substantiate the best protocol of transcutaneous electrical nerve stimulation to the treatment of spasticity.

Male adult rat sperm parameters after skeletal muscle injury / Parâmetros espermáticos de ratos adultos após lesão músculo-esquelética / Parámetros espermáticos de ratas adultas después de lesión músculo-esquelética

ABSTRACT Introduction: Skeletal muscle injuries stimulate a systemic inflammatory response which may interfere in species reproduction. Objective: To evaluate the effects caused by skeletal muscle injuries on the inflammatory response and sperm parameters of male adult rats. Methods: The sample group was composed of 30 Wistar rats distributed evenly across control and injury groups. Muscle injury was induced by bruising, caused by the release of a 200 g weight from a height of 30 cm onto the gastrocnemius muscle. Blood (CBC and damage/muscle inflammation markers), muscle (oxidative stress) and gonad (sperm parameters) samples were collected 72h after the injury. Results: The muscle injury increased monocytes, creatine kinase, C-reactive protein, reactive oxygen species (ROS) concentration and lipid peroxidation. In contrast, the injury reduced antioxidant capacity against peroxyl radicals (ACAP), membrane integrity (36%) and sperm acrosome (33%). Membrane integrity and acrosome (p<0.05) correlate directly with ACAP (ρ=0.602; ρ=0.513 respectively) and inversely with monocytes (ρ=-0.703; ρ=-0.635, respectively), creatine kinase (ρ=-0.450; ρ=-0.603), C-reactive protein (ρ=-0.511; ρ=-0.703) and parameters of oxidative stress (ROS ρ=-0.703; ρ=-0.635; lipid peroxidation ρ=-0.494; ρ=-0.559). Conclusion: The acute systemic inflammatory response arising from skeletal muscle injury interferes in the male reproductive cell organelles (membrane and acrosome). Level of Evidence V; Experimental study.

RESUMO Introdução: As lesões músculo-esqueléticas estimulam uma resposta inflamatória sistêmica que pode interferir na reprodução das espécies. Objetivo: Avaliar os efeitos causados pelas lesões músculo-esqueléticas sobre a resposta inflamatória e os parâmetros espermáticos de ratos machos adultos. Métodos: O grupo da amostra foi composto por 30 ratos Wistar uniformemente distribuídos nos grupos controle e grupo lesionado. A lesão muscular foi induzida por meio de contusão, causada ao se soltar um peso de 200 g de uma altura de 30 cm sobre o músculo gastrocnêmio. Foram coletadas amostras de sangue (hemograma completo e marcadores de danos e inflamação muscular), músculo (estresse oxidativo) e gônadas (parâmetros espermáticos) 72 horas após a lesão. Resultados: A lesão muscular aumentou os monócitos, creatina quinase, proteína C-reativa, concentração de espécies reativas de oxigênio (ROS) e lipoperoxidação. Por outro lado, a lesão reduziu a capacidade antioxidante contra os radicais peroxil (ACAP), a integridade da membrana (36%) e o acrossoma espermático (33%). A integridade da membrana e o acrossoma (p<0,05) se correlacionaram diretamente com ACAP (ρ=0,602; ρ=0,513 respectivamente) e inversamente com os monócitos (ρ=-0,703; ρ=-0,635, respectivamente), creatina quinase (ρ=-0,450; ρ=-0,603), proteína C-reativa (ρ=-0,511; ρ=-0,703) e parâmetros de estresse oxidativo (ROS ρ=-0,703; ρ=-0,635; lipoperoxidação ρ=-0,494; ρ=-0,559). Conclusão: A resposta inflamatória sistêmica aguda decorrente da lesão músculo-esquelética interfere nas organelas das células reprodutivas masculinas (membrana e acrossoma). Nível de evidência V; Estudo experimental.

RESUMEN Introducción: Las lesiones músculo-esqueléticas estimulan una respuesta inflamatoria sistémica que puede interferir en la reproducción de las especies. Objetivo: Evaluar los efectos causados por las lesiones músculo-esqueléticas sobre la respuesta inflamatoria y los parámetros espermáticos de ratas macho adultas. Métodos: El grupo de la muestra fue compuesto por 30 ratas Wistar distribuidas uniformemente en los grupos control y grupo lesionado. La lesión muscular fue inducida por medio de contusión, causada al soltarse un peso de 200 g desde una altura de 30 cm sobre el músculo gastrocnemio. Fueron colectadas muestras de sangre (hemograma completo y marcadores de daños e inflamación muscular), músculo (estrés oxidativo) y gónadas (parámetros espermáticos) 72 horas después de la lesión. Resultados: La lesión muscular aumentó los monocitos, creatina quinasa, proteína C reactiva, concentración de especies reactivas de oxígeno (ROS) y lipoperoxidación. Por otro lado, la lesión redujo la capacidad antioxidante contra los radicales peroxilo (ACAP), la integridad de la membrana (36%) y el acrosoma espermático (33%). La integridad de la membrana y el acrosoma (p<0,05) se correlacionan directamente con ACAP (ρ=0,602; ρ=0,513 respectivamente) e inversamente con los monocitos (ρ=-0,703; ρ=-0,635, respectivamente), creatina quinasa (ρ=-0,450, ρ=-0,603), proteína C reactiva (ρ=-0,511; ρ=-0,703) y parámetros de estrés oxidativo (ROS ρ=-0,703; ρ=-0,635; lipoperoxidación ρ=-0,494; ρ=-0,559). Conclusión: La respuesta inflamatoria sistémica aguda proveniente de la lesión músculo-esquelética interfiere en los orgánulos de las células reproductivas masculinas (membrana y acrosoma). Nivel de evidencia V; Estudio experimental.

Muscular Atrophy in Cardiovascular Disease.

Currently, the number of chronic diseases has increased due to increasing in life expectancy of population. Among them, cardiovascular diseases (CVD) are the most prevalent and responsible for the high mortality and morbidity rates. Patients with CVD have metabolic, hemodynamic, and musculoskeletal changes. There is a debate regarding the correct term for musculoskeletal changes that affect this group of patients; therefore, we found in literature myopia, muscular atrophy, cardiac cachexia, and sarcopenia. However, although there is no standardization in relation to correct term, these musculoskeletal consequences directly affect the quality of life and are associated with a poor prognosis. In this way, the importance of prevention of muscular atrophy, but also of treatment for those patients with progressive muscle decline, is proven. We also emphasize the importance of a multi-professional team, because therapeutic strategies are needed that are capable of delaying the onset or minimizing the consequences of skeletal muscle loss, from pharmacological management and nutrition to physical exercise.

Effects of High-Intensity Inspiratory Muscle Training Associated with Aerobic Exercise in Patients Undergoing CABG: Randomized Clinical Trial.

OBJECTIVE: Evaluate the interaction between high-intensity inspiratory muscle training (IMT) and aerobic exercise on physical capacity, respiratory muscle strength, peripheral muscle strength, and quality of life of patients who underwent coronary artery bypass grafting (CABG). METHODS: Twenty-four patients underwent CABG were randomized into two groups. During 36 sessions, one group received IMT associated with aerobic exercise and the other group received only aerobic exercise. Primary outcome was the distance in the six-minute walk distance (6MWD) test. Secondary outcomes included respiratory muscle strength, peripheral muscle strength, and quality of life. Measures were taken at the baseline, at the 12th session, the 24th session, and 36th session. RESULTS: Baseline characteristics were similar between the groups. There was no statistically significant difference between the two groups in any outcome [6MWD - P=0.935; peak oxygen consumption (PeakVO2) - P=0.853; maximal inspiratory pressure (MIP) - P=0.243; maximal expiratory pressure (MEP) - P=0.268; sitting-rising test (SRT) - P=0.212], but there was interaction in MIP (P=0.000) and all outcomes improved in the two groups (6MWD - P=0.000; PeakVO2 - P=0.000; MIP - P=0.000; MEP - P=0.000; SRT - P=0.000). CONCLUSION: There was an improvement of all outcomes in both groups, but IMT was not able to provide additional benefits. The use of this combination should be used with caution to not generate higher costs in the rehabilitation process of these patients.

Effects of high-intensity inspiratory muscle training associated with aerobic exercise in patients undergoing cabg: randomized clinical trial

Abstract Objective: Evaluate the interaction between high-intensity inspiratory muscle training (IMT) and aerobic exercise on physical capacity, respiratory muscle strength, peripheral muscle strength, and quality of life of patients who underwent coronary artery bypass grafting (CABG). Methods: Twenty-four patients underwent CABG were randomized into two groups. During 36 sessions, one group received IMT associated with aerobic exercise and the other group received only aerobic exercise. Primary outcome was the distance in the six-minute walk distance (6MWD) test. Secondary outcomes included respiratory muscle strength, peripheral muscle strength, and quality of life. Measures were taken at the baseline, at the 12th session, the 24th session, and 36th session. Results: Baseline characteristics were similar between the groups. There was no statistically significant difference between the two groups in any outcome [6MWD - P=0.935; peak oxygen consumption (PeakVO2) - P=0.853; maximal inspiratory pressure (MIP) - P=0.243; maximal expiratory pressure (MEP) - P=0.268; sitting-rising test (SRT) - P=0.212], but there was interaction in MIP (P=0.000) and all outcomes improved in the two groups (6MWD - P=0.000; PeakVO2 - P=0.000; MIP - P=0.000; MEP - P=0.000; SRT - P=0.000). Conclusion: There was an improvement of all outcomes in both groups, but IMT was not able to provide additional benefits. The use of this combination should be used with caution to not generate higher costs in the rehabilitation process of these patients.

Different frequencies of transcutaneous electrical nerve stimulation on sympatho-vagal balance / Diferentes frequências da estimulação elétrica nervosa transcutânea no balanço simpato-vagal

This study aims to evaluate the effects of TENS at different frequencies on autonomic balance in healthy volunteers. It is a case-control study, and was composed of fourteen healthy volunteers (5 women) with 28 (3.9) years old who underwent low (10 Hz 200ms-1) and high (100 Hz 200ms-1) frequency TENS. The interventions were randomized and applied for 30 minutes in the trajectory brachial nerve plexus from non -dominant member. Intensities were adjusted every 5 minutes and maintained below motor threshold. The autonomic balance was assessed before and after interventions by heart rate variability (HRV). TENS 10 Hz increased 10% sympathetic activity and decreased 10% parasympathetic activity; however, TENS 100 Hz showed opposite effects (p < 0.05). The sympatho-vagal balance increased with low frequency TENS and decreased with high frequency (p < 0.05). It can be concluded that different frequencies of TENS applied in the trajectory brachial nerve plexus modify cardiovascular autonomic responses. High frequency TENS reduces sympathetic activity and increases the parasympathetic, which favors beneficial effects on autonomic balance in healthy volunteers.

Este estudo objetiva avaliar os efeitos de diferentes frequências da TENS sobre o balanço autonômico em voluntários saudáveis. Estudo caso-controle composto de quatorze voluntários saudáveis (5 mulheres), com 28 (3,9) anos de idade que foram submetidos a baixa (10 Hz 200 ms-1) e a alta (100 Hz 200 ms-1) frequências da TENS. As intervenções foram randomizadas e aplicadas por 30 minutos sobre a trajetória do plexo nervoso braquial do membro não dominante. As intensidades foram ajustadas a cada 5 minutos e mantidas abaixo do limiar motor. O balanço autonômico foi avaliado antes e após as intervenções pela variabilidade da frequência cardíaca (VFC). TENS a 10 Hz aumentou 10% da atividade simpática e diminui 10% a atividade parassimpática, mas a TENS a 100 Hz apresentou efeitos opostos (p < 0,05). O balanço simpato-vagal aumentou com a TENS de baixa frequência e diminuiu com a alta frequência (p < 0,05). Conclui-se que as diferentes frequências da TENS aplicadas sobre a trajetória do plexo nervoso braquial modificam as respostas autonômicas cardiovasculares. A alta frequência da TENS reduz a atividade simpática e aumenta a parassimpática, o que favorece aos efeitos benéficos sobre o balanço autonômico em voluntários saudáveis.

Effects of Different Therapeutic Ultrasound Waveforms on Endothelial Function in Healthy Volunteers: A Randomized Clinical Trial.

The purpose of this study was to determine the effects of different therapeutic 1-MHz ultrasound waveforms on endothelial function before and after cyclooxygenase (COX) inhibition. Forty-two healthy volunteers aged 27.2 ± 3.8 y underwent interventions and an evaluation for endothelial function (n = 15; with COX inhibition, n = 15; duration of the vasodilator effect, n = 12) by technique flow-mediated dilation. Continuous ultrasound therapy (0.4 W/cm(2 SATA)), pulsed ultrasound therapy (20% duty cycle, 0.08 W/cm(2 SATA)) or placebo (equipment power off) was randomly applied over the brachial artery for 5 min. COX inhibition (aspirin) was carried out 30 min before treatments. In relation to the placebo, flow-mediated dilation increased by 4.8% using continuous ultrasound and by 3.4% using pulsed ultrasound. After COX, flow-mediated dilation was enhanced by 2.1% by continuous ultrasound and 2.6% by pulsed ultrasound. This vasodilation persisted for 20 min. Continuous and pulsed therapeutic 1-MHz ultrasound waveforms improved endothelial function in humans, which provided them with anti-inflammatory vascular effects.

EFEITOS DO TREINAMENTO FÍSICO NO ENDOTÉLIO APÓS CIRURGIA DE REVASCULARIZAÇÃO / EFFECTS OF PHYSICAL TRAINING ON ENDOTHELIUM AFTER CORONARY ARTERY BYPASS GRAFT / EFECTOS DEL ENTRENAMIENTO FÍSICO EN EL ENDOTELIO DESPUÉS DE REVASCULARIZACIÓN

Introdução A cirurgia de revascularização do miocárdio (CRM) é uma das mais frequentes cirurgias realizadas em todo o mundo, muitos estudos vêm relatando os benefícios do treinamento físico para a melhora da capacidade funcional, porém há poucos estudos sobre os efeitos na função endotelial vascular. Objetivo Analisar os efeitos do treinamento físico sobre a função endotelial vascular em pacientes submetidos à CRM, isoladamente na fase tardia da reabilitação após seis meses de programa de reabilitação cardíaca (PCR). Métodos Foram incluídos pacientes que haviam sido submetidos à CRM no período máximo de um ano após a cirurgia. O PRC foi empregado durante seis meses consecutivos, com três sessões semanais. Todos os pacientes realizaram exames laboratoriais, teste de força muscular de uma repetição máxima (1-RM) para os membros superiores e inferiores, teste de caminhada de 6 min (TC6M) e avaliação da função endotelial através da técnica de vasodilatação mediada pelo fluxo. Resultados Onze pacientes iniciaram o PRC, porém nove pacientes o completaram. A média de idade foi de 66 anos (50 a 82 anos) e o sexo masculino foi predominante (55,6%). Houve mudanças significativas nos exames laboratoriais bioquímicos: aumento do colesterol total (Basal: 162 ± 31mg/dL vs. 195 ± 39mg/dL; P=0,012) e diminuição da hemoglobina glicada (Basal: 6,74 ± 1,64% vs. 6,26 ± 1,62%; P=0,028). A força muscular aumentou significativamente nos membros superiores e inferiores (P=0,030 e P=0,038, respectivamente); no TC6M observou-se um aumento significativo de 20% na distância percorrida (P=0,020) após seis meses consecutivos de treinamento e houve uma melhora na vasodilatação mediada pelo fluxo (Basal: 6,35 ± 3,92% vs. 6 meses: 9,90 ± 4,19%; P=0,026). Conclusão O treinamento combinado realizado em seis meses ajudou a melhorar a função endotelial e a capacidade funcional de pacientes sedentários que foram submetidos à CRM na fase tardia da reabilitação.

Introduction The coronary artery bypass graft surgery (CABG) is one of the most common surgeries performed worldwide, many studies have reported the benefits of physical training to improve functional capacity, however there are few studies about the effect of this training on vascular endothelial function. Objective To analyze the effects of physical training on vascular endothelial function in patients who underwent CABG surgery alone in the last phase of rehabilitation after six months of cardiac rehabilitation program (CRP). Methods Patients who underwent CABG surgery in a maximum period of one year after surgery were included in the study. The CRP was carried out during six consecutive months, with three sessions per week. All patients underwent biochemical blood tests, muscle strength testing of one repetition maximum (1-RM test) for upper and lower limbs, 6-minute walk test (6MWT), and evaluation of endothelial function through the flow-mediated vasodilation technique. Results Eleven patients started CRP, but only nine patients completed it. The mean age was 66 years old (50 to 82 years old), males being predominant (55.6%). There were significant changes in biochemical laboratory tests: increase on total cholesterol (Baseline: 162 ± 31mg/dL vs. 195 ± 39mg/dL; P=0.012), and decrease on glycated hemoglobin (Baseline: 6.74 ± 1.64% vs. 6.26 ± 1.62%; P=0.028). Muscle strength was significantly increased in upper and lower limbs (P=0.030, and P=0.038, respectively) and in 6MWT we observed a significant increase of 20% in distance traveled (P=0.020) after six consecutive months of training. There was also a flow-mediated vasodilation improvement (6.35 ± 3.92% vs. 9.90 ± 4.19%; P=0.026). Conclusion The combined training carried out in six months helped to improve endothelial function and functional capacity in sedentary patients submitted to CABG surgery in the last phase of cardiac rehabilitation.

Introducción La cirugía de revascularización miocárdica (CRM) es una de las cirugías más comunes que se realizan en todo el mundo, muchos estudios han reportado los beneficios del entrenamiento físico para mejorar la capacidad funcional, pero hay pocos estudios sobre el efecto en la función endotelial vascular. Objetivo Analizar los efectos del entrenamiento físico sobre la función endotelial vascular en los pacientes sometidos a CRM solo en la última fase de la rehabilitación después de seis meses del programa de rehabilitación cardíaca (PRC). Métodos Fueron incluidos los pacientes que habían sido sometidos a CRM con el período máximo de un año después de la cirugía. Los pacientes fueron sometidos a lo PRC por seis meses consecutivos, con tres sesiones semanales. Todos los pacientes realizaron pruebas de laboratorio, pruebas de fuerza muscular una repetición máxima (1-RM) para miembros superiores e inferiores, prueba de la marcha de 6 minutos (PM6M) y la evaluación de la función endotelial mediante la técnica de la vasodilatación mediada por flujo. Resultados Once pacientes iniciaron el PRC, pero nueve pacientes lo completaron. La edad promedio fue de 66 años (50-82 años) y los varones predominaron (55,6%). Hubo cambios significativos en las pruebas de laboratorio bioquímico: aumento en el colesterol total (basal: 162 ± 31 mg/dl vs. 195 ± 39 mg/dl; p = 0,012) y disminución de la hemoglobina glucosada (basal: 6,74 ± 1,64% % vs. 6,26 ± 1,62, p = 0,028). La fuerza muscular se incrementó significativamente en los miembros superiores e inferiores (P = 0,030 y P = 0,038, respectivamente) y en PM6M se observó un aumento significativo de 20% en la distancia cubierta (p = 0,020) después de seis meses consecutivos de entrenamiento y también la vasodilatación mediada por flujo ha mejorado (basal: 6,35 ± 3,92% vs. 9,90 ± 4,19%, p = 0,026). Conclusión El entrenamiento combinado realizado en seis meses ha mejorado la función endotelial y la capacidad funcional de los pacientes sedentarios sometidos a CRM en la última fase de la rehabilitación.

Trans-resveratrol reduces cardiac oxidative stress in rats exposed to cigarette smoke / O trans-resveratrol reduz o estresse oxidativo cardíaco de ratos expostos à fumaça de cigarro

Differences between reactive oxygen species and antioxidant defense system unbalance the redox status. The exposure to cigarette smoke can increase this imbalance. Trans-resveratrol is a polyphenol with great antioxidant action that reduces the oxidative stress. This study investigated the effect of the trans-resveratrol supplementation on the cardiac oxidative stress in rats exposed to cigarette smoke. Male Wistar rats were randomized into four groups: Control Group (CG), Exposure to Smoke Group (ESG), Antioxidant Group (AG) and Exposure to Smoke plus Antioxidant Group (ESAG). Animals were exposed to cigarette smoke and supplemented with trans-resveratrol (6.0 mg kg-1) for two months. The lipid peroxidation (TBARS) and the enzymatic activity of catalase (CAT) were measured in the cardiac muscle. The ESG presented the highest lipid peroxidation level compared with CG (p < 0.001), AG (p < 0.001) and ESAG (p < 0.006). The CAT activity was higher in the AG (p < 0.001) and ESAG (p < 0.001) compared with CG. The ESG presented lower CAT activity compared with the ESAG (p < 0.001). The supplementation of Trans-resveratrol attenuated the cardiac oxidative stress and increased the activity of catalase. Our findings evidenced the cardioprotective effect of trans-resveratrol in rats exposed to cigarette smoke.

Diferenças entre espécies reativas de oxigênio e sistema de defesa antioxidante desequilibram o estado redox. Exposição à fumaça de cigarro pode aumentar esse desequilíbrio. Trans-resveratrol é um polifenol com ação antioxidante que reduz o estresse oxidativo. O objetivo do presente estudo foi investigar os efeitos da suplementação com trans-resveratrol no estresse oxidativo cardíaco de ratos expostos à fumaça de cigarro. Randomização de 32 ratos Wistar machos em quatro grupos: Controle (CG), Exposição à Fumaça (ESG), Antioxidante (AG) e Exposição à Fumaça+Antioxidante (ESAG). Animais foram expostos à fumaça de cigarro e suplementados trans-resveratrol (6,0 mg kg-1) durante dois meses. Lipoperoxidação (TBARS) e atividade enzimática da catalase (CAT) foram mensuradas no músculo cardíaco. ESG apresentou maiores níveis de lipoperoxidação quando comparado ao CG (p < 0,001), AG (p < 0,001) e ao ESAG (p < 0,006). Atividade da CAT foi maior no AG (p < 0,001) e no ESAG (p < 0,001) quando comparados ao CG. ESG apresentou a menor atividade da CAT quando comparado ao ESAG (p < 0,001). A suplementação com trans-resveratrol atenuou o estresse oxidativo cardíaco e aumentou a atividade enzimática de defesa catalase. Esses resultados sugerem evidências de efeitos cardioprotetores do trans-resveratrol em ratos expostos à fumaça de cigarro.