Effects of blood flow restriction exercise on hemostasis: a systematic review of randomized and non-randomized trials.

BACKGROUND: Blood flow restriction (BFR) exercise has shown to induce a positive influence on bone metabolism and attenuate muscle strength loss and atrophy in subjects suffering from musculoskeletal weakness. Despite the known benefits of BFR exercise, it remains unclear whether or not the pressurization of blood vessels damages the endothelial cells or increases risk for formation of thrombi. Thus, the effects of BFR exercise on coagulation, fibrinolysis, or hemostasis, remains speculative. OBJECTIVE: The aim of the present study was to perform a systematic review of the short and long- term effects of BFR exercise on blood hemostasis in healthy individuals and patients with known disease (ie, hypertension, diabetes, obesity, and ischemic heart disease). DATA SOURCES: A systematic review of English and non-English articles was conducted across PubMed, Science Direct, and Google Scholar databases, including reference lists of relevant papers. Study quality assessment was evaluated using the modified version of Downs and Black checklist. Search results were limited to exercise training studies investigating the effects of BFR exercise on blood hemostasis in healthy individuals and patients with disease. Level of evidence was determined according to the criteria described by Oxford Center for Evidence-Based Medicine. STUDY SELECTION: Only randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) that examined the effects of exercise with BFR exercise vs exercises without BFR on blood hemostasis in healthy individuals and patients were included. DATA EXTRACTION: Nine studies were eligible (RCT =4; NRCT =5). RESULTS: The average score on the Downs and Black checklist was 11.22. All studies were classified as having poor methodological quality wherein the level of evidence provided in all reviewed studies was level IIb only (ie, poor quality RCTs). CONCLUSION: Considering the limitations in the available evidence, firm recommendations cannot be provided.

The impact of sarcopenic obesity on inflammation, lean body mass, and muscle strength in elderly women.

OBJECTIVE: The objective of this study was to apply the newly standardized definition for sarcopenia from the Foundation for the National Institutes of Health (FNIH) and the current definition for obesity to 1) determine the prevalence of sarcopenic obesity (SO) in obese elderly women; 2) compare the muscle strength, lean body mass, and markers of inflammation between obese elderly women with SO and nonsarcopenic obesity (NSO), and 3) elucidate the relationship between appendicular lean mass adjusted for body mass index (aLM/BMI) with muscle strength, lean body mass, and obesity indices. METHODS: A total of 64 elderly obese women (age: 68.35±6.04 years) underwent body composition analysis by dual-energy X-ray absorptiometry. Participants were classified into two groups according to the definition of SO and NSO. Blood samples were collected for total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, uric acid, urea, interleukin-6 (IL-6), glucose, and creatine kinase (CK) measurements. RESULTS: The SO group presented a significantly greater BMI, fat (%), glucose, a marginal trend toward significance for uric acid, and IL-6 compared to the NSO group. In addition, the SO group displayed lower values for muscle strength and lean body mass. From a correlation standpoint, a higher aLM/BMI was positively associated with lean body mass and muscle strength and negatively associated with a lower BMI and percentage body fat. CONCLUSION: The definition criteria from FNIH and obesity permit the ability to illustrate the prevalence and identify SO in elderly women with low muscle mass, low muscle strength, and impaired markers of inflammation.

Blood pressure response to resistance training in hypertensive and normotensive older women.

PURPOSE: The purpose of the present study was to identify the variability of blood pressure response to a 10-week resistance training (RT) program in hypertensive and normotensive elderly women. PARTICIPANTS AND METHODS: Twenty-seven untrained hypertensive and 12 normotensive elderly women participated in the present study. A whole-body RT program was performed on two nonconsecutive days per week for 10 weeks. The responsiveness of resting systolic blood pressure (SBP) was determined based on the percent decline between the pre- and post-training time points T1 and T4. The term responders were used to describe subjects who exhibited a percent SBP decline ≥-2.58% and the term nonresponders for subjects who exhibited a percent SBP decline <-2.58%, respectively. RESULTS: Both the responders and nonresponders in the hypertensive group presented significant changes in SBP (-7.83 ± 5.70 mmHg vs 3.78 ± 7.42 mmHg), respectively. Moreover, the responders and nonresponders in the normotensive group presented significant changes in SBP as well (-8.58 ± 5.52 mmHg vs 5.71 ± 3.84 mmHg). CONCLUSION: SBP presents a heterogeneous response to a controlled RT program in hypertensive and normotensive elderly women. A different modality of training and additional therapies should be used for nonresponders in order to decrease resting SBP.

Understanding the individual responsiveness to resistance training periodization.

This study was designed to compare the effects of linear periodization (LP) and undulating periodization (UP) on functional capacity, neuromuscular function, body composition, and cytokines in elderly sedentary women. We also aimed to identify the presence of high responders (HR), medium responders (MR), and low responders (LR) for irisin, interleukin-1 beta (IL-1ß), toll-like receptor-4 (TLR-4), and brain-derived neurotrophic factor (BDNF) to resistance training (RT). Forty-nine elderly women were assigned to a control group, LP, and UP scheme. Functional capacity, body composition, maximal strength, irisin, TLR-4, BDNF, and IL-1ß were evaluated. Both periodization models were effective in improving 45° leg press 1RM, chair-stand, arm curl, and time-up and go tests, with no significant differences in body composition and cytokines. Furthermore, HR, MR, and LR were identified for irisin, IL-1ß, TLR-4, and BDNF, with differences between groups and moments. This study provides evidence that both periodization models were effective in improving functional capacity and neuromuscular function, with no effect on body composition and cytokines (probably as a consequence of the different responsiveness). Furthermore, for the first time, HR, MR, and LR were identified for irisin, IL1-ß, TLR-4, and BDNF in response to RT.

Sustained effect of resistance training on blood pressure and hand grip strength following a detraining period in elderly hypertensive women: a pilot study.

INTRODUCTION: Hypertension is the most prevalent modifiable risk factor with a high prevalence among older adults. Exercise is a nonpharmacological treatment shown to benefit all patients with hypertension. OBJECTIVE: This study examined the effects of a 14-week moderate intensity resistance training program (RT) on the maintenance of blood pressure and hand grip strength during an extended detraining period in elderly hypertensive women. METHODS: Twelve hypertensive sedentary elderly women completed 14 weeks of whole body RT at a moderate perceived exertion following a detraining period of 14 weeks. RESULTS: Following the training period, participants demonstrated an increase in absolute hand grip strength (P=0.001), relative hand grip strength (P=0.032) and a decrease of systolic (P=0.001), diastolic (P=0.008), and mean blood pressure (P=0.002) when compared to pre-exercise values. In addition, these effects were sustained after 14 weeks of detraining. CONCLUSION: Resistance training may be a valuable method to improve muscular strength and blood pressure in elderly people with benefits being maintained up to 14 weeks following training cessation.

Identification of high responders for interleukin-6 and creatine kinase following acute eccentric resistance exercise in elderly obese women.

OBJECTIVES: Resistance exercise is used as a non-pharmacological tool to elicit both gains in and maintenance of physical function in the elderly. Thus, the present study examined the acute response of creatine kinase and interleukin-6 following an eccentric resistance exercise session in elderly obese women classified as high responders or normal responders. DESIGN: Cross-sectional field study. METHODS: Ninety elderly obese women (69.4 ± 6.01 years) were tested for a 10 repetition maximum on the leg extension exercise and then completed an acute eccentric resistance exercise session consisting of seven sets of 10 repetitions at 110% of 10 repetition maximum with a rest of 3 min between sets. Subjects were divided into normal response or high response on the basis of the peak serum interleukin-6 (NR = 59 and HR = 7) and creatine kinase (NR = 81 and HR = 9) concentration being greater than (HR) or less than (NR) the 90th percentile. RESULTS: Creatine kinase was higher at 0 h, 3h, 24h and 48 h following the ERE for the HR group. The peak creatine kinase was significantly higher in HR group versus the normal response group. The average increase in the serum interleukin-6 Δ for the HR group (∼ 850%) was significantly higher versus the normal response group (∼ 55%). Serum interleukin-6 was significantly higher at 0 h and 24h following eccentric resistance exercise only for the high response group, while peak levels were significantly higher in high response group versus the normal response group (p ≤ 0.005). Only one subject met the criteria to be classified as high response for both creatine kinase and interleukin-6 responsiveness. CONCLUSIONS: Elderly individuals classified as high response experienced greater creatine kinase and interleukin-6 responses to ERE. Thus, a prudent approach for eccentric resistance exercise prescription might be programming additional recovery days and/or lower intensity training, especially in the beginning stages of a program.

Fatores associados à qualidade de vida de idosos que frequentam uma unidade de saúde do Distrito Federal / Factors associated with quality of life of elderly attending a health unit in the Federal District, Brazil

OBJETIVO: Identificar os fatores associados à qualidade de vida de idosos que frequentam uma unidade de saúde de Ceilândia-DF. MÉTODO: Pesquisa de abordagem quantitativa do tipo descritiva com delineamento transversal, realizada com 277 idosos, por meio de entrevista para investigação das variáveis demográficas, socioeconômicas, clínicas e aplicação do WHOQOL-bref, com análise estatística descritiva. RESULTADOS: Os idosos avaliados demonstraram melhor qualidade de vida no domínio "relações sociais", seguido do "psicológico", "físico" e, por último, "meio ambiente". CONCLUSÕES: Os fatores significativamente associados à qualidade de vida neste estudo foram: doença, tabagismo, atividade física, alteração visual e história de queda. Os problemas/barreiras conhecidos neste estudo podem direcionar os profissionais de saúde que atuam na atenção primária. A assistência direcionada poderá permitir uma relação de confiança entre o profissional de saúde e o idoso, além de auxiliá-los a resolver os problemas/barreiras que estão afetando sua qualidade de vida. .

OBJECTIVE: To identify factors associated with quality of life of elderly attending a Health Unit in Ceilandia, Federal District, Brazil. METHOD: Quantitative approach with descriptive cross-sectional design conducted with 277 elderly through interviews to investigate demographic, socioeconomic, and clinical variables and application of the WHOQOL-bref, with descriptive statistical analysis. RESULTS: The elderly showed better quality of life in the domain "social relations", followed by "psychological", "physical" and finally "environment". CONCLUSIONS: Factors significantly associated with quality of life in this study were: disease, smoking, physical activity, visual and history of falls. The problems / barriers known in this study can guide the health professionals who work at primary health care. The targeted assistance may enable a trusting relationship between the health professional and the elderly as well as help them to solve the problems / barriers that affect their quality of life. .

Association of body composition with sarcopenic obesity in elderly women.

The aim of the present study was to investigate the prevalence of sarcopenic obesity and its association with obesity and sarcopenia in elderly Brazilian women. Two hundred and seventy-two sedentary women with a mean age of 66.75 ± 5.38 years were recruited for participation in this study. Obesity was determined by both body mass index and dual-energy X-ray absorptiometry (DXA) evaluations. Sarcopenic obesity diagnosis was established from the ratio between fat-free mass and body surface area as obtained by DXA. There was no association of obesity with sarcopenic obesity (P = 0.424). In contrast, sarcopenia was significantly related to sarcopenic obesity (P < 0.001), although most of the elderly women with sarcopenia (n = 171) did not exhibit sarcopenic obesity. These results highlight the importance of diagnosing sarcopenic obesity as elderly women exhibiting sarcopenia could be either eutrophic or obese.