Adding neuromuscular training to a strengthening program did not produce additional improvement in clinical or kinematic outcomes in women with patellofemoral pain: A blinded randomised controlled trial.

BACKGROUND: Patellofemoral pain (PFP) is a knee pain condition with multifactorial aetiology, twice common in women. The recommended conservative treatment is based on strengthening of the core, hip, and knee musculatures. Addition of neuromuscular training to a strengthening protocol might provide further benefits on pain, function, and kinematics in PFP individuals. However, evidence for the effectiveness of this protocol is lacking. OBJECTIVE: To investigate whether adding neuromuscular training to strengthening program could provide any additional improvements of pain, function, and kinematics in PFP women. METHODS: 71 PFP women were randomly into two groups and submitted to different interventions for 12 weeks. The strengthening group (SG) performed strengthening exercises for the trunk, hip, and knee muscles, while the neuromuscular training group (NMTG) performed the same exercises as SG, plus neuromuscular training from the 4th week onwards. The primary outcomes were pain intensity, function, and 2-D kinematics of the trunk and lower limb. The secondary outcomes were isometric muscle strength and patient satisfaction level. All outcomes were evaluated at 12 weeks, immediately post-treatment. RESULTS: At 12 weeks, there was no evidence of between-group differences for any outcome, but both interventions provided clinically significant improvements for pain intensity (SG: mean difference -3.9, 95% confidence interval [CI] -5.0, -2.9; NMTG: mean difference -3.1, 95% CI -4.1, -2.0) and function (SG: mean difference 15.3, 95% CI 11.5, 19.2; NMTG: mean difference 16.9, 95% CI 13.2, 20.7). CONCLUSION: Neuromuscular training did not produce any additional benefits for pain, function, or kinematics at 12 weeks of treatment.

Expiratory Flow Limitation at Different Exercise Intensities in Coronary Artery Disease.

INTRODUCTION: Expiratory flow limitation (EFL) during moderate intensity exercise is present in patients with myocardial infarction (MI), whereas in healthy subjects it occurs only at a high intensity. However, it is unclear whether this limitation already manifests in those with stable coronary artery disease (CAD) (without MI). MATERIALS AND METHODS: Forty-one men aged 40-65 years were allocated into (1) recent MI (RMI) group (n = 8), (2) late MI (LMI) group (n = 12), (3) stable CAD group (n = 9), and (4) healthy control group (CG) (n = 12). All participants underwent two cardiopulmonary exercise tests at a constant workload (moderate and high intensity), and EFL was evaluated at the end of each exercise workload. RESULTS: During moderate intensity exercise, the RMI and LMI groups presented with a significantly higher number of participants with EFL compared to the CG (p < 0.05), while no significant difference was observed among groups at high intensity exercise (p > 0.05). Moreover, EFL was only present in MI groups during moderate intensity exercise, whereas at high intensity all groups presented EFL. Regarding the degree of EFL, the RMI and LMI groups showed significantly higher values at moderate intensity exercise in relation to the CG. At high intensity exercise, significantly higher values for the degree of EFL were observed only in the LMI group. CONCLUSION: The ventilatory limitation at moderate intensity exercise may be linked to the pulmonary consequences of the MI, even subjects with preserved cardiac and pulmonary function at rest, and not to CAD per se.

Relação entre a variabilidade da frequência cardíaca e VO 2pico em mulheres ativas / Relationship between heart rate variability and VO 2peak in active women / Relación entre la variabilidad de la frecuencia cardíaca y VO 2pico en mujeres activas

OBJETIVO: Ava+liar a associação entre os índices da variabilidade da frequência cardíaca (VFC) e a aptidão cardiorrespiratória. MÉTODOS: Sessenta e duas mulheres (idade 22,1 ± 3,3 anos) foram divididas em quatro grupos: treinamento aeróbio (AER, n = 15), treinamento de força (FOR, n = 13), treinamento combinado (aeróbio e força) (AER+FOR, n = 15) e controle (C, n = 19). O teste cardiopulmonar foi realizado para avaliar a aptidão cardiorrespiratória a partir do consumo de oxigênio pico (VO2pico). A FC foi coletada em repouso na postura supina. A VFC foi analisada a partir de métodos lineares e não lineares. RESULTADOS: Os grupos AER e AER+FOR apresentaram maiores índices da VFC (lineares e não lineares) indicadores da modulação vagal e menores índices da VFC indicadores da modulação simpática, em relação ao grupo C. Os grupos AER e AER+FOR apresentaram maior complexidade e menor regularidade dos intervalos RR e maior VO2pico em relação aos grupos FOR e C. O VO2pico apresentou correlação com os índices da VFC. CONCLUSÃO: Este estudo mostrou que o treinamento físico aeróbio e combinado contribuíram significativamente para maior modulação autônoma da FC e aptidão cardiorrespiratória. A modulação autônoma da FC, avaliada a partir de métodos lineares e não lineares, está associada ao maior consumo de oxigênio. .

OBJECTIVE: To evaluate the associations between heart rate variability (HRV) with cardiorespiratory fitness. METHODS: Sixty-two women (aged 22.1 ± 3.3) were divided into four groups: aerobic training (AER, n = 15), strength training (STR, n = 13), combined aerobic and strength training (AER+STR, n = 15) and controls (C, n = 19). Cardiopulmonary exercise testing was performed to measure cardiorespiratory fitness by assessing peak oxygen consumption (VO2peak). The HR was recorded at rest in the supine position. The HRV was analyzed by linear and nonlinear methods. RESULTS: The AER and AER+STR groups had higher vagal HRV (linear and nonlinear) indicators of vagal modulation and lower indices of HRV indicators of sympathetic modulation, compared to group C. The AER and AER+STR groups showed greater complexity and lower regularity of R-R intervals and higher peak compared to STR and C groups. The VO2peak was correlated with HRV indices. CONCLUSION: This study showed that aerobic and combined exercise significantly contributed to greater autonomic modulation of HR and cardiorespiratory fitness. The autonomic HR modulation, assessed by linear and nonlinear methods, was associated with a greater oxygen consumption. .

OBJETIVO: Evaluar la asociación entre los índices de variabilidad de la frecuencia cardíaca (VFC) y la aptitud cardiorrespiratoria. MÉTODOS: Sesenta y dos mujeres (edad 22,1 ± 3,3 años) fueron divididas en cuatro grupos: entrenamiento aeróbico (AER, n = 15), entrenamiento de fuerza (FOR, n = 13), entrenamiento combinado (aeróbico y fuerza) (AER+FOR, n = 15) y control (C, n = 19). El test cardiopulmonar fue realizado para evaluar la aptitud cardiorrespiratoria a partir del consumo de oxígeno pico (VO2pico). La FC fue colectada en reposo en la postura supina. La VFC fue analizada a partir de métodos lineales y no lineales. RESULTADOS: Los grupos AER y AER+FOR presentaron mayores índices de VFC (lineales y no lineales) indicadores de la modulación vagal y menores índices de VFC indicadores de la modulación simpática, en relación al grupo C. Los grupos AER y AER+FOR presentaron mayor complejidad y menor regularidad de los intervalos RR y mayor VO2pico en relación a los grupos FOR y C. O VO2pico presentó correlación con los índices de VFC. CONCLUSIÓN: Este estudio mostró que el entrenamiento físico aeróbico y combinado contribuyeron significativamente para mayor modulación autónoma de FC y aptitud cardiorrespiratoria. La modulación autónoma de FC, evaluada a partir de métodos lineales y no lineales, está asociada al mayor consumo de oxígeno. .