Agreement between heart rate at first ventilatory threshold on treadmill and at 6-min walk test in coronary artery disease patients on ß-blockers treatment.

The purpose of this study was to verify the accuracy of the agreement between heart rate at the first ventilatory threshold (HRVT1) and heart rate at the end of the 6-min walk test (HR6MWT) in coronary artery disease (CAD) patients on ß-blockers treatment. This was a cross-sectional study with stable CAD patients, which performed a cardiopulmonary exercise test (CPET) on a treadmill and a 6-min walk test (6MWT) on nonconsecutive days. The accuracy of agreement between HRVT1 and HR6MWT was evaluated by Bland-Altman analysis and Lin's concordance correlation coefficient (rc), mean absolute percentage error (MAPE), and standard error of estimate (SEE). Seventeen stable CAD patients on ß-blockers treatment (male, 64.7%; age, 61±10 years) were included in data analysis. The Bland-Altman analysis revealed a negative bias of -0.41±6.4 bpm (95% limits of agreements, -13 to 12.2 bpm) between HRVT1 and HR6MWT. There was acceptable agreement between HRVT1 and HR6MWT (rc=0.84; 95% confidence interval, 0.63 to 0.93; study power analysis=0.79). The MAPE of the HR6MWT was 5.1% and SEE was 6.6 bpm. The ratio HRVT1/HRpeak and HR6MWT/HRpeak from CPET were not significantly different (81%±5% vs. 81%±6%, P=0.85); respectively. There was a high correlation between HRVT1 and HR6MWT (r=0.85, P<0.0001). Finally, the results of the present study demonstrate that there was an acceptable agreement between HRVT1 and HR6MWT in CAD patients on ß-blockers treatment and suggest that HR6MWT may be useful to prescribe and control aerobic exercise intensity in cardiac rehabilitation programs.

Efeitos da eletroestimulação neuromuscular de quadríceps sobre a funcionalidade de idosos frágeis e pré-frágeis hospitalizados: ensaio clínico randomizado / Efectos de la electroestimulación neuromuscular del cuádriceps sobre la funcionalidad de ancianos frágiles y prefrágiles hospitalizados: un ensayo clínico aleatorizado / Effects of neuromuscular electrostimulation of quadriceps on the functionality of fragileand pre-frail hospitalized older adults: randomized clinical trial

RESUMO Este artigo teve como objetivo avaliar os efeitos da eletroestimulação neuromuscular (EENM) sobre a funcionalidade de idosos frágeis e pré-frágeis hospitalizados. Trata-se de um ensaio clínico randomizado com 17 idosos hospitalizados. Foram avaliados dados antropométricos, socioeconômicos e clínicos, seguido da escala proposta por Fried para identificação da síndrome da fragilidade. Além disso, foram avaliados a perimetria da coxa e a força de membros inferiores pelo Medical Research Council (MRC) e teste de sentar e levantar (TSL). Os pacientes foram randomizados em grupo-controle (GC; n=9), com idade de 67,7±6,9 anos e grupo intervenção (GI; n=8), com idade de 71,2±5,6 anos. Ambos os grupos receberam atendimento de fisioterapia convencional. O protocolo de EENM foi aplicado somente no grupo intervenção. Os grupos foram semelhantes quanto ao perfil sociodemográfico, antropométrico, quanto às características clínicas e quanto ao uso contínuo de medicamentos. Houve efeitos significativos da EENM quando comparados ao GC para perimetria da coxa direita (p=0,03); para o número de repetições no TSL (p=0,004) e para a força muscular do quadríceps (p=0,01), avaliados pela escala MRC. O treinamento muscular de quadríceps com a EENM foi efetivo nos idosos frágeis e pré-frágeis hospitalizados, promovendo aumento da força e do desempenho funcional.

RESUMEN Este artículo tuvo como objetivo evaluar los efectos de la electroestimulación neuromuscular (EENM) sobre la funcionalidad de ancianos frágiles y prefrágiles hospitalizados. Es un ensayo clínico aleatorizado en el cual participaron 17 ancianos hospitalizados. Se evaluaron los datos antropométricos, socioeconómicos y clínicos, seguidos de la escala propuesta por Fried para identificar el síndrome de fragilidad. Además, se evaluaron la perimetría del muslo y la fuerza de las extremidades inferiores utilizando el Medical Research Council (MRC) y el test de sentarse y levantarse (TSL). Los pacientes se asignaron aleatoriamente a un grupo de control (GC; n=9), con promedio de 67,7±6,9 años, y al grupo de intervención (GI; n=8), con 71,2±5,6 años. Ambos grupos recibieron fisioterapia convencional. El protocolo de EENM se aplicó solo al grupo de intervención. Los resultados de los grupos fueron similares en relación a las características sociodemográficas, antropométricas, clínicas y de uso continuo de medicamentos. Hubo efectos significativos de la EENM en comparación al GC para la perimetría del muslo derecho (p=0,03); para el número de repeticiones en el TSL (p=0,004) y para la fuerza muscular del cuádriceps (p=0,01), evaluados por la escala MRC. El entrenamiento muscular del cuádriceps con la EENM fue eficaz en los ancianos frágiles y prefrágiles hospitalizados, pues promovió un aumento de la fuerza y el rendimiento funcional.

ABSTRACT This work aimed to evaluate the effects of neuromuscular electrostimulation (NMES) on the functionality of frail and pre-frail hospitalized older adults. It is a randomized clinical trial that dealt with 17 hospitalized people. Anthropometric, socioeconomic and clinical data were evaluated, followed by the scale proposed by Fried to identify the frailty syndrome. In addition, we evaluated thigh perimetry and lower limb strength according to the Medical Research Council (MRC) as well as conducted the sit-to-stand test (STST). Patients were allocated to the control group (CG; n=9), aged 67.7±6.9 years and intervention group (IG; n=8), aged 71.2±5.6 years. Both groups received conventional physiotherapy care. The NMES protocol was applied only in the intervention group. The groups were similar in terms of sociodemographic, anthropometric profile, clinical characteristics and continuous use of medications. There were significant effects of NMES when compared to CG for right thigh perimetry (p=0.03); number of repetitions in STST (p=0.004) and quadriceps muscle strength (p=0.01) evaluated by the MRC scale. The quadriceps muscle training with the aid of NMES was effective in frail and pre-frail hospitalized people, promoting increased strength and functional performance.

Cardiorespiratory responses to isokinetic exercise in patients with coronary artery disease / Respostas cardiorrespiratórias ao exercício isocinético em pacientes com doença arterial coronariana / Respuestas cardiorrespiratorias al ejercicio isocinético en pacientes con enfermedad arterial coronaria

ABSTRACT Introduction Exercise training using an isokinetic dynamometer is an alternative for improving muscle strength in patients with coronary artery disease (CAD). Few studies have shown metabolic and cardiorespiratory responses to submaximal isokinetic exercises in patients in cardiac rehabilitation programs. Objective To describe cardiorespiratory responses at two intensities of isokinetic exercise. Additionally, we compared the cardiorespiratory responses of isokinetic exercise with data from the incremental cardiopulmonary exercise test (CPET). Methods Eight individuals with CAD (61.7 ± 6.6 years) performed the following tests: 1) CPET on a treadmill; 2) Peak torque test (five repetitions) and fatigue resistance test (20 repetitions) of knee flexion-extension at angular speeds of 120°/s and 180°/s; 3) Two sets of 20 repetitions were performed at 30-40% (low-intensity, LI) and 50-60% (moderate-intensity, MI) of peak torque at angular speeds of 120°/s and 180°/s, using an isokinetic dynamometer. During the exercises, the individuals were connected to an expired gases analyzer with simultaneous monitoring of the electrocardiogram trace, heart rate (HR), oxygen consumption (VO2), carbon dioxide production, and minute ventilation (VE). The differences (∆) between the peak measurements during exercises and the baseline values were calculated. Results Both LI and MI produced cardiorespiratory responses below the anaerobic threshold (82.8 ± 8.1% of HRmax and 74.4 ± 9.6% of VO2peak) compared to the CPET data ( P < 0.01). MI showed higher ∆ HR (9.8 ± 5.5 vs. 6.3 ± 4.6 bpm; P = 0.01), ∆ rate pressure product (3015 ± 2286 vs. 1957 ± 1932 mmHg·bpm; P = 0.01), and ∆VE (10.2 ± 6.2 vs. 6.9 ± 7 L·min-1; P = 0.03) than LI at the angular velocity of 180°/s. Conclusion These results suggest that this isokinetic exercise protocol may be used as a strategy for cardiac rehabilitation programs in patients with CAD. Level of evidence IV; Case series.

RESUMO Introdução O treinamento no dinamômetro isocinético é uma alternativa para aumentar a força muscular em pacientes com doença arterial coronariana (DAC). Poucos estudos têm investigado as respostas metabólicas e cardiorrespiratórias do exercício isocinético submáximo em pacientes de um programa de reabilitação cardíaca. Objetivos Descrever as respostas cardiorrespiratórias em duas intensidades de exercícios isocinéticos. Adicionalmente, comparamos as respostas cardiorrespiratórias do exercício isocinético com os dados de um teste de exercício cardiopulmonar (TECP) incremental. Métodos Oito indivíduos com DAC (61,7± 6,6 anos) realizaram os seguintes testes: 1) TECP em esteira ergométrica; 2) Teste de pico de torque (cinco repetições) e resistência à fadiga (20 repetições) de flexão-extensão de joelho nas velocidades angulares de 120º /s e 180º/s; 3) Duas séries de 20 repetições em 30% a 40% (baixa intensidade, BI) e 50% a 60% (moderada intensidade, MI) do pico de torque nas velocidades angulares de 120 o /s e 180º/s no dinamômetro isocinético. Durante os exercícios, os indivíduos foram conectados ao analisador de gases expirados com monitoração simultânea do traçado eletrocardiográfico, frequência cardíaca (FC), consumo de oxigênio (VO2), produção de dióxido de carbono e ventilação minuto (VE). Foi calculada a diferença (∆) entre a medida pico durante os exercícios e os valores basais. Resultados Tanto a BI quanto a MI produziram respostas cardiorrespiratórias abaixo do limiar anaeróbico (82,8 ± 8,1% da FCmáx e 74,4 ± 9,6% do VO2pico) comparadas com os dados do TECP (P < 0,01). A MI mostrou valores maiores de ∆ FC (9,8 ± 5,5 vs. 6,3 ± 4,6 bpm; P = 0,01), ∆ duplo produto frequência-pressão (3.015 ± 2.286 vs. 1.957 ± 1.932 mmHg.bpm; P = 0,01) e ∆VE (10,2 ± 6,2 vs. 6,9 ± 7 L.min-1; P = 0,03) quando comparado com a BI na velocidade angular de 180º/s. Conclusão Esses resultados sugerem que este protocolo de exercícios isocinéticos pode ser usado como estratégia para programas de reabilitação cardíaca em pacientes com DAC. Nível de evidência IV; Série de casos.

RESUMEN Introducción El entrenamiento en el dinamómetro isocinético es una alternativa para aumentar la fuerza muscular en pacientes con enfermedad arterial coronaria (EAC). Pocos estudios han investigado las respuestas metabólicas y cardiorrespiratorias del ejercicio isocinético submáximo en pacientes de un programa de rehabilitación cardíaca. Objetivos Describir las respuestas cardiorrespiratorias en dos intensidades de ejercicios isocinéticos. Además, comparamos las respuestas cardiorrespiratorias del ejercicio isocinético con los datos de un test de ejercicio cardiopulmonar (TECP) incremental. Métodos Ocho individuos con EAC (61,7 ± 6,6 años) realizaron los siguientes tests: 1) TECP en cinta ergométrica; 2) Test de pico de torque (cinco repeticiones) y resistencia a la fatiga (20 repeticiones) de flexión-extensión de la rodilla en las velocidades angulares de 120º/s y 180º/s; 3) Dos series de 20 repeticiones en 30% a 40% (baja intensidad, BI) y 50% a 60% (moderada intensidad, MI) del pico de torque en las velocidades angulares de 120º/s y 180º/s en el dinamómetro isocinético. Durante los ejercicios, los individuos fueron conectados al analizador de gases expirados con monitorización simultánea del trazado electrocardiográfico, frecuencia cardiaca (FC), consumo de oxígeno (VO2), producción de dióxido de carbono y ventilación minuto (VE). Fue calculada la diferencia (∆) entre la medida pico durante los ejercicios y los valores basales. Resultados Tanto BI como MI produjeron respuestas cardiorrespiratorias por debajo del umbral anaeróbico (82,8 ± 8,1% de la FCmax y 74,4 ± 9,6% del VO2pico) en comparación con los datos de la TECP (P < 0,01). La MI mostró valores mayores de ∆ FC (9,8 ± 5,5 vs 6,3 ± 4,6 lpm; P = 0,01), ∆ producto frecuencia-presión (3015±2286 vs. 1957±1932 mmHg.lpm; P = 0,01) y ∆VE (10,2±6,2 vs. 6,9±7 L.min-1; P = 0,03) en comparación con la BI en la velocidad angular de 180°/s. Conclusión Estos resultados sugieren que este protocolo de ejercicios isocinéticos puede ser utilizado como estrategia para programas de rehabilitación cardíaca en pacientes con EAC. Nivel de evidencia IV; Serie de casos.

Effects of exercises on pain and functional capacity in hospitalized cancer patients / Efeitos dos exercícios sobre a dor e a capacidade funcional em pacientes oncológicos hospitalizados

ABSTRACT BACKGROUND AND OBJECTIVES: There are few studies evaluating the effects of physiotherapy with multidimensional instruments on cancer pain. The objective of this study was to evaluate the effects of physiotherapy on pain and functional capacity in hospitalized cancer patients. METHODS: This is a quasi-experimental study including 40 participants with a mean age of 51±18 years assessed before and after physiotherapy interventions, using the verbal numerical rating scale, the McGill Pain Questionnaire - Short Form, the International Physical Activity Questionnaire, the Sit-to-Stand test, and the Eastern Cooperative Oncology Group questionnaire for functional capacity evaluation. The participants were classified according to the number of performed sessions: group 1≤ 5 sessions (n=25) and group 2 ≥ 6 sessions (n=15). RESULTS: There was a reduction in cancer pain measured by sensory (p=0.02) and mixed descriptors (p=0.05) of the McGill questionnaire as well as by the numerical visual scale (p=0.03) in patients who performed at least six physiotherapy sessions. There was a significant correlation (r=0.81; p<0.001) between the reduction in pain measured by the numerical visual scale and the reduction in pain measured by the Total McGill questionnaire. There were no significant differences in the Sit-to-Stand test and the Eastern Cooperative Oncology Group functional capacity questionnaire. CONCLUSION: At least six sessions of physiotherapy with emphasis on kinesiotherapy were needed to promote a reduction of cancer pain in hospitalized patients. We recommend the use of multidimensional instruments in the evaluation of cancer pain in hospitalized patients submitted to physiotherapy.

RESUMO JUSTIFICATIVA E OBJETIVOS: São escassos os estudos que avaliaram os efeitos da fisioterapia sobre a dor oncológica com instrumentos multidimensionais. O objetivo deste estudo foi avaliar os efeitos da fisioterapia sobre a dor e a capacidade funcional em pacientes oncológicos hospitalizados. MÉTODOS: Estudo quase-experimental, composto por 40 participantes com idade média de 51±18 anos, avaliados pré e pós intervenção fisioterapêutica pela escala verbal numérica, Questionário de Dor de McGill, Questionário Internacional de Atividade Física, teste de sentar e levantar da cadeira e capacidade funcional pelo questionário Eastern Cooperative Oncology Group. Os participantes foram estratificados de acordo com o número de sessões realizadas em grupo 1 ≤ 5 atendimentos (n=25) e grupo 2 ≥ 6 atendimentos (n=15). RESULTADOS: Houve redução da dor oncológica mensurada pelos descritores sensitivo (p=0,02) e misto (p=0,05) do questionário de McGill e na escala visual numérica (p=0,03) nos pacientes que realizaram no mínimo seis sessões de fisioterapia. Houve correlação significativa (r=0,81; p<0,001) entre a redução da dor mensurada pela escala visual numérica e a redução da dor mensurada pelo questionário McGill Total. Não houve diferenças significativas no teste de sentar e levantar e no questionário de capacidade funcional pelo Eastern Cooperative Oncology Group. CONCLUSÃO: Foram necessárias no mínimo seis sessões de fisioterapia com ênfase na cinesioterapia para promover redução da dor oncológica em pacientes hospitalizados. Recomenda-se o uso do instrumento multidimensional na avaliação da dor oncológica em pacientes hospitalizados submetidos à fisioterapia.

Cardiorespiratory fitness and muscular strength of deaf futsal players.

The present study compared the cardiopulmonary exercise capacity and peak torque of the knee extensor and flexor muscles in team players associated with the Gaucho Deaf Futsal Federation players to those of their hearing peers. In this cross-sectional study, 16 male athletes, eight futsal players with hearing impairment (deaf group, DG; 22.6±7.7 years), and eight futsal players with normal hearing (control group, CG; 22.5±2.9 years) underwent a cardiopulmonary test on a treadmill and isokinetic dynamometry at 60°/sec. All athletes were subjected to a cardiopulmonary test on a treadmill and isokinetic dynamometry at 60°/sec. The main results showed a reduction in the cardiorespiratory fitness of deaf athletes when compared to the control group maximal oxygen consumption (VO2max) (40.3±9.8 mL/kg/min vs. 50.7±4.7 mL/kg/min, P= 0.01), oxygen pulse (15.3±4.8 mL/bpm vs. 20.7±2.6 mL/bpm, P=0.01) and ventilation (70.1±22 L/min vs. 96.2±15 L/min, P=0.01), respectively. The relative torque peak of the dominant knee flexors was significantly lower in the deaf group when compared to the control (1.5±0.2 N.m/kg vs. 1.9±0.2 N.m/kg, P=0.004), respectively. There was a significant correlation between VO2max and peak torque of the dominant knee flexors (r s=0.83, P<0.001) and extensors (r s=0.65, P=0.006). When compared to players with normal hearing, deaf players showed lower cardiorespiratory fitness and decreased knee flexor strength. The performance of the thigh muscles was associated with aerobic capacity.

Exercise training improves the IL-10/TNF-α cytokine balance in the gastrocnemius of rats with heart failure.

OBJECTIVE: This study examined the effects of exercise training (ExT) upon concentration of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) in the gastrocnemius of rats with heart failure (HF) induced by left coronary artery ligation. METHODS: Adult male Wistar rats submitted to myocardial infarction (MI) or sham surgery were randomly allocated into one of four experimental groups: trained HF (Tr-HF), sedentary HF (Sed-HF), trained sham (Tr-Sham) and sedentary sham (Sed-Sham). ExT protocol was performed on treadmill for a period of 8 weeks (60m/days, 5×/week, 16m/min), which started 6 weeks after MI. Cardiac hemodynamic evaluations of left ventricular end-diastolic pressure (LVEDP) and morphometric cardiac were used to characterize HF. The hemodynamic variables were recorded and gastrocnemius muscle was collected. TNF-α, IL-6 and IL-10 protein levels were determined by multiplex bead array. RESULTS: Sed-HF group presented increase of TNF-α level when compared with the Sed-Sham group (mean difference, MD 1.3; 95% confidence interval, CI -0.04 to 2.5). ExT reduced by 59% TNF-α level in Tr-HF group (MD -1.7; 95% CI -2.9 to -0.3) and increased IL-10 (MD 15; 95% CI 11-26) when compared with the Sed-HF group. Thus, the gastrocnemius muscle IL-10/TNF-α ratio was increased in Tr-HF rats (MD 15; 95% CI -8 to 47) when compared with the Sed-HF rats. CONCLUSION: These results demonstrate that ExT not only attenuates TNF-α level but also improves the IL-10 cytokine level in skeletal muscle of HF rats.

Efeitos agudos da bandagem elástica na atividade muscular / Acute effects of elastic taping on muscle activity

Introdução: A bandagem elástica tem sido usada principalmente na reabilitação musculoesquelética, tornando-se relevante a realização de estudos que tenham como foco os efeitos dessa intervenção. Objetivo: Analisar o efeito agudo da bandagem elástica sobre o pico de torque e amplitude eletromiográfica do músculo reto femoral. Métodos: Estudo transversal experimental, com amostra composta por oito indivíduos saudáveis do gênero feminino, com idade média de 21 anos, que realizaram a avaliação dinamométrica na velocidade de 60°/s e eletromiográfica do músculo reto femoral pré e pós aplicação da bandagem elástica. Resultados: Demonstrou-se um pico de torque pré-intervenção de 112,9 ± 43,38 Nm e pós de 115,4 ± 39,18 Nm, resultando p=0,41. A amplitude eletromiográfica pré foi de 736,3 ± 307,7 µV e pós de 721,6 ±246,8µV e um p=0,79. Conclusão: A aplicação da bandagem elástica não alterou agudamente de forma significativa o pico de torque e a amplitude eletromiográfica do músculo reto femoral.

Background: Elastic tape has been used mainly in musculoskeletal rehabilitation, making studies relevant to the effects of this intervention relevant. Purpose: To analyze the acute effect of the elastic tape on the peak torque and electromyographic amplitude of the rectus femoris muscle. Methods: A cross - sectional study was carried out with a sample composed of eight healthy females, with a mean age of 21 years, who underwent a 60 ° / s angular speed and electromyographic evaluation of the rectus femoris muscle before and after the intervention. Results: A pre-intervention torque peak of 112.9 ± 43.38 Nm was demonstrated and after 115.4 ± 39.18 Nm, resulting p = 0.41. The pre-electromyographic amplitude was 736.3 ± 307.7 µV and after of 721.6 ± 246.8µV and a p = 0.79. Conclusion: The application of the elastic tape did not significantly alter the peak torque and the electromyographic amplitude of the rectus femoris muscle.

EFEITOS DO TREINAMENTO AERÓBICO E DO FORTALECIMENTO EM PACIENTES COM INSUFICIÊNCIA CARDÍACA / EFFECTS OF AEROBIC TRAINING AND STRENGTHENING IN PATIENTS WITH HEART FAILURE / EFECTOS DEL ENTRENAMIENTO AERÓBICO Y DEL FORTALECIMIENTO EN PACIENTES CON INSUFICIENCIA CARDÍACA

RESUMO Introdução: A intolerância ao exercício e a dispneia são os principais sintomas da insuficiência cardíaca (IC). Objetivo: Avaliar os efeitos de um programa de exercícios aeróbicos e de fortalecimento sobre a aptidão cardiorrespiratória, o pico de torque dos flexores e extensores de joelho e a qualidade de vida de pacientes com IC. Métodos: Estudo prospectivo, com avaliação pré e pós-reabilitação cardiovascular (RCV) de sete pacientes, com idade de 61 ± 6 anos, classe funcional II e III e fração de ejeção do ventrículo esquerdo 45,4 ± 2,3%. O programa de RCV consistiu em 24 sessões de 60 minutos com treinamento aeróbico na intensidade do limiar de anaerobiose (LA) e fortalecimento dos membros inferiores usando caneleiras de 3 a 5 kg. No início e após RCV os pacientes realizaram prova de esforço, dinamometria isocinética do joelho dominante e responderam o questionário WHOQOL-bref. Resultados: Após RCV, o tempo de exercício para atingir o LA foi atrasado (p= 0,04) e houve aumento significativo no consumo de oxigênio (VO2) (p < 0,01), da frequência cardíaca (FC) (p= 0,04), pulso de oxigênio (VO2/FC) (p = 0,02) e ventilação (VE) (p = 0,01) na intensidade do LA. Houve aumento do pico de torque dos músculos extensores de joelho (p = 0,02) e melhora significativa do domínio psicológico (p = 0,04) do questionário de qualidade de vida. Conclusão: O programa de RCV foi seguro e resultou em melhora do desempenho de exercícios submáximos, da força dos músculos extensores de joelho e da qualidade de vida de pacientes com IC.

ABSTRACT Introduction: Exercise intolerance and dyspnea are the main symptoms of heart failure (HF). Objective: To evaluate the effects of a program of aerobic exercises and strengthening on cardiorespiratory fitness, maximum torque of knee flexors and extensors, and quality of life of patients with HF. Methods: Prospective, pre- and post-cardiovascular rehabilitation (CVR) study of seven patients, aged 61 ± 6 years, functional class II and III and left ventricular ejection fraction 45.4 ± 2.3%. The CVR program consisted of 24 sessions of 60 minutes with aerobic training in intensity of the anaerobic threshold (AT) and strengthening of the lower limbs using ankle weights of 3 to 5 kg. At the beginning and after CVR, the patients performed stress test, isokinetic dynamometry of the dominant knee and completed the WHOQOL-bref questionnaire. Results: After CVR, exercise time to reach AT was delayed (p=0.04) and there was a significant increase in oxygen consumption (VO2) (p<0.01), heart rate (HR) (p=0.04), pulse of oxygen (VO2/HR) (p=0.02) and ventilation (VE) (p=0.01) in the intensity of AT. There was an increase in maximum torque of knee extensor muscles (p=0.02) and significant improvement in the psychological domain (p=0.04) of the quality of life questionnaire. Conclusion: The CVR program was safe and resulted in improved performance of submaximal exercises, knee extensor muscles strength and quality of life of patients with HF.

RESUMEN Introducción: La intolerancia al ejercicio y la disnea son los síntomas principales de la insuficiencia cardiaca (IC) . Objetivo: Evaluar los efectos de un programa de ejercicio aeróbico y fortalecimiento en la capacidad cardiorrespiratoria, el par máximo de los flexores y extensores de rodilla y la calidad de vida de los pacientes con IC. Métodos: Estudio prospectivo, con evaluación pre y post-rehabilitación cardiovascular (RCV) de siete pacientes, edad 61 ± 6 años, clase funcional II y III y fracción de eyección del ventrículo izquierdo de 45,4 ± 2,3%. El programa de RCV consistió en 24 sesiones de 60 minutos con la intensidad del entrenamiento aeróbico en el umbral de anaerobiosis (UA) y el fortalecimiento de las extremidades inferiores utilizando pesos de tobillo de 3 a 5 kg. Al principio y después de la RCV los pacientes se sometieron a la prueba de esfuerzo, dinamometría isocinética de la rodilla dominante y respondieron el cuestionario WHOQOL-bref. Resultados: Después de la RCV, el tiempo de ejercicio para alcanzar UA se retrasó (p = 0,04) y hubo un aumento significativo en el consumo de oxígeno (VO2) (p < 0,01), frecuencia cardiaca (FC) (p = 0,04), pulso de oxígeno (VO2/FC) (p = 0,02) y la ventilación (VE) (p = 0,01) en la intensidad del UA. Hubo un aumento del par máximo de los músculos extensores de la rodilla (p = 0,02) y una mejora significativa en el dominio psicológico (p = 0,04) del cuestionario de calidad de vida. Conclusión: El programa de RCV fue seguro y mejoró el rendimiento de los ejercicios submáximos, la fuerza de los músculos extensores de la rodilla y la calidad de vida de los pacientes con IC.

Respiratory Muscle Training Improves Chemoreflex Response, Heart Rate Variability, and Respiratory Mechanics in Rats With Heart Failure.

BACKGROUND: The aim of the present report was to evaluate respiratory muscle training (RMT) effects on hemodynamic function, chemoreflex response, heart rate variability, and respiratory mechanics in rats with heart failure (HF rats). METHODS: Wistar rats were divided into 4 groups: sedentary-sham (Sed-Sham, n = 8), respiratory muscle trained-sham (RMT-Sham, n = 8), sedentary-HF (Sed-HF, n = 8) and respiratory muscle trained-HF (RMT-HF, n = 8). Animals were submitted to an RMT protocol performed 30 minutes per day, 5 days per week for 6 weeks, whereas the sedentary animals did not exercise. RESULTS: In HF rats, RMT promoted the reduction of left ventricular end-diastolic pressure, right ventricular hypertrophy, and pulmonary edema. Moreover, RMT produced a reduction in pressure response during chemoreflex activation, sympathetic modulation, and sympathetic vagal balance in addition to an increase in parasympathetic modulation. Also after RMT, HF rats demonstrated a reduction in respiratory system resistance, tissue resistance, Newtonian resistance, respiratory system compliance, and quasistatic compliance. CONCLUSIONS: These findings suggested that 6 weeks of RMT in HF rats promoted beneficial adaptations in hemodynamics, autonomic function, and respiratory mechanics and attenuated pressure response evoked by chemoreflex activation in HF rats.

Efeito da suplementação com ômega-3 associado à hidrocinesioterapia em idosos com osteoartrite de joelho: ensaio clínico randomizado / Effect of supplementation with omega-3 associated with hydrotherapy in elderly with osteoarthritis of the knee: randomized controlled trial

Introdução: A osteoartrite (OA) é causada por fatores mecânicos e inflamatórios que reduz a qualidade de vida (QV) de idosos. Objetivos: Avaliar os efeitos da suplementação com ômega-3 associado à hidrocinesioterapia sobre a QV e o perfil inflamatório em idosos com OA de joelho. Metodologia: Dezesseis idosos com idade média 65±3,5 anos divididos em 2 grupos. Oito pacientes no Grupo Ômega-3 (GO) suplementado com 2g de ômega-3 por dia durante 30 dias e oito pacientes no Grupo Ômega-3 associado à hidrocinesioterapia (GOH). Foram avaliadas a proteína C reativa de alta sensibilidade (PCR-AS), velocidade de sedimentação globular (VSG) e questionário de QV (SF-36). Resultados: A associação do ômega-3 com a hidrocinesioterapia promoveu redução significativa (p=0,02) da PCR-AS e da VSG (p<0,05) comparado aos valores pré-intervenção. Houve melhora significativa (p<0,05) na QV no GOH. Conclusão: A associação da hidrocinesioterapia com ômega-3 promoveu melhora no perfil inflamatório e na QV em idosos com OA de joelho.

Introduction: Osteoarthritis (OA) is caused by mechanical and inflammatory factors that reduce the quality of life (QOL) in elderly. Objectives: To evaluate the effects of supplementation with omega-3 associated with hydrotherapy on the quality of life and inflammatory profile in elderly suffering from knee osteoarthritis (OA). Methods: Sixteen elderly patients, average age 65±3.5 years old divided into 2 groups. Eight patients allocated in the Omega-3 Group (OG) supplemented with 2g of omega-3 per day for 30 days and eight patients in the Omega-3 Group associated with Hydrotherapy (OGH). High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and the QOL questionnaire (SF-36) were evaluated. Results: The association of Omega-3 with hydrotherapy promoted a significant reduction (p=0.02) of hs-CRP and ESR (p<0.05) compared to before intervention. There was significant improvement (p<0.05) on QOL in GOH. Conclusion: The association of hydrotherapy with omega-3 promoted improvement in inflammatory profile and QOL in elderly with knee OA.

Exercise training attenuates the pressor response evoked by peripheral chemoreflex in rats with heart failure.

The effects of exercise training (ExT) on the pressor response elicited by potassium cyanide (KCN) in the rat model of ischemia-induced heart failure (HF) are unknown. We evaluated the effects of ExT on chemoreflex sensitivity and its interaction with baroreflex in rats with HF. Wistar rats were divided into four groups: trained HF (Tr-HF), sedentary HF (Sed-HF), trained sham (Tr-Sham), and sedentary sham (Sed-Sham). Trained animals underwent to a treadmill running protocol for 8 weeks (60 m/day, 5 days/week, 16 m/min). After ExT, arterial pressure (AP), baroreflex sensitivity (BRS), peripheral chemoreflex (KCN: 100 µg/kg body mass), and cardiac function were evaluated. The results demonstrate that ExT induces an improvement in BRS and attenuates the pressor response to KCN relative to the Sed-HF group (P < 0.05). The improvement in BRS was associated with a reduction in the pressor response following ExT in HF rats (P < 0.05). Moreover, ExT induced a reduction in left ventricular end-diastolic pressure and pulmonary congestion compared with the Sed-HF group (P < 0.05). The pressor response to KCN in the hypotensive state is decreased in sedentary HF rats. These results suggest that ExT improves cardiac function and BRS and attenuates the pressor response evoked by KCN in HF rats.

Treinamento muscular inspiratório melhora a força muscular respiratória e o pico de fluxo expiratório em idosas hipertensas / Inspiratory muscle training improves respiratory muscle strength and the peak expiratory flow in hypertensive elderly women

Introdução: O processo de envelhecimento promove alterações no sistema cardiorrespiratório, aumentando a prevalência de hipertensão arterial e reduzindo a força da musculatura respiratória. Objetivos: Avaliar os efeitos de um programa de treinamento muscular inspiratório domiciliar (TMID) sobre a função pulmonar, força muscular respiratória e distância percorrida no teste de caminhada de 6 minutos (TC6min) em idosas hipertensas. Métodos: Dezesseis mulheres com diagnóstico de hipertensão arterial foram divididas em dois grupos. Oito participaram do grupo intervenção (GI) e foram submetidas ao TMID durante seis semanas, e as demais compuseram o grupo controle (GC). Resultados: Ao final do TMID, constatou-se aumento da PImáx, -47±13 cmH₂0 para -92±32 cmH₂0 (p<0,001), e PEmáx, 45±6 cmH₂0 para 84±24 cmH₂0 (p<0,001), do Pico de Fluxo Expiratório (PFE), 211,6±60 L/min para 248,8±58 L/min (p=0,004). Conclusões: O TMID realizado diariamente durante seis semanas proporciona melhora na força muscular respiratória e no pico de fluxo expiratório em idosas hipertensas.

Introduction: The aging process brings changes to the cardiovascular system, increasing the prevalence of hypertension and reducing the respiratory muscle strength. Objectives: To assess the effects of a home-based inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength and distance walked in 6-minute walk test (6MWT) in hypertensive elderly women. Methods: Sixteen women with clinical diagnosis of hypertension were divided into two groups. Eight participated in the intervention group (IG) and were subjected to the home-based IMT during six weeks, and the others composed the control group (CG). Results: At the end of the IMT, we found out the increase of maximal inspiratory pressure (MIP), -47±13 cmH₂0 to -92±32 cmH₂0 (p<0.001), the maximal expiratory pressure (MEP), 45±6 cmH₂0 to 84±24 cmH₂0 (p<0.001), and the peak expiratory flow (PEF), 211.6±60 l/min to 248.8±58 l/min (p=0.004). Conclusions: The home-based IMT daily performed for six weeks improves the respiratory muscle strength and in the PEF in hypertensive elderly women.

Efeitos do repouso e do exercício no solo e na água em hipertensos e normotensos / Effects of rest and exercise on ground and in water in hypertensive and normotensive patients

Este estudo visou avaliar o efeito do repouso e do exercício, realizados no solo e na água, sobre a frequência cardíaca (FC), pressão arterial sistólica (PAS) e diastólica (PAD) e o volume de diurese em indivíduos hipertensos e normotensos. Foram analisados 20 indivíduos divididos em dois grupos, normotensos (GN, n=8) e hipertensos (GH, n=12). Em ambos foram realizados quatro protocolos distintos, dois de exercícios e dois de repouso, no solo e na água. A PAS, PAD e FC foram mensuradas durante repouso e aos 30, 60 e 90 minutos após cada protocolo. O volume de diurese foi corrigido pelo peso corporal e coletado 30 minutos após cada protocolo. No GH, o protocolo de exercício no solo promoveu redução média de 16,5±3,7 mmHg (p=0,01) da PAS aos 90 minutos pós-exercício. No GN, o protocolo de repouso na água promoveu redução média de 14 bpm (p<0,01) da FC e o volume de diurese foi maior quando comparado aos protocolos realizados no solo (p<0,01). Portanto, a imersão desencadeou bradicardia e aumento do volume de diurese no GN. Não houve efeito hipotensor significativo nos protocolos realizados na água em ambos os grupos. Os resultados sugerem que uma sessão de exercício físico no solo com duração de 45 minutos, em intensidade submáxima, provoca redução da PAS em indivíduos hipertensos.

The aim of this study was to assess the effect of rest and exercise, accomplished on the ground or in water on the heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the volume of diuresis in hypertensive and normotensive individuals. Twenty individuals were analyzed and divided into two groups, normotensive (GN, n=8) and hypertensive (GH, n=12). Both groups accomplished four distinct protocols, two protocols of exercise and two protocols of rest on the ground and in the water. The SBP, DBP and HR were measured at rest and at 30, 60 and 90 minutes after each protocol. The volume of diuresis was corrected for the body weight and collected 30 minutes after each protocol. In the GH, the exercise protocol on the ground caused an average reduction of 16.5±3.7 mmHg (p=0.01) in SBP at 90 minutes post-exercise. In the GN, the protocol of rest in the water caused an average reduction of 14 bpm (p<0.01) in HR and the volume of diuresis was increased when compared with the protocols accomplished on the ground (p<0.01). Therefore, the immersion triggered bradycardia and increase in volume of diuresis in the normotensive group. There was no significant hypotensive effect in the protocols performed in water in both groups. The results suggest that an exercise session on the ground during 45 minutes in submaximal intensity causes a reduction in SBP in hypertensive subjects.

Efeitos de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em hipertensas / Effects of aquatic exercise on cardiorespiratory fitness and blood pressure in hypertensive women

O estudo visou avaliar a influência de um programa de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em mulheres hipertensas. Dez hipertensas participaram do programa de exercícios aquáticos - aeróbicos de fortalecimento, alongamento e relaxamento...

The aim of this study was to assess the influence on aquatic exercise program on cardiorespiratory fitness and blood pressure in hypertensive women. Ten hyperntive women took part in the study. The programa consisted of aquatic aerobic, strengthening and stretching exercices in intensity near the anaerobic...

Treinamento muscular inspiratório em pacientes com insuficiência cardíaca: estudo de caso / Inspiratory muscle training for patients with heart failure: a case report

A insuficiência cardíaca (IC) pode ser definida como uma síndrome clínica complexa, caracterizada pela incapacidade de o coração ejetar quantidade suficiente de sangue para atender às necessidades metabólicas dos diferentes tecidos. Pacientes com IC podem apresentar força muscular inspiratória diminuida, o que contribui para os sintomas de fadiga e dispnéia observados durante o esforço...

Heart failure (HF) may be defined as a complex clinical syndrome wherein the heart is unable to eject enough blood so as to meet the diverse tissues metabolic demands. HF patients may present inspiratory muscle weakness, which adds up to the symptoms of fatigue and dyspnoea felt during exertion or daily life activities...

Effect of chronic treatment with clomipramine on food intake, macronutrient selection and body weight gain in rats.

Long-term treatment with clomipramine (CMI), a tricyclic antidepressant, induces food craving and body weight gain in patients. The present study investigated the effects of chronic treatment with CMI on total food intake, macronutrient selection, and body weight gain in rats. Male Wistar rats were maintained on a dietary self-selection regime with separate sources of protein, fat and carbohydrate. Animals received i.p. injections of CMI (0, 3, 10, 30 mg/kg) during 27 consecutive days. Food consumption and body weight were recorded daily and results were calculated as average of three consecutive days, namely during pre-treatment (3 d before pharmacological treatment), treatment (7th-9th; 16th-18th and 25th-27th days), and post-treatment (28th-33rd days). Results showed that CMI (30 mg/kg) significantly decreased energy intake during all treatment period, an effect that was related to a decrease in both carbohydrate-rich diet intake and body weight gain. At dose of 3 mg/kg CMI increased the total energy intake in the 16th-18th days, suggesting an apparent biphasic effect of chronic treatment with CMI on caloric intake. Chronic administration with CMI (27 d) did not alter protein-rich or fat-rich diet consumption. The main result of this study indicated that chronic treatment with CMI decreases rather than increase food consumption and body weight gain in rats exposed to a macronutrient self-selection procedure.