Effect of concurrent training (aerobic+resistance) more static stretching on flexibility in women with breast cancer / Efeito do treinamento concorrente (aeróbio + resistência) mais alongamento estático na flexibilidade em mulheres com câncer de mama

Objective. was to assess flexibility in women with breast cancer who underwent concurrent training (aerobic+resistance) (CT) more static stretching. Methods. This was a controlled pilot study, with 31 women (age 30 to 59) under breast cancer treatment, 14 women were allocated to a training group (TG) who underwent CT more static stretching, concomitant to hospital treatment and 17 women for the control group (CG) who only underwent hospital treatment. The CT more static stretching was performed in 12 weeks with 5 sessions per week, three sessions (aerobic+resistance) and two sessions (stretching exercises) on alternate days. The flexibility of the shoulder was measured by means of the 360º Sanny pendulum goniometer and the flexibility of the lower limbs was assessed through the sit-and-reach test. Data were analyzed using repeated measures ANOVA Test and Bonferroni Post-hoc using SPSS 21 software, with α of 5%. Results. The TG presented increased flexibility in the horizontal abduction of the right shoulder (p=0.001) and in the lower limbs (p<0.001), but the CG showed a reduction in the horizontal abduction of the right shoulder (p=0.003). The effect size for horizontal abduction of the right shoulder was medium (p=0.508) and for the lower limbs was large (p=0.839). Conclusion. CT more static stretching may be a therapeutic intervention to increase flexibility of upper and lower limbs in women with breast cancer. (AU)

Objetivo. Avaliar a flexibilidade em mulheres com câncer de mama que realizaram treinamento concorrente (aeróbio + resistência) (TC) mais alongamento estático. Métodos. Este foi um estudo piloto controlado, com 31 mulheres (de 30 a 59 anos) em tratamento para câncer de mama, 14 mulheres foram alocadas em um grupo de treinamento (GT) que realizaram TC mais alongamento estático, concomitante a tratamento hospitalar e 17 mulheres para o grupo de controle (GC) que somente realizaram tratamento hospitalar. O TC mais alongamento estático foram realizados em 12 semanas com 5 sessões semanais, três sessões (aeróbia + resistência) e duas sessões (exercícios de alongamento) em dias alternados. A flexibilidade do ombro foi medida por meio do goniômetro de pêndulo 360º Sanny e a flexibilidade de membros inferiores foi avaliada por meio do teste de sentar e alcançar. Os dados foram analisados usando o Teste ANOVA de medidas repetidas e Post-hoc de Bonferroni no software SPSS 21, com α de 5%. Resultados. O GT apresentou aumento da flexibilidade na abdução horizontal do ombro direito (p=0,001) e nos membros inferiores (p<0,001), mas o GC apresentou redução da abdução horizontal do ombro direito (p=0,003). O tamanho do efeito para abdução horizontal do ombro direito foi médio (p=0,508) e para membros inferiores foi grande (p=0,839). Conclusão. O TC mais alongamento estático podem ser uma intervenção terapêutica para aumentar a flexibilidade de membros superiores e inferiores em mulheres com câncer de mama. (AU)

Mechanisms of muscle stretching exercises for reduction of low back pain: narrative review / Mecanismos de exercícios de alongamento muscular para redução de dor lombar: revisão narrativa

ABSTRACT BACKGROUND AND OBJECTIVES: Stretching exercises are present in physical training and muscle rehabilitation programs. Within the context of rehabilitation of patients with low back pain (lombalgy), there is still a gap about the mechanisms that these exercises should reduce pain and disability in these patients. The aim of this study was to investigate what are the possible mechanisms through which muscle stretching exercise could reduce pain in individuals with chronic low back pain.CONTENTS: Pain in the lumbar region is one of the most disabling pains when it comes to limitations for daily functions, so it's necessary to investigate alternatives that provide relief for these patients. As the cause of non-specific chronic low back pain is multifactorial, the treatment of the pathology occurs mainly to reduce the sensation of pain. As an alternative, the flexibility training through stretching exercises can be efficient because they generate biomechanical and sensory changes, which would result in an analgesic effect. Additionally, it's still possible that these two effects occur together to explain the reduction in low back pain after performing stretching exercises. CONCLUSION: There is theoretical basis in the literature to support the performance of stretching exercises as a non-pharmacological strategy for the treatment of chronic low back pain. Biomechanical and neurophysiological mechanisms can be pointed out to explain these benefits.

RESUMO JUSTIFICATIVA E OBJETIVOS: Exercícios de alongamento estão presentes em programas de treinamento físico e reabilitação muscular. Dentro do contexto da reabilitação de indivíduos com dor na região lombar (lombalgia), ainda existe uma lacuna sobre os mecanismos pelos quais esses exercícios reduzem dor e incapacidade nesses pacientes. O objetivo deste estudo foi descrever os possíveis mecanismos pelos quais o exercício de alongamento pode reduzir dor em indivíduos com lombalgia crônica. CONTEÚDO: A dor na região lombar é uma das dores mais incapacitantes quando se trata de limitações para as funções no cotidiano. Por isso, é necessário investigar alternativas que possam proporcionar o seu alívio nesses pacientes. Considerando que a causa da lombalgia crônica não específica é multifatorial, o tratamento desta doença ocorre principalmente na tentativa de reduzir a sensação dolorosa. Como alternativa, o treinamento da flexibilidade por meio de exercícios de alongamento pode agir reduzindo a dor lombar por gerarem alterações biomecânicas e sensoriais que resultam em efeito analgésico. Adicionalmente, ainda é possível que esses dois efeitos possam atuar em conjunto para explicar a redução da dor lombar após a realização de exercícios de alongamento. CONCLUSÃO: Existe suporte teórico na literatura para sustentar a realização dos exercícios de alongamento como estratégia não farmacológica para o tratamento da dor lombar crônica. Mecanismos biomecânicos e neurofisiológicos poderiam ser apontados para explicar tais benefícios.

Dietary supplements and fatigue in patients with breast cancer: a systematic review.

PURPOSE: Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of physical or emotional and/or cognitive exhaustion. The treatment of CRF includes pharmacological and non-pharmacological therapies; dietary strategies with promising results have also been used. This study aimed to identify dietary supplements that improve fatigue in patients with breast cancer. METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained from PubMed, Scopus, MEDLINE, CENTRAL, and CINAHL databases using the following MeSH terms: breast neoplasms, dietary supplements, diet, and fatigue. In addition, the Google and Google Scholar search engines were used to find grey literature. Methodological quality was evaluated using the risk of bias in randomised clinical trials in the systematic Cochrane reviews, and the quality of the evidence was also analysed using the GRADE system. RESULTS: A total of 893 studies were assessed, of which eight were included in the review, with 932 women diagnosed with breast cancer. The most commonly used supplements that improve fatigue were guarana, acetyl-L-carnitine, and co-enzyme Q10. Two studies had a low risk of bias in all categories and three had high-quality evidence. CONCLUSIONS: Dietary supplements or diet patterns are seldom used to treat fatigue in patients with breast cancer. The results of this review showed that guarana extract and a diet rich in whole foods, omega-3 fatty acids, fruits, and vegetables could be used to treat CRF in patients with breast cancer. The studies had a low risk of bias with high-quality evidence on the efficacy of the interventions in treating fatigue in the study population.

Effect of exercise on pain and functional capacity in breast cancer patients.

PURPOSE: To assess the influence of combined training on pain, fatigue, maximal oxygen uptake (VO2 max), body mass index (BMI), flexibility, and strength in patients with breast cancer. METHODS: A controlled pilot study with 28 patients undergoing chemotherapy, radiation therapy, and clinical observation in a renowned cancer treatment center; the patients were aged from 30 to 59 years old and were not engaged in physical training for three months previously. The Study Group (SG) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20 s and was performed in sets of three repetitions. The Control Group (CG) received only the standard hospital treatment. Participants were evaluated at the beginning of the study to establish a baseline and reevaluated at the end of 12 weeks. RESULTS: Patients in the SG showed a significant decrease in total pain points (p = 0.0047), pain intensity (p = 0.0082), and the extent to which pain interfered with their daily life (p = 0.0047). There was an increase in maximum oxygen uptake (p = 0.0001), flexibility (p = 0.0001), and strength on both sides (right p = 0.0001 and left p = 0.0008). No significant differences were observed in fatigue (p = 0.0953) or BMI (p = 0.6088). CONCLUSION: Combined training was effective in decreasing pain and increasing VO2 max, flexibility and static strength in patients with breast cancer. TRIAL REGISTRATION: NCT03061773 . Registered on February 19, 2017, 'retrospectively registered'.

Potência anaeróbia máxima e índice de fadiga em atletas de Futsal feminino: descrição e comparação entre as posições / Maximum anaerobia power and Futsal female athletes fatigue index: description and comparison between positions

A potência anaeróbia máxima é uma capacidade física presente nos mais diversos gestos esportivos do futsal. Essas ações são realizadas de forma repetitivas o que exige dos jogadores valores importantes no índice de fadiga a fim de manter o desempenho durante a partida. O estudo objetivou traçar o perfil morfológico e neuromotor de uma equipe de futsal feminino e mensurar a potência anaeróbia máxima e o índice de fadiga conforme as posições de jogo. Participaram 17 atletas, idade de 21,8±4,1 anos, estatura 159±0,07cm e massa corporal 56,2±8,2kg. Foram avaliadas medidas antropométricas, composição corporal, neuromotora e da potência anaeróbia máxima. Os dados foram descritos em (média ± desvio padrão, mínimo, máximo e coeficiente de variação). O teste de Shapiro Wilk foi usado para averiguar a normalidade dos dados através do software Stata 14.0 e adotado um valor de α= 5%. Foi observado um índice de fadiga menor das Alas o que mostra melhor resistência ao esforço comparado às outras posições, porém todas foram classificadas com nível "bom". Na potência anaeróbia máxima houve diferenças nos valores entre as posições, porém todas foram classificadas com nível "fraco". Concluiu-se que existem diferenças na potência máxima entre as jogadoras, porém não foi suficiente para classificá-las em níveis aceitáveis para essa capacidade de acordo com a literatura.Diferentemente do IF, mesmo com diferenças entre as posições, todas apresentaram nível classificado como "bom" de acordo com os estudos....(AU)

The maximum anaerobic power is physical capacity present in the most diverse sports gestures of futsal. These actions are carried out repetitively which demand from the players values important in the index of fatigue in order to maintain performance during the match.The study aimed to trace the morphological profile and neuromotor of a famale futsal team and to measure maximum anaerobic power and fatigue index according to the game positions. There were 17 athletes, age of 21.8±4.1 years, stature 159±0.07cm and body mass 56.2±8.2kg. Anthropometric measurements were performed, body composition, neuromotor and maximum naerobic power. The data were described in (average ± standard deviation, minimum, maximum and coefficient of variation). The test of Shapiro Wilk was used to ascertain the normality of the data through State 14.0 software and adopted a value of α= 5%. A lower fatigue index was observed for the Wings, which shows better resistance to stress compared to other positions, but all were classified as "good". In the maximum anaerobic power there were differences in the values between the positions, but all were classified as "weak". It's concluded that there are differences in the maximum power between the players, but it was not enough to classify according to the literature. Unlike the IF, even with differences betweens positions, all presented a level classified as "good" according to the studies....(AU)