Short-Term Effects of a Resistance Training Program Using Elastic Tubing in Patients with Heart Disease

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)

Analysis of the heart rate deflection point as a tool for exercise prescription in subjects with COPD - a cross-sectional study.

Background: Prescription of exercise training in subjects with chronic obstructive pulmonary disease (COPD) remains a challenge in clinical practice. The heart rate deflection point (HRDP) is an option to reduce costs, reflects the anaerobic threshold and it is noninvasive; however its applicability in COPD is still unknown. Aim: To compare HRDP with gas exchange threshold values (GET) in subjects with COPD. Methods: Thirty-one subjects were evaluated in this cross-sectional study, diagnosed with COPD. The subjects performed an incremental exercise test on a treadmill to determine the GET, peak oxygen consumption (VO2PEAK), speed corresponding to VO2PEAK (sVO2PEAK), and peak values of heart rate (HRPEAK). To determine HRDP the heart rate values observed were plotted as a function of intensity. Results: The HRDP was visible in 96.77% of subjects. There was no difference between HRDP and GET (p = 0.07) and a moderate intraclass correlation coefficient (ICC): 0.74 [0.52-0.87] and high limits of agreements were presented (±1.1 km·h-1). Conclusion: The HRDP cannot be used to determine the limits between the physiological domains of these subjects. Thus, although significant correlation was found between HRDP and GET, their application for training prescription and monitoring in subjects with COPD proved to be limited.

Burnt sugarcane harvesting is associated with rhinitis symptoms and inflammatory markers / Colheita de cana-de-açúcar queimada está associada a sintomas de rinite e marcadores inflamatórios

Abstract Introduction: Burnt sugarcane harvesting requires intense physical exertion in an environment of high temperature and exposure to particulate matter. Objective: To evaluate the effects of burnt sugarcane harvesting on rhinitis symptoms and inflammatory markers in sugarcane workers. Methods: A total of 32 male sugarcane workers were evaluated with questionnaire for rhinitis symptoms, and for inflammatory markers on peripheral blood and nasal lavage, in the non-harvesting, and 3 and 6 months into the sugarcane harvesting period. Weather data and particulate matter fine concentrations were measured in the same day. Results: The particulate matter concentrations in sugarcane harvesting were 27 (23-33 µg/m3), 112 (96-122 µg/m3), and 63 (17-263 µg/m3); 24 h temperatures were 32.6 (25.4-37.4 ºC), 32.3 (26.7-36.7 ºC) and 29.7 (24.1-34.0 ºC) and relative humidities were 45.4 (35.0-59.7%), 47.9 (39.1-63.0%), and 59.9 (34.7-63.2%) in the non-harvesting period, three and 6 months of the harvesting period. The age was 37.4 ± 10.9 years. The prevalence of rhinitis symptoms was significantly higher at 3 months of the harvesting period (53.4%), compared to non-harvesting period (26.7%; p = 0.039) and at 6 months into the harvesting period (20%; p = 0.006). Concentrations of interleukin 6 (IL-6) in nasal lavage increased after 3 months of the harvesting period compared to the non-harvesting period (p = 0.012). The presence of rhinitis symptoms, after 3 months of the harvesting period, was directly associated with blood eosinophils and inversely associated with neutrophils. Conclusions: After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.

Resumo Introdução: A colheita de cana-de-açúcar queimada requer esforço físico intenso em um ambiente com altas temperaturas e exposição a material particulado. Objetivo: Avaliar os efeitos da colheita de cana-de-açúcar queimada nos sintomas de rinite e marcadores inflamatórios de cortadores de cana-de-açúcar. Método: Foram avaliados 32 cortadores de cana-de-açúcar do sexo masculino por meio de um questionário para sintomas de rinite, e marcadores inflamatórios em sangue periférico e lavado nasal, no período de entressafra, e em 3 e 6 meses após o início da colheita da cana-de-açúcar. Os dados climáticos e as concentrações de material particulado fino foram medidos no mesmo dia. Resultados: O material particulado fino na entressafra e em 3 e 6 meses de safra foi 27 (23-33 µg/m3), 112 (96-122 µg/m3) e 63 (17-263 µg/m3), respectivamente; a temperatura de 24 horas foi 32,6 (25,4º-37,4ºC), 32,3 (26,7º-36,7ºC) e 29,7 (24,1º-340ºC) e a umidade relativa do ar foi 45,4 (35,0%-59,7%), 47,9 (39,1%-63,0%), e 59,9 (34,7%-63,2%), na entressafra, 3 e 6 meses após o início da colheita. A idade foi de 37,4 ± 10,9 anos. A prevalência de sintomas de rinite foi significativamente maior em 3 meses da S (53,4%), comparado com a entressafra (26,7%; p = 0,039) e 6 meses da safra (20%; p = 0,006). As concentrações de interleucina 6 (IL-6) no lavado nasal aumentaram após 3 meses do início da colheita comparado com a entressafra (p = 0,012). A presença de sintomas de rinite, após 3 meses do início da colheita, foi diretamente associada com eosinófilos e inversamente associada com neutrófilos. Conclusões: Após 3 meses do início da colheita da cana-de-açúcar queimada, houve aumento na prevalência de sintomas de rinite e IL-6 em LN. Além disso, as contagens de eosinófilos foram diretamente associadas aos sintomas de rinite no período de maior concentração de material particulado.

Burnt sugarcane harvesting is associated with rhinitis symptoms and inflammatory markers.

INTRODUCTION: Burnt sugarcane harvesting requires intense physical exertion in an environment of high temperature and exposure to particulate matter. OBJECTIVE: To evaluate the effects of burnt sugarcane harvesting on rhinitis symptoms and inflammatory markers in sugarcane workers. METHODS: A total of 32 male sugarcane workers were evaluated with questionnaire for rhinitis symptoms, and for inflammatory markers on peripheral blood and nasal lavage, in the non-harvesting, and 3 and 6 months into the sugarcane harvesting period. Weather data and particulate matter fine concentrations were measured in the same day. RESULTS: The particulate matter concentrations in sugarcane harvesting were 27 (23-33µg/m3), 112 (96-122µg/m3), and 63 (17-263µg/m3); 24h temperatures were 32.6 (25.4-37.4°C), 32.3 (26.7-36.7°C) and 29.7 (24.1-34.0°C) and relative humidities were 45.4 (35.0-59.7%), 47.9 (39.1-63.0%), and 59.9 (34.7-63.2%) in the non-harvesting period, three and 6 months of the harvesting period. The age was 37.4±10.9 years. The prevalence of rhinitis symptoms was significantly higher at 3 months of the harvesting period (53.4%), compared to non-harvesting period (26.7%; p=0.039) and at 6 months into the harvesting period (20%; p=0.006). Concentrations of interleukin 6 (IL-6) in nasal lavage increased after 3 months of the harvesting period compared to the non-harvesting period (p=0.012). The presence of rhinitis symptoms, after 3 months of the harvesting period, was directly associated with blood eosinophils and inversely associated with neutrophils. CONCLUSIONS: After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.

Burnt sugarcane harvesting work: effects on pulmonary and systemic inflammatory markers.

Objective: To evaluate the effects of burnt sugarcane harvesting on the plasmatic and urinary concentrations of the club cell secretory protein (CC16) and inflammatory systemic biomarkers in a group of sugarcane cutters. Methods: Seventy-eight sugar cane workers were evaluated. The plasmatic and urinary concentrations of CC16, a pulmonary damage marker and inflammatory systemic biomarkers were collected at three time points: before, three months after and six months after the onset of the burnt sugarcane harvesting period. All evaluations were performed at ∼7 am, before the daily work shift. In the three-month evaluation, a post-work shift assessment (acute effect) was also performed. Results: The age of the workers was 37.9 ± 11.0 years. The PM2.5 concentrations were 27.0 (23.0-33.0) and 101.0 (31.0-139.5) µg/m3 in the pre harvest and harvest periods, respectively (p < .001). Burnt sugarcane harvesting was associated with a reduction, throughout the work during burnt sugarcane harvesting (subchronic effect), in plasmatic and urinary CC16 concentrations. Acutely, there was a decrease in plasmatic concentrations. There were acute and subchronic increases in inflammatory markers (neutrophils, monocytes) and muscle damage markers (CK and LDH) and a decrease in red blood cells. Conclusions: Harvesting of burnt sugarcane was associated with acute and subchronic reductions in the plasmatic and urinary concentrations of CC16 protein and changes in systemic inflammatory markers.

Analysis of Autonomic Modulation in Response to a Session of Aerobic Exercise at Different Intensities in Patients With Moderate and Severe COPD.

Despite the many benefits of performing physical exercise in patients with chronic obstructive pulmonary disease (COPD), information on the response of acute cardiac autonomic modulation in subjects with moderate and severe COPD during and after an aerobic exercise session at different intensities is unknown. The aim of this study was to evaluate the response of cardiac autonomic modulation in patients with moderate and severe COPD during and after an aerobic exercise session at different intensities. Twenty-seven patients with COPD, divided into: Moderate Group and Severe Group, underwent an aerobic exercise sessions with intensities equivalent to 60% and 90% of velocity corresponding to peak oxygen consumption. The heart rate variability (HRV) indices were analyzed in the time and frequency domains at the following times: at rest, during exercise, immediately after, and 5, 10, and 15 minutes after exercise. In the comparison analysis between the two groups, no differences were observed in any of the HRV indices at different intensities applied. However, it was observed that the exercise caused autonomic changes when the groups were analyzed separately. Sessions of aerobic exercise influence the autonomic modulation in patients with COPD. However, COPD severity did not influence the autonomic nervous system response to exercise and recovery moments; and there was no difference between the exercise intensities.

Sugarcane cutting work, risks, and health effects: a literature review.

OBJECTIVE: Describe the main work risks for sugarcane cutters and their effects on workers' health. METHODS: Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-açú car , and colheita de cana -de-açúcar . The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter's health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author. RESULTS: From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents. CONCLUSIONS: Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.

Critical Velocity Determined by a Non-Exhaustive Method in Subjects With COPD.

BACKGROUND: Exercise training is an effective and low-cost tool for COPD rehabilitation. Thus, validating a non-exhaustive method to determine a patient's anaerobic threshold would be a very interesting tool in practical settings. We aimed to test the reproducibility of critical velocity values determined in a non-exhaustive manner (CVNE) and tolerance for exercise performed at this physiological marker in subjects with COPD. METHODS: Twelve subjects with COPD were evaluated in this cross-sectional study. The study was divided into 2 phases: Phase A consisted of reproducibility of CVNE for subjects with COPD, and Phase B determined the tolerance for exercise tests performed at this physiological marker. RESULTS: The proposed protocol for determining CVNE presented fair reproducibility according to blood lactate concentrations (intraclass correlation coefficient = 0.58). However, we cannot consider that the tests were reproducible due to the wide CI (0.03-0.85). Furthermore, moderate and strong correlations were observed between the CVNE determined by lactate concentration, by oxygen consumption (V̇O2 ) (r = 0.66), and by heart rate (r = 0.88). However, a high limit of agreement was observed ±1.45 km/h and ±1.55 km/h, respectively. In the tolerance for exercise test, none of the subjects presented lactate destabilization, whereas 3 tests were interrupted by oxygen saturation decline and 1 test was interrupted by hemodynamic instability. CONCLUSIONS: Although most of the subjects presented good tolerance for exercise at CVNE, fair levels of reproducibility were observed in subjects with COPD, even using lactate. Thus, the use of CVNE determined through double 3-min efforts should be considered with caution.

Sugarcane cutting work, risks, and health effects: a literature review / O trabalho no corte de cana-de-açúcar, riscos e efeitos na saúde: revisão da literatura

ABSTRACT OBJECTIVE Describe the main work risks for sugarcane cutters and their effects on workers' health. METHODS Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-açú car , and colheita de cana -de-açúcar . The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter's health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author. RESULTS From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents. CONCLUSIONS Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.

RESUMO OBJETIVO Descrever os principais riscos do trabalho de cortadores de cana-de-açúcar e seus efeitos na saúde dos trabalhadores. MÉTODOS Revisão critica de artigos, com pesquisa bibliográfica realizada nas bases de dados PubMed, SciELO Medline, e Lilacs. Foram empregadas as palavras-chave: sugarcane workers, sugarcane cutters, s ugarcane harvesting , cortadores de cana-de-açúcar e colheita de cana-de-açúcar. Os critérios de inclusão foram artigos publicados entre janeiro de 1997 a junho de 2017, que avaliaram as condições de trabalho e os efeitos na saúde em trabalhadores cortadores de cana-de-açúcar. Foram excluídos aqueles que não tratassem do impacto do trabalho no corte da cana-de-açúcar queimada e não queimada na saúde do cortador. O grupo final de manuscritos foi selecionado pelo autor principal deste estudo e revisado por um coautor. As discordâncias foram resolvidas por consenso usando os critérios de inclusão e exclusão predefinidos e, quando necessário, a decisão final foi realizada consultando um terceiro coautor. RESULTADOS De 89 artigos encontrados, 52 atenderam aos critérios de seleção e foram avaliados. Os estudos mostraram que os cortadores trabalham em condições de sobrecarga física e mental, sobrecarga térmica, exposição a poluentes e sujeitos a acidentes. Os principais efeitos observados foram respiratórios, cardiovasculares, renais, osteomusculares, estresse por calor, desidratação, genotóxicos e decorrente de acidentes. CONCLUSÕES O trabalho no corte manual da cana-de-açúcar, principalmente da cana-de-açúcar queimada, expõem os trabalhadores a diversos riscos, com variados impactos à saúde. A redução de riscos com exposição à poluição e sobrecarga térmica e física se impõe como medida para preservação da saúde do trabalhador.

Evaluation of frequency of positive exercise-induced bronchospasm between swimmers and sedentary individuals / Avaliação da frequência do broncoespasmo induzido por exercício (BIE) positiva entre nadadores e sedentários

Abstract Introduction: Despite the prevalence of prescribed asthma, there is uncertainty about the incidence of exercise-induced bronchospasm (EIB). Objective: Compare the frequency of EIB between swimmers and sedentary individuals, and observe heart rate variability during bronchial activity. Methods: In total, 18 swimmers (group 1) and 18 sedentary individuals (group 2) were included. The participants rested for 30 minutes for evaluation of HRV. Blood pressure (PA), respiratory rate (RR), and pulse oxygen saturation (SpO2) were measured. The volunteers remained seated for the spirometry test (maneuver of forced vital capacity - FVC). This was repeated 5, 10, 15, 20, and 30 minutes after the exercise test. The statistical analysis used the Student t, Mann Whitney, and Shapiro-Wilks tests. The significance level was p <0.05. Results: The spirometry findings showed 3 sedentary individuals and 10 swimmers with obstructive ventilatory disorder (OVD). Only 2 of the sedentary and none of the swimmer group demonstrated positive bronchial provocation. A key criterion for diagnosing OVD, the relationship between forced expiratory volume in one second and FVC (FEV1/FVC), was statistically lower in the swimmer group. The measures of the root mean square of the successive differences between adjacent normal RR intervals, in a time interval (RMSSD), and the standard deviation of all normal RR intervals recorded in a time interval (SDNN) were significantly higher among the athletes. Conclusion: The bronchial provocation test identified a higher prevalence of bronchospasm among sedentary individuals. However, there was a reduction in the FEV1/FVC ratio and higher HRV in the group of swimmers.

Resumo Introdução: Apesar da prevalência da asma definida, há imprecisão sobre incidência de broncoespasmo induzido por exercício (BIE). Objetivo: Comparar a freqüência de BIE entre nadadores e sedentários, e observar a variabilidade da freqüência cardíaca durante a atividade de broncoprovocação. Métodos: Incluídos 18 nadadores (grupo 1) e 18 sedentários (grupo 2). Permaneceram por 30 minutos de repouso para a avaliação da VFC. Foi aferida a pressão arterial (PA), frequência respiratória (f) e a saturação de pulso de oxigênio (SpO2). Permaneceram sentados, para o teste de espirometria (manobra da capacidade vital forçada - CVF). Essa foi repetida em 5, 10, 15, 20 e 30 minutos após o teste de esforço. A análise estatística usou os testes t de Student, Mann Whitney de Shapiro-Wilk, com nível de significância p<0,05. Resultados: A espirometria evidenciou 3 sedentários e 10 nadadores com distúrbio ventilatório obstrutivo (DVO). Apenas 2 do grupo sedentário apresentaram broncoprovocação positiva e nenhum do grupo de nadadores. Um critério fundamental para diagnosticar DVO, a relação entre o volume expiratório no primeiro segundo e a CVF (VEF1/CVF) foi estatisticamente menor no grupo de nadadores. As médias da raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes, em um intervalo de tempo (RMSSD) e no desvio padrão de todos os intervalos RR normais gravados em um intervalo de tempo (SDNN), foram estatisticamente maiores entre os atletas. Conclusão: O teste de broncoprovocação identificou maior prevalência de broncoespasmo entre os sedentários. Entretanto, houve redução na relação VEF1/CVF e maior VFC no grupo de nadadores.

Efeitos de técnicas respiratórias no clearance mucociliar, força e fluxo expiratório no pós-operatório de revascularização do miocárdio / Effects of respiratory techniques in the mucociliary clearance, strength and expiratory flow in the post-operative myocardial revascularization

Introdução: Técnicas respiratórias são fundamentais no pós-operatório de cirurgia cardíaca a fim de reduzir complicações pós-operatórias. Objetivos: Comparar duas técnicas de fisioterapia respiratória no clearance mucociliar, força muscular respiratória e obstrução de vias aéreas após cirurgia cardíaca. Métodos: Foram avaliados 32 pacientes submetidos à cirurgia de revascularização do miocárdio, alocados para o grupo respiração por pressão positiva intermitente ou para o grupo exercício de respiração profunda. As avaliações foram compostas de: força muscular respiratória (pressão expiratória máxima e da pressão inspiratória máxima), pico de fluxo respiratório e clearance mucociliar (através do teste do tempo de transito da sacarina, expresso em minutos); e realizadas em três momentos: pré-operatório e pós-operatório antes e após a aplicação das técnicas. Resultados: Na análise do transporte mucociliar, força muscular respiratória e pico de fluxo expiratório, a comparação entre os momentos antes e após a aplicação das técnicas não apresentaram diferenças significativas (transporte mucociliar: p = 0,3844, Pimáx p = 0,2244; Pemáx p = 0,4968; Peak flow p = 0,8383). Nas análises individuais de cada grupo, puderam ser observadas diferenças significativas nas variáveis de força muscular respiratória e pico de fluxo expiratório (p<0.0001). Conclusão: Não foram observadas diferenças significativas entre as técnicas, porém foram eficientes no clearance mucociliar, força muscular e pico de fluxo expiratório quando avaliadas separadamente.

Introduction: Respiratory techniques are fundamental in the postoperative period of cardiac surgery in order to reduce postoperative complications. Objectives: The aim of this study was to compare two techniques of respiratory physiotherapy in mucociliary clearance, respiratory muscle strength and airway obstruction after cardiac surgery. Methods: Thirty-two patients undergoing coronary artery bypass grafting were assigned to the intermittent positive pressure group or to the deep breathing exercise group. The evaluations were composed of: respiratory muscle strength (maximal expiratory pressure and maximal inspiratory pressure), peak respiratory flow and mucociliary clearance (through the saccharine transit time test, expressed in minutes); And performed in three moments: preoperative and postoperative before and after the application of the techniques. Results: In the analysis of mucociliary transport, respiratory muscle strength and peak expiratory flow, the comparison between the moments before and after the application of the techniques did not present significant differences (mucociliary transport: p = 0.3844, Pimax p = 0.2244; = 0.4968; Peak flow p = 0.8383). In the individual analyzes of each group, significant differences were observed in the variables of respiratory muscle strength and peak expiratory flow (p <0.0001). Conclusion: There were no significant differences between the techniques, but were efficient in mucociliary clearance, muscle strength and peak expiratory flow when evaluated separately.

Effects of 12 weeks of aerobic training on autonomic modulation, mucociliary clearance, and aerobic parameters in patients with COPD.

INTRODUCTION: Patients with chronic obstructive pulmonary disease (COPD) exhibit aerobic function, autonomic nervous system, and mucociliary clearance alterations. These parameters can be attenuated by aerobic training, which can be applied with continuous or interval efforts. However, the possible effects of aerobic training, using progressively both continuous and interval sessions (ie, linear periodization), require further investigation. AIM: To analyze the effects of 12-week aerobic training using continuous and interval sessions on autonomic modulation, mucociliary clearance, and aerobic function in patients with COPD. METHODS: Sixteen patients with COPD were divided into an aerobic (continuous and interval) training group (AT) (n=10) and a control group (CG) (n=6). An incremental test (initial speed of 2.0 km·h(-1), constant slope of 3%, and increments of 0.5 km·h(-1) every 2 minutes) was performed. The training group underwent training for 4 weeks at 60% of the peak velocity reached in the incremental test (vVO2peak) (50 minutes of continuous effort), followed by 4 weeks of sessions at 75% of vVO2peak (30 minutes of continuous effort), and 4 weeks of interval training (5×3-minute effort at vVO2peak, separated by 1 minute of passive recovery). Intensities were adjusted through an incremental test performed at the end of each period. RESULTS: The AT presented an increase in the high frequency index (ms(2)) (P=0.04), peak oxygen uptake (VO2peak) (P=0.01), vVO2peak (P=0.04), and anaerobic threshold (P=0.02). No significant changes were observed in the CG (P>0.21) group. Neither of the groups presented changes in mucociliary clearance after 12 weeks (AT: P=0.94 and CG: P=0.69). CONCLUSION: Twelve weeks of aerobic training (continuous and interval sessions) positively influenced the autonomic modulation and aerobic parameters in patients with COPD. However, mucociliary clearance was not affected by aerobic training.

Is dynamometry able to infer the risk of muscle mass loss in patients with COPD?

INTRODUCTION: Sarcopenia is characterized by a progressive and generalized decrease of strength and muscle mass. Muscle mass loss is prevalent in patients with chronic obstructive pulmonary disease (COPD) as a result of both the disease and aging. Some methods have been proposed to assess body composition (and therefore identify muscle mass loss) in this population. Despite the high accuracy of some methods, they require sophisticated and costly equipment. AIM: The purpose of this study was to infer the occurrence of muscle mass loss measured by a sophisticated method (dual energy X-ray absorptiometry [DEXA]) using a more simple and affordable equipment (dynamometer). METHODS: Fifty-seven stable subjects with COPD were evaluated for anthropometric characteristics, lung function, functional exercise capacity, body composition, and peripheral muscle strength. A binary logistic regression model verified whether knee-extension strength (measured by dynamometry) could infer muscle mass loss (from DEXA). RESULTS: Patients with decreased knee-extension strength were 5.93 times more likely to have muscle mass loss, regardless of sex, disease stage, and functional exercise capacity (P=0.045). CONCLUSION: Knee-extension dynamometry was able to infer muscle mass loss in patients with COPD.

Analysis of autonomic modulation after an acute session of resistance exercise at different intensities in chronic obstructive pulmonary disease patients.

PURPOSE: Physical exercises are employed as part of the treatment of patients with chronic obstructive pulmonary disease (COPD); however information regarding cardiac autonomic modulation after an acute session of resistance exercise (RE) is unknown. The aim of this study was to evaluate the cardiac autonomic modulation, via heart rate variability after an acute session of RE applied at different intensities in COPD patients. PATIENTS AND METHODS: Twelve COPD patients underwent an acute session of RE with an intensity of 60% and another of 90% of the one repetition maximum test. For analysis of autonomic modulation, heart rate was recorded beat-by-beat for 20 minutes at rest and after the training session. Heart rate variability indexes were obtained in the time and frequency domains for the assessment of autonomic modulation. RESULTS: Regardless of exercise intensity, RE acute sessions influenced the autonomic modulation when the recovery period was compared with the baseline. An increase in standard deviation of normal to normal RR intervals was observed throughout recovery time after the RE, as compared to baseline in both protocols: 60% and 90% of the one repetition maximum test. The spectral component of low frequency index (ms) was higher throughout recovery when compared to baseline in both protocols. The same was also observed in the spectral component of high frequency index (ms) for the protocols of 60% and 90%. CONCLUSION: RE sessions impact on the autonomic modulation of COPD patients by promoting differences in the recovery period compared to baseline, regardless of the intensity of the exercise performed.

Integridade respiratória é prejudicada em tabagistas passivos adultos expostos em ambiente domiciliar / Respiratory integrity is impaired in adults passive smokers exposed in household environment

Objetivo: Analisar a integridade respiratória de adultos tabagistas passivos expostos em ambiente domiciliar. Métodos: Avaliaram-se 56 voluntários, divididos em grupo de tabagistas passivos (GTP; n=29), composto por familiares de tabagistas, e grupo controle (GC; n=27). Foi realizada avaliação inicial que constava de dados pessoais, antropométricos, pressão arterial (PA), frequência cardíaca, saturação periférica de oxigênio, frequência respiratória. Em seguida, foi aplicado um questionário de afecções respiratórias, mensurado o nível de monóxido de carbono no ar exalado e realizada espirometria. Resultados: Valores de PA mais elevados no GTP foram observados. O GTP apresentou menores valores espirométricos nos índices volume expiratório forçado no primeiro segundo (p<0,0342) e capacidade vital forçada (p<0,0291). Com relação à intensidade dos sintomas, pôde-se observar diferença significativa no sintoma relacionado à coceira no nariz, no qual o GTP relatou maior intensidade (p<0,002). Maior intensidade também foi relatada no GTP no sintoma de respirar com mais dificuldade em lugares que tenham muita poeira ou quando o clima muda (p<0,0001). Conclusão: Tabagistas passivos apresentam prejuízo em sua integridade respiratória caracterizado por maior intensidade de sintomas respiratórios e alterações de função pulmonar.

Objective: To analyze the respiratory integrity of adult passive smokers exposed in home environment. Methods: A total of 56 volunteers, divided into passive smokers group (GPS; n = 29) composed of family members of smokers and a control group (CG; n = 27) with no history of exposure. Initial evaluation was performed which consisted of personal data, anthropometric, blood pressure (BP), heart rate, peripheral oxygen saturation, respiratory rate. Then a questionnaire was administered to respiratory diseases, measured the carbon monoxide level in exhaled air and spirometry was performed. Results: Higher BP values were observed in the GPS. The GPS showed lower spirometric values in forced expiratory volume in one second (p <0.0342) and forced vital capacity (p <0.0291). Regarding the intensity of the symptoms we observed significant difference in the symptom related to itchy nose, in which the GPS reported higher intensity (p <0.002). Higher intensity was also reported in the GPS symptom in breathing more difficult in places that have a lot of dust or when the weather changes symptom (p <0.0001). Conclusion: Passive smokers presented impairment in their respiratory health characterized by a greater intensity of respiratory symptoms and alterations in lung function.