Long-Term Electrode-Skin Impedance Variation for Electromyographic Measurements.

This study aims to observe the evolution of the electrode-skin interface impedance of surface EMG electrodes over the time taken to determine the time of stabilization. Eight healthy subjects participated in the study. Electrode-skin impedance was evaluated in the rectus abdominal muscle every five minutes, over a total period of 50 min. A reduction of 13.23% in the impedance values was observed in minute 10 (p = 0.007), and a reduction of 9.02% was observed in minute 15 (p = 0.029). No statistically significant differences were observed in the other instants evaluated. The findings obtained in the present study demonstrate a decrease in electrode-skin impedance from minute 5 to minute 15, followed by a stabilization period with a low percentage of variation till minute 50.

Could Electromyographic and Pressure Related Signals Identify Differences in Abdominal Activity and Postural Control between Women with and without C-Section?

BACKGROUND: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control-stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. METHODS: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the "caesarean delivery" group, scar mobility was evaluated using a modified adheremeter. RESULTS: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p < 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p > 0.05). CONCLUSIONS: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.

Home-based Virtual Reality Exercise Program During the Maintenance Stage of Cardiac Rehabilitation: A Randomized Controlled Trial

Abstract Background: Home-based virtual reality technology may become an alternative to cardiac rehabilitation. Objectives: To evaluate the effects of a specific, home-based exercise program, performed either through a virtual reality (Kinect) or a conventional format (booklet) in the maintenance stage of cardiac rehabilitation for six months on functional muscle strength of the lower limbs, physical activity and exercise tolerance. Methodology: This is a randomized clinical trial (ClinicalTrials.gov — NCT02753829) with individuals with coronary artery disease from a hospital in Porto, Portugal, randomly allocated to an experimental group "1" (EG1; n = 11), submitted to a virtual reality exercise program (Kinect); an experimental group "2" (EG2; n = 11), submitted to an exercise program described in a booklet (conventional format); or a control group (CG) (n=11), submitted to routine care. Parameters of functional muscle strength of the lower limbs (sit-to-stand test), physical activity (accelerometer) and exercise tolerance (stress test) were assessed and compared between the groups. Descriptive and inferential statistics were applied, with 95% with a significance level of 0.05. Results: Significant improvements in functional muscle strength of the lower limbs were observed in EG1 compared to EG2, at three months (19.5 ± 7.7 versus 11.9 ± 4.7, p = 0.042), and at six months (23.0 ± 7.7 versus 14.6 ± 4.6, p = 0.027) of intervention. Conclusions: The program did not demonstrate superior results, in relation to the control group and among the different formats, in physical activity and effort tolerance. In relation to the functional muscle strength of the lower limbs, the virtual reality format showed significantly better results when compared to the conventional format only.

Application of cryolipolysis in adipose tissue: A systematic review.

BACKGROUND: Cryolipolysis is characterized by localized and controlled cooling of the subcutaneous adipose tissue, in a non-invasive way, causing a localized panniculitis, followed by adipocyte death by apoptosis and, consequently, a decrease in adipose tissue in the treated area. AIM(S): To evaluate the scientific evidence and methodological qualities about effects, adverse reactions, and level of satisfaction of cryolipolysis for the reduction of subcutaneous adipose tissue. METHODS: A systematic review was carried out according to the PRISMA recommendation. Searches were conducted in different databases. We included studies that used a randomized control and self-control design and were carried out in humans. Articles published in English and Portuguese were screened, with no time limit regarding the year of publication. The methodological quality of the studies was assessed using the Cochrane Rob2 scale. RESULTS: Of 381 articles, seven were considered eligible for inclusion. After applying the Cochrane Rob2 scale, five studies were included in the final sample. Most studies showed significant results for cryolipolysis in reducing localized fat. The incorporation of a dietary program into the treatment was shown to contribute to a significant improvement in the lipid profile and liver enzymes, which does not happen when cryolipolysis is applied in isolation. Rare adverse effects have been identified, but never persisting beyond a month. CONCLUSIONS: Cryolipolysis is an effective technique for reducing localized fat, safe, and well tolerated, with most participants satisfied at the end of the treatment. However, more randomized controlled studies should be carried out, since there is a limited number of articles with good methodological quality.

Effects of Abdominal Microcurrent in the Consumption and Proportion of Energy Substrates during Aerobic Exercise: A Pilot Study.

Microcurrent therapy can increase lipolytic activity. However, it is unknown if the increased availability of lipids can influence the selection of energy substrates during a single session of aerobic exercise. We aimed to analyze the effect of microcurrent application to the abdominal region in the consumption of lipids and carbohydrates, and respiratory exchange ratio (RER) during a single session of moderate aerobic exercise in young adults. A pilot study was conducted in which participants were allocated to intervention (IG) or placebo (PG) groups. In both groups, 40 min of microcurrent application with two frequencies (25 and 10 Hz) followed by 50 min of moderate-intensity aerobic exercise (45−55% of heart rate reserve) on a cycloergometer were performed. The microcurrent application was performed without intensity in the PG. A portable gas analyzer (K4b2) was used during exercise in both groups. Thirty-eight participants (20.6 ± 1.8 years; 18 in IG and 20 in PG) were enrolled. There were no significant differences in the consumption of substrates or RER between the groups during exercise (p > 0.05). Microcurrent application seems to be insufficient to influence the consumption of energy substrates and RER during a single session of aerobic exercise in young adults.

Comparison of the effects of shock waves versus radiofrequency on abdominal lipolysis: A randomized clinical trial.

BACKGROUND: High levels of abdominal adiposity mean higher risk of developing cardiovascular diseases. Aerobic exercise per si reduces the risk of developing this type of diseases. Radiofrequency and shockwave therapy showed to be effective in the reduction of localized abdominal fat. AIM (S): To compare the effects of prescribed moderate aerobic exercise associated with 6 sessions of shockwave therapy or radiofrequency, in the subcutaneous abdominal adipose tissue, in overweight female individuals in fertile age. METHODS: Randomized clinical trial, with 30 volunteers in fertile age with overweight and/or obese, randomly and equitably allocated in two experimental groups (1-shockwave therapy and 2-radiofrequency) and one control group. Aerobic physical exercise was prescribed to all groups. The values of anthropometric measurements were measured in two moments. The intervention protocol was performed in a clinic for six weeks, with one session per week. The ANOVA test, paired samples t test, Kruskal-Wallis test, and Wilcoxon test were used to compare the results, for a significance level of 0.05. RESULTS: Of 28 participants completed the study. There were significant differences in waist circumference reduction between the experimental group 1 and 2 when compared to the control group (p = 0.005 and p = 0.014, respectively). There was a statistically significant reduction in navel level circumference in experimental group 1 when compared to experimental group 2 (p = 0.024) and with the control group (p = 0.016). CONCLUSION: Both resources were effective in reducing abdominal measurements when compared to the control group. However, SWT was superior in reducing the navel level circumference.

Effect of capacitive radiofrequency on the dermis of the abdominal region.

The purpose of this study is to evaluate the effects of radiofrequency (RF) on sagging skin. This is a case series study with five volunteers who received a single application of capacitive RF (BTL-6000 TR-Therapy Pro®) in the right infraumbilical abdominal region, with epidermal temperature above 40°C, for 10 min (2 min per applicator area), and the skin of the contralateral region was used as control. After 30 days, on average, the skin of the abdominal region was collected for histological analysis and stained with hematoxylin and eosin, Picro-sirus, and Verhoff. The percentage of collagen and elastic fibers found was marked by the Image J®. The statistical analysis was performed in the SPSS program (version 20), with a significance level of 95%. This was registered with the ethics and research comitee of UFTM n 3.461.688 on Jul 12, 2019 and clinical trial registration n. NCT04182542, retrospectively registered. Morphometric analysis demonstrated a remodeling of collagen and elastic fibers on the side treated with RF; however, the morphometry for collagen showed no significant difference, with an average percentage of 60.94 ± 0.32 for the control side and 61.97 ± 2.80 for the treated with p=0.32. Similarly, elastic fibers also showed no significant difference between groups, with a mean percentage of 5.67 ± 2.70 for control and 6.21 ± 2.01 for treated with p=0.19. The RF with the parameters used in this study was able to cause morphological changes in collagen and elastic fibers of the abdominal region skin; however, it showed no change in the percentage of these fibers.

Effect of shock wave therapy associated with aerobic exercise on cellulite: A randomized controlled trial.

BACKGROUND: Cellulite is a multifactor and controversial condition. Several methods have been explored to reduce it, not always with favorable results. Shock Wave Therapy has been shown to be effective, but the results of its association with an Aerobic Exercise Program are unknown. AIMS: To verify whether Shock Wave Therapy in association with an Aerobic Exercise Program reduces the degree of severity of Cellulite in the gluteal region and in the ⅓ of the proximal posterior of the thigh. METHODS: Forty-five healthy women, aged from 18 to 32, randomly assigned, considering the severity degree in the Cellulite Severity Scale and the level of physical activity, in three groups: two experimental and one control group. The control group performed the evaluations. The experimental group 1 performed an Aerobic Exercise Program, and the experimental group 2 associated this program with a Radial Shock Wave Therapy protocol. The experimental groups completed six interventions within 3 weeks. In addition, the degree of severity in the Cellulite Severity Scale, height, body composition, skin temperature, and subcutaneous adipose tissue thickness were assessed. One-way ANOVA test and Kruskal-Wallis were used to obtain the results, with level of significance of 0.05. RESULTS: Forty-two women completed the study. There was a significant reduction in the severity of Cellulite between experimental group 2 and group 1 (P = 0.032), and from group 2 to the control group (P = 0.042). CONCLUSION: The association of Shock Wave Therapy and Aerobic Exercise was shown to be effective in reducing the severity of cellulite.

Effect of one session of aerobic exercise associated with abdominal laser therapy in lipolytic activity, lipid profile, and inflammatory markers.

BACKGROUND: Increased abdominal fat and sedentary lifestyles contribute to cardiovascular disease risk. The combination of exercise and low-level laser therapy (LLLT) appears to be an innovative method to increase the lipolytic rate of abdominal adipocytes, in order to reduce abdominal fat. OBJECTIVES: To evaluate the effect of one session of aerobic exercise associated with abdominal laser therapy in lipolytic activity, profile lipid, and inflammatory markers (C-reactive protein-CRP). METHODS: Experimental randomized controlled study in 36 participants of female sex divided into three groups: placebo group (PG) (n = 12), experimental group 1 (EG1) (n = 11), and experimental group 2 (EG2) (n = 13). The EG1 and EG2 performed the laser therapy protocol followed by 50 minutes of aerobic exercise on cycle ergometer, of 45%-55% of reserve heart rate; however, in EG2 the laser therapy was applied without power. The PG only performed the laser therapy protocol without power. The anthropometric measures were evaluated, and all participants were subject to blood samples at the beginning and at the end of the intervention for measure glycerol, lipid profile (total cholesterol, triglycerides, HDL, and LDL), and CRP. One-way ANOVA was used to compare the groups in the quantitative variables and Fisher's test to compare the groups in the qualitative variables. To compare the variables between moments (M0 and M1), we used the t test for paired samples. RESULTS: In the group that performed physical exercise and lipolytic laser and in the group that performs only physical exercise, there was a significant increase in glycerol mobilization between M0 and M1 (P < .001). The same did not occur in the placebo group. Regarding the CRP levels and lipidic profile, no significant differences were observed between moments in the experimental groups. CONCLUSION: It is concluded that one session of aerobic exercise associated with LLLT and one session of aerobic exercise appears to be able to increase the lipolytic activity. However, it appears that LLLT does not provide increased value to the aerobic physical exercise by itself in lipolysis process.

Effect of four sessions of aerobic exercise with abdominal radiofrequency in adipose tissue in healthy women: Randomized control trial.

BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To analyze the effect of four intervention sessions on abdominal adipose tissue. METHODOLOGY: The study analyzes the effect of four sessions of aerobic exercise combined with radiofrequency. Participants were 28 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and a placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed four sessions of abdominal radiofrequency followed by moderate aerobic exercise, assessing body mass, body mass index, fat mass, waist circumference, waist/height ratio, subcutaneous adipose thickness, and horizontal abdominal adipose fold at the first and fourth sessions. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40°C and 42°C to the epidermis. In the placebo group, the power of the radiofrequency was 0 W. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There was a statistically significant decrease in waist circumference, abdominal subcutaneous adipose thickness, and horizontal abdominal fold in the experimental group compared to the placebo group (P < 0.05). CONCLUSION: Combined exercise intervention with radiofrequency has been shown to be effective in reducing abdominal adiposity.

Effect of an aerobic exercise session combined with abdominal radiofrequency on lipolytic activity in women: Randomized control trial.

BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. METHODOLOGY: The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40º C and 42º C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). CONCLUSION: The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.

Ultraviolet A/blue light-emitting diode therapy for vulvovaginal candidiasis: a case presentation.

Vulvovaginal candidiasis (VVC) is a frequent infection of the female genitourinary tract. It is considered the second most common genital infection in women, after bacterial vaginosis. VVC is treated with oral or topical azole derivatives. However, these agents may lead to adverse reactions and their chronic use might lead to resistance to antifungal agents. Given that the ultraviolet A/blue light-emitting diode (LED) is an electromagnetic radiation source with antimicrobial properties, it is hypothesized that this resource may be a non-drug alternative to the treatment of vulvovaginitis. A technical/experimental safety test was conducted to characterize the light source spectrum and temperature generation of the device, followed by a pilot study in a 52-year-old patient with a clinical diagnosis of VVC confirmed by culture and examination of fresh vaginal samples, owing to the presence of lumpy vaginal discharge and a complaint of pruritus. The vulva and vagina were exposed to 401 ± 5 nm ultraviolet A/blue LED irradiation in a single session, divided into two applications. A reassessment was performed 21 days after the treatment. The light-emitting device had a visible spectrum, in the violet and blue ranges, and a maximum temperature increase of 7 °C. During the reassessment, the culture was found to be negative for fungus, and the signs and symptoms of the patient had disappeared. A light-emitting device with a spectrum in the range of 401 ± 5 nm could potentially be an alternative treatment modality for women with VVC, as it led to the resolution of clinical and microbiological problems in our patient.

Effects of radiofrequency on adipose tissue: A systematic review with meta-analysis.

BACKGROUND: Equipment that acts in the reduction in adipose tissue are becoming widely investigated. One of the resources that begin to gain recognition is radiofrequency. PURPOSE: To verify the existence of scientific evidence and the methodological quality of the articles on the effects of radiofrequency in the reduction in adipose tissue. METHODOLOGY: Systematic review with meta-analysis on the effects of radiofrequency on adipose tissue. The research was carried out using several databases and including experimental studies only in humans. The evaluation of the methodological quality of the articles was done based on the PEDro Scale. RESULTS: Twelve articles related with adipose tissue and cellulitis were included. There was a great variability of protocols, and the methodological quality was generally low and the methods most used for the evaluation of results were anthropometry, photography, and histopathology. Clinical results suggest a positive effect of radiofrequency on the reduction in adipose tissue, proving an increase in adipocyte lipolysis. After statistical analysis, it was verified that the anthropometry presented questionable results. CONCLUSION: The clinical results of the studies point to the positive effects of radiofrequency on the reduction in adipose tissue; however, the low methodological make this topic still debatable, requiring more controlled studies.

Effects of a Phase IV Home-Based Cardiac Rehabilitation Program on Cardiorespiratory Fitness and Physical Activity.

BACKGROUND: Cardiovascular diseases are the leading cause of death globally and sedentary lifestyle is one of the main risk factors. Home-based cardiac rehabilitation (CR) programs appear to be effective to improve exercise tolerance. The aim of the study, therefore, was to evaluate the effects of a phase IV (maintenance) home-based CR program on cardiorespiratory fitness and daily physical activity of patients recovering from an acute myocardial infarction. METHODS: This pilot study, with a sub-group randomised controlled trial, included 32 individuals recovering from a myocardial infarction, randomly divided into the experimental group (EG, n=16) and the control group (CG, n=16). The EG performed an exercise program, three times per week, at home during eight weeks. The two groups received health education sessions. Baseline and final assessments included cardiorespiratory fitness, resting and peak heart rate, blood pressure and rate pressure, heart rate recovery and daily physical activity. (ClinicalTrials.gov: NCT01887080). RESULTS: At baseline no significant differences were observed between groups. After eight weeks of exercise, the EG significantly increased peak oxygen uptake (p=0.02), test duration (p=0.019), peak rate pressure (p=0.003), peak heart rate (p=0.003) and heart rate recovery (0.025) when compared to the CG. No changes were observed on daily physical activity in both groups. CONCLUSION: This specific phase IV home-based exercise program seems to improve cardiorespiratory fitness, haemodynamics at peak exercise and heart rate recovery, an indicator of cardiac autonomic function.

Effects of the Mediterranean diet and exercise in subjects with coronary artery disease.

INTRODUCTION: The association of the Mediterranean diet and exercise appears to have a protective role, reducing cardiovascular risk. This study investigated the effects of education sessions on the Mediterranean diet and an exercise program in modifying eating behaviors, body composition and abdominal fat. METHODS: An experimental study was performed on 20 subjects with known coronary heart disease randomly assigned to experimental (n=10) and control (n=10) groups. Both groups received education sessions on the Mediterranean diet, but the experimental group also followed an eight-week program of specific exercises. A semiquantitative food frequency questionnaire was administered to analyze food intake, bioimpedance was used to measure weight, fat mass and lean mass, and waist circumference was measured to calculate waist-to-height ratio. RESULTS: After eight weeks, protein (p<0.05) and cholesterol (p<0.05) intake in the experimental group had decreased significantly compared with the control group. Between the beginning and end of the study, there were significant decreases in the control group in carbohydrate (p<0.05) and saturated fat intake (p<0.05). In both groups the percentage of total fat (p<0.05) and fat mass (p<0.05) was significantly decreased. In the experimental group the waist-to-height ratio was significantly reduced (p<0.05). CONCLUSION: The Mediterranean diet reduced carbohydrate and saturated fat intake, reflected in reduced fat mass. The association of the exercise program showed additional benefits in reduction of protein and cholesterol intake and abdominal fat.

Effects of aerobic exercise associated with abdominal microcurrent: a preliminary study.

OBJECTIVE: To analyze the short- and long-term effects of microcurrent used with aerobic exercise on abdominal fat (visceral and subcutaneous). METHODS: Forty-two female students from a university population were randomly assigned into five group: intervention group (IG) 1 (n=9), IG2 (n=9), IG3 (n=7), IG4 (n=8), and placebo group (PG) (n=9). An intervention program of 10 sessions encompassing microcurrent and aerobic exercise (performed with a cycloergometer) was applied in all groups, with slightly differences between them. In IG1 and IG2, microcurrent with transcutaneous electrodes was applied, with different frequency values; 30-minute exercise on the cycloergometer was subsequently performed. IG3 used the same protocol as IG1 but with different electrodes (percutaneous), while in IG4 the microcurrent was applied simultaneously with the cycloergometer exercise. Finally, the PG used the IG1 protocol but with the microcurrent device switched off. All groups were evaluated through ultrasound and abdominal perimeter measurement for visceral and subcutaneous abdominal fat assessment; through calipers for skinfolds measurement; through bioimpedance to evaluate weight, fat mass percentage, and muscular mass; and through blood analyses to measure cholesterol, triglyceride, and glucose levels. RESULTS: After intervention sessions, visceral fat decreased significantly in IG1 compared with the PG. Subcutaneous fat was reduced significantly in all groups compared with the PG. After 4 weeks, almost all results were maintained. CONCLUSION: The addition of microcurrent to aerobic exercise may reduce fat more than does aerobic exercise alone.

Efficacy of low-level laser therapy on scar tissue.

BACKGROUND: Physiotherapy has a very important role in the maintenance of the integumentary system integrity. There is very few evidence in humans. Nevertheless, there are some studies about tissue regeneration using low-level laser therapy (LLLT). AIM: To analyze the effectiveness of LLLT on scar tissue. METHODS: Seventeen volunteers were stratified by age of their scars, and then randomly assigned to an experimental group (EG) - n = 9 - and a placebo group (PG) - n = 8. Fifteen sessions were conducted to both the groups thrice a week. However, in the PG, the laser device was switched off. Scars' thickness, length, width, macroscopic aspect, pain threshold, pain perception, and itching were measured. RESULTS: After 5 weeks, there were no statistically significant differences in any variable between both the groups. However, analyzing independently each group, EG showed a significant improvement in macroscopic aspect (p = 0.003) using LLLT. Taking into account the scars' age, LLLT showed a tendency to decrease older scars' thickness in EG. CONCLUSION: The intervention with LLLT appears to have a positive effect on the macroscopic scars' appearance, and on old scars' thickness, in the studied sample. However, it cannot be said for sure that LLLT has influence on scar tissue.

Plaster body wrap: effects on abdominal fat.

BACKGROUND: Abdominal fat is associated with metabolic disorders, leading to cardiovascular risk factors and numerous diseases. This study aimed to analyze the effect of plaster body wrap in combination with aerobic exercise on abdominal fat. METHODS: Nineteen female volunteers were randomly divided into intervention group (IG; n = 10) performing aerobic exercise with plaster body wrap, and control group (CG; n = 9) performing only exercise. Subcutaneous and visceral fat were measured using ultrasound; subcutaneous fat was also estimated on analysis of skinfolds and abdominal perimeters. RESULTS: At the end of the 10-sessions protocol, the IG demonstrated a significant decrease (p ≤ 0.05) in subcutaneous fat at the left anterior superior iliac spine (ASIS) level and in iliac crest perimeter measurements. A large intervention effect size strength (0.80) was found in subcutaneous fat below the navel and a moderate effect size strength on the vertical abdominal skinfold (0.62) and the perimeter of the most prominent abdominal point (0.57). Comparing the initial and final data of each group, the IG showed a significant decrease in numerous variables including visceral and subcutaneous fat above and below the navel measured by ultrasound (p ≤ 0.05). CONCLUSION: Plaster body wrap in combination with aerobic exercise seems to be effective for abdominal fat reduction.