Validity of equations for estimating fat-free mass in people living with the human immunodeficiency virus.

BACKGROUND & AIMS: Equations estimating fat-free mass (FFM) in people living with the human immunodeficiency virus (HIV) show differences in the validation process. The current study aimed to verify the validity of FFM estimation equations derived from bioelectrical impedance (BIA) in people living with HIV aged 40 years and older. METHODS: A cross-sectional study was conducted with 68 participants evaluated using dual-energy X-ray absorptiometry (DXA) and by two BIA devices (Analyzer and Biodynamics). The study aimed to determine the validity of six different FFM equations from four different studies by Lukaski and Bolonchuk (1987), Kotler et al. (1996), Beraldo et al. (2015) and Hegelund et al. (2017). Comparisons were made using the t-test or Wilcoxon test. To verify the validity between DXA and two BIA devices, the following statistical analyses were performed: Lin's concordance correlation coefficient, intraclass correlation coefficient, coefficient of determination, standard error of the estimate, differences in the limits of agreement by Bland and Altman analysis, correlation between the average and the differences of the methods by Pearson or Spearman correlation. RESULTS: Only equation 2 of Kotler et al. (1996) for males by Biodynamics BIA showed no difference in FFM. The Lin's concordance correlation coefficient was excellent (0.96), irrespective of sex, for Equation 2 of Kotler et al. (1996) by BIA Analyzer. All equations were reproducible (>0.85). The coefficient of determination ranged from 68% to 92%, and the standard error of the estimates ranged from 1.8 kg to 5.0 kg. The differences between the limits of agreement ranged from 7.2 kg to 14.9 kg, and the correlations between the average and the differences of the methods showed differences in FFM for three equations (p < 0.01). CONCLUSION: The choice of equations must consider the equipment used and the sex of the sample investigated. Only Equation 2 of Kotler et al. (1996) was considered valid, irrespective of sex, to estimate the FFM by BIA Analyzer.

Effects of lipodystrophy and physical exercise on bioimpedance parameters in people living with HIV: A cross-sectional study.

OBJECTIVE: The aim of this study was to evaluate the effects of lipodystrophy and physical exercise on the parameters of bioimpedance spectroscopy (BIS) and bioimpedance vector analysis (BIVA) of people living with HIV (PLWHIV). METHODS: Seventy patients were divided into two groups: PLWHIV with lipodystrophy (PLWHIV-L) and PLWHIV without lipodystrophy (PLWHIV-NL). The phase angle (PhA) and the BIVA were determined from the values of resistance and reactance collected by the BIS. The percentage of fat mass and lean soft tissue (LST) were determined by dual-energy x-ray absorptiometry. For comparisons between the PLWHIV-L and PLWHIV-NL groups, the t test for independent samples or the Mann-Whitney test was used. From the BIVA, the average of the impedance vectors of the two groups was calculated with the 95% confidence ellipse, and the individual vectors of the patients divided by sex were also compared with the tolerance ellipses of 50%, 75%, and 95% of the healthy reference population. The relationships between the variables of interest were determined by the Pearson or Spearman correlation coefficient and the coefficient of determination. Analysis of covariance was used for comparisons between groups, adjusted for possible confounding variables. RESULTS: PLWIV-L showed better hydration conditions (P <0.01), higher LST (P <0.01), and lower percent of fat mass (P <0.01). No differences in PhA were observed between PLWHIV who practiced or did not practice physical exercise. There was a significant difference between the impedance vectors of the groups with and without lipodystrophy (T = 42.4 and P <0.01). Additionally, most of the patients who were positioned beyond the ellipse limits of 50% of tolerance fell into the areas of edema and cachexia. The extracellular to intracellular water ratio explained 81% of the PhA variations. When PhA was adjusted for height2, fat mass/height2 and LST, it was significantly different between groups of the female sex (PhA: P <0.01). CONCLUSION: Lipodystrophy and the practice of physical exercise do not present direct involvement in the PhA values, with sex, body composition, and hydration variables being the main influences on this variable. BIVA was able to show differences in the body composition of the groups even when the PhA values were similar.

The effectiveness of high-intensity interval training on body composition of rodent models of obesity: A systematic review and meta-analysis.

The present systematic review was compiled to analyze the effectiveness of High-intensity interval training (HIIT) protocols on the body composition of rodents with obesity. Databases were searched until February 2021 for experimental trials in rodents with a minimum duration of four weeks of HIIT and endpoints associated with obesity. The data were analyzed by meta-analysis performed for comparisons of body composition. Sensitivity analysis was performed to investigate the consistency of individual researches. Of all of the 524 studies found, only 14 were included. The analysis showed a significant reduction in body weight ([CI 95%: -8.35; -1.98] P ≤ 0.01), adiposity index ([IC 95%: -1.04; -0.80] P ≤ 0.01), and fat pads ([IC 95%: -0.59; -0.06] P ≤ 0.01). HIIT performed on treadmill or water was effective to reduce body weight (P < 0.05). In conclusion, HIIT attenuated both body weight and adiposity induced either by HFD (high-fat diet) or by GOM (genetic obese model), thereby inducing positive changes in body composition.

Effects of Concurrent Training on 1RM and VO2 in Adults: Systematic Review with Meta-analysis.

The purpose of this systematic review was to analyze the effects of concurrent training on one repetition maximum (1RM), maximum oxygen consumption (VO2max), and peak oxygen consumption (VO2peak) in healthy adults. The review followed PRISMA recommendations using randomized controlled trials in nine databases. Twenty-one studies met the inclusion criteria, totaling a sample of 796 subjects to perform the meta-analysis. As result, concurrent training provides similar increases in 1RM as strength training for upper limbs (standardized mean difference [SMD]: 0.12; 95% IC: [-0.18; 0.41]; p=0.43) and for the lower limbs (SMD: -0.32; 95% IC: [-0.79; 0.15]; p=0.19). Similarly, no difference was found in the aerobic capacity between the concurrent training vs. aerobic training groups ([SMD - VO2max]: -0.19; 95% IC: [-0.71; 0.33]; p=0.48 and [SMD - VO2peak]: -0.24; 95% IC: [-0.57; 0.08]; p=0.14). Based on the results found, we can affirm that a) similar to strength training, concurrent training provides maximum strength development for upper and lower limbs; and b) cardiorespiratory capacity is not impaired by concurrent training in relation to aerobic training, demonstrating the compatibility of the two training sessions.

Effects of functional training on pain and functional capacity in elderly women / Efeito do treinamento funcional na dor e capacidade funcional de mulheres idosas

Abstract Introduction: The growing rate of elderly people in the world can became a public health problem when they exhibit insufficient levels of physical activity, which can increase chronic pain and lead to functional disability. Objective: To analyze the effects of functional training on pain and functional capacity in elderly women. Methods: A non-randomized controlled clinical trial was conducted with 32 elderly women, divided into two groups: functional training (FT: n = 17) and control group (CG: n = 15). Functional capacity was analyzed using the Physical Fitness Test for the Elderly. Pain was assessed by reports of musculoskeletal discomfort symptoms and their characteristics using the Nordic Musculoskeletal Pain Questionnaire and pain visual analog scale (VAS). The functional training program was applied for 12 weeks at a frequency of three times a week. Results: Significant effects after the intervention in the FT group were observed, with pain reduction, increased flexibility and resistance for lower limbs, and cardiorespiratory capacity (p < 0.05). Conclusion: The functional training program in elderly women was effective in improving the variables of lower limb flexibility, pain perception, lower limb strength resistance and cardiorespiratory capacity.

Resumo Introdução: O crescimento da taxa de idosos no mundo pode tornar-se um problema de saúde pública quando estes exibem níveis insuficientes de atividade física, que têm o potencial de aumentar dores crônicas e causar incapacidade funcional. Objetivo: Analisar os efeitos do treinamento funcional na dor e capacidade funcional de mulheres idosas. Métodos: Desenvolveu-se um ensaio clínico controlado não randomizado com 32 idosas, divididas em dois grupos: treino funcional (TF: n = 17) e grupo controle (GC: n = 15). Como indicador da capacidade funcional foi utilizado o Teste de Aptidão Física para Idosos. A dor foi avaliada pelos relatos de sintomas de desconforto musculoesquelético e suas características por meio do Questionário Nórdico de Sintomas Osteomusculares de Dor e Escala visual Analógica de Dor (EVA). O programa de treinamento funcional foi aplicado por 12 semanas em uma frequên-cia de três vezes semanais. Resultados: Verificaram-se efeitos significativos após a intervenção no grupo TF, com redução da dor e aumento da flexibilidade e resistência para membros inferiores e capacidade cardiorrespiratória (p < 0,05). Conclusão: O programa de treinamento funcional em idosas foi efetivo para a melhoria das variáveis de flexibilidade de membros inferiores, percepção de dor, resistência de força de membros inferiores e capacidade cardiorrespiratória.

Combined Exercise Modulates Cortisol, Testosterone, and Immunoglobulin A Levels in Individuals Living With HIV/AIDS.

BACKGROUND: Combined exercise (CE) has been recommended for individuals living with HIV/AIDS (ILWHA) under antiretroviral therapy. However, depending on the intensity and duration, physical exercise may occasionally increase inflammatory parameters and reduce immunological responses that if not reversed, cause health injury specifically in this population. Information about immunological and hormonal responses after CE in ILWHA has not been completely elucidated. Therefore, the aim is to verify the acute effects of CE on cortisol, testosterone, immunoglobulin A, and pro-inflammatory and anti-inflammatory cytokines over 24 hours in ILWHA. METHODS: Noninfected individuals and ILWHA undergone 5 sessions of CE prior to the acute assessment session. Seventy-two hours after the last session, the subjects were submitted to one session of CE (aerobic exercise: 25 min at 60-70% reserve heart rate and resistance exercise: 3 sets of 15 maximum repetitions of 6 exercises). Saliva samples were collected before, immediately, 6 and 24 hours after CE. RESULTS: CE reduced cortisol (6 h: 2.54 [0.58] vs 0.65 [0.22] pg·mL-1; P = .02), increased testosterone (all moments) and immunoglobulin A levels (24 h: 255.3 [44.7] vs 349.2 [41.9] µm·mL-1; P = .01) without significant difference in cytokines levels in ILWHA. CONCLUSION: CE modulates cortisol, testosterone, and immunoglobulin A levels without the change in immunological parameters in ILWHA.

Atividade física e indicadores de saúde em pessoas vivendo com HIV/aids / Physical activity and health indicators in people living with HIV/aids

INTRODUÇÃO: O estilo de vida ativo pode contribuir de forma expressiva em pessoas vivendo com HIV/aids auxiliando na melhoria das capacidades físicas e combate aos efeitos adversos da medicação. OBJETIVO: Analisar a associação entre atividade física e fatores sociodemográficos e de saúde em pessoas vivendo com HIV/aids do município de Ourinhos-SP. MÉTODOS: Foram entrevistados pacientes em tratamento no Serviço de Atendimento Especializado em Doenças Infecciosas (SAEDI). A atividade física habitual e seus domínios foram avaliados mediante o questionário de Baecke, além disso, os prontuários dos pacientes foram acessados para coleta de dados adicionais de saúde. RESULTADOS: Como principais resultados, observou-se baixos níveis de atividade física de lazer na população investigada (21,0%). Modelos de regressão de Poisson ajustados por fatores de confundimento identificaram associação entre atividade física ocupacional e maior classe social (RP: 3,32; IC95%: 1,34-8,25); atividades físicas de lazer e locomoção e maior pressão arterial diastólica (PAD) (RP: 3,17; IC95%: 1,43-7,07); atividade física habitual e tempo de diagnóstico superior a 150 meses (RP: 3,18; IC95%: 1,16-8,72) e maior prevalência de exercícios físicos no lazer associou-se a maior classe social (RP: 2,86; IC95%: 1,11-7,36). CONCLUSÃO: Pessoas vivendo com HIV/aids em tratamento na região de Ourinhos apresentam baixos níveis de atividade física. Além disso, classe social, tempo de diagnóstico e PAD apresentaram relações com atividade física.

INTRODUCTION: An active lifestyle may contribute significantly to people living with HIV/aids by improving physical abilities and reducing the adverse effects of medications. OBJECTIVE: To analyze the association between physical activity and sociodemographic and health factors in people living with HIV/aids in the municipality of Ourinhos-SP. METHODS: Patients undergoing treatment were interviewed at the Specialized Infectious Diseases Care Service. Habitual physical activity and its domains were evaluated using the Baecke questionnaire and patients' charts were consulted for additional health data. RESULTS: The proportion of individuals undertaking leisure physical activity in our sample was low (21%). Poisson regression models, adjusted for confounding factors, identified associations between occupational physical activity and higher social class (PR: 3.32; 95% CI: 1.34-8.25); between leisure physical activity and locomotion and higher diastolic blood pressure (DBP) (PR: 3.17; 95% CI: 1.43-7.07); and between habitual physical activity and duration of diagnosis >150 months (PR: 3.18; 95% CI: 1.16-8.72) and higher prevalence of leisure physical activities was associated with higher social class (PR: 2.86, 95% CI: 1.11-7.36). CONCLUSION: People living with HIV/aids and undergoing treatment in the Ourinhos region have low levels of physical activity. Furthermore, social class, duration of diagnosis and DBP were found to be associated with physical activity.

Adesão e aderência a um programa de exercício físico em pessoas vivendo com HIV/AIDS / Adherence to a physical exercise program in people living with HIV/AIDS

O objetivo do estudo foi identificar barreiras percebidas à prática de atividade física antes e após participarem de um programa de exercícios físicos (EF), bem como aspectos ligados à adesão e a aderência à este programa, em pessoas vivendo com HIV/aids, especificamente: motivos referidos para faltas as sessões, número de desistências ao longo do programa, continuidade de prática após seis meses ao término do programa e motivos para eventuais não continuidades. Dezenove sujeitos participaram de 14 semanas de um programa de EF. Foram coletadas informações sobre barreiras percebidas para a prática de atividade física, os motivos de faltas ou desistência e a continuidade após seis meses ao término do programa. Para análise dos dados utilizou-se estatística descritiva, o teste de McNemar para verificar as diferenças nas frequências de cada barreira, e de Wilcoxon para comparar o número médio de barreiras no momento pré e pós programa. A média de assiduidade às sessões foi de 58,5% e os principais motivos relatados para as faltas foram "problemas de saúde" e "compromissos pessoais". Cerca de 40% das pessoas que iniciaram o programa não chegaram até o final do mesmo. A maior parte das desistências aconteceu entre a 11ª e a 20ª sessão. Não houve diferenças significativas nas barreiras referidas pré e pós programa, nem no número médio de barreiras. Somente 21% dos sujeitos referiram estar praticando EF após seis meses. Programas de EF devem considerar estes acha-dos e buscar elaborar ações mais sustentáveis e de maior impacto a longo prazo na saúde dos sujeitos.

The objective of the study was to evaluate, in people living with HIV/AIDS, perceived barriers to physical activity practice before and after participating in a physical exercise (PE) program, as well as aspects related to adherence to the program, specifically: reasons given for absence from sessions, number of with drawals during the program, continuity of practice six months after the end of the program, and reasons for eventual non-continuity. Nineteen subjects participated in a 14-week PE program. Information was collected on perceived barriers to physical activity, reasons for absences or withdrawal, and continuity six months after the end of the program. Descriptive statistics were used for analysis of the data, the Mc Nemar test to verify the differences in the frequencies of each barrier, and the Wilcoxon test to compare the mean number of barri-ers pre- and post-program. The average at tendance at the sessions was 58.5% and the main reasons reported for absences were "health problems" and "personal commitments". About 40% of the people who started the program did not continue to the end of the program. The majority of dropouts occurred between the 11th and 20th sessions. There were no significant differences in the pre- and post- barriers reported, or in the mean number of barriers. Only 21% of the subjects reported racticing PE six months after the program. PE programs should consider these findings and seek to develop more sustainable actions with a greater long-term impact on the health of the subjects.

Effect of combined training on body composition and metabolic variables in people living with HIV: A randomized clinical trial.

PURPOSE: The aim of this study was to conduct a randomized clinical trial to assess the effects of 16 weeks of combined training on body composition, lipid profile, adiponectin, C-reactive protein (CRP), and leptin levels in people living with HIV/AIDS (PLWHA). METHODS: Fifty-eight HIV-infected individuals were randomized into a training group (T) or a control group (C). Combined training consisted of aerobic and resistance exercises performed at the same training session, applied at a frequency of three times a week for a total of 16 weeks. Waist circumference, body mass, body fat percentage (%fat), fat mass, lipid profile, adiponectin, CRP, and leptin levels were measured pre- and post-training in both groups. RESULTS: Sixteen weeks of combined training decreased (P < 0.05) body fat in different body segments in PLWHA. Lipodystrophic PLWHA experienced greater reduction in body fat in the android region than non-lipodystrophic PLWHA after combined training. Lipid profile and circulating levels of adiponectin, leptin, and CRP remained unchanged. CONCLUSIONS: Sixteen weeks of combined training was effective to reduce body fat in different body segments, without altering plasma lipid and cytokine levels.

Peak Velocity as an Alternative Method for Training Prescription in Mice.

Purpose: To compare the efficiency of an aerobic physical training program prescribed according to either velocity associated with maximum oxygen uptake (vVO2max) or peak running speed obtained during an incremental treadmill test (Vpeak_K) in mice. Methods: Twenty male Swiss mice, 60 days old, were randomly divided into two groups with 10 animals each: 1. group trained by vVO2max (GVO2), 2. group trained by Vpeak_K (GVP). After the adaptation training period, an incremental test was performed at the beginning of each week to adjust training load and to determine the amount of VO2 and VCO2 fluxes consumed, energy expenditure (EE) and run distance during the incremental test. Mice were submitted to 4 weeks of aerobic exercise training of moderate intensity (velocity referring to 70% of vVO2max and Vpeak_K) in a programmable treadmill. The sessions lasted from 30 to 40 min in the first week, to reach 60 min in the fourth week, in order to provide the mice with a moderate intensity exercise, totaling 20 training sessions. Results: Mice demonstrated increases in VO2max (ml·kg-1·min-1) (GVO2 = 49.1% and GVP = 56.2%), Vpeak_K (cm·s-1) (GVO2 = 50.9% and GVP = 22.3%), EE (ml·kg-0,75·min-1) (GVO2 = 39.9% and GVP = 51.5%), and run distance (cm) (GVO2 = 43.5% and GVP = 33.4%), after 4 weeks of aerobic training (time effect, P < 0.05); there were no differences between the groups. Conclusions: Vpeak_K, as well as vVO2max, can be adopted as an alternative test to determine the performance and correct prescription of systemized aerobic protocol training to mice.

Aerobic exercise training performed by parents reduces mice offspring adiposity.

The present study aimed to determine the effects of physical training performed by parents on mice offspring adiposity. Male and female parents underwent an aerobic training protocol for 7 weeks. The trained and sedentary parents were allowed to mate and the resultant offspring divided in: S (Offspring from Sedentary Parents), T (Offspring from Trained Parents), ST (Offspring from Sedentary Father and Trained Mother) and TS (Offspring from Trained Father and Sedentary Mother). After weaning, offspring was euthanized, blood collected and samples of mesenteric and inguinal fat pads used to isolate adipocytes for morphologic and histological analyses. Lee index, mesenteric fat pad, sum of visceral fat and total fat weight of female T was reduced in comparison to the other groups (p < 0.05). Periepididymal and sum of visceral fat in male T group was also reduced when compared to the other groups (p < 0.05). The diameter of mesenteric and inguinal adipocytes of T group was smaller compared to all groups comparisons for both sexes (p < 0.05). In summary, exercise training performed by parents reduced visceral offspring adiposity, the diameter of subcutaneous adipocytes and improved metabolic parameters associated to metabolic syndrome.

Exercise improves cytokine profile in HIV-infected people: A randomized clinical trial.

PURPOSE: Verify the effects of concurrent training on cytokines in people living with HIV under antiretroviral therapy (ART) treatment. METHODS: This was a blinded, parallel-group, clinical trial, where 49 participants, divided in two groups, either control group or concurrent training group, took part in the intervention. The control group performed recreational activities and concurrent training group participated of 16-week, 3 times per week of heart rate guided-aerobic plus resistance training for major muscular groups. Cytokines (interleukins 4, 5, 6, 8, 10, tumor necrosis factor-α, interferon-γ, and granulocyte-macrophage colony-stimulating factor) were measured before and after 16-week experimental period using flow cytometry. RESULTS: From 49 participants who took part in the intervention, 28 completed the program and had data analyzed. There was a significant interaction for IL-8, which increased for control group: 7.1±5.1 vs. 8.1±6.0 and a decrease for concurrent training: 8.0±4.4 vs. 5.4±2.3. In addition, magnitude-based inference showed a likely beneficial effect for the training group when compared to the control group for IL-8, IL-5, and IL-10. The difference perceptual: mean and [CI 90%] between delta of difference within groups was -43.1 [-64.0 to -10.0] and -6.6 [-14.7 to 2.3], respectively. CONCLUSION: Short-term exercise is able to decrease the levels of IL-5, IL-8, and IL-10 in HIV-infected people undergoing ART.

RESPOSTAS AGUDAS DO EXERCÍCIO FÍSICO EM PESSOAS INFECTADAS PELO HIV: UMA REVISÃO SISTEMÁTICA / ACUTE RESPONSES OF PHYSICAL EXERCISE IN PEOPLE INFECTED BY HIV: A SYSTEMATIC REVIEW / RESPUESTAS AGUDAS AL EJERCICIO FÍSICO EN PERSONAS INFECTADAS POR EL VIH: UNA REVISIÓN SISTEMÁTICA

RESUMO O treinamento físico é uma estratégia importante para a saúde de pessoas que vivem com HIV/AIDS; contudo, suas respostas a curto prazo ainda não foram amplamente estudadas, o que limita o entendimento dos efeitos e da segurança da prescrição do treinamento para essa população. Portanto, objetivou-se revisar sistematicamente as respostas agudas decorrentes do exercício físico em pessoas com HIV sobre variáveis fisiológicas e imunológicas. Para isso, foi realizada uma revisão sistemática a partir de trabalhos indexados nas seguintes bases de dados: Medline, Lilacs, Scielo, Web of Science e Science Direct. Os descritores utilizados foram: acquired immunodeficiency syndrome, HIV, AIDS, seropositive, acute session, short, physical activity, exercise, training. As buscas foram realizadas em fevereiro de 2015 e atualizadas em dezembro de 2015 e foram conduzidas sem restrição de datas de publicação ou idioma específico. Foram incluídos para esta revisão artigos que avaliaram as respostas agudas decorrentes de algum modelo de prescrição de treinamento físico envolvendo exercícios aeróbicos, com pesos ou combinados (exercícios aeróbicos e com pesos) relacionados com variáveis fisiológicas e imunológicas em pessoas infectadas pelo HIV. Foram encontrados 2.422 títulos, dos quais, após exclusão das duplicatas e a aplicação dos critérios de elegibilidade, foram selecionados sete artigos para síntese qualitativa. De acordo com os resultados reportados pelos estudos há evidências de que, imediatamente após a realização do exercício físico, ocorre um aumento do número de células circulantes, incluindo leucócitos totais, neutrófilos, monócitos e linfócitos T CD8+ em pessoas infectadas pelo HIV. Além disso, também se observaram alterações significantes nas concentrações de lactato, triglicerídeos, epinefrina e norepinefrina imediatamente após a realização do treinamento aeróbico, independentemente do uso de TARV e/ou de hiperlactatemia. No entanto, não há evidências suficientes para afirmar que o treinamento físico seja totalmente seguro e eficaz para esta população.

ABSTRACT Physical training is an important strategy for the health of people living with HIV/aids; however, its short-term responses have not yet been extensively studied, which limits the understanding of the effects and safety training prescription for this population. Therefore, we aimed to systematically review the acute responses resulting from physical exercise in people with HIV on physiological and immunological variables. For this, a systematic review was carried out from works indexed in the following databases: Medline, Lilacs, Scielo, Web of Science and Science Direct. The keywords used were acquired immunodeficiency syndrome, HIV, AIDS, seropositive, acute session, short, physical activity, exercise, training. The searches were conducted in February 2015 and updated in December 2015 and were conducted without restriction of publication dates or specific language. We included for this review articles that evaluated the acute responses derived from some model of prescription of physical training involving aerobic, weight or combined exercises (aerobic and weight exercises) related to physiological and immunological variables in HIV infected individuals. We found 2,422 titles of which, after exclusion of the duplicates and the application of the eligibility criteria, seven articles were selected for qualitative synthesis. According to the results reported by the studies, there is evidence that immediately after physical exercise an increase in the number of circulating cells occurs, including total leukocytes, neutrophils, monocytes and T CD8+ lymphocytes in HIV-infected people. Furthermore, significant changes in the concentrations of lactate, triglycerides, epinephrine and norepinephrine were also observed immediately after aerobic training regardless the use of HAART and/or hyperlactatemia. However, there is insufficient evidence to state that physical training is totally safe and effective for this population.

RESUMEN El entrenamiento físico es una estrategia importante para la salud de las personas que viven con el VIH/SIDA. Sin embargo, sus respuestas a corto plazo no han sido ampliamente estudiadas, lo que limita la comprensión de los efectos y la seguridad de la prescripción de entrenamiento para esta población. Por lo tanto, el objetivo fue revisar sistemáticamente las respuestas agudas al ejercicio en personas con VIH en las variables fisiológicas e inmunológicas. Para esto, se realizó una revisión sistemática de artículos indexados en las siguientes bases de datos: Medline, Lilacs, Scielo, Web of Science y Science Direct. Los descriptores utilizados fueron: acquired immunodeficiency syndrome, HIV, AIDS, seropositive, acute session, short, physical activity, exercise, training. Las búsquedas se realizaron en febrero de 2015 y fueron actualizadas en diciembre de 2015, siendo llevadas a cabo sin restricciones de fecha de publicación o idioma específico. Se seleccionaran en esta revisión los artículos que evaluaron las respuestas agudas de algún modelo de entrenamiento físico que implica la prescripción de ejercicios aeróbicos, con pesas o combinados (práctica de ejercicio aeróbico y pesas) relacionadas con variables fisiológicas e inmunológicas en las personas con VIH. Se encontraron 2.422 títulos, de los cuales, después de la exclusión de duplicados y la aplicación de los criterios de elegibilidad, se seleccionaron siete artículos para síntesis cualitativa. De acuerdo con los resultados reportados por estudios hay pruebas de que inmediatamente después del ejercicio hay un aumento en el número de células circulantes, incluyendo leucocitos totales, neutrófilos, monocitos y linfocitos T CD8+ en individuos infectados por el VIH. Además, se observaron cambios significativos en las concentraciones de lactato, triglicéridos, epinefrina y norepinefrina inmediatamente después del entrenamiento aeróbico, independientemente del uso de HAART y/o hiperlactatemia. Sin embargo, no hay pruebas suficientes para afirmar que el entrenamiento físico es completamente seguro y eficaz para esta población.

Effects of physical training for people with HIV-associated lipodystrophy syndrome: a systematic review.

INTRODUCTION: Human immunodeficiency virus-associated lipodystrophy syndrome (HALS) is a major problem among people living with HIV/aids. The exercise training has been used for its treatment; however, the knowledge about benefits and safety still is emerging. The aim was systematically review the literature for physiological, metabolic, immunologic, and morphologic adaptations to aerobic, resistance, and concurrent training in people living with HALS. EVIDENCE ACQUISITION: A search of the Medline, Embase, Cinahl, Lilacs, Scielo, Web of Science, the Cochrane Controlled Trials Register Library and PEDro was performed. The study selection was performed by two blinded researchers follow screening of titles, abstracts, and full-text articles. Therefore, only randomised clinical trials, which investigated the effects of physical training in people with HALS, were included in the present review. The risk of bias was assessed using a Jadad's scale. EVIDENCE SYNTHESIS: From the electronic and manual searches, 332 studies were selected by title, 139 abstracts were read and 95 were excluded, leaving 44 studies, which were read in full. After full text examination only five studies were included in the qualitative analyses. The limitations were: heterogeneity in training prescription, nutritional recommendations, and diagnosis of lipodystrophy, small sample size, utilization of methods with questionable validity for assessments. CONCLUSIONS: There is no effect of physical training on CD4 cell count. In addition, aerobic and concurrent training improve VO2max, likewise resistance and concurrent training improve muscular strength.

Effects of 16 Weeks of Concurrent Training on Resting Heart Rate Variability and Cardiorespiratory Fitness in People Living With HIV/AIDS Using Antiretroviral Therapy: A Randomized Clinical Trial.

Pedro, RE, Guariglia, DA, Okuno, NM, Deminice, R, Peres, SB, and Moraes, SMF. Effects of 16 weeks of concurrent training on resting heart rate variability and cardiorespiratory fitness in people living with HIV/AIDS using antiretroviral therapy: a randomized clinical trial. J Strength Cond Res 30(12): 3494-3502, 2016-The study evaluated the effects of concurrent training on resting heart rate variability (HRVrest) and cardiorespiratory fitness in people living with HIV/AIDS undergoing antiretroviral therapy (ART). Fifty-eight participants were randomized into 2 groups (control and training group); however, only 33 were analyzed. The variables studied were HRVrest indices, submaximal values of oxygen uptake (V[Combining Dot Above]O2sub) and heart rate (HR5min), peak speed (Vpeak), and peak oxygen uptake (V[Combining Dot Above]O2peak). The training group performed concurrent training (15-20 minutes of aerobic exercise plus 40 minutes of resistance exercise), 3 times per week, for 16 weeks. Posttraining V[Combining Dot Above]O2peak and Vpeak increased, and HR5min decreased. Resting heart rate variability indices did not present statistical differences posttraining; however, the magnitude-based inferences demonstrated a "possibly positive effect" for high frequency (HF) and low frequency (LF) plus high frequency (LF + HF) and a "likely positive effect" for R-Rmean posttraining. In conclusion, concurrent training was effective at improving cardiorespiratory fitness and endurance performance. Moreover, it led to probably a positive effect on HF and a likely positive effect on R-Rmean in people living with HIV/AIDS undergoing ART.

Effect of Two- Versus Three-Way Split Resistance Training Routines on Body Composition and Muscular Strength in Bodybuilders: A Pilot Study.

The purpose of this study was to compare different split resistance training routines on body composition and muscular strength in elite bodybuilders. Ten male bodybuilders (26.7 ± 2.7 years, 85.3 ± 10.4 kg) were randomly assigned into one of two resistance training groups: 4 and 6 times per week (G4× and G6×, respectively), in which the individuals trained for 4 weeks, 4 sets for each exercise performing 6-12 repetitions maximum (RM) in a pyramid fashion. Body composition was assessed by dual energy X-ray absorptiometry, muscle strength was evaluated by 1RM bench-press testing. The food intake was planned by nutritionists and offered individually throughout the duration of the experiment. Significant increases (p < .05) in fat-free mass (G4× = +4.2%, G6× = +3.5%) and muscular strength (G4× = +8.4%, G6× = +11.4%) with no group by time interaction were observed. We conclude that 4 and 6 weekly sessions frequencies of resistance training promote similar increases in fat-free mass and muscular strength in elite bodybuilders.

Comparação de instrumentos de avaliação da flexibilidade da coluna cervical em mulheres universitárias / Comparison of instruments for spinal cord range of motion assessment in college women

O objetivo do presente estudo foi analisar a concordância de três instrumentos de medidas de amplitude da coluna cervical. A amostra foi constituída por quarenta e uma mulheres universitárias (20,8 ± 2,2 anos, 1,78 ± 0,07 m, 57,1 ±11,3 kg) as quais foram avaliadas pelos diferentes instrumentos de medida (inclinômetro marca Lafayette, flexímetro marca Sanny e flexímetro marca Code) nos movimentos de flexão e extensão da coluna cervical. Todas as medidas foram realizadas no período da manhã, por um único avaliador experiente e familiarizado com os procedimentos de coleta e a ordem de medida foi idêntica para todas as participantes. Não houve diferenças significantes na extensão da coluna cervical entre os três instrumentos, com valores de concordância próximos de zero (-0,04 < d < 0,31), todavia, com coeficientes de determinação baixos (0,64 < R2 < 0,71). O movimento de flexão da coluna cervical, embora com valores de concordância também próximos de zero (-0,2 < d < -1,6), apresentou diferenças significantes entre os instrumentos (Inclinômetro vs Flexímetros Code e Sanny), com coeficientes de determinação mais baixos (0,01 < R2 < 0,41). Concluímos que os instrumentos apresentam diferença nos escores produzidos, especificamente, em relação ao movimento de flexão da coluna cervical de mulheres universitárias. Em casos de aplicação clínica, qualquer um dos instrumentos pode ser empregado para avaliação. Entretanto, para a flexão da coluna cervical, deve haver certa cautela quanto à escolha do instrumento, tendo em vista a diferença existente entre os escores produzidos.

The purpose of the present study was to compare and analyze the agreement of three equipments of cervical spine range of motion assessment. The sample was composed by forty-one college women (20.8 ± 2.2 years, 1.78 ± 0.07 m, 57.1 ±11.3 kg), who were evaluated by the different equipments (Lafayette inclinometer, Sanny and Code fleximeters) in flexion and extension of cervical spine. All the measures were performed in the morning period, by an experienced technician and conversant with the data procedures, and the measurement order was identical for all the participants. There were no significant differences among scores produced by the three instruments for extension (median=63 degrees; p = 0.95), with concordance scores around zero (-0,04 < d < 0,31), however, with low determination and explanation coefficients (0,64 < R2 < 0,71). For the flexion of cervical spine, although with concordance scores around zero (-0,2 < d < -1,6), there were significant differences between the equipments (Inclinometer vs Fleximeters (Code and Sanny). We concluded that the equipments present differences over the scores, specifically on the flexion of cervical spine in college women.

Comparação e concordância de instrumentos de avaliação da amplitude de movimento da coluna cervical de homens universitários / Comparison of methods for assessing cervical range of motion in college men

O objetivo deste estudo é comparar e analisar a concordância de três instrumentos de medidas (inclinômetro marca Lafayette, flexímetro marca Sanny e flexímetro marca Code) nos movimentos de flexão e extensão da coluna cervical. A amostra foi composta por 41 homens universitários (20,8 ± 2,2 anos, 1,78 ± 0,07 m, 57,1 ±11,3 kg). Para a análise dos dados, utilizaram-se ANOVA one-way, concordância de Bland e Atlman, análise de regressão múltipla, correlação de Spearman, adotando-se uma significância de 5%. Não houve diferenças significantes entre os valores de amplitude de movimento avaliados pelos diferentes instrumentos para a flexão (mediana=63 graus; P=0,95) e extensão da coluna cervical (mediana=73 graus; P=0,90). Para todos os instrumentos, foram observados valores de concordância, entre as análises, próximos de zero (-0,34< < 0,26). Conclui-se que os valores de amplitude de movimento não diferem entre os instrumentos, possibilitando a comparação de medidas realizadas por eles, especificamente para universitários do sexo masculino.

The purpose of the present study was to compare and analyze the concordance of three instruments (Inclinometer Lafayette, fleximeter Sanny, and fleximeter Code) in flexion and extension of cervical spine. The sample was composed by forty-one college men (20.8 ± 2.2 years, 1.78 ± 0.07 m, 57.1 ±11.3 kg). For statistical analyses ANOVA one-way, Bland and Atlman procedures, multiple regression analysis, and Spearman correlation coefficient were employed, with P< 0.05. According to the results, there were no significant differences among scores produced by the three instruments for flexion (median=63 degrees; P=0.95) and extension of cervical spine (median=73degrees; P=0.90), and concordance scores, between the analyzes, near zero (-0.34< < 0.26). The results of this study indicate that the fleximeter Code, fleximeter Sanny, and inclinometer Lafayette measurement values are consistent, which allows comparisons between themselves and using similar cutoffs, specifically for healthy male college students, in flexion and extension of cervical spine, specifically for college men.

Barreiras pessoais para prática de atividade física percebidas por portadores de AIDS / Personal barriers to physical activity perceived by patients with

O propósito deste estudo foi analisar a prevalência de barreiras pessoais para a prática de atividade física percebidas em portadores de AIDS. Trinta e cinco sujeitos de ambos os gêneros participaram voluntariamente deste estudo. Três questionários foram aplicados na seguinte sequência: a) barreiras pessoais percebidas para prática de atividade física; b) nível de atividade física habitual e c) socioeconômico. A prevalência de prática de atividade física adequada nas horas de lazer (≥ 150 min/sem) foi de 23,5%. As principais barreiras pessoais percebidas para prática de atividade física identificadas foram: (1) preguiça ou cansaço (48,6%); (2) falta de companhia (45,7%); (3) possuir lesão ou doença (37,2%) e (4) falta de dinheiro e medo de se machucar (34,3%, para ambas). Os resultados sugerem que a principal barreira pessoal percebida para prática de atividade física relatada pelos participantes guarda relação com os efeitos colaterais da medicação antirretroviral utilizada para o controle da AIDS.

The purpose of this study was to analyze the prevalence of personal barriers to physical activity perceived by patients with AIDS. Thirty-five subjects, both genders, voluntarily participated in this study. Three questionnaires were applied in the following sequence: a) perceived personal barriers to physical activity, b) the level of habitual physical activity, and c) Socioeconomic. The prevalence of adequate physical activity during leisure time (≥ 150 min / week) was 23.5%. The main personal barriers perceived to physical activity were: (1) laziness or fatigue (48.6%), (2) lack of company (45.7%), (3) injury or illness (37.2 %), (4) lack of money and fear of injury (34.3% for both). The results suggest that the main barrier perceived by participants to personal physical activity is related to the side effects of antiretroviral drugs used to control AIDS.

Níveis de atividade física e alterações metabólicas em pessoas vivendo com HIV/AIDS / Levels of physical activity and metabolic alterations in people living with HIV /AIDS

Com a introdução da highly active antiretroviral therapy (HAART) - terapia antirretroviral fortemente ativa - o curso da infecção pelo HIV sofreu profundas modificações; ocorreu aumento da sobrevida e melhora na qualidade de vida, com restauração parcial do sistema imune. Após cerca de 10 anos do uso da HAART, começaram a aparecer os efeitos da combinação tratamento/vírus. Estes incluem alterações no metabolismo dos lipídios com hipertrigliceridemia, hipercolesterolemia, resistência insulínica, hiperglicemia e redistribuição da gordura corporal que são fatores de risco para doença cardiovascular. Estudos observacionais em pessoas vivendo com HIV/AIDS mostram que o indivíduo, ao se descobrir portador da doença, acaba sentindo medo ou vergonha, reduzindo o círculo social, atividades de trabalho e lazer, e se isolando em casa ou em pequenos grupos os quais tenham em comum a identidade de portadores HIV/AIDS. O objetivo deste trabalho foi avaliar a relação entre o nível de atividade física habitual e de lazer de pessoas vivendo com HIV/AIDS e sua relação com alterações metabólicas. Os pacientes foram classificados em sedentários e ativos, utilizando o questionário de atividade física habitual proposto por Baecke e validado para pacientes HIV/AIDS. Para classificação utilizou-se as recomendações do Colégio Americano de Medicina do Esporte. O metabolismo foi avaliado por meio das dosagens de glicemia de jejum, colesterol total, HDL-colesterol, LDL-colesterol e triglicérides, utilizando-se kits comerciais. A amostra foi composta por 65 pacientes HIV que utilizavam terapia HAART há pelo menos cinco anos. Foram classificados 64,6% como sedentários e 35,4% ativos. O estudo mostra uma relação direta entre nível de atividade física e melhores níveis de HDL-colesterol em pacientes HIV/AIDS. O HDL-colesterol é uma lipoproteína de proteção cardiovascular e, embora outros parâmetros avaliados não tenham mostrado diferença, estes resultados apontam a necessidade de estudos adicionais sobre fatores de risco e atividade física para pacientes HIV/AIDS, possibilitando propostas de intervenções específicas para esses pacientes.

The introduction of Highly Active Antiretroviral Therapy (HAART) - antiretroviral therapy highly active has deeply changed the course of HIV infection with increase in survival and improvement in quality of life as well as partial restoration of the immune system. After about ten years from the HAART use, the effects of combination treatment / virus started to come out. Among these, we can mention changes in lipid metabolism with hypertriglyceridemia, hypercholesterolemia, insulin resistance, hyperglycemia and redistribution of body fat as risk factors for cardiovascular disease. Observational studies with people living with HIV / AIDS evidence that when an individual finds out that he/she is an HIV/AIDS patient, he/she end ups feeling fear or shame, reducing hence social circle, work and leisure activities, and becomes isolated at home or in small groups which have common identity of HIV / AIDS patients. The purpose of this work was to evaluate the relationship between the level of habitual physical activity and recreation of people living with HIV / AIDS and its relation with metabolic changes. The patients were classified into active and sedentary, using the Habitual Physical Activity questionnaire proposed by Baecke and validated for HIV / AIDS patients. Classification was conducted according to the recommendations of the American College of Sports Medicine. Metabolism was assessed through plasma levels of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides, using commercial kits. The sample consisted of 65 HIV patients who used HAART for at least five years. 64.6% were classified as sedentary and 35.4% as active. The study shows a direct relationship between physical activity level and higher levels of HDL - cholesterol in HIV / AIDS. HDL - Cholesterol is a lipoprotein of cardiovascular protection and, although other assessed parameters have not shown difference, these results highlight the need for additional studies on risk factors and physical activity for HIV / AIDS enabling proposals for specific interventions for these patients.