Effects of post-exercise cold-water immersion on performance and perceptive outcomes of competitive adolescent swimmers.

PURPOSE: To evaluate the effects of repeated use of cold-water immersion (CWI) during a training week on performance and perceptive outcomes in competitive adolescent swimmers. METHODS: This randomized-crossover study included 20 athletes, who received each intervention [CWI (14 ± 1 °C), thermoneutral water immersion (TWI) (27 ± 1 °C) as placebo, and passive recovery (PAS)] three times a week between the land-based resistance training and swim training. The interventions were performed in a randomized order with a 1-week wash-out period. We tested athletes before and after each intervention week regarding swim (100 m freestyle sprints) and functional performance (flexibility, upper and lower body power, and shoulder proprioception). We monitored athlete's perceptions (well-being, heaviness, tiredness, discomfort and pain) during testing sessions using a 5-item questionnaire. Athlete preferences regarding the interventions were assessed at the end of the study. We used generalized linear mixed models and generalized estimating equations for continuous and categorical variables, respectively (intervention x time). RESULTS: We found a time effect for swim performance (p = .01) in which, regardless the intervention, all athletes improved sprint time at post-intervention compared to baseline. There was an intervention effect for pain (p = .04) and tiredness (p = .04), but with no significant post-hoc comparisons. We found no significant effects for other outcomes. All athletes reported a preference for CWI or TWI in relation to PAS. CONCLUSION: The repeated use of CWI throughout a training week did not impact functional or swim performance outcomes of competitive adolescent swimmers. Perceptive outcomes were also similar across interventions; however, athletes indicated a preference for both CWI and TWI.

Repeated Massage Improves Swimmers' Perceptions during Training Sessions but Not Sprint and Functional Performance: A Randomized Controlled Trial.

This study aimed to investigate the effects of repeated massage adjusted for swimmers' training on the perceptive, functional, and performance outcomes of a sprint. We also investigated the effects of a single short massage on swimmers' self-reported perceptions after resistance training. This cross-over randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis included 19 male and female competitive swimmers between 12 and 20 years old. Participants were subjected to three 12-min interventions over a week between resistance and swim training and monitored regarding training load and perceptions. After the intervention week we assessed: perceptive (well-being, heaviness, tiredness, discomfort, and pain), performance (sprint time, FINA points, and stroke characteristics), and functional outcomes (flexibility, squat jump, bench press, proprioception), in addition to athlete beliefs and preferences. A massage was defined as consisting of sliding movements on the arms, back, and anterior thigh, with metronomic rhythm control (1:1), and was divided into two protocols: superficial massage (SM) (light touch) and deep massage (DM) (light, moderate, intense effleurage) while the control (CON) rested. After repeated massage (SM and SM), participants had less chances to report tiredness, and they also maintained perceptions of well-being while CON got worse throughout the week. However, we found evidence of worsening of the perceptions of heaviness and pain at the main stages of the swim training for the massage groups. SM and DM had no effects over sprint and functional performance. Our results suggest that the swimmers were able to train harder with no harm to recovery.

What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis.

OBJECTIVE: Our objective was to determine the efficacy of cold-water immersion (CWI) on the management of muscle soreness to identify the impact of immersion time, water temperature, CWI protocol, and type of exercise on this outcome. DESIGN: Intervention systematic review and meta-analysis. SETTING: MEDLINE/PubMed, Embase, Central, and SPORTDiscus databases were searched from their earliest record to July 30, 2020. Only randomized controlled trials that assessed muscle soreness comparing CWI and control were included. Studies were pooled in different subgroups regarding the used protocol: water temperature (severe or moderate cold), immersion time (short, medium, or longer time), CWI protocol (intermittent or continuous application), and type of exercise (endurance or resistance exercise). Data were pooled in a meta-analysis and described as weighted mean difference (95% confidence interval, P < 0.05). PARTICIPANTS: Athletes and nonathletes. INTERVENTIONS: Cold-water immersion and control condition. MAIN OUTCOME MEASURES: Muscle soreness. RESULTS: Forty-four studies were included. For immediate effects, CWI was superior to control regardless of water temperature and protocol, and for short and medium immersion times and endurance exercises. For delayed effects, CWI was superior to control in all subgroups except longer immersions time. CONCLUSIONS: This study suggests that CWI is better than control for the management of muscle soreness and water temperature and CWI protocol do not influence this result, but only short and medium immersions times presented positive effects. Aiming immediate effects, the best results suggest CWI application only after endurance exercises, while delayed effect CWI was superior both after endurance and resistance exercises.

Fear of falling does not predict self-reported physical activity: an observational study with community-dwelling older adults.

OBJECTIVES: To investigate the relationship between FOF and self-reported physical activity levels among older adults. DESIGN: Observational cross-sectional. SETTING AND PARTICIPANTS: Community-dwelling older adults aged 60 years and over and without cognitive deficits were recruited. MAIN OUTCOME MEASURES: Data collected included cognitive function [i.e., Mini Mental Status Examination (MMSE)], FOF [i.e., Iconographic Falls Efficacy Scale (Icon-FES); Falls Efficacy Scale - International (FES-I)], self-reported physical activity (i.e., Modified Baecke Questionnaire for Elderly People), history of falls, number of comorbidities and clinical tests of balance and mobility (i.e., Short Physical Performance Battery and the single leg stance test with closed and opened eyes). Multivariable linear regression was used to test whether FOF predicts self-reported physical activity levels. RESULTS: A total of 200 older adults living in the community were enrolled in this study. Our results showed that FOF, as measured by FES-I or Icon-FES, did not predict self-reported physical activity levels in community-dwelling older adults. CONCLUSION: Our results did not support previous evidence that higher FOF predicts lower levels of self-reported physical activity. These results question the role of FOF in influencing self-reported physical activity levels among community-dwelling older adults.

Effects of 12-week Pilates training program on cardiac autonomic modulation: a randomized controlled clinical trial.

Aim: To evaluate the effects of 12-week Pilates training program on cardiac autonomic modulation. Materials & methods: A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 54 men were randomly allocated to either a control or a Pilates group. Initially, the RR intervals were captured for 20 min for later analysis of heart rate variability (HRV). The training protocol was then initiated, in which the Pilates group performed 36 sessions of the Pilates method for approximately 60 min each session, three-times a week, totaling 12 weeks. The control group was instructed to maintain their normal activities during this period. One week after the end of the training, the final evaluations were performed with the capture of RR intervals in both the groups. Linear indices in the time (SDNN and rMSSD) and frequency (low frequency [LF] and high frequency [HF]) domains, and the Poincaré plot (SD1 and SD2) were used. Nonlinear indices were also analyzed (approximate entropy and detrended fluctuation analysis). Descriptive statistics and generalized mixed models were performed. Results: There was a group effect for LF (ms2) and a time effect for SD2. There was a training effect observed by the time*group interactions in which an increase in global HRV indices was found for the Pilates group after 12 weeks (SDNN: mean difference [MD] = 9.82; standard deviation [SD] = 18.52; ES = -0.514; LF [ms2]: MD = 334.23; SD = 669.43; ES = -0.547; SD2: MD = 14.58; SD = 24.28; ES = -0.693). Conclusion: A 12-week Pilates training program promotes significant improvement in global modulation of HRV in the Pilates group considering the significant increase in SDNN, LF (ms2) and SD2 indices. Trial registration number: NCT03232866.

Low back pain prevalence in Sao Paulo, Brazil: A cross-sectional study.

BACKGROUND: Low back pain (LBP) is the leading cause of disability worldwide, and the burden of LBP is expected to increase in coming decades, particularly in middle-income countries. There is a lack of large and high-quality studies investigating the prevalence of LBP in Brazil. OBJECTIVE: To estimate the point, one-year, and lifetime prevalence of non-specific LBP in adults from the city of São Paulo, Brazil. METHODS: This community-based, cross-sectional study recruited 3000 participants in flow point locations randomly selected from census sectors of São Paulo. Interviews and self-administered questionnaires were used to estimate point prevalence, one-year prevalence, and lifetime prevalence of LBP. RESULTS: The estimate of point prevalence was 9.8% (95% CI: 8.8, 11.0), one-year prevalence was 48.1% (95% CI: 46.3, 49.9), and lifetime prevalence was 62.6% (95% CI: 60.8, 64.3). One-year and lifetime prevalence were higher in females, obese people, people insufficiently active and sedentary, current smokers, people who are exposed to repetitive movements, crouched or kneeling position, people dissatisfied with their job, people a little bit or very stressed, a little bit or very anxious, and a little bit depressed, and people with good and fair or poor general health. Lifetime prevalence was also higher in people exposed to standing positions and exposure to carrying weight. CONCLUSIONS: The high point, one-year, and lifetime prevalence of LBP in Brazil indicates that there is a need for coordinated efforts from government, the private sector, universities, health workers, and civil society to deliver appropriate management of LBP in middle-income countries.

Submaximal Elastic Resistance Band Tests to Estimate Upper and Lower Extremity Maximal Muscle Strength.

Muscle strength assessment is fundamental to track the progress of performance and prescribe correct exercise intensity. In field settings, simple tests are preferred. This study develops equations to estimate maximal muscle strength in upper- and lower-extremity muscles based on submaximal elastic resistance tests. Healthy adults (n = 26) performed a maximal test (1 RM) to validate the ability of the subsequent submaximal tests to determine maximal muscle strength, with elastic bands. Using a within-group repeated measures design, three submaximal tests of 40%, 60%, and 80% during (1) shoulder abduction, (2) shoulder external rotation, (3) hip adduction, and (4) prone knee flexion were performed. The association between number of repetitions and relative intensity was modeled with both 1st and 2nd order polynomials to determine the best predictive validity. For both upper-extremity tests, a strong linear association between repetitions and relative intensity was found (R2 = 0.97-1.00). By contrast, for the lower-extremity tests, the associations were fitted better with a 2nd order polynomial (R2 = 1.00). The results from the present study provide formulas for predicting maximal muscles strength based on submaximal resistance in four different muscles groups and show a muscle-group-specific association between repetitions and intensity.

Effect of Senior Dance (DanSE) on Fall Risk Factors in Older Adults: A Randomized Controlled Trial.

BACKGROUND: Older people's participation in structured exercise programs to improve balance and mobility is low. Senior Dance is an alternative option, as it may provide a safe and fun way of targeting balance. OBJECTIVE: The aim was to investigate the effect of Senior Dance on balance, mobility, and cognitive function compared with a control intervention. DESIGN: The study was a randomized controlled trial. SETTING/PATIENTS: Eighty-two community-dwelling older people aged 60 years or over and cognitively intact were recruited in Brazil. INTERVENTION: Participants were randomly allocated to 2 groups: Dance plus education (intervention group) and education alone (control group). The Senior Dance program consisted of 12 weeks of twice-weekly group-based dance classes. Participants in both groups attended a single 1-hour educational session on prevention of falls. MEASUREMENTS: The primary outcome was single-leg stance with eyes closed. Secondary outcomes were timed sit-to-stand test, standing balance test, timed 4-m walk, and cognitive function tests, for example, Trail Making Test and Montreal Cognitive Assessment. RESULTS: Of the 82 participants randomized, 71 (87%) completed the 12-week follow-up. Single-leg stance with eyes closed (primary outcome) improved in the Senior Dance group (mean difference [MD] = 2.3 seconds, 95% confidence interval [CI] = 1.1 to 3.6) compared with the control group at follow-up. Senior Dance group performed better in the standing balance tests (MD = 3.7 seconds, 95% CI = 0.6 to 6.8) and were faster in the sit-to-stand test (MD = - 3.1 seconds, 95% CI = -4.8 to -1.4) and 4-m walk test (MD = -0.6 seconds, 95% CI = -1.0 to -0.1). There were no significant between-group differences for cognitive function tests. LIMITATIONS: Participants and therapists were not blinded. CONCLUSION: Senior Dance was effective in improving balance and mobility but not cognitive function in community-dwelling older people.

Post-exercise recovery of biological, clinical and metabolic variables after different temperatures and durations of cold water immersion: a randomized clinical trial.

BACKGROUND: Cold water immersion (CWI) is a commonly used recuperative strategy. However there is a lack of standardization of protocols considering the duration and temperature of application of the technique and the stress model. Therefore it is important to study the issue of dose response in a specific stress model. Thus the objective was to analyze and compare the effects of CWI during intense post-exercise recovery using different durations and temperatures of immersion. METHODS: One hundred and five male individuals were divided into five groups: one control group (CG) and four recovery groups (G1: 5' at 9±1 °C; G2: 5' at 14±1 °C; G3: 15' at 9±1 °C; G4: 15' at 14±1 °C). The volunteers were submitted to an exhaustion protocol that consisted of a jump program and the Wingate Test. Immediately after the exhaustion protocol, the volunteers were directed to a tank with water and ice, where they were immersed for the recovery procedure, during which blood samples were collected for later lactate and creatine kinase (CK) analysis. Variables were collected prior to the exercise and 24, 48, 72, and 96 hours after its completion. RESULTS: For the CK concentration, 15 minutes at 14 °C was the best intervention option, considering the values at 72 hours after exercise, while for the moment of peak lactate an advantage was observed for immersion for 5 minutes at 14 °C. Regarding the perception of recovery, CWI for 5 minutes at 14 °C performed better long-term, from the time of the intervention to 96 hours post-exercise. For pain, no form of immersion responded better than the CG at the immediately post-intervention moment. CONCLUSIONS: There were no differences in behavior between the CWI intervention groups for the outcomes studied.

The effects of cold water immersion with different dosages (duration and temperature variations) on heart rate variability post-exercise recovery: A randomized controlled trial.

OBJECTIVES: The aim of the present study was to investigate the effects of cold water immersion during post-exercise recovery, with different durations and temperatures, on heart rate variability indices. DESIGN: Hundred participants performed a protocol of jumps and a Wingate test, and immediately afterwards were immersed in cold water, according to the characteristics of each group (CG: control; G1: 5' at 9±1°C; G2: 5' at 14±1°C; G3: 15' at 9±1°C; G4: 15' at 14±1°C). METHODS: Analyses were performed at baseline, during the CWI recuperative technique (TRec) and 20, 30, 40, 50 and 60min post-exercise. The average HRV indices of all RR-intervals in each analysis period (MeanRR), standard deviation of normal RR-intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent RR-intervals (RMSSD), spectral components of very low frequency (VLF), low frequency (LF) and high frequency (HF), scatter of points perpendicular to the line of identity of the Poincaré Plot (SD1) and scatter points along the line of identity (SD2) were assessed. RESULTS: Mean RR, VLF and LF presented an anticipated return to baseline values at all the intervention groups, but the same was observed for SDNN and SD2 only in the immersion for 15min at 14°C group (G4). In addition, G4 presented higher values when compared to CG. CONCLUSIONS: These findings demonstrate that if the purpose of the recovery process is restoration of cardiac autonomic modulation, the technique is recommended, specifically for 15min at 14°C.

Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial.

INTRODUCTION: Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. METHODS AND ANALYSIS: This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. ETHICS AND DISSEMINATION: Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences. TRIAL REGISTRATION NUMBER: NCT02603523, Pre-results.

Characteristics and associated factors with sports injuries among children and adolescents

BACKGROUND: The participation of children and adolescents in sports is becoming increasingly common, and this increased involvement raises concerns about the occurrence of sports injuries. OBJECTIVES: To characterize the sports injuries and verify the associated factors with injuries in children and adolescents. METHOD: Retrospective, epidemiological study. One thousand three hundred and eleven children and adolescents up to 18 years of age enrolled in a sports initiation school in the city of Presidente Prudente, State of São Paulo, Brazil. A reported condition inquiry in interview form was used to obtain personal data and information on training and sports injuries in the last 12 months. Injury was considered any physical complaint resulting from training and/or competition that limited the participation of the individual for at least one day, regardless of the need for medical care. RESULTS: The injury rate per 1000 hours of exposure was 1.20 among the children and 1.30 among the adolescents. Age, anthropometric data, and training characteristics only differed with regard to the presence or absence of injuries among the adolescents. The most commonly reported characteristics involving injuries in both the children and adolescents were the lower limbs, training, non-contact mechanism, mild injury, asymptomatic return to activities, and absence of recurrence. CONCLUSIONS: The injury rate per 1000 hours of exposure was similar among children and adolescents. Nevertheless, some peculiarities among adolescents were observed with greater values for weight, height, duration of training, and weekly hours of practice. .

The influence of resistance exercise with emphasis on specific contractions (concentric vs. eccentric) on muscle strength and post-exercise autonomic modulation: a randomized clinical trial.

BACKGROUND: Compared to eccentric contractions, concentric contractions result in higher cardiovascular stress. However, we do not know how these two types of contractions influence cardiac autonomic modulation during the post-exercise recovery period. OBJECTIVE: to compare the effect of resistance training that is performed with concentric vs. eccentric emphasis on muscle strength and on post-exercise recovery which was assessed by examining heart rate variability (HRV), for the knee extensor muscle group in young healthy adults. METHODS: For this study, 105 men between 18 and 30 years of age were randomized into 4 groups: concentric control (CONCC), eccentric control (ECCC), concentric training (CONCT) and eccentric training (ECCT). The CONCC and ECCC groups underwent one session of resistance exercise (RE) using the knee extensor muscle group (3 sets of 1 repetition at 100% of the maximal repetition [1MR]) and the CONCT and ECCT groups performed 10 training sessions. The HRV was analyzed at baseline and across four recovery periods (T1, T2, T3 and T4). RESULTS: The ECCT group exhibited increased muscle strength at the end of the study. Regarding cardiac autonomic modulation, the CONCC and ECCC groups exhibited increases in overall variability (SDNN and SD2) at T1 compared to baseline, and the ECCT group demonstrated increases in variables reflecting vagal modulation and the recovery process (RMSSD, SD1 and HF [ms2]) at T1, T2 and T4 compared to baseline. CONCLUSIONS: Resistance training with emphasis on eccentric contractions promoted strength gain and an increase in cardiac vagal modulation during recovery compared to baseline.

The influence of resistance exercise with emphasis on specific contractions (concentric vs. eccentric) on muscle strength and post-exercise autonomic modulation: a randomized clinical trial / Influência de exercício resistido com ênfase em contrações específicas (concêntrica vs excêntrica) sobre a força muscular e a modulação autonômica pós-esforço: ensaio clínico randomizado

Background: Compared to eccentric contractions, concentric contractions result in higher cardiovascular stress. However, we do not know how these two types of contractions influence cardiac autonomic modulation during the post-exercise recovery period. Objective: to compare the effect of resistance training that is performed with concentric vs. eccentric emphasis on muscle strength and on post-exercise recovery which was assessed by examining heart rate variability (HRV), for the knee extensor muscle group in young healthy adults. Methods: For this study, 105 men between 18 and 30 years of age were randomized into 4 groups: concentric control (CONCC), eccentric control (ECCC), concentric training (CONCT) and eccentric training (ECCT). The CONCC and ECCC groups underwent one session of resistance exercise (RE) using the knee extensor muscle group (3 sets of 1 repetition at 100% of the maximal repetition [1MR]) and the CONCT and ECCT groups performed 10 training sessions. The HRV was analyzed at baseline and across four recovery periods (T1, T2, T3 and T4). Results: The ECCT group exhibited increased muscle strength at the end of the study. Regarding cardiac autonomic modulation, the CONCC and ECCC groups exhibited increases in overall variability (SDNN and SD2) at T1 compared to baseline, and the ECCT group demonstrated increases in variables reflecting vagal modulation and the recovery process (RMSSD, SD1 and HF [ms2]) at T1, T2 and T4 compared to baseline. Conclusions: Resistance training with emphasis on eccentric contractions promoted strength gain and an increase in cardiac vagal modulation during recovery compared to baseline. .

Contextualização: Ações concêntricas apresentam maior estresse cardiovascular quando comparadas às excêntricas. Entretanto, não se sabe a influência desses tipos de ações no comportamento da modulação autonômica cardíaca durante o processo de recuperação pós-esforço. Objetivo: Comparar o efeito de um treinamento resistido para o grupo extensor do joelho realizado com ênfase concêntrica vs excêntrica sobre a força muscular e a recuperação pós-exercício considerando índices de variabilidade de frequência cardíaca (VFC) em jovens saudáveis. Método: Cento e cinco homens, com idades entre 18 e 30 anos, foram randomizados em quatro grupos: controle concêntrico (CCONC), controle excêntrico (CEXC), treinamento concêntrico (TCONC) e treinamento excêntrico (TEXC). Os grupos CCONC e CEXC realizaram uma sessão de exercício reduzido (ER) para o grupo extensor do joelho [três séries de uma repetição a 100% de uma repetição máxima (1RM)], e os grupos TCONC e TEXC realizaram dez sessões de treinamento. A VFC foi analisada no momento basal e na recuperação após as sessões (T1, T2, T3 e T4). Resultados: Observou-se aumento da força muscular para o grupo TEXC. Em relação à modulação autonômica cardíaca, observou-se, em comparação ao momento basal, aumento dos índices SDNN e SD2 no momento T1 nos grupos CCONC e CEXC e aumento dos índices RMSSD, SD1 e AF (ms2) nos momentos T1, T2 e T4 no grupo TEXC. Conclusões: Conclui-se que o treinamento resistido realizado com ênfase em contrações excêntricas promoveu ganho de força e aumento da modulação vagal cardíaca durante o processo de recuperação ...

Characteristics and associated factors with sports injuries among children and adolescents.

BACKGROUND: The participation of children and adolescents in sports is becoming increasingly common, and this increased involvement raises concerns about the occurrence of sports injuries. OBJECTIVES: To characterize the sports injuries and verify the associated factors with injuries in children and adolescents. METHOD: Retrospective, epidemiological study. One thousand three hundred and eleven children and adolescents up to 18 years of age enrolled in a sports initiation school in the city of Presidente Prudente, State of São Paulo, Brazil. A reported condition inquiry in interview form was used to obtain personal data and information on training and sports injuries in the last 12 months. Injury was considered any physical complaint resulting from training and/or competition that limited the participation of the individual for at least one day, regardless of the need for medical care. RESULTS: The injury rate per 1000 hours of exposure was 1.20 among the children and 1.30 among the adolescents. Age, anthropometric data, and training characteristics only differed with regard to the presence or absence of injuries among the adolescents. The most commonly reported characteristics involving injuries in both the children and adolescents were the lower limbs, training, non-contact mechanism, mild injury, asymptomatic return to activities, and absence of recurrence. CONCLUSIONS: The injury rate per 1000 hours of exposure was similar among children and adolescents. Nevertheless, some peculiarities among adolescents were observed with greater values for weight, height, duration of training, and weekly hours of practice.

Analysis of cardiovascular system responses to forced vital capacity in COPD.

BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

Analysis of cardiovascular system responses to forced vital capacity in COPD / Análise das respostas do sistema cardiovascular ao teste de capacidade vital forçada na DPOC

BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

CONTEXTUALIZAÇÃO: O teste de capacidade vital forçada (CVF) é rotineiramente realizado na avaliação da função pulmonar de pacientes com doença pulmonar obstrutiva crônica (DPOC). Entretanto, permanece pouco compreendida a influência do teste de CVF sobre o sistema cardiovascular de pacientes com DPOC. OBJETIVOS: Analisar o comportamento da frequência cardíaca (FC), pressão arterial (PA) e variabilidade da frequência cardíaca (VFC) no teste de CVF na DPOC. MÉTODOS: Dezenove homens com DPOC (72 ± 7 anos, no estágio de gravidade GOLD I=3, II=5, III=7 e IV=4 pacientes) realizaram a manobra de CVF e tiveram sua FC monitorada durante todo o exame, e a VFC analisada nos domínios do tempo (rMSSD) e da frequência (BF, AF e BF/AF) durante o repouso, antes e após a melhor manobra de CVF. A PA foi analisada no repouso, imediatamente ao final da manobra de CVF e 10 minutos após o término de todos os testes. RESULTADOS: Ao início da manobra de CVF, a FC reduziu (p<0,001) e, em seguida, aumentou progressivamente até o final do teste (p<0,001). Após término da manobra, a FC continuou a aumentar até atingir um pico (p<0,001) e depois caiu rapidamente a valores inferiores aos de repouso (p<0,001) e retornou ao seu valor basal. A PA e os índices da VFC não sofreram alterações nos períodos analisados. CONCLUSÃO: O teste de CVF influencia o comportamento da FC, sem alterar o seu controle autonômico, bem como a PA em pacientes com DPOC nos períodos analisados.

Comparação da pressão plantar e dos sintomas osteomusculares por meio do uso de palmilhas customizadas e pré-fabricadas no ambiente de trabalho / Comparison of plantar pressure and musculoskeletal symptoms with the use of custom and prefabricated insoles in the work environment

OBJETIVOS: Comparar os efeitos do uso de dois tipos de palmilhas, customizadas e pré-fabricadas, sobre a descarga plantar de peso e o comportamento de sintomas osteomusculares em trabalhadoras de linha de montagem. MÉTODOS: Ensaio randomizado com 27 mulheres que trabalhavam em postura ortostática estática, com média de idade de 30,3±7,09 e massa de 64,85±13,65 e que apresentavam sintomas osteomusculares. Inicialmente, aplicou-se o Questionário Nórdico de Sintomas Osteomusculares e coletaram-se as pressões plantares pelo sistema de baropodometria computadorizada (FootWork). Posteriormente, a casuística foi dividida em grupo controle (GC), que utilizou palmilha pré-fabricada e grupo intervenção (GI), que usou palmilha customizada de etilvinilacetato (EVA) durante oito semanas. Dados baropodométricos foram novamente coletados assim como a reaplicação do questionário. RESULTADOS: Não houve diferença estatística significante na comparação entre grupos e dados baropodométricos. Notou-se, entretanto, mudança de comportamento nas variáveis de descarga em cada momento avaliado, assim como o aumento para as variáveis de média pressão de descarga e pressão plantar máxima (p<0,05). Também não foi mostrada diferença estatística significante para qualquer local anatômico entre os grupos nos diferentes momentos de avaliação. Observou-se que, dentro de cada grupo, houve redução dos níveis dolorosos na região dos pés e da coluna lombar, quando comparado momento inicial e final da intervenção (p<0,05). CONCLUSÕES: Ambas as palmilhas reduziram os níveis dos sintomas na coluna lombar e pé. Após oito semanas, houve aumento da pressão máxima e média das pressões nos pés e redução de área de superfície plantar, observados nas duas palmilhas.

OBJECTIVES: To compare the effect of the use of custom and prefabricated insoles on the behavior of plantar weight load and musculoskeletal symptoms in assembly line workers. METHODS: A randomized trial was carried out with 27 women who worked in a static standing position and had musculoskeletal symptoms. The mean age was 30.3±7.09 years and the weight 64.85±13.65 Kg. The Nordic Musculoskeletal Questionnaire was administered, and plantar pressure was determined using a computerized baropodometric system (FootWork). The sample was then divided into control group, which wore pre-fabricated insoles, and intervention group, which wore ethylvinylacetate insoles for eight weeks. Baropodometric data were collected and the questionnaire was administered once again. RESULTS: There was no statistically significant difference in the comparison between groups and baropodometric data. However, a change was noted in the behavior of the load variables between evaluations, with an increase in mean load pressure and maximal plantar pressure (p<0.05). No statistically significant difference was found between groups for any anatomical site in the different evaluations. Within each group, there was a reduction in foot pain and back pain between evaluations (p<0.05). CONCLUSIONS: Both types of insole reduced pain symptoms in the lumbar region and feet. After eight weeks of use, there was an increase in maximal and mean plantar pressure and a reduction in plantar surface area with both types of insole.

Efeito da cinesioterapia e eletroestimulação transvaginal na incontinência urinária feminina: estudo de caso / Effect of kinesiotherapy and transvaginal electrical stimulation in the urinary incontinence in women: case study

Embora a incontinência urinária não coloque diretamente a vida das pessoas em risco, é uma condição quepode trazer sérias implicações. Publicações recentes têm demonstrado melhora significativa no quadro clínicoe na qualidade de vida de mulheres incontinentes submetidas ao tratamento conservador. Portanto, o presenteestudo teve como objetivo avaliar o efeito do tratamento fisioterapêutico sobre a qualidade de vida de umamulher com incontinência urinária. Apresentação do caso: estudo de caso de uma mulher com incontinênciaurinária de esforço. Inicialmente foi realizada anamnese e exame físico, coletando-se dados como histórico dadoença e tonicidade dos músculos do assoalho pélvico; em seguida a paciente respondeu ao questionárioInternational Consultation on Incontinence Questionnaire - Short Form. Após 20 sessões de fisioterapiao mesmo exame físico e o mesmo questionário foram aplicados e os escores iniciais e finais, bem como osdados coletados nos exames físicos foram comparados. Resultados: a paciente apresentou aumento notônus muscular do assoalho pélvico e aumento no grau de força dos mesmos, melhora do quadro clínico e dasua qualidade de vida. Conclusão: O presente estudo concluiu que a fisioterapia, baseada em cinesioterapiae eletroterapia endovaginal, contribuiu para a melhora no quadro de incontinência urinária e, conseqüentemente,na melhora da qualidade de vida de paciente tratada.

Even though urinary incontinence does not directly threaten people’ lives, it is a condition that can bringserious implications. Recent publications have shown significant improvement in clinical and quality of lifeof incontinent women submitted to conservative treatment. Therefore, this study aimed to evaluate the effectof physiotherapeutic treatment on the quality of life of a woman with urinary incontinence. Presentation ofthe case: a case study of a woman with stress urinary incontinence. Initially, a careful anamnesis and aphysical examination were undertaken to collect data such as past medical history, course of the disease, andthe muscle tonus of the pelvic floor. Then, the patient was asked to answer the International Consultation onIncontinence Questionnaire - Short Form. After 20 sessions of physiotherapy the same physical examinationand the same questionnaire were undertaken again. The initial and final scores and data previously collectedwere compared. Results: The patient had an increase in muscle tonus of the pelvic floor and increased thestrength degree of limbs, improved the clinical picture and their quality of life. Conclusion: This studyconcluded that physiotherapy based on kinesitherapy and electrotherapy transvaginal contributed to theimprovement of the clinical picture of stress urinary incontinence and, consequently, improves the quality oflife of the patients treated.

Intervenção fisioterapêutica na síndrome do ombro doloroso em portadores de hemiplegia / Painful shoulder syndrome in hemiplegic patients – a physical therapy intervention

Acidente Vascular Encefálico é a causa mais freqüente de incapacidade física e cognitiva; sua principal conseqüência é a hemiplegia. As limitações de movimentos do lado plégico são acentuadas no membro superior e tornam fator causal do ombro doloroso em mais de 50 dos pacientes. Estas prejudicam a realização das atividades de vida diária, retorno ao trabalho, convívio social, que levam a sofrimentos e impactos negativos na recuperação global. Buscou-se identificar na literatura atual, as melhores formas de prevenção, reabilitação funcional e analgésica do ombro doloroso em hemiplégicos, bem como conseqüentes limitações ocasionadas por essa complicação. Nesta abordagem identificou-se na literatura especializada e atualizada que, o uso de órteses de imobilização transitória, o posicionamento adequado no leito e a cinesioterapia precoce, foram os procedimento preconizados.