Effects of kettlebell swing training on cardiorespiratory and metabolic demand to a simulated competition in young female artistic gymnasts.

We examined the effects of adding a Kettlebell Swing training program (KB) to the regular skill-training protocol (REGULAR) on cardiorespiratory fitness, cardiorespiratory/metabolic demand, and recovery to a simulated competition of female artistic gymnastics. Nine gymnasts (13±2 years) had their REGULAR complemented with a 4-week kettlebell training (REGULAR+KB), consisting of 3 sessions/week of 12x30" swings x 30" rest with » of their body weight, while 9 aged-matched gymnasts acted as a comparison group. Peak oxygen uptake ([Formula: see text]) during routines was estimated from the O2 recovery curve using backward extrapolation and off-kinetics parameters were modeled through a mono-exponential function. Heart rate (HR) was monitored continuously and capillary blood lactate (BLa-) was measured before and after each routine (1st and 3rd min). Cardiorespiratory fitness ([Formula: see text]) was evaluated using a ramp cycle ergometer test. A training-by-time interaction effect was observed for [Formula: see text] (p = 0.009) as increments were only observed after REGULAR+KB (M = 8.85, SD = 9.67 ml.kg.min-1). No training-by-time interactions were observed for HRpeak (p = 0.39), [Formula: see text] (p = 0.07), or La-post3 (p = 0.25), both training protocols reduced HRpeak (M = -12; SD = 11 b.min-1) and BLa-post1 (M = -0.70; SD = 1.29 mmol.L-1) during the simulated competition, but not relative [Formula: see text]. No training-by-time interaction was observed for the off-transient [Formula: see text] time constant (p = 0.38). [Formula: see text] recovery was slower (M = 5; SD = 10 s) after both protocols. Both training protocols improved cardiorespiratory and metabolic demands and recovery kinetics to a simulated competition of female artistic gymnastics, although increases in cardiorespiratory fitness were only observed in REGULAR+KB.

Comparison of Acute Arterial Responses Following a Rescue Simulation and Maximal Exercise in Professional Firefighters.

Cardiovascular events are the leading cause of on-duty deaths among firefighters. Screening firefighters for risk of sudden cardiac event is a critical element of a comprehensive medical program. Although intense physical exertion has been shown to trigger sudden cardiac events in the general population, it is unclear how hemodynamic responses following clinical exercise testing compare to that of performing firefighting tasks in personal protective equipment. Therefore, the purpose of this study was to compare hemodynamic responses following rescue simulation (RS) and maximal exercise in firefighters. This was a cross-over repeated measures study. Thirty-eight professional firefighters (31.8 ± 5.2 yr; VO2peak: 57.9 mL/kg/min) completed a maximal aerobic exercise test (MAET) and an RS. Pulse wave velocity (PWV), pulse pressure (PP), and brachial and central mean arterial pressure (MAP) were measured before and 5 and 15 min post-exercise. The findings indicated that femoral PWV decreased after MAET and RS at both time points (p < 0.005). No significant differences were found in aortic and carotid PWV over time or between conditions (p ≥ 0.05). Significant increases in brachial and central PP and MAP were noted 5 min post-MAET and RS (p = 0.004). In conclusion, the present study demonstrated that peripheral arterial stiffness (AS) decreased in firefighters following both conditions, with no differences in central AS. Our findings provide valuable information on hemodynamic responses similar between RS and MAET, and are important for controlling CVD risk and the AS response.

Arterial Stiffness following Endurance and Resistance Exercise Sessions in Older Patients with Coronary Artery Disease.

Arterial stiffness (AS) is associated with coronary artery disease (CAD). Acute endurance training decreases AS, whereas acute resistance training increases it. However, these results are from studies in apparently healthy adults, and there is no information on the effects of such afterload AS in elderly patients with CAD. We aimed to investigate the effect of acute endurance or resistance training on the time course of changes in the indices of AS in elderly patients with CAD in order to understand how stiffness responds after training. We tested 18 trained men with CAD. AS was measured using central and peripheral pulse wave velocity (PWV) after 15 min of rest and after 5, 15, and 30 min of endurance and resistance training sessions. The endurance session consisted of high-intensity interval walking at 85-90% of maximum heart rate, and the resistance session consisted of 70% of the maximum of one repetition. An interaction effect was found for central and peripheral PWV (p ≤ 0.001; carotid, η2 = 0.72; aortic, η2 = 0.90; femoral, η2 = 0.74), which was due to an increase in PWV after resistance and a decrease in central and peripheral PWV after endurance. This study demonstrates that training mode influences the time course of AS responses to acute exercise in these patients. Acute endurance training decreased AS, whereas resistance training significantly increased it.

Arterial Stiffness Response to Acute Combined Training with Different Volumes in Coronary Artery Disease and Heart Failure Patients.

Resistance training has been shown to acutely increase arterial stiffness (AS), while endurance training appears to decrease AS. However, the findings are from studies in apparently healthy subjects and have limited applicability to patients at low and high cardiovascular risk, for whom combined exercise is recommended. We compared the time course of changes in local and regional indices of AS in response to high-volume combined endurance training (CET) and high-volume combined resistance training (CRT) in patients with coronary artery disease (CAD) and heart failure (HF). We studied 20 men with CAD and HF (10 each) aged 68.3 ± 9.6 years. AS was measured by pulse wave velocity (PWV), and brachial and central blood pressure (BP) were determined after 15 min of rest and 5 and 15 min after the exercise session. All patients completed two sessions on nonconsecutive days. A protocol by time interaction effect was observed for carotid (η2 = 0.21, p = 0.02), aortic (η2 = 0.60, p < 0.001), and femoral (η2 = 0.46, p = 0.01) PWV after CET and CRT, suggesting that PWV decreased after CET and increased after CRT. Decreases in the brachial and central variables of BP across time points were observed in both protocols. CET decreased whereas CRT increased carotid, aortic, and femoral PWV at 15 min after exercise in patients with CAD and HF.

The acute effect of maximal exercise on arterial stiffness in adults with and without intellectual and developmental disabilities.

We compared central and peripheral arterial stiffness response patterns between persons with and without intellectual and developmental disabilities (IDD) of different age groups at rest and following a cardiopulmonary exercise test (CPET). Fifteen young adults with and without IDD, and 15 middle-aged adults without IDD performed a CPET. Central and peripheral arterial stiffness were measured at rest and following CPET using estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-ankle (cdPWV) pulse wave velocity derived from piezoelectric mechano-transducers. cfPWV remained unchanged following CPET in adults with and without IDD but increased in middle-aged adults (d = 0.85; 95% CI: 0.27-1.42 m·s-1, p = 0.005), whereas cdPWV was similarly reduced (d = -0.77; 95% CI: -1.06 to -0.48 m·s-1, p < 0.001) in all groups. crPWV remained unchanged in all groups. These results were independent of exercise-related changes in mean arterial pressure. Overall group differences suggested that persons with IDD (d = -1.78; 95% CI: -3.20 to -0.37 m·s-1, p = 0.009) and without IDD (d = -1.84; 95% CI: -3.26 to -0.43 m·s-1, p = 0.007) had lower cfPWV than middle-aged adults. We found no evidence of early vascular aging and diminished vascular reserve following CPET in adults with IDD.

Acute effects of exercise on cardiac autonomic function and arterial stiffness in patients with stable coronary artery disease.

Objectives. To examine the acute effect of a maximal aerobic exercise effort on aortic, peripheral arterial stiffness and cardiovagal modulation of trained and untrained patients with coronary artery disease (CAD). Design. Cross-sectional study. Methods. Eighteen untrained patients with CAD, 18 trained patients with CAD, and 18 apparently healthy trained subjects were sampled and matched for age and body mass index. Aortic and peripheral stiffness were measured by applanation tonometry estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-dorsalis pedis pulse wave velocity (cdPWV), respectively. Cardiovagal modulation was assessed by heart-rate variability (HRV) indices including the standard deviation of normal-to-normal RR intervals (SDNN), root-mean-square of successive differences (RMSSD), and the high-frequency power band (HF). cfPWV, crPWV, cdPWV, and HRV indices were measured at rest, 10 and 30 min following a maximal cardiopulmonary exercise test on a cycle ergometer. Results. No differences were observed between groups at rest nor over time in indices of HRV, cfPWV and cdPWV. Still, main effects of time were observed in cfPWV (p < .001; ɳ2 = 0.313) and cdPWV (p = .003, ɳ2 = 0.111), RMSSD (p < .001, ɳ2 = 0.352), HF (p < .001, ɳ2 = 0.265) and LF/HF (p = .001, ɳ2 = 0.239), as cdPWV, RMSSD, and HF were reduced 10 min following exercise, whereas cfPWV and LF/HF were increased. Changes in cPP were associated with changes in HRV from rest to min 10 (HF, r = 0.302), and to min 30 (HF, r = 0.377; SDNN, r = 0.357; RMSSD, r = 0.429). Conclusion. Training level and CAD do not seem to influence arterial stiffness and cardiac autonomic responses to maximal exercise.

The effects of 12-months supervised periodized training on health-related physical fitness in coronary artery disease: a randomized controlled trial.

We compared the impact of a one-year periodized exercise training versus a non-periodized exercise training on health-related physical fitness (HRPF) including body composition, cardiorespiratory and muscular fitness in patients with coronary artery disease (CAD). Fifty CAD patients (60.4 ± 9.9 years) were randomized to either a periodized training group (PG) (n = 25) or a non-periodized training group (NPG) (n = 25). Both consisted of a combined training programme, performed 3 days/week for 12 months. Thirty-six CAD patients (PG: n = 18, NPG: n = 18) successfully completed the exercise regimes. In both groups, a favourable main effect for time was evident for peak VO2, peak workload, anaerobic threshold and respiratory compensation point workloads and VO2, whole body skeletal muscle mass and quality index at 12 months.In conclusion, a periodized model is as effective as a non-periodized model in promoting increases in HRPF outcomes following a one-year intervention. These findings indicate that health-professionals can add variation to cardiac rehabilitation workouts without compromising effectiveness.

The effect of an expanded long-term periodization exercise training on physical fitness in patients with coronary artery disease: study protocol for a randomized controlled trial.

BACKGROUND: Benefits from cardiac rehabilitation (CR) programs are evidence-based and widely recognized. Less than 50% of people who participate in hospital-based CR programs maintain an exercise regime for as long as six months after completion. Little is known about interventions making the patients continue to exercise after the hospital-based formal program has ended. Methods to ensure sustained benefits of CR need to be tackled. Exercise periodization is a method typically used in sports training, but the impact of periodized exercise to yield optimal beneficial effects in cardiac patients is unclear. Therefore, the purpose of this trial is to evaluate the effects of a long-term exercise periodization on health-related physical fitness components such as cardiorespiratory endurance, muscular strength, skeletal muscle function, and body composition. METHODS: Fifty patients with coronary artery disease will be recruited among those who underwent the hospital-based CR phase. These patients will be randomized (1:1) into one of the following exercise groups: (1) periodized group; and (2) non-periodized group (exercise prescription based on standard guidelines). There will be four assessment time points: at baseline, and 3, 6, and 12 months after starting the exercise training program. At each time point, maximal and submaximal cardiorespiratory fitness, skeletal muscle deoxygenation dynamics, body composition by dual energy radiographic absorptiometry, functional fitness, maximal isometric and dynamic strength, physical activity, and quality of life will be assessed. This experimental design will last for 48 weeks with a frequency of three times per week for both groups. DISCUSSION: Most medium- to long-term exercise-based CR programs do not employ periodization or exercise progression. Randomized controlled trials are necessary to evaluate long-term periodization outcomes and assess the length of change observed in supervised CR programs. This study will contribute to generate evidence-based exercise prescription approaches to prolong the exercise training after the end of hospital-based CR programs. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03335319 . Registered on 22 October 2017.

Influence of exercise on oxidative stress in patients with heart failure.

Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.

Insuficiência cardíaca, exercício físico e sistema inflamatório / Heart failure, exercise training and systemic inflammatory

Fundamentação: No contexto do tratamento da insuficiência cardíaca (IC) se torna relevante a melhor compreensão das repercussões da interação entre exercício físico e inflamação, tendo em vista a forte influência de ambos na evolução clínica dos portadores da síndrome. Objetivo: Busca de informações sobre as repercussões do exercício físico no perfil inflamatório de pacientes com IC. Métodos: Busca por periódicos nas bases de dados, CONCHRANE, PUBMED, LILACS. Os seguintes termos MeSH foram utilizados: heart failure, inflammatory mediators e exercise. Os estudos foram selecionados por dois avaliadores, segundo critérios do instrumento Delphi List. Resultados: Dezenove ensaios clínicos controlados foram selecionados. Os estudos foram semelhantes quanto à modalidade e protocolos de exercícios físicos utilizados na investigação dos efeitos no comportamento dos mediadores inflamatórios, havendo, entretanto, predominância no uso da atividade aeróbica de moderada intensidade. Os desfechos dos estudos mostram redução crônica de citocinas pró-inflamatória de ação sistêmica e cardíaca, como também de ação endotelial e de apoptose celular em decorrência do exercício físico. Nenhum estudo avaliou a influência do exercício de alta intensidade sobre os marcadores inflamatórios. Conclusões: Tem sido demonstrado que o exercício físico utilizado predominantemente de forma aeróbica com intensidade moderada proporciona estabilização e diminuição dos marcadores pró-inflamatórios, algo desejável no tratamento da IC. Não foram encontrados estudos evidenciando o efeito isolado do exercício resistido, assim como o efeito do exercício de alta intensidade sobre os marcadores inflamatórios em pacientes com insuficiência cardíaca.

Exercício intenso e suplementação de testosterona em portadores de insuficiência cardíaca / High-intese exercise and testosterone supplementation in individuals with heart failure / Ejercicio intenso y suplementación de testosterona em portadores de insuficiência cardiaca

INTRODUÇÃO: O sono é um estado natural e recorrente, no qual acontecem processos neurobiológicos importantes. A má qualidade do sono está diretamente A insuficiência cardíaca (IC) é uma síndrome com alterações neuroendócrinas, limitações funcionais associadas à baixa qualidade de vida. Há pouco conhecimento dos efeitos do exercício físico de alta intensidade e terapia de suplementação de testosterona (TST) em portadores de IC e hipotestosteronemia. OBJETIVO: Avaliar os efeitos do exercício de alta intensidade associado a TST na qualidade de vida e potência aeróbia destes pacientes. MÉTODOS: Dezenove pacientes portadores de IC (idade media, 58 ± 10 anos; fração de ejeção, 34 ± 8%) foram randomizados para o grupo exercício de alta intensidade (controle; n=9) e exercício de alta intensidade com suplementação hormonal (intervenção; n=10). Os Pacientes exercitaram-se (40 minutos, 90% do consumo máximo de oxigênio) três vezes semanalmente durante 12 semanas. O grupo intervenção recebeu testosterona na primeira e sexta semanas. Antes e após o período de estudo foram obtidas medidas da capacidade funcional e escores do Minnesota Living with Heart Failure Questionnaire. RESULTADOS: No intragrupo controle e intervenção, respectivamente, houve aumento do pico de consumo de oxigênio (12% vs. 15%; p CONCLUSÃO: Exercício de alta intensidade melhora a capacidade funcional e escores da QV após 12 semanas de tratamento. .

INTRODUCTION: Heart failure is a syndrome related to neuroendocrine alterations and limitations on daily activities associated with poor quality of life. Little is known about the effects of high-intensity exercise and testosterone supplementation therapy (TST) on heart failure patients with hypotestosteronemia. OBJECTIVE: To evaluate the effects of high-intensity exercise and testosterone supplementation on quality of life and aerobic power in these patients. METHODS: Nineteen heart failure patients (age=58 ± 10 years; ejection fraction= 34 ± 8%) were randomized to either a high-intensity exercise group (control; n=9) or high-intensity exercise group with hormonal supplementation (intervention; n=10). Patients exercised (40 minutes, 90% peak oxygen consumption) for 12 weeks, three times weekly and intervention group received testosterone in the first and sixth weeks. Functional capacity measurements and Minnesota Living With Heart Failure Questionnaire (MLWHFQ) scores were obtained before and after the study period. RESULTS: Within control and intervention group respectively there was an increase in peak oxygen uptake (12% vs. 15%; p CONCLUSION: High-intensity exercise improves functional capacity and quality of life scores after 12 weeks of treatment. .

INTRODUCCIÓN: La insuficiencia cardiaca (IC) es un síndrome con alteraciones neuroendocrinas, limitaciones funcionales asociadas a la baja calidad de vida. Hay poco conocimiento de los efectos del ejercicio físico de alta intensidad y terapia de suplementación de testosterona (TST) en portadores de IC e hipotestosteronemia. OBJETIVO: Evaluar los efectos del ejercicio de alta intensidad asociado a TST en la calidad de vida y potencia aeróbica de estos pacientes. MÉTODOS: Diecinueve pacientes portadores de IC (promedio de edad= 58 ± 10 años; fracción de eyección= 34 ± 8%) fueron randomizados para el grupo ejercicio de alta intensidad (control; n=9) y ejercicio de alta intensidad con suplementación hormonal (intervención; n=10). Los pacientes se ejercitaron (40 minutos, 90% del consumo máximo de oxígeno) tres veces semanalmente por 12 semanas, el grupo intervención recibió testosterona en la primera y sexta semanas. Antes y después del período de estudio fueron obtenidas medidas de la capacidad funcional y escores del Minnesota Living with Heart Failure Questionnaire. RESULTADOS: Intragrupo control e intervención respectivamente hubo aumento del pico de consumo de oxígeno (12% vs. 15%; p CONCLUSIONES: El ejercicio de alta intensidad mejora la capacidad funcional y escores de la CV después de 12 semanas de tratamiento. .

Associação do excesso de peso com variáveis demográficas e atividade física no lazer em universitários / Association of overweight with demographic variables and physical activity during leisure time in college

Este estudo objetivou verificar a prevalência e a associação do excesso de peso com variáveis demográficas e nível de atividade física em estudantes de Educação Física de uma instituição pública do estado da Bahia. Trata-se de estudo transversal conduzido com a população de universitários regularmente matriculados no curso de Licenciatura em Educação Física da Universidade Estadual do Sudoeste da Bahia (UESB), durante o segundo semestre de 2010. Foram coletadas informações demográficas (sexo, idade e estado civil), antropométricas (autorrelato) e nível de atividade física no lazer. Foram feitas comparações entre os sexos por meio do teste “t” independente (dados com distribuição normal) e U de Mannn-Whitney (dados com distribuição não normal). As associações entre o desfecho e demais variáveis foram verificadas pela regressão de Poisson. O nível de significância estabelecido em todas as análises foi p<0,05. Participaram do estudo 125 estudantes, sendo 76 (60,8%) estudantes do sexo masculino. A prevalência de excesso de peso foi de 22,8%. As variáveis associadas ao excesso de peso foram idade e o sexo, revelando que os universitários com idade igual ou superior a 21 anos e do sexo masculino apresentam 2,28 (IC95%: 1,03-5,05) e 4,16 (IC95%: 1,07-16,19), respectivamente, maior probabilidade de apresentar o desfecho em relação aos seus pares. Pode-se concluir que a prevalência de excesso de peso na amostra estudada foi elevada, e estudantes do sexo masculino e com idade superior a 20 anos têm maior probabilidade de terem excesso de peso. Há necessidade de programas de prevenção e intervenção ao excesso de peso para estudantes universitários.

The aim of this study were to determine the prevalence and association of overweight with demographic variables and level of physical activity in physical education students of a public institution in the state of Bahia. This cross-sectional study conducted with the university students population that study Physical Education from the State University of Southwest Bahia (UESB) during the second half of 2010. Demographics variables (gender, age and marital status), anthropometric (self-report) and level of physical activity during leisure time were collected. Comparisons between sexes were made using Student t-test for normally distributed data and the Mann-Whitney test for non-parametric data. Poisson regression was used to evaluate the association of the outcome with the independent variables. A level of significance of 5% (p<.05) was adopted in this study. The study included 125 students, 76(60.8%) male students. The prevalence of overweight was 22.8%. Variables associated with overweight were gender and sex, revealing that college aged greater than 21 years old and men have 2.28 (95%CI: 1.03-5.05) and 4.16 (95%CI:1.07-16.19), respectively, higher probability to bring forward this outcomes in relation to their peers. It can be concluded that the prevalence of excess weight in this sample were high, and male students and older than 20 years are more likely to be overweight. Accordingly, there are needed prevention and intervention programs to control overweight in college students.

Capacidade funcional como preditor de qualidade de vida na insuficiência cardíaca / Functional capacity as a predictor of quality of life in heart failure

INTRODUÇÃO: A insuficiência cardíaca (IC) prejudica a qualidade de vida (QV), enquanto a reabilitação cardiopulmonar e metabólica (RCPM) de pacientes com a síndrome proporciona melhora da capacidade funcional (CF) e da qualidade de vida. OBJETIVOS: Determinar a relação dos domínios da QV com a CF de pacientes com IC, assim como propor pontos de corte dos domínios da QV por meio da CF. MATERIAIS E MÉTODOS: Avaliou-se 57 pacientes com IC, classe funcional II e III, sendo 37 ingressantes (GI) no programa de RCPM e 20 participantes (GP) com mais de três meses de programa. A QV foi avaliada pelo questionário de Minnesota por meio dos domínios físicos, emocionais e dimensões gerais. A CF foi determinada por meio do teste de caminhada de seis minutos (TC6'), tendo pontos de corte definidos conforme proposto na literatura. Utilizou-se teste t de Student, correlação de Pearson e análise da curva ROC para responder aos objetivos da pesquisa, considerando significância de 5%. RESULTADOS: Participantes da RCPM apresentaram melhores escores da QV quando comparados aos ingressantes. Correlações significativas foram observadas entre o domínio emocional e TC6' para ambos os grupos. Verificou-se pontos de corte significativos dos domínios da QV advindos da CF, com destaque ao domínio emocional (sensibilidade/especificidade) para ambos os grupos. CONCLUSÃO: Os portadores de IC com mais de três meses de RCPM apresentaram melhor QV e capacidade funcional do que os iniciantes. O domínio emocional do questionário de Minnesota se mostrou um bom preditor de ponto de corte da capacidade funcional.

INTRODUCTION: Heart failure (HF) affects the quality of life (QoL), while metabolic and cardiopulmonary rehabilitation program (MCRP) of patients with the syndrome provides improved functional capacity (FC) and QoL. Objectives: To determine the relationship of the QoL domains with CF in patients with HF and propose cutoff points of the QoL domains by CF. MATERIALS AND METHODS: We evaluated 57 patients with HF functional, class II and III, with 37 beginners (GI) in MCRP and 20 participants (GP) with more than three-month program. QoL was evaluated by the Minnesota through the physical, emotional, and general dimension domains. The CF was determined by testing the six-minute walk (6MWT), with cutoffs defined as proposed in the literature. We used the Student t test, Pearson correlation and ROC curve analysis to answer the research objectives, considering a 5% significance. RESULTS: Participants of RCPM showed better QoL scores when compared to beginners. Significant correlations were observed between the Emotional Domain and 6MWT for both groups. There were significant cutoffs of domains of QoL arising from CF, highlighting the emotional domain (sensitivity/ specificity) for both groups. CONCLUSION: Patients with HF with more than three months MCRP showed better QoL and functional capacity than beginners. The emotional domain of Minnesota questionnaire proved to be a good predictor of cutoff point of functional capacity.