Physiological responses in different intensities of resistance exercise - Critical load and the effects of aging process.

Aim was to identify critical load (CL) in young and elderly apparently healthy male cohorts. To contrast the metabolic, cardiovascular and perceptual responses on CL according to age. We evaluated 12 young (23 ± 3 years) and 10 elderly (70 ± 2 years) apparently healthy active males, who underwent: (1) 1 repetition maximum (1RM) test on a 45° Leg Press; (2) on different days, three high-intensity resistance exercise constant load tests (60%, 75% and 90% 1RM) until fatigue (Tlim). Absolute values of both the CL asymptote and curvature constant (kg) were significantly lower in elderly subjects (P < 0.05). In contrast, elderly subjects demonstrated a significantly higher number of repetitions at CL when compared with young subjects (P < 0.05). As expected, oxygen uptake (VO2) and heart rate (HR) during maximal aerobic exercise testing were significantly reduced in older subjects. However, percent-predicted aerobic capacity were higher in older subjects (P < 0.05). In addition, blood lactate ([La-]) corrected to Tlim and rating of perceived exertion values were greater in younger subjects at all intensities (P < 0.05). These findings, despite reduced force production in older subjects, endurance-related parameters are well preserved according to age-adjusted percent-predicted values in apparently healthy males.

Glycemic behavior in patients with type 2 diabetes during a short period of a combined training program

The present study investigated the behavior of glycemia in subjects with type 2 diabetes (T2DM) during 36 sessions of a combined training program. Methods: This is a single arm clinical study with 20 patients with T2DM submitted to combined exercise training (strength and aerobic exercise). The sessions occurred on alternate days, 3x/week, lasting ~ 80 minutes, totaling ~ 240 minutes/week, for 12 weeks, over a total of 36 sessions. Capillary glycemia was measured before and 10 to 15 minutes after the end of each combined exercise session. Results: There was a significant reduction (p<0.05) in glycemia after application of the combined training program in 27 (75%) of the 36 sessions. Regarding the maintenance of this reduction after about 48 hours, no significant differences were identified (p>0.05). When investigating the cumulative effect of the 36 sessions of combined training program on capillary glycemia, no significant differences were observed (p>0.05). Conclusion: Glycemia exhibits a behavior of reduction immediately after concurrent strength and aerobic training programs in patients with T2DM. However, the immediate reduction of glycemia is not maintained until 48 hours, nor is there a cumulative effect of the 36 training sessions on baseline glycemia.(AU)

Effects of Light-Emitting Diode Therapy on Muscle Hypertrophy, Gene Expression, Performance, Damage, and Delayed-Onset Muscle Soreness: Case-control Study with a Pair of Identical Twins.

OBJECTIVE: The aim of this study was to verify how a pair of monozygotic twins would respond to light-emitting diode therapy (LEDT) or placebo combined with a strength-training program during 12 weeks. DESIGN: This case-control study enrolled a pair of male monozygotic twins, allocated randomly to LEDT or placebo therapies. Light-emitting diode therapy or placebo was applied from a flexible light-emitting diode array (λ = 850 nm, total energy = 75 J, t = 15 seconds) to both quadriceps femoris muscles of each twin immediately after each strength training session (3 times/wk for 12 weeks) consisting of leg press and leg extension exercises with load of 80% and 50% of the 1-repetition maximum test, respectively. Muscle biopsies, magnetic resonance imaging, maximal load, and fatigue resistance tests were conducted before and after the training program to assess gene expression, muscle hypertrophy and performance, respectively. Creatine kinase levels in blood and visual analog scale assessed muscle damage and delayed-onset muscle soreness, respectively, during the training program. RESULTS: Compared with placebo, LEDT increased the maximal load in exercise and reduced fatigue, creatine kinase, and visual analog scale. Gene expression analyses showed decreases in markers of inflammation (interleukin 1ß) and muscle atrophy (myostatin) with LEDT. Protein synthesis (mammalian target of rapamycin) and oxidative stress defense (SOD2 [mitochondrial superoxide dismutase]) were up-regulated with LEDT, together with increases in thigh muscle hypertrophy. CONCLUSIONS: Light-emitting diode therapy can be useful to reduce muscle damage, pain, and atrophy, as well as to increase muscle mass, recovery, and athletic performance in rehabilitation programs and sports medicine.

Relationship between non-invasive haemodynamic responses and cardiopulmonary exercise testing in patients with coronary artery disease.

BACKGROUND: Non-invasive assessment of haemodynamic function by impedance cardiography (IC) constitutes an interesting approach to monitor cardiac function in patients with coronary artery disease (CAD). However, such measurements are most often performed at rest, whereas symptoms are also possible during exertion, particularly at higher intensities. In addition, the association between IC during exertion and cardiopulmonary exercise testing (CPX) is not well understood in these patients, which was the aim of this study. METHODS: Nineteen men (age = 62 ± 6 years) with CAD [left ventricular ejection fraction (LVEF) = 61 ± 10%] underwent a CPX using an incremental protocol on a cycle ergometer, with simultaneous measurement of IC. Cardiac output (CO), stroke volume (SV), cardiac index (CI), peak oxygen consumption (VO2 ), the oxygen uptake efficiency slope (OUES), circulatory power and ventilatory power were determined. RESULTS: Pearson product-moment correlation analysis revealed peak VO2 (r = 0·46) was significantly related to CO. Peak oxygen pulse (0·52) was associated with SV. OUES was associated with resting SV (0·47) and with peak SV (r = 0·52). CONCLUSION: These findings suggest that IC indices are associated with certain, but not all, established CPX measures in patients with stable CAD.

Poor glycemic control impacts linear and non-linear dynamics of heart rate in DM type 2 / Pobre controle glicêmico impacta a dinâmica linear e não linear da frequência cardíaca no DM2 / Control glucémico deficiente impacta la dinámica lineal y no lineal de la frecuencia cardíaca en el DM2

INTRODUCTION: It is well known that type 2 diabetes mellitus (T2DM) produces cardiovascular autonomic neuropathy (CAN), which may affect the cardiac autonomic modulation. However, it is unclear whether the lack of glycemic control in T2DM without CAN could impact negatively on cardiac autonomic modulation. Objective: To evaluate the relationship between glycemic control and cardiac autonomic modulation in individuals with T2DM without CAN. Descriptive, prospective and cross sectional study.METHODS: Forty-nine patients with T2DM (51±7 years) were divided into two groups according to glycosylated hemoglobin (HbA1c): G1≤7% and G2>7.0%. Resting heart rate (HR) and RR interval (RRi) were obtained and calculated by linear (Mean iRR; Mean HR; rMSSD; STD RR; LF; HF; LF/HF, TINN and RR Tri,) and non-linear (SD1; SD2; DFα1; DFα2, Shannon entropy; ApEn; SampEn and CD) methods of heart rate variability (HRV). Insulin, HOMA-IR, fasting glucose and HbA1c were obtained by blood tests.RESULTS: G2 (HbA1c≤7%) showed lower values for the mean of iRR; STD RR; RR Tri, TINN, SD2, CD and higher mean HR when compared with G1 (HbA1c > 7%). Additionally, HbA1c correlated negatively with mean RRi (r=0.28, p=0.044); STD RR (r=0.33, p=0.017); RR Tri (r=-0.35, p=0.013), SD2 (r=-0.39, p=0.004) and positively with mean HR (r=0.28, p=0.045). Finally, fasting glucose correlated negatively with STD RR (r=-0.36, p=0.010); RR Tri (r=-0.36, p=0.010); TINN (r=-0.33, p=0.019) and SD2 (r=-0.42, p=0.002).CONCLUSION: We concluded that poor glycemic control is related to cardiac autonomic modulation indices in individuals with T2DM even if they do not present cardiovascular autonomic neuropathy.

INTRODUÇÃO: É de conhecimento geral que o diabetes mellitus tipo 2 (DM2) produz neuropatia autonômica cardiovascular (NAC), que pode afetar a modulação autonômica cardíaca. Entretanto, não é claro se a falta de controle glicêmico em diabéticos tipo 2 sem NAC, poderia impactar negativamente na modulação autonômica cardíaca. Objetivo: Avaliar a relação entre controle glicêmico e modulação autonômica cardíaca em indivíduos com DM2 sem neuropatia autonômica cardiovascular. Estudo descritivo, prospectivo e transversal.MÉTODOS: Quarenta e nove pacientes com DM2 (51±7 anos) foram divididos em dois grupos de acordo com a hemoglobina glicosilada (HbA1c): G1: ≤ 7% e G2: >7,0%. A frequência cardíaca de repouso (FC) e intervalo RR (iRR) foram obtidos e calculados por métodos lineares (média iRR; média FC; rMSSD; STD RR; LF; HF; LF/HF, TINN e RR Tri) e não lineares (SD1; SD2; DFα1; DFα2, Entropia de Shannon; ApEn; SampEn e CD) de variabilidade de frequência cardíaca. Insulina, HOMA-IR, glicemia de jejum e HbA1c foram obtidas por análises sanguíneas.RESULTADOS: G2 (HbA1c ≤ 7%) mostrou valores menores para média de iRR; STD RR; RR Tri, TINN, SD2, CD e maiores para média de FR quando comparado com G1 (HbA1c > 7%). Adicionalmente, HbA1c correlacionou-se negativamente com media iRR (r=0,28, p=0,044); STD RR (r=0,33, p=0,017); RR Tri (r=-0,35, p=0,013), SD2 (r=-0,39, p=0,004) e positivamente com média FC (r=0,28, p=0,045). Finalmente, a glicemia de jejum correlacionou-se negativamente com STD RR (r=-0,36, p=0,010); RR Tri (r=-0,36, p=0,010); TINN (r=-0,33, p=0,019) e SD2 (r=-0,42, p=0,002).CONCLUSÃO: Conclui que o controle glicêmico deficiente relaciona-se com índices de modulação autonômica cardíaca em indivíduos com DM2, ainda que não apresentem neuropatia autonômica cardiovascular.

INTRODUCCIÓN: Es de conocimiento general que la diabetes mellitus tipo 2 (DM2) produce neuropatía autonómica cardiovascular (NAC), que puede afectar la modulación autonómica cardíaca. Entretanto, no es claro si la falta de control glucémico en diabéticos tipo 2 sin NAC, podría impactar negativamente en la modulación autonómica cardíaca. Objetivo: Evaluar la relación entre control glucémico y modulación autonómica cardíaca en individuos con DM2 sin neuropatía autonómica cardiovascular. Estudio descriptivo, prospectivo y transversal.MÉTODOS: Cuarenta y nueve pacientes con DM2 (51±7 años) fueron divididos en dos grupos de acuerdo con la hemoglobina glucosilada (HbA1c): G1: ≤ 7% y G2: >7,0%. La frecuencia cardíaca de reposo (FC) e intervalo RR (iRR) fueron obtenidos y calculados por métodos lineales (promedio iRR; promedio FC; rMSSD; STD RR; LF; HF; LF/HF, TINN y RR Tri) y no lineales (SD1; SD2; DFα1; DFα2, Entropía de Shannon; ApEn; SampEn y CD) de variabilidad de frecuencia cardíaca. Fueron obtenidas insulina, HOMA-IR, glucemia en ayunas y HbA1c a través de análisis sanguíneos.RESULTADOS: G2 (HbA1c ≤ 7%) mostró valores menores para el promedio de iRR; STD RR; RR Tri, TINN, SD2, CD y mayores para el promedio de FR al ser comparado con G1 (HbA1c > 7%). Adicionalmente, HbA1c se correlacionó negativamente con el promedio iRR (r=0,28, p=0,044); STD RR (r=0,33, p=0,017); RR Tri (r=-0,35, p=0,013), SD2 (r=-0,39, p=0,004) y positivamente con el promedio FC (r=0,28, p=0,045). Finalmente, la glucemia en ayunas se correlacionó negativamente con STD RR (r=-0,36, p=0,010); RR Tri (r=-0,36, p=0,010); TINN (r=-0,33, p=0,019) e SD2 (r=-0,42, p=0,002).CONCLUSIÓN: Concluimos que el control glucémico deficiente se relaciona con índices de modulación autonómica cardíaca en individuos con DM2, aunque no presenten neuropatía autonómica cardiovascular.

Potential Effects on Cardiorespiratory and Metabolic Status After a Concurrent Strength and Endurance Training Program in Diabetes Patients - a Randomized Controlled Trial.

BACKGROUND: Concurrent aerobic and resistance training (CART) programs have been widely recommended as an important strategy to improve physiologic and functional performance in patients with chronic diseases. However, the impact of a personalized CART program in patients with type 2 diabetes (T2D) requires investigation. Therefore, the primary aim of the current study is to investigate the impact of CART programs on metabolic profile, glycemic control, and exercise capacity in patients with diabetes. METHODS: We evaluated 41 subjects with T2D (15 females and 19 males, 50.8 ± 7 years); subjects were randomized into two groups; sedentary (SG) and CART (CART-G). CART was performed over 1.10-h sessions (30-min aerobic and 30-min resistance exercises) three times/week for 12 weeks. Body composition, biochemical analyses, peripheral muscular strength, and cardiopulmonary exercise testing were primary measurements. RESULTS: The glycated hemoglobin HbA1c (65.4 ± 17.9 to 55.9 ± 12.7 mmol/mol), cholesterol (198.38.1 ± 50.3 to 186.8 ± 35.1 mg/dl), and homeostasis model assessment insulin resistance (HOMA-IR) (6.4 ± 6.8 to 5.0 ± 1.4) decreased in the CART-G compared to the SG. Although body weight did not significantly change after training, skinfold measurement indicated decreased body fat in the CART-G only. CART significantly enhanced muscle strength compared to the SG (p < 0.05). CART was also associated with significant increase in peak oxygen uptake and maximal workload compared to the SG (p < 0.05). CONCLUSIONS: These data support CART as an important strategy in the treatment of patients with T2D, producing both physiologic and functional improvements. TRIAL REGISTRATION: Ensaiosclinicos.gov.br, RBR492q8z.

Estudo do comportamento cortisol, gh e insulina apos uma sessao de exercicio resistido agudo / Study of the behavior of cortisol, gh and insulin after a session of acute resisted exercise / Estudio del comportamiento de cortisol, gh e insulina despues de uma sesion de ejercicio resistido agudo

INTRODUÇÃO: Muitos trabalhos têm estudado o comportamento hormonal nos exercício resistido, entretanto poucos relacionam os hormônios cortisol, GH e insulina. OBJETIVO: Estudar os ajustes das concentrações plasmáticas dos hormônios cortisol, GH e insulina em exercícios resistidos de mesma intensidade com relação à massas musculares distintas. MÉTODOS: Dez voluntários, com 20,3 ± 4,2 anos, 74,1 ± 10,2 kg de peso, 177,2 ± 4,6 cm de estatura e 23,8 ± 3,2 kg/m2 de IMC, realizaram uma sessão de leg press (LP) e supino reto (SR) com quatro séries com 10 repetições a 70% 1 RM com três minutos de intervalo. Foram coletadas amostras de sangue para dosagem das concentrações plasmáticas de cortisol, GH e insulina em repouso (Pré) e em 0' (Rec. 0'), 30' (Rec. 30') e 90' (Rec. 90') de recuperação. RESULTADOS: As concentrações plasmáticas de cortisol foram significativamente reduzidas ao final da recuperação em LP (2,20±0,37 ng/dl para 1,33±0,38ng/dl) em relação à pré-dosagem. As concentrações de GH e insulina elevaram-se significativamente durante a recuperação. GH em LP foi significativamente maior em Rec. 0' (2,75±3,29 ng/ml para 9,60±5,32 ng/dl) do que em pré. A insulina elevou-se significativamente em Rec. 30' em LP (14,70±7,92 ulU/ml para 21,66 ± 8,61 ulU/ml) e em SR (6,17 ± 2,99 ulU/ml para 19,70 ± 13,8 ulU/ml) em relação à pré. As concentrações plasmáticas de insulina pré em LP foram significativamente superiores a SR (14,70 ulU/ml e 6,17 ± 2,99 ulU/ml). CONCLUSÃO: O exercício resistido promoveu diferentes ajustes nas concentrações hormonais de cortisol, GH e insulina durante o período de recuperação. .

INTRODUCTION: Many works have studied the hormonal behavior in resistance exercise, however, few relate the cortisol, GH and insulin hormones. OBJECTIVE: To study the adjustments of plasma concentrations of the cortisol, GH and insulin hormones in resisted exercises of the same relative intensity with different muscle musses. METHODS: Ten volunteers, aged 20.3 ± 4.2 years, weight 74.1 ± 10.2 Kg, 177.2 ± 4.6 cm of stature and 23.8 ± 3.2 Kg/m2 of BMI, underwent a session of leg press (LP) and bench press (BP) with four sets of 10 repetitions at 70% 1 RM with three minutes apart. We collected blood samples to measure plasma concentrations of cortisol, GH and insulin at rest (Pre) and 0' (Rec. 0'), 30' (Rec. 30') and 90' (Rec. 90') of recovery. RESULTS: Plasma concentrations of cortisol decreased significantly at the end of the recovery in LP (2.20 ± 0.37 ng/dl to 1.33 ± 0.38 ng/dl) compared to pre. The GH and insulin concentrations significantly increased during recovery. GH was significantly higher in LP Rec. 0' (2.75 ± 3.29 ng/ml to 9.60 ± 5.32 ng/dl) than in pre. Insulin was significantly elevated in Rec. 30' in LP (14.70 ± 7.92 ulU/ml to 21.66 ± 8.61 ulU/ml) and BP (6.17 ± 2.99 ulU/ml to 19.70 ± 13.8 ulU/ml) for pre. The plasma insulin concentrations pre PL were significantly higher in the BP (14.70 ulU/ml and 6.17 ± 2.99 ulU/ml). CONCLUSION: Resisted exercise promoted different adjustments in hormone concentrations of cortisol, GH and insulin during the recovery period. .

INTRODUCCIÓN: Muchos trabajos han estudiado el comportamiento hormonal en el ejercicio de resistencia, sin embargo, pocos se refieren el cortisol, GH y las hormonas insulina. OBJETIVO: Estudiar los ajustes de las concentraciones plasmáticas de las hormonas cortisol, GH e insulina en ejercicios resistidos, de igual intensidad, en relación con las masas musculares diferentes. MÉTODOS: Diez voluntarios, con 20,3 ± 4,2 años, 74,1 ± 10,2 kg de peso, 177,2 ± 4,6 cm de estatura y 23,8 ± 3,2 kg/m2 de IMC, realizaron una sesión de leg press (LP) y supino recto (SR) con cuatro series, de 10 repeticiones a 70% 1 RM, con tres minutos de intervalo. Se recolectaron muestras de sangre para dosificación de las concentraciones plasmáticas de cortisol, GH e insulina en reposo (Pré) y en 0' (Rec. 0'), 30' (Rec. 30') y 90' (Rec. 90') de recuperación. RESULTADOS: Las concentraciones plasmáticas de cortisol se redujeron significativamente al final de la recuperación en LP (2,20±0,37 ng/dl para 1,33±0,38ng/dl) en relación con la predosificación. Las concentraciones de GH e insulina aumentaron significativamente durante la recuperación. GH en LP fue significativamente mayor en Rec. 0' (2,75±3,29 ng/ml para 9,60±5,32 ng/dl) en comparación con la predosificación. La insulina se elevó significativamente en Rec. 30' en LP (14,70±7,92 ulU/ml para 21,66 ± 8,61 ulU/ml) y en SR (6,17 ± 2,99 ulU/ml para 19,70 ± 13,8 ulU/ml) en relación con la predosificación. Las concentraciones plasmáticas de insulina, predosificación, en LP fueron significativamente superiores a SR (14,70 ulU/ml y 6,17 ± 2,99 ulU/ml). CONCLUSIÓN: El ejercicio resistido causó diferentes ajustes en las concentraciones hormonales de cortisol, GH e insulina durante el período de recuperación. .

Análise eletromiográfica dos músculos da coxa no exercício agachamento afundo até a exaustão / Thigh muscles electromyographic activity during lunge exercise to fatigue

O agachamento afundo possui um posicionamento dos membros inferiores diferencial em relação ao agachamento padrão, necessitando de maiores esclarecimentos acerca das participações dos músculos envolvidos. O objetivo foi analisar a atividade eletromiográfica dos músculos vastus lateralis (VL), vastus medialis (VM), bíceps femoris (BF) e semitendinosus (ST) durante a execução do agachamento afundo até à exaustão com o membro inferior posicionado frontalmente e posteriormente. Participaram do estudo nove mulheres ativas com média (DP) de idade de 22 (3,4) anos e massa corporal 60,3 (4,1) kg. O agachamento afundo foi dividido em duas etapas, diferindo apenas o posicionamento do membro inferior dominante (randomizado). Os sinais eletromiográficos foram captados utilizando um eletromiógrafo e analisados os valores "root mean square" (RMS) na fase concêntrica. Os resultados indicaram um aumento significativo do RMS em função do tempo para o membro inferior posicionado frontalmente e posteriormente (p< 0,001). No membro posicionado frontalmente, o aumento do RMS correspondeu a 50 por cento para o VL, 54 por cento para o VM e 48 por cento para o BF. O membro posicionado posteriormente apresentou um aumento de 75 por cento para o VL, 113 por cento para o VM, 62 por cento para o BF e 48 por cento para o ST. O RMS também foi significativamente maior no músculo VM em relação ao ST no membro inferior posicionado anteriormente (p = 0,03) e em relação ao ST e BF no membro inferior posicionado posteriormente (p = 0,02). Não ocorreu interação significativa entre o efeito do tempo e músculo na atividade eletromiográfica. O RMS normalizado não apresentou diferenças estatisticamente significativas no que se refere ao posicionamento do membro inferior dominante. A atividade muscular foi semelhante em ambos os posicionamentos do membro inferior, apresentando maior aumento de ativação dos músculos VL e VM em relação ao BF e ST.

The position of lower limbs during lunge is different from squat without clear understanding on differences in muscle activation. The objective was to compare the electromyographic activity of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF) and semitendinosus (ST) during the execution of the lunge to exhaustion of the lower limb, changing position of the legs frontally and posteriorly. Nine active women participated of this study with a mean (SD) age of 22 (3.4) years and body mass 60.3 (4.1) kg. The lunge was divided in two phases, changing the forward leg (random order). The electromyographic signals were captured by an eletromyograph, and the root mean square (RMS) values were analyzed during the concentric phase. There was a significant increase of the RMS in time for the LL positioned frontally and posterior (p< 0,001). For the forward position, the increase of RMS was 50 percent for VL, 54 percent for VM and 48 percent for BF. The backward position had an increase of 75 percent for VL, 113 percent for VM, 62 percent for BF and 48 percent for ST. The RMS was significantly higher for VM than for ST the forward position (p = 0,03) and ST and BF for the backward position (p = 0,02). No interaction was observed between time and muscle in the electromyigraphic activity. The normalized RMS was not statistically different comparing the forward and backward position of the dominant leg. Muscle activity was similar in both positions of the LL, showing increased activation of the VM and VL muscles in relation to the BF and ST.

The measurement of lactate threshold in resistance exercise: a comparison of methods.

Resistance incremental tests (IT) make it possible to determine critical metabolic and cardiovascular changes, such as the lactate threshold (LT). Different methods are frequently used to improve the exactness of LT identification. The objective of the study was to identify LT by four different methods (visual inspection, log-log, algorithmic adjustment and QLac) during resistance exercise and to evaluate which methods present more precision. Twelve men performed a maximal IT on the leg press at relative intensities of 10%, 20%, 25%, 30%, 35%, 40%, 50%, 60%, 70%, 80% and 90% of 1RM with 1-min stages. During the 2-min interval between stages, capillary blood was collected for blood lactate analysis. LT was detected using each of the four methods. The intensity of LT by visual inspection method was 26·9 (5·2)% of 1RM, adjustment algorithmic method was 27·8 (3·6)% of 1RM, log-log method was 23·3 (3·5)% of 1RM and QLac method was 31·6 (9·8)% of 1RM, with significant difference only between log-log and QLac methods. Bland and Altman analysis shows better concordance for visual inspection versus adjustment algorithmic methods. The visual inspection, algorithmic and log-log methods detected the LT at the same intensity. The mathematical models, specially the algorithmic method, provide more precision.