Effects of remote ischemic conditioning on conditioned pain modulation and cardiac autonomic modulation in women with knee osteoarthritis: placebo-controlled randomized clinical trial protocol.

BACKGROUND: It is estimated that over 240 million people worldwide have osteoarthritis, which is a major contributor to chronic pain and central changes in pain processing, including endogenous pain modulation. The autonomic nervous system plays a crucial role in the pain regulatory process. One of the main mechanisms of remote ischemic conditioning is neuronal signaling from the preconditioned extremity to the heart. This study aims to analyze the acute effect of remote ischemic conditioning on local pain, conditioned pain modulation, and cardiac autonomic control in women with knee osteoarthritis and to see if there is a correlation between them. METHODS: Women more than 50 years with knee osteoarthritis diagnosed according to the American College of Rheumatology criteria in the postmenopausal period will be considered eligible. The study will have blind randomization, be placebo-controlled, and be balanced in a 1:1 ratio. The total of 44 participants will be divided into two groups (22 participants per group): (i) remote ischemic conditioning and (ii) placebo remote ischemic conditioning. Protocol consisting of four cycles of total ischemia, followed immediately by four cycles of 5 min of vascular reperfusion, totaling 40 min. The primary outcomes in the protocol are conditioned pain modulation, which has the pressure pain threshold (kgf/cm2) as its primary outcome measure, and cardiac autonomic modulation, which has the indices found in heart rate variability as its primary outcome measure. Comparisons will be performed using generalized linear mixed models fitted to the data. For correlation, the Pearson or Spearman test will be used depending on the normality of the data. All analyses will assume a significance level of p < 0.05. DISCUSSION: It is believed that the results of this study will present a new perspective on the interaction between the pain processing system and the cardiovascular system; they will provide the professional and the patient with a greater guarantee of cardiovascular safety in the use of the intervention; it will provide knowledge about acute responses and this will allow future chronic intervention strategies that aim to be used in the clinical environment, inserted in the multimodal approach, for the treatment of osteoarthritis of the knee. TRIAL REGISTRATION: ClinicalTrials.gov NCT05059652. Registered on 30 August 2021. Last update on 28 March 2023.

Acute effects of resistance exercise with blood flow restriction on cardiovascular response: a meta-analysis.

Aim: To compare the acute effects of low-load resistance training associated with blood flow restriction (LLRT-BFR) with low-load resistance training (LLRT) and high-load resistance training (HLRT) on cardiovascular outcomes in healthy individuals. Methods: This review was registered and the studies were selected using seven databases. Randomized controlled clinical trials were included that evaluated LLRT-BFR compared with LLRT and HLRT in young individuals for the cardiovascular outcomes. Results: 19 studies were included. In the comparison of LLRT-BFR with HLRT, there were significant differences for cardiac output and heart rate - with reduced values and in favor of LLRT-BFR. Conclusion: There are no greater acute effects of the addition of blood flow restriction, with the exception of the reduction in cardiac output and heart rate for LLRT-BFR compared with HLRT.

Effects of different ischemic preconditioning occlusion pressures on muscle damage induced by eccentric exercise: a study protocol for a randomized controlled placebo clinical trial.

INTRODUCTION: Due to its greater generation of muscle strength and less metabolic demand, eccentric exercise has been widely used in rehabilitation and for improving physical fitness. However, eccentric exercise can induce muscle damage by providing structural changes and reduced muscle function, so even with the protection caused by the repeated bout effect from eccentric exercise, it is necessary to seek alternatives to reduce this damage caused by stress. Thus, ischemic preconditioning could represent an aid to reduce the damage muscle or increase the protective effect caused by eccentric exercise. OBJECTIVES: To compare the effects of ischemic preconditioning, using different occlusion pressures, on acute and delayed responses to perceptual outcomes, markers of muscle damage, and performance in post-eccentric exercise recovery. METHODS: A randomized controlled placebo clinical trial will be carried out with 80 healthy men aged 18 to 35 years who will be randomly divided into four groups: ischemic preconditioning using total occlusion pressure, ischemic preconditoning with 40% more than total occlusion pressure, placebo (10 mmHg), and control. The ischemic preconditioning protocol will consist of four cycles of ischemia and reperfusion of five minutes each. All groups will perform an eccentric exercise protocol, and assessments will be carried out before, immediately after, and 24, 48, 72, and 96 h after the end of the eccentric exercise to evaluate creatine kinase, blood lactate, perception of recovery using the Likert scale, being sequentially evaluated, pain by the visual analog scale, pain threshold using a pressure algometer, muscle thickness by ultrasound, muscle tone, stiffness and elasticity by myotonometry, vectors of cell integrity through electrical bioimpedance, and maximal voluntary isometric contraction using the isokinetic dynamometer. The trial was registered at ClinicalTrials.gov (NCT04420819). DISCUSSION: The present study aims to present an alternative technique to reduce muscle damage caused by eccentric exercise, which is easy to apply and low cost. If the benefits are proven, ischemic preconditioning could be used in any clinical practice that aims to minimize the damage caused by exercise, presenting an advance in the prescription of eccentric exercise and directly impacting on the results of post-exercise recovery. TRIAL REGISTRATION: ClinicalTrials.gov NCT04420819 . Registered on 19 May 2020; Last update 24 March 2021.

Effects of the Mat Pilates Method on Body Composition: Systematic Review With Meta-Analysis.

BACKGROUND: The objective of this systematic review was to determine the efficacy of the mat Pilates method on body composition in healthy adult subjects compared with traditional exercise or control condition models. DESIGN: Systematic review with meta-analysis. DATA SOURCES: MEDLINE, EMBASE, SPORTDiscus, PEDro, SciELO, CINAHAL, and the Cochrane Library. RESULTS: A total of 10 eligible studies were selected for revision. The findings of this review demonstrated that the mat Pilates method was not more effective than the traditional exercise or control condition models for the analyzed variables (body mass index, lean mass, body fat percentage, and abdominal circumference). Moreover, in the exploratory analysis with older people, adults, and overweight/obese individuals, the mat Pilates method was also not superior for the analyzed outcomes. CONCLUSION: The findings of this study suggest that the mat Pilates method is no better than the control condition or other types of training to reduce body composition.

Load monitoring on Pilates training: a study protocol for a randomized clinical trial.

BACKGROUND: Currently there are campaigns to raise the awareness of the need to practice physical exercise with several objectives, mainly as a preventive measure. The Pilates method is a form of therapeutic exercise for maintaining and improving health. However, despite being popular, there is still no scientific evidence on the standardization and progression of the method. Therefore, the purpose of this study was to develop a protocol to monitor the progression of daily Pilates loads between the basic, intermediate, and advanced levels, as well as to analyze the effects of the method on psychometric, cardiorespiratory, and autonomic measures. METHODS/DESIGN: In total, 54 healthy men underwent 36 sessions of Pilates mat work. Before each training session, cardiorespiratory measures, pain (visual analogue scale), and a psychometric questionnaire were collected. Heart rate (HR), subjective perception of effort (SPE), and RR intervals were measured during the sessions and used later in the analysis of the progression of training load by monitoring the internal training load and heart rate variability. At the end of the sessions, cardiorespiratory measures, the visual analogue scale, and the psychometric questionnaire were measured again. After 15 min of rest, the final HR measurement was made and the participants noted the effort on the SPE scale. The psychometric, cardiorespiratory, and autonomic measures were evaluated before and after each of the 36 training sessions. DISCUSSION: This is a parallel randomized clinical trial of standardized Pilates training, with the aim of estimating training loads and measuring the efficacy of Pilates through clinical, cardiorespiratory, and autonomic outcomes. The protocol can easily be reproduced and could be used to support professionals in prescribing the method. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03232866 . Registered on 28 July 2017.