Transcranial Direct Current Stimulation Associated With Functional Exercise Program for Treating Fibromyalgia: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of transcranial direct current stimulation (tDCS) associated with functional exercise on pain, functional performance, psychological symptoms, and quality of life of patients with fibromyalgia (FM). DESIGN: Randomized controlled trial. Participants were randomized by blocks into 2 groups: tDCS associated with functional exercise (n=17) and sham-tDCS associated with functional exercise (n=14). SETTING: Laboratory of neuromuscular performance in the department of physical therapy. PARTICIPANTS: Women with FM (N=31) according to American College of Rheumatology-2010 criteria. INTERVENTIONS: Anodal tDCS or sham-tDCS was applied over the left motor cortex for 5 consecutive days during the first week of intervention (2 mA; 20min). All volunteers also engaged in 8 weeks of functional exercises 3 times per week. MAIN OUTCOME MEASURES: Pain intensity, functional performance, psychological symptoms, and quality of life were assessed pre-exercise and immediately after the first, fourth, and eighth weeks of intervention. RESULTS: Pain intensity, functional performance, psychological symptoms, and quality of life increased significantly in both groups (P<.05); however, no significant differences between groups were found in all outcomes (P>.05). CONCLUSION: tDCS associated with functional exercises did not enhance the effects of physical exercise on pain, functional performance, psychological symptoms, and quality of life of patients with FM.

Efeito do treino com restrição de fluxo sanguíneo versus treino resistido de alta intensidade sobre a força de indivíduos sedentários: um ensaio clínico controlado e randomizado / Blood flow restriction training versus high-intensity resistance training in sedentary individuals: a randomized controlled trial

Objetivos: comparar os efeitos do treino com restrição de flux o sanguíneo com o treino resistido de alta intensidade no ganho de força e hipertrofia. Material e métodos: n este ensaio clínico randomizado e controlado, 24 homens sedentários foram randomizados em do is grupo s: treino com restrição de fluxo sanguíneo ou treino resistido de alta intensidade. Ambos os grupos realizaram 10 sessões de exercício de preensão manual até com 3 séries de exercícios até a falha, sendo que o grupo com treino de restrição de fluxo sanguíneo realizou com 30% da carga máxima obtida no teste de 1 repetição máxima, enquanto que o grupo de alta intensidade realizou com 80% da carga. T odo s o s voluntários foram avaliados e reavaliados a dinamometriade preensão manual e a perimetria de antebraço. Os dados foram tabulados e analisados no statistical package for the social sciences, utilizando o teste t-student, e o não paramétrico u de mann whitney, adotando a significância de 5% (α = 0,05). Resultados: para o desfecho força, identificou-se que tanto o grupo que treino com restrição do fluxo, quanto o grupo que treinou com alta intensidade tiveram aumentos significativos (p= 0,005 e 0,026, respectivamente). Já em relação ao aumento da circunferência, notou-se que somente o treino de restrição do flux o se mostrou estatisticamente quando comparado o aumento entre os grupos (p= 0,00 1). Conclusão: foi possível concluir que o treinamento com restrição do fluxo sanguíneo mostrou eficaz tanto para o ganho de força, quanto para o aumento de circunferência, apresentando vantagens quando comparado ao grupo de treinamento resistido com alta intensidade...(AU)

Objectives: to compare the effects of blood flow restriction trainin g wit h h igh in tensity resistance training on strength gain and hypertrophy. Material and methods: in this randomized controlled trial, 24 sedentary men were randomized into two groups: restricted blood flow training or high inten sity resistance training. Both groups performed 10 handgrip exercise sessions up to 3 sets of exercises un t il failure, and the group with blood flow restriction training performed with 3 0 % o f t he m ax imum lo ad obtained in the 1-repetition maximum test, while the high intensity group performed with 80% of the load. All volunteers were assessed and reassessed by handgrip dynamometry and forearm perimetry. Data were tabulated and analyzed in the statistical package for the social sciences, using the t-studen t test an d t he non-parametric mann whitney u test, adopting the significance of 5% (α = 0.05). Results: for the stren gth outcome, it was found that both the flow restriction training group and the high intensity train in g gro up had significant increases (p = 0.005 and 0.026, respectively). Regarding the increase in circumference, it was noted that only the flow restriction training was statistically when compared to the increase bet ween the groups (p = 0.001). Conclusion: it was concluded that training with blood flow restriction was effective for both strength gain and circumference increase, presenting advantages when compared to the high intensity resistance training group...(AU)

Whole body vibration improves maximum voluntary isometric contraction of knee extensors in patients with chronic kidney disease: A randomized controlled trial.

BACKGROUND: Whole body vibration (WBV) training improves maximum voluntary isometric contraction (MVIC) of knee extensors, postural balance, functional capacity, and quality of life (QOL) in several diseases. The objective was to assess the efficacy of WBV training in patients with chronic kidney disease (CKD) on hemodialysis (HD) in the interdialytic period. METHOD: A randomized, controlled trial study with concealed allocation, intention-to-treat analysis, and triple blinding. Sixteen patients with CKD of both genders aged over 40 years were allocated in two groups, the WBV group or the sham group, training 2 times a week for 12 weeks. The primary outcome was knee extensor muscle strength, and the secondary outcomes were quadriceps thickness, distance walked, balance, and QOL. RESULTS: The WBV group improved MVIC of knee extensors with a difference between groups in improvement of 117.29 N (95% CI, 32.25-202.24) at the end of training. The other outcomes were not different between groups. Practical applications: The WBV program has shown to be effective and may be able to help in prescribing the appropriate training program for CKD. CONCLUSION: WBV training improves MVIC of knee extensors in patients with CKD on HD in the interdialytic period. WBV training could be considered in the management of patients with CKD.