Cardiovascular responses to pelvic floor muscle contraction in healthy women: Prospective study.

OBJECTIVE: Analyze the acute heart rate and blood pressure responses to two protocols of pelvic floor muscles contractions in premenopausal and postmenopausal women. METHODS: Fifty-four women without pelvic floor muscles disorders were eligible and allocated into two groups: premenopausal and postmenopausal. The groups underwent two protocols and the pelvic floor muscle endurance, heart rate, and blood pressure values were monitored. Both protocols included 10 pelvic floor muscles contractions; one series contained contractions lasting 5 s with 5 s of rest between each contraction and the other series contained contractions lasting 10 s with 10 s of rest. RESULTS: In both groups, there was a significant increase in the heart rate during pelvic floor muscles contractions (premenopausal: 71.0 ± 7.3 and 80.3 ± 7.7; postmenopausal: 65.4 ± 6.6 and 73.6 ± 6.6, at rest and contractions peak, respectively) and in systolic blood pressure immediately after the contractions. The observed values during exercise returned to basal values seconds after the contractions. A positive correlation between heart rate and vaginal squeeze pressure (r = 0.45, p = 0.0007 and r = 0.48, p = 0.0003, 5- and 10-s series, respectively) was observed. CONCLUSION: The proposed protocol of isometric pelvic floor muscles contractions caused an increase in heart rate and blood pressure within the normal range and might not represent a cardiovascular risk for healthy postmenopausal women without urinary incontinence and without cardiovascular dysfunctions.

Shuttle walking test in obese women: test-retest reliability and concurrent validity with peak oxygen uptake.

OBJECTIVE: The aim of this study was to evaluate the test-retest reliability, concurrent validity and agreement with peak oxygen uptake (VO2 ) obtained during cardiopulmonary exercise testing (CPX) on a treadmill for the incremental shuttle walking test (ISWT) in obese women. METHODS: Prospective study with a convenient sample of 46 community-dwelling obese women (BMI > 30 kg m(-2) ). The main outcome measures were walking distance on the ISWT and peak VO2 . RESULTS: Test-retest reliability was good to excellent for the exercise tests (ISWT distance ICC: 0.90; and CPX peak VO2 ICC: 0.90). Peak VO2 obtained during CPX correlated significantly with ISWT distance (r = 0.54, P<0.05) and peak VO2 obtained during the ISWT (r = 0.64, P<0.05). Bland and Altman plots demonstrated a high degree of repeatability. CONCLUSION: The ISWT had excellent reliability as well as good concurrent validity and agreement. The ISWT may be a potential tool for monitoring clinical status and intervention efficacy (e.g. programmes for weight loss and rehabilitative strategies) in this population.

Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women / Análise clínica e metabólica comparativa entre o teste de caminhada de seis minutos e o teste de exercício cardiopulmonar em mulheres obesas e eutróficas

BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX) and a treadmill six-minute walking test (tread6MWT) in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.

CONTEXTUALIZAÇÃO: A reduzida tolerância ao exercício está relacionada à diminuída capacidade funcional consequente da obesidade. Objetivos: Analisar e comparar respostas cardiopulmonares, metabólicas e subjetivas durante um teste de esforço cardiopulmonar e um teste de caminhada de seis minutos na esteira em mulheres obesas e eutróficas. MÉTODO: Foram incluídas 29 mulheres com idades entre 20 e 45 anos. Catorze voluntárias foram alocadas no grupo de obesas e 15, no grupo de eutróficas. Foram realizadas medidas antropométricas e de composição corporal. RESULTADOS: Em ambos os testes, as obesas apresentaram maiores valores de consumo absoluto de oxigênio, ventilação-minuto e pressão arterial sistólica e diastólica; ainda apresentaram menor velocidade de caminhada, distância percorrida e consumo de oxigênio relativo, quando comparadas com as eutróficas. Durante o teste máximo de exercício, a dispneia percebida foi maior e o quociente respiratório menor nas obesas em relação às eutróficas. Durante o teste submáximo, produção de dióxido de carbono, volume corrente e frequência cardíaca foram maiores nas obesas, comparadas às eutróficas. Houve forte correlação entre a frequência cardíaca e moderada correlação entre o consumo de oxigênio no pico dos testes. A frequência cardíaca obtida no teste submáximo aplicado foi capaz de predizer a frequência cardíaca obtida no teste máximo. Os gráficos de Bland-Altman demonstraram concordância entre os testes para identificar parâmetros metabólicos e fisiológicos no pico do exercício. CONCLUSÃO: O teste de caminhada de seis minutos induziu respostas ventilatórias, metabólicas e cardiovasculares concordantes com as do teste máximo, provando ser importante na rotina de avaliação funcional fisioterápica de mulheres obesas.

Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women.

BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX) and a treadmill six-minute walking test (tread6MWT) in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.