Atribuciones profesionales en el ejercicio para la salud de la Sociedad Española de Medicina del Deporte / Professional attributions in the exercise for the health of the Spanish Society of Sports Medicine

La práctica regular de ejercicio físico es extraordinariamente efectiva en el manejo de un número creciente de patologíascrónicas algunas de ellas con una prevalencia de magnitud pandémica, por lo que la sociedad debe asumir la incorporaciónde la actividad física como estrategia de salud para prevenir y para servir como tratamiento complementario de la enfermedad.La medicina y la fisioterapia tienen un papel primordial en el manejo del ejercicio para la salud y también, fuera de la sanidad,las titulaciones de ciencias de la actividad física y el deporte ocupan un papel muy destacado en este ámbito de trabajo.Desde la sanidad, la medicina y la fisioterapia tienen un papel primordial en el manejo del ejercicio para la salud y también,fuera de la sanidad, las titulaciones de ciencias de la actividad física y el deporte ocupan un papel muy destacado en la pro-moción y ejecución de estrategias para el fomento de la salud.Estas profesiones han venido ocupando una posición en el abordaje de este problema que, en algunas ocasiones, ha supuestopuntos de fricción respecto a su papel, responsabilidades y función. Por otra parte, existe la necesidad de resolver la cuestiónde los ámbitos competenciales de las profesiones manteniendo la voluntad de reconocer simultáneamente los crecientesespacios competenciales compartidos interprofesionalmente y los muy relevantes espacios específicos de cada profesión.Este documento parte de la necesidad de abordar la incorporación del ejercicio en la prevención y manejo de la enfermedadde una forma sólida y consistente, considerando la aportación de las profesiones implicadas desde la óptica del trabajo mul-tidisciplinar y con una colaboración no conflictiva sino cooperativa, transparente y respetuosa y, siempre, con el objetivo deservir a la sociedad de la forma más efectiva posible, definiendo de una forma clara cuáles con las atribuciones profesionalesde la medicina, de la fisioterapia y de las ciencias...(AU)

The regular practice of physical exercise is extraordinarily effective in the management of a growing number of chronic diseases,some of them with a prevalence of pandemic magnitude, for which the society must assume the incorporation of physicalactivity as a health strategy to prevent and to serve as a complementary treatment of the disease.Not only medicine and physiotherapy play a fundamental role in the management of exercise for health but also, outside ofhealth, Sports science and physical education degree is crucial in this field of work.From a health point of view, medicine and physiotherapy have a primary role in the management of exercise for health andalso, outside of health, sports science and physical education degree occupy a very prominent role in the promotion andimplementation of strategies for the promotion of health.These professions have been occupying a position in addressing this problem that, on some occasions, has led to points offriction with respect to their role, responsibilities and function. On the other hand, there is a need to resolve the question ofthe professions’ areas of competence while maintaining the will to simultaneously recognize the growing areas of competenceshared interprofessionally and the highly relevant areas specific to each profession.This document is based on the need to address the incorporation of exercise in the prevention and management of disease ina solid and consistent way, considering the contribution of the professions involved from the perspective of multidisciplinarywork and with a non-conflictual but cooperative, transparent and respectful collaboration. In addition, this collaborationshould always aim at serving society in the most effective way possible, clearly defining the professional attributions of me-dicine, physiotherapy and physical activity and sport sciences in everything related to the use of exercise as a tool for health.(AU)

Soccer Matches but Not Training Sessions Disturb Cardiac-Autonomic Regulation During National Soccer Team Training Camps.

Purpose: Heart rate variability (HRV) can be used to monitor changes in autonomic nervous system (ANS) function. Monitoring HRV via the natural log of the root-mean-square difference of successive normal RR intervals (lnRMSSD), a decrease was related to lower parasympathetic activity and a fatigued state, and an increase was related to higher parasympathetic activity and better physical conditioning. This study analyzed daily ANS function changes among professional soccer players at national team training camps during preparation for the UEFA Eurocup 2016. Method: 23 professional soccer players were distributed into two groups: First eleven (players who played more than 60 minutes per soccer match) and Reserves (the rest of the players). HRV and session training load (s-TL) were monitored. Between-group daily differences were assessed using two-way mixed repeated measures ANOVA. Results: s-TL significantly increased (p < .05) at the beginning of each camp and significantly decreased the day before the soccer match (p < .001). There was a significant time by group interaction in lnRMSSD (p = .024). Changes were found in the First eleven group from match day +1 to match day +2 (+0.523 ms, p = .003). After the soccer match, there were between-group differences (p < .05) at +24h and +72h in lnRMSSD. Conclusions: During national team training camps, ANS function was only modified 24h and 72h after playing soccer matches, in players who played a minimum of 60 minutes. This knowledge can help coaches to monitor the impact of soccer matches during training camps to detect fatigue and improve recovery.

Comparison of Omegawave Device and an Ambulatory ECG for RR Interval Measurement at rest.

The aim of this study was to validate the measurements of the beat intervals taken at rest by the Omegawave® device by comparing them to an ambulatory electrocardiogram system. For this purpose, the electrocardiogram was digitally processed, time-aligned, and scrutinized for its suitable use as gold-standard. Rest measurements were made for 10 minutes on 5 different days to 10 men and 3 women (24.8±5.05 years; 71.82±11.02 kg; 174.35±9.13 cm). RR intervals were simultaneously recorded using the Omegawave device and a Holter electrocardiogram. The processing of Holter electrocardiogram signals included the detrending of baseline noise and a high-pass filtering for emphasizing the QRS complexes and attenuating the T waves. After obtaining the RR intervals from the electrocardiogram, those from the Omegawave device were automatically aligned to them with cross-correlation digital processing techniques and compared to check whether both measurements could be considered superimposable. A Bland-Altman analysis was applied to the 5 measurements made for all subjects. The Omegawave device exhibited very strong agreement with a quality-controlled Holter electrocardiogram. Deviations not exceeding 25 ms could be expected in 95% of the cases, which is within manageable ranges both for clinical practice and for sports.

Obesidad y ejercicio físico en adultos / Obesity and physical exercise in adults

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Long-Term Combined Training in Idiopathic Pulmonary Fibrosis: A Case Study.

A supervised combined training program was applied to a sedentary 56-year-old man with idiopathic pulmonary fibrosis (IPF) along three years, until lung transplantation. It included: (a) aerobic continuous (CT) and interval training (IT), (b) high load resistance training (RT) and (c) inspiratory muscle training (IMT). IT and IMT were applied for two years, while CT and RT could be maintained until transplantation using supplemental oxygen. Maximal inspiratory pressure (MIP) kept above 180 cm H2O and forced vital capacity (FVC) remained stable until lung transplantation. Peak oxygen uptake VO2 increased during 1.5 years before its decline, staying above the poor prognosis level two years. Finally, the patient maintained his walking capacity and independence for 2 years, before the decline due to the disease. After receiving a two-lung transplant, the patient remained intubated for 12 h, left the intensive care unit after 3.5 days and was discharged after 18 days (average values: 48 h, 7-10 days and 25-35 days, respectively). These results show that systematic and supervised combined training can be safety applied in an IPF patient to maintain functionality and quality of life. In addition, we show that RT can be maintained for as long as necessary without complications.

Individual versus team heart rate variability responsiveness analyses in a national soccer team during training camps.

Heart rate variability (HRV) analyses can be performed using group or individual changes. Individual changes could be of potential interest during training camps for national soccer teams. The purpose of this study was to compare whether analysis of individual daily HRV could detect changes in cardiac autonomic responses during training camps for national soccer teams. During two different training camps, 34 professional soccer players were monitored daily over 9 days, using heart rate monitors. Players were divided into First Eleven (those who participated in the main squad) or Reserves. Daily HRV was individually analyzed using a day-to-day method or a baseline (days prior to first match) method, using the smallest worthwhile change and the typical error in the estimate to establish a trivial (random change) zone. Group changes were also analyzed using an ANOVA one-way repeated measures test. Players' responsiveness was classified as High-, Low- or Non-response depending on individual changes. Both analyses showed substantial daily individual changes after playing a soccer match, regardless of the group. However, group changes showed that only First Eleven players had significant changes after playing a soccer match. In conclusion, individual daily HRV analyses are useful in detecting individual changes in professional soccer players.

Basal and post-exercise heart rate variability correlates with training load in endurance athletes / La variabilidad de la frecuencia cardíaca basal y posterior al ejercicio correlaciona con la carga de entrenamiento en atletas de resistencia / A variabilidade da frequência cardíaca basai e pós-exercício está correlacionada com a carga de treinamento em atletas de resistência

OBJECTIVE: Heart rate variability has been proposed as a valid method to examine the individual response to training load in endurance athletes. Thanks to this tool, the relationship between basal and post-exercise Heart rate variability measurements can be analyzed during a microcycle (one week) using straight values or their coefficients of variation. METHOD: Ten amateur endurance athletes (n = 5 men, n = 5 women) were monitored during a 7-day microcycle that included three road-cycling sessions, two running sessions and two trail-running sessions. The RR series were measured for 5 minutes upon wake up and after training, in a seating position, using a chest strap. RESULTS: Basal and post-exercise Heart rate variability measurements showed high correlation when weekly mean values were used, very similar to when coefficients of variation values were used. In women, the root mean square of successive differences (RMSSD) was: r= 0.73; RMSSD coefficients of variation (RMSSDcv) was: r= 0.66; natural logarithm (Ln) RMSSD: r= 0.68; LnRMSSDcv: r= 0.79; and in men it RMSSD was: r= 0.78; RMSSDcv: r= -0.62; LnRMSSD: r= 0.75; LnRMSSDcv: r= -0.73). CONCLUSION: the relationship between these two measurements could be useful to program the training loads of the following microcycle

OBJETIVO: La variabilidad de la frecuencia cardíaca se ha propuesto como un método válido para examinar la respuesta individual a la carga de entrenamiento en atletas de resistencia. El objetivo de este estudio fue analizar la relación entre las mediciones basales y post ejercicio durante un microciclo (una semana) utilizando valores directos o sus coeficientes de variación. MÉTODO: Se monitorizó a diez atletas aficionados de resistencia durante un microciclo de 7 días, que incluyó tres sesiones de ciclismo de ruta, dos sesiones de carrera y dos sesiones de trail running. Las series RR se midieron durante 5 minutos al despertar y después del entrenamiento, en posición sentado, utilizando una banda torácica. RESULTADOS: Las mediciones de variabilidad de la frecuencia cardíaca basales y post ejercicio mostraron una alta correlación cuando se usaron valores medios semanales, como cuando se usaron valores de los coeficientes de variación. En mujeres, la raíz cuadrada de la media de las diferencias de la suma de los cuadrados entre intervalos RR adyacentes (RMSSD) fue: r = 0.73; el coeficiente de variación (cv) de la RMSSD fue RMSSDcv: r = 0.66; el logaritmo natural (Ln) de la RMSSD (LnRMSSD) fue: r = 0.68; LnRMSSDcv: r = 0.79; y en los hombres fueron RMSSD: r = 0.78; RMSSDcv: r = -0.62; LnRMSSD: r = 0.75; LnRMSSDcv: r = -0.73. CONCLUSIONES: La relación entre estas dos mediciones podría ser útil para el programa de entrenamiento del microciclo posterior

OBJETIVO: A variação da frequência cardíaca tem sido utilizada como método de análise de respostas individuais a carga de treino em atletas de endurance. Graças a esta ferramenta, a relação entre a variação da frequência cardíaca basal e pós-exercício pode ser analisada durante um microciclo (uma semana) usando valores diretos ou seus coeficientes de variação. MÉTODO: Dez atletas de endurance amadores (n = 5 homens, n = 5 mulheres) foram monitorados durante microciclos de 7 dias que incluíram 3 sessões de ciclismo em estrada, duas sessões de corrida e duas sessões de corrida em trilha. As series de RR foram medidas durante 5 minutos depois de acordar e depois do exercício, em posição sentada, com recurso a cardiofrenquencímetros toráxicos. RESULTADOS: Os resultados mostram uma correlação alta entre as medidas de variação de frequência cardíaca basal e pós-exercício quando utilizados valores médios semanais, muito semelhantes aos resultados quando utilizados coeficientes de variação. Nas mulheres, a raiz quadrada media das diferenças sucessivas (RMSSD) foi: r= 0.73; coeficientes de variação RMSSD, (RMSSDcv) foi: r= 0.66; logaritmo natural (Ln) RMSSD: r = 0.68; LnRMSSDcv: r= 0.79; e nos homens, raiz quadrada media das diferenças sucessivas r= 0.78; RMSSDcv: r= -0.62; LnRMSSD: r= 0.75; LnRMSSDcv: r= -0.73). CONCLUSÃO: a relação entre estas duas medidas poderia ser útil para prescrição de cargas de treino dos microciclos seguintes

Heart rate variability to assess the effect of sleep deprivation in mountain troops of the chilean army: a pilot study / Variabilidad de la frecuencia cardíaca para evaluar el efecto de la privación del sueño en tropas de montaña del ejército chileno: un estudio piloto

BACKGROUND: Our objective was to identify the effect of sleep deprivation on a stress test simulating a military march, via changes in heart rate variability (HRV) in special mountain troops. Eight subjects from special mountain troops carried out a simulated march test on a treadmill. The incremental march test had 7 stages of 3 minute duration at a constant velocity of 5 km/h and slopes of 1, 3, 5, 7, 8, 9 and 10 %. To assess the HRV, two heartbeat records were taken over 5 minutes in dorsal decubitus position before and after the march test; the first session took place without sleep deprivation, and the following day with sleep deprivation. RESULTS: The main finding of this study is that the physiological stress imposed by the simulated treadmill march is the same with and without sleep deprivation. There were no significant differences between pre and post HRV data in any of the situations, but effect size was moderate or large (d=0.2 was considered as the Smallest Worthwhile Change). indicating a highly relevant response. However, after comparing with and without sleep deprivation tests no changes were found (non-significant and non-relevant). CONCLUSIONS: The stress test performed, did not present differences in physical and physiological responses while being deprived of sleep over 24 hours. A simple test is proposed to evaluate the effect of sleep deprivation as a stressor agent. A treadmill test at a constant speed with increasing slopes would be performed and repeated the following day after 24 hours of sleep deprivation

INTRODUCCIÓN: Nuestro objetivo fue identificar el efecto de la falta de sueño en una prueba de esfuerzo que simula una marcha militar, a través de cambios en la variabilidad de la frecuencia cardiaca (VFC) en tropas especiales de montaña. Ocho sujetos de tropas especiales de montaña realizaron una prueba de marcha simulada en una cinta de correr. La prueba de marcha incremental tuvo 7 etapas de 3 minutos de duración a una velocidad constante de 5 km/h y pendientes de 1, 3, 5, 7, 8, 9 y 10%. Para evaluar la VFC, se tomaron los registros de latidos latido del corazón durante 5 minutos en posición de decúbito dorsal antes y después de la prueba de marcha; la primera sesión tuvo lugar sin privación de sueño y al día siguiente con privación de sueño. RESULTADOS: El principal hallazgo de este estudio es que el estrés fisiológico impuesto por la marcha simulada de la cinta rodante es el mismo con y sin privación del sueño. No hubo diferencias significativas entre los datos de VFC anteriores y posteriores en ninguna de las situaciones, pero el tamaño del efecto fue moderado o grande (d = 0.2 se consideró como umbral de cambio pequeño). Indica una respuesta altamente relevante. Sin embargo, después de comparar con y sin las pruebas de privación de sueño, no se encontraron cambios (no significativos y no relevantes). CONCLUSIONES: La prueba de esfuerzo realizada no presentó diferencias en las respuestas físicas y fisiológicas al estar privada de sueño durante 24 horas. Se propone una prueba simple para evaluar el efecto de la falta de sueño como agente estresante. Se realizaría una prueba de la cinta rodante a una velocidad constante con pendientes crecientes y se repetiría al día siguiente después de 24 horas de falta de sueño

Cambios hormonales en soldados aclimatados durante una marcha en gran altitud con esquí de montaña / Hormonal changes in acclimatized soldiers during a march at a high altitude with mountain skis

Background: The aim of the present study is to identify the physiological impact of acute exposure to high altitudes on special acclimatized troops of the Chilean Army. Twenty-nine soldiers carried out a nocturnal winter march on mountain skis at an initial altitude of 2,800 m and up to 3,640 m. Two separate blood measurements were taken. The first one was taken the day before the march (Pre-sample) and the second one just after returning to the base camp (Post-sample). All subjects had been acclimatized prior to the study. For hypothesis comparison purposes, the normality of the distribution was tested using the Shapiro-Wilk test. To determine if there were significant differences between the Pre and Post tests, a paired-samples Student t-test was applied for the variables with a normal distribution, and the Wilcoxon test was applied for the variables without a normal distribution. In all cases, a level of significance of 95% (p<0.05) was taken into consideration. Results: Exposure of acclimatized troops to altitudes of 2,800 m to 3,640 m has an impact on the endocrine parameters and on the reduction of cortisol (p<0.01), total testosterone (p<0.0001), free testosterone (p<0.0001) and the free testosterone-cortisol ratio (p<0.01). Likewise, an increase in total leukocytes (p<0.0001), neutrophils (p<0.0001), monocytes (p<0.0001) and basophils (p<0.001), as well as a decrease of eosinophils (p<0.0001) and lymphocytes (p<0.01), was observed. No hematological changes were detected. Conclusions: Endocrine changes were observed during high-altitude winter marches on mountain skis carried out by accli-matized Special Operation Troops, resulting in decreased cortisol and free and total testosterone levels. A stress condition due to the high altitudes also affected the anabolic/catabolic environment, which manifested as a significant decrease in the free testosterone/cortisol ratio. No hematological changes were identified. Marked changes were observed in some white cell series

Introducción: El objetivo del presente estudio es identificar el impacto fisiológico (con especial atención a los parámetros endocrinos y hematológicos) de la exposición aguda a gran altitud (GA) en tropas especiales aclimatadas del Ejército de Chile. Veintinueve soldados llevaron a cabo una marcha nocturna con esquí de montaña invernal a una GA de 2.800 m. hasta 3.640 m. Se tomaron dos muestras de sangre. La primera muestra fue tomada el día antes de la marcha (Pretest) y la segunda muestra justo después al regresar al campamento base Post test (a los 2.800 m). Todos los sujetos se encontraban aclimatados antes del estudio. Para cada análisis se testeo la normalidad de las distribuciones empleando el test de Shapiro-Wilk. Se calculó el promedio y la desviación estándar para cada medición. Para determinar si existían diferencias significativas entre el pre y post test se aplicó la prueba de t-Student pareada para las variables con distribución normal y el test de Wilcoxon para las variables que no tenían distribución normal. En todos los casos se consideró un nivel de confianza de 95% (valor p < 0,05). Resultados: La exposición de las tropas aclimatadas a GA tiene un impacto en los parámetros endocrinos y en la reducción de cortisol (p <0,01), testosterona total (p <0,0001), testosterona libre (p <0,0001) y el ratio testosterona libre-cortisol (p <0.01). Asimismo, se observaron un aumento de leucocitos (p <0,0001), neutrófilos (p <0,0001), monocitos (p <0,0001) y basófilos (p <0,001), así como una decrease de eosinófilos (p <0,0001) y linfocitos (p < 0.01). No se observaron cambios en la serie roja. Conclusiones: La marcha invernal nocturna con esquí de montaña en GA para tropas de operaciones especiales aclimatadas presento cambios endocrinos con disminución del cortisol, testosterona libre y total. Una condición de estrés por la marcha en GA también afectó al ambiente anabólico/catabólico, lo que se ve reflejado en una disminución significativa en el cociente testosterona libre/cortisol. No se observaron cambios hematológicos. Se observaron cambios significativos en algunas células de la serie blanca

Efectos hormonales y hematológicos en una marcha invernal de baja altitud en militares chilenos / Hormonal and hematological effects in a low-altitude winter march in chilean military

Introducción: Las exposiciones intermitentes a gran altitud tienen efectos agudos sobre algunos marcadores biológicos, como la testosterona, pero no así en baja altitud. Dado que el entrenamiento de soldados debería ir asociado a tareas militares específicas, adquiere gran importancia valorar los cambios fisiológicos que puedan producirse en determinadas circunstancias (como la altitud) pero durante la realización de actividades propias de las unidades militares. Objetivo: Identificar los cambios hematológicos y en las hormonas Testosterona Libre (TL), Testosterona Total (TT ) y Cortisol en una marcha nocturna a baja altitud en soldados de operaciones en montaña. Metodología: 32 Militares masculinos (26,3 ± 4,50 años, 75,1 ± 7,6 kg) realizaron una marcha invernal nocturna con equipo y un desnivel entre los 902 y 1648 m. Se obtuvieron muestras de sangre antes y después de la marcha y se midió TL, TT, cortisol y hemograma: hematíes (Hmt), hemoglobina (Hb), hematocrito (Htto) y volumen corpuscular medio (VCM). Resultados: Se produjo un descenso significativo de los valores de TL y TT sin cambios en el cortisol plasmático. También se observó un descenso en las cifras de Hmt, Hb, Htto y VCM. Conclusión: Una marcha invernal con equipo de combate, en baja altitud y con un desnivel de 746 m, produce un descenso significativo de los valores plasmáticos de Testosterona (libre y total) en soldados de una unidad de operaciones en montaña. No se observan cambios en los valores de cortisol. Se detecta una reducción significativa de hematíes, hemoglobina, hematocrito y VCM que podrían deberse a un efecto de hemodilución

Introduction: Intermittent exposures at high altitude have acute effects on some biological markers, such as testosterone, but not at low altitude. Since the training of soldiers should carry out specific military activities, is very important to asses physiological changes that can occur in particular circumstances (such as altitude) but during the performance of the activities of the military units. Objective: To identify the hematological changes and the hormones Free Testosterone (TL), Total Testosterone (TT ) and Cortisol during a nocturnal march at low altitude in soldiers of mountain operations. Methodology: 32 male military (26.3 ± 4.50 years, 75.1 ± 7.6 kg) performed a nocturnal winter march with equipment between 902 and 1648 m of altitude. Blood samples were obtained before and after the march, and TL, TT, cortisol and blood count were measured: red blood cells (Hmt), hemoglobin (Hb), hematocrit (Htto) and mean corpuscular volume (MCV ). Results: There was a significant decrease in TL and TT values without changes in plasmatic cortisol. A reduction in the values of Hmt, Hb, Htto and VCM has also been observed. Conclusion: A winter march with combat equipment, at low altitude and with a unevenness of 746 m, produces a significant decrease in the plasma values of Testosterone (free and total) in soldiers of mountain operations. No changes in cortisol values are observed. A significant reduction of red blood cells, hemoglobin, hematocrit and MCV is detected, which could be due to a hemodilution effect

Recovery of Heart Rate Variability After Exercise Under Hot Conditions: The Effect of Relative Humidity.

INTRODUCTION: The aim of this study was to analyze changes in heart rate variability (HRV) during exercise in hot environments and recovery to baseline values depending on relative humidity. METHODS: Ten recreational runners participated in this study. Each participant performed 2 trials consisting of 30 min of continuous running under hot and dry (HD) (38°C and 28% relative humidity) and hot and humid (HH) conditions (38°C and 64% relative humidity) at their common 10 km race-running rhythm. HRV and body mass were assessed pre- and post-trial; the rating of perceived exertion and HRV were assessed during the trial; and HRV measurements were repeated 2, 4, 8, and 24 h postexercise. Primary HRV outcomes were root mean square of the successive differences, high frequency power, stress score, and sympathetic/parasympathetic ratio. One-way analysis of variance testing was used to analyze differences. RESULTS: No significant difference in body mass occurred across the different conditions or distances covered (P>0.05). Rating of perceived exertion presented the highest correlation values with stress score (r=0.729 for HD; r=0.568 for HH) and sympathetic/parasympathetic ratio (r=0.621 for HD; r=0.519 for HH) during exercise. HRV recovered to baseline values more quickly after exercising under dry conditions (4 h) than under humid conditions (between 8 and 24 h). CONCLUSIONS: Stress score and sympathetic/parasympathetic ratio seem to be the best HRV predictors of internal load. Although there are no differences in HRV during recovery at the same time points in both conditions, the recovery is slower after exercise in HH than in HD.

Effects of detraining on breathing pattern and ventilatory efficiency in young soccer players.

BACKGROUND: This study investigated the effects of detraining on breathing pattern. The aim of this study was to evaluate the effect of a six-week detraining period on breathing patterns and ventilatory efficiency. METHODS: Fourteen young soccer players were evaluated at the end of a competitive season and after a six-week detraining period. Assessment of respiratory efficiency was based on VE/VCO2 slope changes below 70% of exercise intensity. All participants underwent twice an incremental graded exercise test up to exhaustion. RESULTS: No differences in breathing frequency and inspiratory time/total time ratio (Ti/Ttot) were found after detraining (P>0.05). Differences in tidal volume (VT), VT/Ti quotient and VE were significant (P<0.05) at between 40 to 100% of exercise intensity. The VE/VCO2 slope did not change (P>0.05) during a postdetraining maximal incremental test. CONCLUSIONS: A six-week detraining period causes changes in inspiratory flow but does not affect the inspiratory time/total respiratory cycle time ratio. The overall ventilatory efficiency of the respiratory system remains constant and is not affected by detraining.

La prevalencia de sobrepeso y obesidad en escolares de educación primaria depende del criterio diagnóstico utilizado. Datos del estudio longitudinal "OBIN" 2011-2017 / The prevalence of overweight and obesity in primary school children depends on the diagnostic criteria used: data from the longitudinal study "OBIN" 2011-2017 / A prevalência de sobrepeso e obesidade em escolares do ensino fundamental depende dos critérios diagnósticos utilizados. Dados do estudo longitudinal "OBIN" 2011-2017

Objetivo: Comparar de forma longitudinal diferentes criterios diagnósticos de sobrepeso y obesidad en niños y niñas de 6 a 11 años. Método: 155 sujetos (86 niñas y 69 niños) pertenecientes a los tres colegíos públicos de La Algaba (Sevilla) fueron estudiados a lo largo de los seis cursos de Educación Primaria (2011-2017). Semestralmente se midió peso, talla y se calculó el Índice de Masa Corporal. Las prevalencias de sobrepeso y obesidad se calcularon mediante los percentiles 85 y 95 del Índice de Masa Corporal respectivamente, utilizando las tablas de los Centers for Disease Control and Prevention de Atlanta (United States of America), la Fundación Orbegozo y la Organización Mundial de la Salud. También se utilizó el criterio de extrapolación de Cole. Resultado: La evolución del peso, la talla y del Índice de Masa Corporal es lineal e idéntica para niños y niñas. La prevalencia de sobrepeso y obesidad en niñas se mantiene estable a lo largo del estudio con los cuatro criterios empleados. En niños muestra una tendencia creciente con todos los criterios salvo con el de la Organización Mundial de la Salud. La prevalencia de sobrepeso es mayor que la de obesidad en todos los casos, salvo con el criterio Centers for Disease Control and Prevention que ocurre lo contrario. La prevalencia total (sobrepeso y obesidad) es menor con el criterio de Orbegozo, tanto para niños (32.7%) como para niñas (27.1%) y el valor más alto con el criterio de la Organizacíon Mundial de la Salud (51% para ambos). Conclusiones: Es de gran importancia que al facilitar datos de prevalencia se informe de qué criterios se están utilizando y no comparar nunca datos obtenidos con diferentes criterios de diagnóstico o comparando periodos de tiempo donde estos criterios hayan variado

Objective: To compare longitudinally different diagnostic criteria of overweight and obesity in children from 6 to 11 years old. Method: 155 children (86 girls and 69 boys) belonging to the three public schools of La Algaba (Seville) were studied throughout the six courses of Primary Education (2011-2017). Weight, height and were measured every six months and Body Mass Index were calculated every six months.The prevalences of overweight and obesity were calculated using the 85th and 95th Body Mass Index percentiles respectively, using the tables of the Centers for Disease Control and Prevention of Atlanta (USA), the Orbegozo Foundation and the World Health Organization. The Cole extrapolation criterion was also used. Results: The evolution of weight, height and Body Mass Index is linear and identical for boys and girls. The prevalence of overweight and obesity in girls remains stable throughout the study with the four criteria used. In children it shows a growing trend with all the criteria except that of the World Health Organization. The prevalence of overweight is greater than that of obesity in all cases, except with the Centers for Disease Control and Prevention criterion that the opposite occurs. The total prevalence (overweight and obesity) is lower with the Orbegozo criterion, both for children (32.7%) and for girls (27.1%) and the highest value is reached with the World Health Organization criterion (51% for both). Conclusions: It is of great importance that, when providing prevalence data, it is reported which criteria are being used and never compare data obtained with different diagnostic criteria or comparing periods of time where these criteria have varied

Objetivo: Comparar os diferentes critérios diagnósticos de sobrepeso e obesidade em meninos e meninas de 6 a 11 anos. Método: Foram estudados 155 sujeitos (86 meninas e 69 meninos) pertencentes à três escolas públicas de La Algaba (Sevilha) ao longo dos seis anos do Ensino Fundamental (2011-2017). Peso, altura e IMC foram medidos a cada seis meses. As prevalências de sobrepeso e obesidade foram calculadas a partir dos percentis 85 e 95 do IMC, respectivamente, utilizando as tabelas do CDC de Atlanta (EUA), da Fundação Orbegozo, da OMS e o critério de extrapolação Cole. Resultado: O aumento do peso, altura e IMC é linear e idêntica para meninos e meninas. A prevalência de sobrepeso e obesidade em meninas permanece estável ao longo do estudo de acordo com os quatro critérios utilizados. Já em meninos, há uma tendência crescente com todos os critérios, exceto o da OMS. A prevalência de sobrepeso é maior que a da obesidade em todos os casos, exceto de acordo com o critério do CDC. A prevalência total (sobrepeso e obesidade) é menor de acordo com o critério de Orbegozo, tanto para meninos (32,7%) quanto para meninas (27,1%). Em contrapartida, o maior valor de prevalência é observado através do diagnóstico de acordo com o critério da OMS (51% para ambos). Conclusões: É de suma importância que, ao fornecer dados de prevalência, sejam especificados quais os critérios diagnóstico estão sendo utilizados e evitar que dados obtidos de diferentes critérios sejam comparados

Hábitos nutricionales y de actividad física en escolares de educación primaria: datos del estudio longitudinal "OBIN" 2011-2017 / Nutritional habits and physical activity in primary school children: data from the longitudinal study "OBIN" 2011-2017 / Hábitos nutricionais e atividade física em escolas primárias de educação: dados do estudo longitudinal "OBIN" 2011-2017

Objetivo: Determinar los hábitos de alimentación y actividad física de forma comparada entre niños y niñas, en un estudio longitudinal a seis años y empleando técnicas de calorimetría para valorar el nivel de actividad física y poderlo contrastar con la información proporcionada por los cuestionarios clásicos. Método: A lo largo de seis cursos de primaria 155 sujetos (86 niñas y 69 niños) cumplimentaron un cuestionario de actividad física y otro de dieta mediterránea. A 41 sujetos (25 niñas y 16 niños) se les midió anualmente el gasto energético total (GET) y en actividad (GEA) durante 48 horas con un medidor ArmBand(R). Resultados: Se registraron GEA de 600 kcal/dia en niñas y 900 kcal/dia en niños (40 y 50 % del GET respectivamente). Dado que ArmBand considera GEA todo el gasto por encima de 2.5 METs, las niñas y niños del estudio tuvieron gastos energéticos por encima de 2.5 METs durante el 40 y 50 % del tiempo respectivamente. Los niños realizan 18000 pasos diarios y las niñas 14.000. Todo ello representa un nivel medio de actividad que podemos calificar del moderado-alto. Conclusiones: La actividad física medida por calorimetría muestra mejor información que los cuestionarios. El nivel de actividad es claramente mayor en niños que en niñas y se mantiene estable durante los 6 años. La adherencia a la dieta mediterránea puede calificarse de media, necesitando mejoras

Objective: To determine the habits of nutrition and physical activity in a comparative way between boys and girls, in a longitudinal study to six years and using calorimetry techniques to assess the level of physical activity and to be able to contrast with the information by the classic questionnaires. Method: Throughout six primary courses, 155 children (86 girls and 69 boys) completed a physical activity questionnaire and a Mediterranean diet questionnaire. Total energy expenditure (GET) and activity (GEA) were measured annually for 48 hours with an ArmBand(R) device in 41 subjects (25 girls and 16 boys). Results: GEA of 600 kcal / day in girls and 900 kcal / day in boys were recorded (40 and 50% of GET respectively). Since ArmBand considers GEA to be all expenses above 2.5 METs, the children in the study had energy costs above 2.5 METs during 40 and 50% of the time respectively. The children perform 18000 daily steps and the girls 14000. All this represents a level of activity that we can qualify as moderate-high. Conclusions: Physical activity measured by calorimetry shows better information than questionnaires. The level of activity is clearly higher in boys than in girls and it remains stable during the 6 years. The adherence to the Mediterranean diet can be described as medium, needing improvements

Objetivo: Determinar os hábitos de alimentação e atividade física de forma comparativa entre meninos e meninas, em um estudo longitudinal de seis anos com utilização técnicas de calorimetria para avaliar o nível de atividade física e contrastá-la com as informações fornecidas pelos questionários clássicos. Método: Ao longo de seis anos primários, 155 indivíduos (86 meninas e 69 meninos) responderam um questionário de atividade física e um questionário sobre dieta mediterrânea. Desses, 41 indivíduos (25 meninas e 16 meninos) foram avaliados anualmente quanto ao gasto energético total (GET) e de atividade (GEA) por 48 horas com um medidor ArmBand(R). Resultados: GEA de 600 kcal/dia em meninas e 900 kcal/dia em meninos foram registrados (40 e 50% do GET, respectivamente). Como a ArmBand considera a GEA todas as despesas acima de 2,5 METs, as crianças do estudo tiveram gastos de energia acima de 2,5 METs durante 40 e 50% do tempo, respectivamente. Os meninos do estudo realizaram 18.000 passos diários e as meninas 14.000. Tudo isso representa um nível médio de atividade que podemos qualificar como moderado-alto. Conclusões: A atividade física medida pela calorimetria mostra melhor informação do que os questionários. O nível de atividade é claramente maior em meninos do que em meninas e permanece estável durante os 6 anos. A adesão à dieta mediterrânea pode ser descrita como moderada, necessitando de melhorias

Full Band Spectra Analysis of Gait Acceleration Signals for Peripheral Arterial Disease Patients.

Peripheral arterial disease (PAD) is an artherosclerotic occlusive disorder of distal arteries, which can give rise to the intermittent claudication (IC) phenomenon, i.e., limb pain and necessity to stop. PAD patients with IC have altered their gait, increasing the fall risk. Several gait analysis works have studied acceleration signals (from sensors) to characterize the gait. One common technique is spectral analysis. However, this approach mainly uses dominant frequency (fd ) to characterize gait patterns, and in a narrow spectral band, disregarding the full spectra information. We propose to use a full band spectral analysis (up to 15 Hz) and the fundamental frequency (f0) in order to completely characterize gait for both control subjects and PAD patients. Acceleration gait signals were recorded using an acquisition equipment consisting of four wireless sensor nodes located at ankle and hip height on both sides. Subjects had to walk, free-fashion, up to 10 min. The analysis of the periodicity of the gait acceleration signals, showed that f0 is statistically higher (p < 0.05) in control subjects (0.9743 ± 0.0716) than in PAD patients (0.8748 ± 0.0438). Moreover, the spectral envelope showed that, in controls, the power spectral density distribution is higher than in PAD patients, and that the power concentration is hither around the fd . In conclusion, full spectra analysis allowed to better characterize gait in PAD patients than classical spectral analysis. It allowed to better discriminate PAD patients and control subjects, and it also showed promising results to assess severity of PAD.

Heart rate variability is lower in patients with intermittent claudication: a preliminary study / La variabilidad de la frecuencia cardiaca es menor en pacientes con claudicación intermitente: un estudio preliminar

Introduction: Peripheral arterial disease is a chronic disorder affecting blood flow to lower limbs and many patients can develop intermittent claudication (IC). They suffer a blood flow decrease to lower limbs, making impossible to walk short distances without feeling pain or stopping the gait. Heart Rate Variability (HRV) is a non-invasive tool based on the calculation of time variations along consecutive heartbeats. It is reasonable to think that, since HRV assess the autonomic balance through the cardiovascular system, it could be useful in the assessment of patients with IC. Objectives: The aim of this study was to assess if there are differences in resting HRV between patients with IC and age matched controls, both with linear and non-linear analysis, and its possible relation with the gait capacity. Methods: 14 control male subjects (60±5 years) and 14 male IC patients (64±6 years) underwent 10 minutes of HRV analysis. The study calculated Time Domain variables, Poincaré Plot analysis and nonlinear parameters (Entropy and slopes of Detrend Fluctuation Analysis). Results: The main finding of this study is the presence of a clear sympathetic predominance at rest in the IC patients and a significant correlation between the parasympathetic rest tone and the distance covered in the 6MWT when all subjects are included. Conclusions: HRV seems to be an accurate method to detect the sympathetic misbalance present in patients with IC but as a nonspecific finding that could be present in other cardiovascular pathologies. Complex structure of the heartbeat signal is not affected by IC

Introducción: La enfermedad arterial periférica es un trastorno crónico que afecta al flujo sanguíneo de los miembros inferiores y muchos pacientes desarrollan claudicación intermitente (CI), sufriendo una reducción del flujo sanguíneo que les hace imposible caminar cortas distancias sin sufrir dolor o tener que detenerse. La variabilidad de la frecuencia cardiaca (VFC) es una herramienta no invasiva basada en el cálculo de las variaciones de tiempo entre latidos sucesivos. Es razonable pensar que, puesto que la VFC evalúa el balance autonómico a través del sistema cardiovascular, podría ser útil en la valoración de pacientes con CI. Objetivos: Evaluar si hay diferencias en la VFC de reposo entre pacientes con CI y controles de la misma edad (tanto con análisis lineal como no lineal) y su posible relación con la capacidad de marcha. Métodos: Se realiza un análisis de VFC de 10 min a 14 controles (60±5 años) y 14 pacientes con CI (64±6 años). Se calcularon variables del dominio de tiempo, gráfico de Poincaré y parámetros no lineales. Todos los sujetos realizaron a continuación un test de 6 min. Resultados: El principal hallazgo de este estudio es la presencia de un claro predominio simpático en reposo en los pacientes con CI y una correlación significativa entre el tono parasimpático de reposo y la distancia recorrida en el test de 6 min. Conclusiones: La VFC parece ser un método adecuado para detectar la disfunción simpática presente en pacientes con CI pero como un hallazgo inespecífico que puede estar presente en otras patologías vasculares. La estructura compleja de la señal cardiaca no se ve afectada en la CI

Efectos de la exposición aguda a gran altitud en jugadores profesionales de fútbol aclimatados y no aclimatados / Effects of acute exposure to high altitude in acclimatized and non-acclimatized professional soccer player

Objetivo: Evaluar la respuesta cardiopulmonar, equilibrio ácido base y gases en una prueba cardiopulmonar máxima en futbolistas profesionales de primera división de Bolivia residentes de altitudes bajas, medidos durante las primeras seis horas de llegada a la gran altura de 3.600 m. Métodos: A once futbolistas bolivianos residentes a 150 m (lowlanders, LL) y diez residentes a 3.600 m (highlanders, HL) se les realizó el Yo-Yo endurance test con ergoespirometría, determinación de pH, exceso de bases (EB), gases y lactato en sangre capilar a 150 m y a 3.600 m una semana después. Resultados: El VO2 max (L*min-1) disminuyó a 3.600 m en ambos grupos estudiados, sin diferencia entre el lugar de residencia y altitud. En LL (p<0.001) 3,52±0,46 vs 2,92±0,38. En HL (p<0.001) 4,02±0,5 vs 3,41±0,45. La distancia máxima recorrida (metros) fue menor en altura (3.600 m) en ambos grupos, 1.903,64±202,55 vs 1.358,2±210,6 (p<0.001) en LL, y 2.096,0±272,4 vs 1.605,0±281,17 (p<0.001) en HL. Pre-ejercicio a 3.600 m, los LL tuvieron mayor pCO2 (38,3±3,0 vs 30,69±1,78 mmHg; p<0.001 y menor satO2 (83,1± 2,7 vs 88,1 ± 1,1%; p<0.01). El ejercicio en altura generó en LL mayores decrementos de pH (-0,258±0,06 vs -0,206±0,03; p<0.05) y de EB (-18,73±2,83 vs -12,62±2,13) sin diferencias en lactato sérico (10,8 ± 2,09 vs 9,43 ± 2,1 mmol/L para LL y HL respectivamente). Conclusión: En las primeras seis horas a 3.600 m, la caída del rendimiento aeróbico es similar en LL y HL, a pesar de una menor respuesta ventilatoria y oxigenación en reposo del grupo LL, además en ejercicio se genera una mayor acidosis metabólica en LL en ambas alturas

Objective: To evaluate the cardiopulmonary response, gases and acid base balance in a cardiorespiratory maximal test applied to professional football players of first division of Bolivia living at low altitude, during the first six hours after arrival to the high altitude of 3,600 meters. Methods: Eleven Bolivian players living at an altitude of 150 m (lowlanders, LL) and ten highlanders (HL), living at an altitude of 3,600 m, performed the Yo-Yo endurance test with ergospirometry. Base excess (BE), pH, blood gases and capillary blood lactate were determined at 150 m and at 3,600 m seven days later. Results: VO2 max (L·min-1) decreased at 3,600 m in both groups, without differences in slopes or interaction between the factors residence and altitude. In LL (p<.001), 3.52±0.46 vs 2.92±0.38. In HL (p<.001) 4.02±0.5 vs 3.41±0.45. The distance covered in the test was lower at 3,600 m in both groups: 1358.2±210.6 vs 1903.64±202.55 m in LL (p < .001) and 1605.0±281.17 vs 2096.0±272.4 m in HL (p < .001). Pre-exercise at 3600 m, LL had a higher pCO2 (38.3 ± 3.0 vs 30.69 ± 1.78 mmHg; p<.001) and a lower satO2 (83.1± 2.7 vs 88.1 ± 1.1% p<.01) Exercise performed at high altitude produced in LL a higher decrement in pH (-0.258 ± 0.06 vs -0.206 ± 0.03; p<.05) and in BE (-18.73±2.83 vs -12.62±2.13) with no differences in blood lactate (10.8 ± 2.09 vs 9.43 ± 2.1 mmol/L for LL and HL, respectively). Conclusion: During the first six hours at 3,600 m, aerobic performance decrease is similar in LL and HL, although a lower ventilatory response and resting oxygenation of the LL group is found. LL group also showed a greater metabolic acidosis in both altitudes during exercise

Impact of Hypothermic Stress During Special Operations Training of Chilean Military Forces.

Introduction: The Chilean Army considers processes that can optimize physical capacities for responding to the impact of situations and given stressors. The study of the effect of hypothermia as a stressor agent (HSA) and its relationship with cardiovascular, hematological, anthropometric, endocrine, and immunological parameters has not been fully addressed experimentally in military populations. Objective: To identify the endocrine, hematological, cardiovascular, and immunological changes caused by HSA and to associate these variables with body composition and physical fitness in the military special operation courses of the Chilean Army. Materials and Methods: Forty-two male subjects were exposed to remain in cold water (10.6 °C) in the context of regular military operations training, the longest time of exposure was determined by individual volitional limits. The measurements were taken in pre-hypothermia conditions, then 2 d later under acute hypothermia condition, and finally during the course period of lesser physical and psychological stressors where the baseline measurements were taken. The statistical analysis consisted of testing normality of the distribution through the Shapiro-Wilk test, assessing the equality of variances through the Levene test, and variance analysis by applying the ANOVA test (analysis of variance). The Bonferroni test was used for multiple comparison correction and the Pearson test for correlations between two variables. The level of significance was of p < 0.05. Results: The main finding of this study is that HSA has a significant impact at the cardiovascular level and produces an increment in the cell population of the immune and hematologic systems. Significant hormonal changes were observed: ACTH (r = 0.50, p < 0.002), cortisol (r = 0.32, p < 0.03), free testosterone (r = 0.13, p < 0.002), total testosterone r = 0.31, p < 0.002), and anthropometrics (r = -0.51, p < 0.05). However, there is no significant correlation between physical fitness and HAS. Conclusions: All subjects experienced hypothermia stress elicited by immersion in cold water. This was evidenced by the decrease in core temperature as well as cardiovascular, endocrine, anthropometric, and immunological changes. Individual differences exist between subjects and their resistance to hypothermia in cold water. These differences are not explained by the physical fitness profile but rather respond to a greater body adiposity index and minor changes in the adrenocorticotropic hormone and cortisol hormone. An acute hypothermia stress condition also affects the anabolic/catabolic environment. Finally, HSA produces an increase in the cell population of the immune system. The authors believe that this study allows to standardize HSA exposure times during regular military operations training by identifying the physiological impacts under this extreme environment. At present, the availability of intra-abdominal temperature measurement apparatus with capsule thermometers raises the interest of corroborating the findings of the current study through the use of such measuring devices. Likewise, an interesting line of research for the future would be to compare the HSA against a psychological evaluation with the purpose of identifying the stress management mechanisms among subjects of these characteristics and include heart rate variability measurements as an indicator of sympathetic stress.

Autonomic Responses to Ultrasound-Guided Percutaneous Needle Electrolysis: Effect of Needle Puncture or Electrical Current?

OBJECTIVE: The aim of this study was to establish if the changes in sympathetic and parasympathetic activity (analyzed through heart-rate variability [HRV]) during ultrasound (US)-guided percutaneous needle electrolysis (PNE) is due to the effect of needle puncture only or of the PNE technique per se where the puncture and galvanic current are combined. METHODS: This was an experimental, case-control study that took place at the University of Seville. Subjects were 36 male footballers who were randomly allocated to three groups: a control group (CG; 12 players), for whom HRV was recorded for 10 min, both at rest and during an exhaustive US examination of the patellar tendon and adjacent structures; a first experimental group (PNE group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE in the patellar tendon; and a second experimental group (needle group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE without electrical current in the patellar tendon. The outcome measures were the diameters of the Poincaré plot (SD1, SD2), stress score, and sympathetic/parasympathetic ratio. RESULTS: There were no differences between groups in any baseline measurements, nor were there any significant differences between CG measurements (baseline vs. intervention). The PNE group exhibited statistically significant increases in SD1 (p = 0.01) and SD2 (p = 0.004) and statistically significant decreases in SS and S/PS ratio (p = 0.03), indicating increased parasympathetic and decreased sympathetic activity, respectively. The needle group exhibited statistically significant increases in SD2 (p = 0.02) and statistically significant decreases in SS (p = 0.02), indicating decreased sympathetic activity. CONCLUSIONS: The application of the US-guided PNE technique caused a measurable increase in parasympathetic activity (detected by HRV), which was due to the combination of needle puncture and electric current.