Comparing Video Analysis to Computerized Detection of Limb Position for the Diagnosis of Movement Control during Back Squat Exercise with Overload.

Incorrect limb position while lifting heavy weights might compromise athlete success during weightlifting performance, similar to the way that it increases the risk of muscle injuries during resistance exercises, regardless of the individual's level of experience. However, practitioners might not have the necessary background knowledge for self-supervision of limb position and adjustment of the lifting position when improper movement occurs. Therefore, the computerized analysis of movement patterns might assist people in detecting changes in limb position during exercises with different loads or enhance the analysis of an observer with expertise in weightlifting exercises. In this study, hidden Markov models (HMMs) were employed to automate the detection of joint position and barbell trajectory during back squat exercises. Ten volunteers performed three lift movements each with a 0, 50, and 75% load based on body weight. A smartphone was used to record the movements in the sagittal plane, providing information for the analysis of variance and identifying significant position changes by video analysis (p < 0.05). Data from individuals performing the same movements with no added weight load were used to train the HMMs to identify changes in the pattern. A comparison of HMMs and human experts revealed between 40% and 90% agreement, indicating the reliability of HMMs for identifying changes in the control of movements with added weight load. In addition, the results highlighted that HMMs can detect changes imperceptible to the human visual analysis.

Energetics contribution during no-gi Brazilian jiu jitsu sparring and its association with regional body composition.

We used measurements of metabolic perturbation obtained after sparring to estimate energetics contribution during no-gi Brazilian jiu-jitsu. Ten advanced grapplers performed two six-minute sparring bouts separated by 24 hours. Kinetics of recovery rate of oxygen uptake was modelled and post-combat-sparring blood-lactate concentration measured to estimate oxygen equivalents for phospholytic and glycolytic components of anaerobic energetics, respectively. Linear regression was used to estimate end-combat-sparring rate of oxygen uptake. Regional and whole-body composition were assessed using dual X-ray absorptiometry with associations between these measurements and energy turnover explored using Pearson's correlation coefficient (significance, P < 0.05). Estimated oxygen equivalents for phospholytic and glycolytic contributions to anaerobic metabolism were 16.9 ± 8.4 (~28%) and 44.6 ± 13.5 (~72%) mL∙kg-1, respectively. Estimated end-exercise rate of oxygen uptake was 44.2 ± 7.0 mL∙kg-1∙min-1. Trunk lean mass was positively correlated with both total anaerobic and glycolytic-specific energetics (total, R = 0.645, p = 0.044; glycolytic, R = 0.692, p = 0.027) and negatively correlated with end-exercise rate of oxygen uptake (R = -0.650, p = 0.042). There were no correlations for any measurement of body composition and phospholytic-specific energetics. Six minutes of no-gi Brazilian jiu-jitsu sparring involves high relative contribution from the glycolytic component to total anaerobic energy provision and the link between this energetics profile and trunk lean mass is consistent with the predominance of ground-based combat that is unique for this combat sport. Training programs for Brazilian jiu-jitsu practitioners should be designed with consideration given to these specific energetics characteristics.

Physiological Responses During High-Intensity Interval Training in Young Swimmers.

This study analyzed whether 100- and 200-m interval training (IT) in swimming differed regarding temporal, perceptual, and physiological responses. The IT was performed at maximal aerobic velocity (MAV) until exhaustion and time spent near to maximalVO2 peak oxygen uptake (⩒O2peak), total time limit (tLim), peak blood lactate [La-] peak, ⩒O2 kinetics (⩒O2K), and rate of perceived exertion (RPE) were compared between protocols. Twelve swimmers (seven males 16.1 ± 1.1 and five females 14.2 ± 1 years) completed a discontinuous incremental step test for the second ventilatory threshold (VT2), ⩒O2peak, and MAV assessment. The swimmers subsequently completed two IT protocols at MAV with 100- and 200-m bouts to determine the maximal ⩒O2 (peak-⩒O2) and time spent ≥VT2, 90, and 95% of ⩒O2peak for the entire protocols (IT100 and IT200) and during the first 800-m of each protocol (IT8x100 and IT4x200). A portable apparatus (K4b2) sampled gas exchange through a snorkel and an underwater led signal controlled the velocity. RPE was also recorded. The Peak-⩒O2 attained during IT8x100 and IT4x200 (57.3 ± 4.9 vs. 57.2 ± 4.6 ml·kg-1·min-1) were not different between protocols (p = 0.98) nor to ⩒O2peak (59.2 ± 4.2 ml·kg-1·min-1, p = 0.37). The time constant of ⩒O2K (24.9 ± 8.4 vs. 25.1 ± 6.3-s, p = 0.67) and [La-] peak (7.9 ± 3.4 and 8.7 ± 1.5 mmol·L-1, p = 0.15) also did not differ between IT100 and IT200. The time spent ≥VT2, 90, and 95%⩒O2peak were also not different between IT8x100 and IT4x200 (p = 0.93, 0.63, and 1.00, respectively). The RPE for IT8x100 was lower than that for IT4x200 (7.62 ± 2 vs. 9.5 ± 0.7, p = 0.01). Both protocols are considered suitable for aerobic power enhancement, since ⩒O2peak was attained with similar ⩒O2K and sustained with no differences in tLim. However, the fact that only the RPE differed between the IT protocols suggested that coaches should consider that nx100-m/15-s is perceived as less difficult to perform compared with nx200-m/30-s for the first 800-m when managing the best strategy to be implemented for aerobic power training.

Women's femoral mass content correlates to muscle strength independently of lean body mass / A massa femoral das mulheres relaciona-se com a força muscular independentemente da massa magra / La masa femoral de las mujeres se relaciona con la fuerza muscular, independiente de la masa magra

ABSTRACT Introduction There is limited consensus regarding the recommendation of the most effective form of exercise for bone integrity, despite the fact that weight training exercise promotes an increase in muscle mass and strength as recurrent responses. However, strength variations in women do not depend on muscle mass development as they do in men, but strength enhancement has shown the potential to alter bone mineral content (BMC) for both sexes. Objective This study analyzed the potential of muscle strength, as well as that of whole-body and regional body composition, to associate femoral BMC in young women. Methods Fifteen female college students (aged 24.9 ± 7.2 years) were assessed for regional and whole-body composition using dual-energy X-ray absorptiometry (DXA). Maximum muscle strength was assessed by the one-repetition maximum (1RM) test in the following exercises: bench press (BP), lat pulldown (LP), knee flexion (KF), knee extension (KE) and 45° leg press (45LP). Linear regression analyzed BMC relationships with regional composition and 1RM values. Dispersion and error measures (R 2 aj and SEE), were tested, defining p ≤0.05. Results Among body composition variables, only total lean body mass was associated with femoral BMC values (R 2 aj = 0.37, SEE = 21.3 g). Regarding strength values, 1RM presented determination potential on femoral BMC in the CE exercise (R 2 aj = 0.46, SEE = 21.3 g). Conclusions Muscle strength aptitude in exercises for femoral regions is relevant to the femoral mineralization status, having associative potential that is similar to and independent of whole-body lean mass. Therefore, training routines to increase muscle strength in the femoral region are recommended. In addition, increasing muscle strength in different parts of the body may augment bone remodeling stimulus, since it can effectively alter total whole-body lean mass. Level of Evidence II; Development of diagnostic criteria in consecutive patients (with universally applied reference ''gold'' standard).

RESUMO Introdução Há pouco consenso em relação à recomendação sobre o exercício mais efetivo para a integridade óssea, apesar de o exercício com peso apresentar como respostas recorrentes o aumento da força e da massa muscular. Contudo, entre mulheres as variações da força não dependem do desenvolvimento da massa muscular, tanto quanto em homens, mas o aumento da força tem evidenciado potencial para alterar o conteúdo mineral ósseo (BMC) em ambos os sexos. Objetivos O presente estudo analisou o potencial da força muscular, assim como da composição regional e corporal, ao associar o BMC do fêmur entre as mulheres jovens. Métodos Quinze universitárias (24,9 ± 7,2 anos) foram avaliadas quanto à composição regional e corporal por meio de absorciometria por duplo feixe de raios-X (DXA). A força muscular máxima foi avaliada por uma repetição máxima (1RM) nos exercícios de supino-reto (SR), puxada-alta (PA), flexão do joelho (FJ), extensão do joelho (EJ) e leg press 45° (LP45). A regressão linear analisou as relações de BMC com a composição regional e os valores de 1RM. Foram testadas medidas de dispersão e erro (R2aj e EPE), definindo p≤0,05. Resultados Entre as variáveis da composição corporal, apenas a massa magra corporal total associou-se aos valores de BMC femoral (R2aj=0,37, EPE=21,3 g). Em relação aos valores de força, 1RM no exercício de CE apresentou potencial de determinação sobre o BMC femoral (R2aj=0,46, EPE=21,3 g). Conclusão A aptidão da força muscular em exercícios para regiões próximas ao fêmur é relevante para o estado de mineralização femoral, com potencial associativo similar e independente à massa magra corporal. Recomenda-se, portanto, rotinas de treinamento para aumentar a força muscular da região próxima ao fêmur; adicionalmente, o aumento da força para diferentes regiões corporais pode potencializar o estímulo sobre a remodelação óssea, uma vez que é efetivo na alteração da massa magra corporal total. Nível de Evidência II; Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com padrão de referência "ouro" aplicado).

RESUMEN Introducción Hay poco consenso con relación a la recomendación sobre el ejercicio más efectivo para la integridad ósea, a pesar de que el ejercicio con peso presenta como respuestas recurrentes el aumento de la fuerza y de la masa muscular. Sin embargo, entre mujeres las variaciones de la fuerza no dependen del desarrollo de la masa muscular, tanto como en hombres, sino que el aumento de la fuerza ha evidenciado potencial para alterar el contenido mineral óseo (BMC) en ambos sexos. Objetivos El presente estudio analizó el potencial de la fuerza muscular, así como de la composición regional y corporal, al asociar el BMC del fémur entre las mujeres jóvenes. Métodos Quince universitarias (24,9 ± 7,2 años) fueron evaluadas cuanto a la composición regional y corporal por medio de absorciometría de rayos X de doble energía (DXA). La fuerza muscular máxima fue evaluada por una repetición máxima (1RM) en los ejercicios de press de banca recto (PBR), remada alta (RA), flexión de rodilla (FR), extensión de rodilla (ER) y leg press 45° (LP45). La regresión lineal analizó las relaciones de BMC con la composición regional y los valores de 1RM. Fueron probadas medidas de dispersión y error (R2aj y EEE), definiendo p≤0,05. Resultados Entre las variables de la composición corporal, sólo la masa magra corporal total se asoció a los valores de BMC femoral (R2aj=0,37, EEE=21,3 g). Con relación a los valores de fuerza, 1RM en el ejercicio de CE presentó potencial de determinación sobre el BMC femoral (R2aj=0,46, EEE=21,3 g). Conclusión La aptitud de la fuerza muscular en ejercicios para regiones próximas al fémur es relevante para el estado de mineralización femoral, con potencial asociativo similar e independiente a la masa magra corporal. Se recomiendan, por lo tanto, rutinas de entrenamiento para aumentar la fuerza muscular de la región próxima al fémur; adicionalmente, el aumento de la fuerza para diferentes regiones corporales puede potencializar el estímulo sobre la remodelación ósea, dado que es efectivo en la alteración de la masa magra corporal total. Nivel de Evidencia II; Desarrollo de criterios diagnósticos en pacientes consecutivos (con patrón de referencia "oro" aplicado).

Regional body composition and muscle strength are related to bone mineral content in elderly / Composição corporal regional e força muscular se relacionam com o conteúdo mineral ósseo em idosos / Composición regional y fuerza muscular si relacionan con él contenido mineral óseo de mayores

ABSTRACT Introduction: The increase, or maintenance, of lean body mass and muscle strength are major determinants of functional independence in the elderly, since they are associated with bone remodeling, and therefore with a reduced risk of falls and fractures. However, the regional relationship between lean body mass/strength and bone mineral content (BMC) has not sufficient theoretical support. Objective: To analyze whether regional body composition and muscle strength are factors potentially related to BMC. Methods: Ten older men (63.3±6.4 years, 169.4±6.8 cm and 79.3±10.5 kg) underwent body composition assessments using dual energy X-ray absorptiometry (DXA) to obtain regional and whole-body lean mass and BMC measures. The subjects also underwent the one-repetition maximum (1RM) test involving flat bench press, 45° leg press, arm curl and knee extension. Regional/whole-body composition and 1RM values were correlated to BMC using Pearson's coefficient (r). The level of significance for the correlations was p ≤0.05, the confidence interval was 95% (Z1-a/2=1.96), and the sample power was 80% (1-b). Results: The flat bench press 1RM was related to BMC in the left (r=0.764) and right (r=0.748) arms, while the 45° leg press 1RM was associated with BMC in the left (r=0.677) and right (r=0.714) legs and trunk (r=0.810), with sample power of 77.7%, 66.8%, 12.7%, 40.4% and 97.0%, respectively. Whole-body BMC was related to abdominal skinfold (r=0.819), lean mass of left arm (r=0.834), left (r=0.845) and right (r=0.868) legs, and whole-body lean mass (r=0.787), with sample power of 98.4%, 99.6%, 99.9%, 100.0% and 90.1%, respectively. Conclusion: The results supported regional lean body mass as a parameter related to BMC, with potential similar to that consistently reported for whole-body lean mass. Results also suggested that muscle strength plays an important role in improving or maintaining regional and whole-body BMC. Level of Evidence II; Development of diagnostic criteria in consecutive patients (with "gold" benchmark standard applied).

RESUMO Introdução: O aumento ou a manutenção, da massa magra e da força muscular são importantes fatores que determinam a independência funcional em idosos, uma vez que se associam ao remodelamento ósseo e, assim, à redução dos riscos de quedas e fraturas. Todavia, a relação regional da massa magra e da força muscular com o conteúdo mineral ósseo (BMC) não apresenta suficiente apoio teórico. Objetivo: Analisar se a composição regional e a força muscular são fatores possivelmente relacionados à BMC. Métodos: Dez homens idosos (63,3 ± 6,4 anos; 169,4 ± 6,8 cm e 79,3 ± 10,5 kg) submeteram-se às avaliações de composição por meio de absorciometria por feixe duplo de raio-X (DEXA) para obter a massa magra e BMC regionais e corporais. Os participantes também foram submetidos ao teste de uma repetição máxima (1RM) com supino horizontal, leg press 45°, rosca direta e extensão de joelho. Os valores de composição regional e corporal e de 1RM foram relacionados ao BMC pelo coeficiente de Pearson (r). O nível de significância para as correlações foi p ≤ 0,05, o intervalo de confiança foi 95% (Z1-α/2=1,96) e o poder da amostra foi 80% (1-b). Resultados: A 1RM no supino horizontal relacionou-se ao BMC do braço esquerdo (r = 0,764) e direito (r = 0,748), assim como 1RM no leg press 45° associou-se ao BMC da perna esquerda (r = 0,677), direita (r = 0,714) e do tronco (r = 0,810), com poder de amostra de 77,7%, 66,8%, 12,7%, 40,4% e 97,0%, respectivamente. O BMC corporal relacionou-se a prega cutânea abdominal (r = 0,819), massa magra do braço esquerdo (r = 0,834), perna esquerda (r = 0,845) e direita (r = 0,868) e massa magra corporal (r = 0,787), com poder de amostra de 98,4%, 99,6%, 99,9%, 100,0% e 90,1%, respectivamente. Conclusão: Os resultados confirmaram a massa magra regional como parâmetro relacionado ao BMC, com potencial similar ao da massa magra corporal e também sugerem que a força muscular tem papel importante no aumento ou manutenção do BMC regional e corporal. Nível de Evidência II; Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com aplicação do padrão de referência).

RESUMEN Introducción: El aumento o mantenimiento de la masa delgada y fuerza son determinantes de independencia funcional de adultos mayores, debido a asociaciones con la modulación ósea y, de la misma forma, con la reducción de riesgos de fracturas y caídas. Sin embargo, las relaciones regionales de masa delgada y fuerza con el contenido mineral óseo (CMO) no tienen suficiente apoyo teórico. Objetivo: Analizar si la composición regional y la fuerza están potencialmente relacionadas con CMO. Métodos: Diez adultos mayores (63,3±6,4 años, 169,4±6,8cm y 79,3±10,5kg) se sometieron a las evaluaciones de composición corporal por absorciometría de doble rayos-X (DXA) que proveyó la masa delgada para y CMO regional y corporal, así como el test de repetición máxima (1RM) en supino horizontal, leg press 45°, flexión de brazo y extensión rodilla. Los valores de la composición regional, corporal y de 1RM se relacionaron con CMO por el coeficiente de Pearson (r). El nivel de significancia fue p≤0,05 para las correlaciones, y el índice de seguridad de 95% (Z1-α/2=1,96) y potencia de muestra de 80% (1-β) para evaluar el poder de la muestra. Resultados: El 1RM en supino horizontal se relacionó con CMO del brazo izquierdo (r=0,764) y derecho (r=0,748), así como el 1RM en leg press 45° se relacionó al CMO de la pierna izquierda (r=0,677), derecha (r=0,714), y tronco (r=0,810), con poder de muestra, respectivamente, de 77,7%, 66,8%, 12,7%, 40,4% y 97,0%. El parámetro CMO corporal se relacionó con el pliegue cutáneo abdominal (r=0,819), masa delgada del brazo izquierdo (r=0,834), pierna izquierda (r=0,845), derecha (r=0,868) y masa delgada corporal (r = 0,787), con poder de muestra, respectivamente, de 98,4%, 99,6%, 99,9%, 100,0% y 90,1%. Conclusión: Los resultados confirman haber relación entre masa delgada regional e CMO, con potencial similar a la masa delgada corporal, sugiriendo también que la fuerza muscular ejerce un papel promisor en el aumento, o manutención, del CMO regional y corporal. Nivel de Evidencia II; Desarrollo de criterios diagnósticos en pacientes consecutivos (con estándar de referencia "oro" aplicado).

Resposta aguda do lactato sanguíneo a diferentes protocolos de treinamento com pesos / Acute response of blood lactate to different weight training protocols / Respuesta aguda del lactato sanguíneo a diferentes protocolos de entrenamiento con pesos

RESUMO Introdução: O treinamento em circuito é um modelo de treinamento resistido que permite uma variada combinação de sobrecarga e, por isso, requer mais informações para que se compreenda a demanda glicolítica anaeróbia durante sua execução. Objetivo: O objetivo foi comparar dois protocolos de treinamento com pesos, com (Tconv) e sem (Tcirc) pausa entre as execuções, quanto à resposta do lactato sanguíneo ([la]). Métodos: Onze homens (21,0 ± 2,3 anos; 76,7 ± 5,4 kg, 179,5 ± 7,0 cm) foram submetidos ao teste de repetição máxima. O Tcirc e o Tconv foram prescritos a 60%1RM, 12 repetições, sendo três passagens com pausa de 300 s para Tcirc e três séries de cada exercício com 180 s de pausa para o Tconv. Os exercícios que compuseram ambos os protocolos de treinamento foram: supino reto, cadeira extensora unilateral, peck-deck, mesa flexora, pulley alto, leg press 45º, remada horizontal e panturrilha no hack. O teste de ANOVA (Bonferroni post hoc) comparou o [la] no 1º, 3º e 5º minuto após as passagens no Tcirc e após cada série no Tconv. O teste t independente comparou as médias do pico de lactato entre Tcirc e Tconv. Em todas as análises adotou-se p ≤ 0,05. Resultados: Foram observadas diferenças para o [la] entre a 1ª (10,6 ± 1,0 mmol/l) e a 2ª passagem (13,5 ± 1,8 mmol/l, P = 0,01) e entre a 1ª e a 3ª passagem (15,0 ± 2,5 mmol/l, P < 0,01) no Tcirc. Durante Tconv, os maiores valores médios de [la] foram observadas nos exercícios pulley alto (11,2 ± 2,2 mmol/l) e leg press 45º (11,9 ± 2,6 mmol/l). Houve diferença (P < 0,01) ao comparar o pico de [la] após Tconv (12,8 ± 2,2 mmol/l) e Tcirc (15,9 ± 2,0 mmol/l). Conclusão: O Tcirc demanda maior resposta glicolítica, enfatizando sua efetividade no aumento da capacidade anaeróbia muscular. Além disso, a execução não intermitente do Tcirc pode explicar sua maior demanda glicolítica, uma vez que Tconv e Tcirc foram proporcionalmente delineados, quanto ao volume e carga do protocolo. Nível de Evidência I; Estudos diagnósticos-Investigação de um exame para diagnóstico.

ABSTRACT Introduction: Circuit training is a model of resistance exercise that allows a varied combination of overload and therefore, requires more information to understand the anaerobic glycolytic demand during its execution. Objective: The objective was to compare two weight training protocols with (Tconv) and without (Tcirc) pause between performances, regarding the blood lactate ([la]) response. Methods: Eleven men (21.0±2.3 years old, 76.7±5.4 kg, 179.5±7.0 cm) underwent to one-maximum repetition test (1RM). Tconv and Tcirc were prescribed at 60%1RM, 12 repetitions, three laps with 300 s rest for Tcirc and three series of exercise with 180 s rest for Tconv. The exercises that comprised both training protocols were bench press, unilateral leg extension, shoulder press, double leg curl, high pulley, leg press 45º, seated row and hack-squat. The ANOVA (Bonferroni post-hoc) test compared [la] at the 1st, 3rd e 5th minute after the Tcirc laps and after each Tconv series. The independent t-test compared the means of the lactate peak between Tcirc and Tconv. In all analyzes the level of significance was set at P≤0.05. Results: Differences were observed for the [la] between the 1st (10.6±1.0 mmol/l) and 2nd lap (13.5±1.8 mmol/l, P=0.01), and between 1st and 3rd lap (15.0±2.5 mmol/L, P<0.01) in the Tcirc. During Tconv, the highest mean peak values of [la] were observed in high pulley (11.2±2.2 mmol/l) and leg-press 45º (11.9±2.6 mmol/l) exercises. There was a difference (P<0.01) when comparing the [la] between after Tconv (12.8±2.2 mmol/l) and Tcirc (15.9±2.0 mmol/l). Conclusion: Tcirc demands greater glycolytic response, emphasizing its effectiveness to increasing anaerobic muscle capacity. Furthermore, the non-intermittent execution of Tcirc can explain its greater glycolytic demand, since Tconv and Tcirc were proportionally designed regarding the volume and load protocol. Level of Evidence I; Diagnostic studies - Investigating a Diagnostic Test.

RESUMEN Introducción: El entrenamiento en circuito es un modelo de entrenamiento resistido que permite una variada combinación de sobrecarga, por eso, requiere más informaciones para que se comprenda la demanda glucolítica durante su ejecución. Objetivo: El objetivo fue comparar dos protocolos de entrenamiento con pesos, con (Tconv) y sin (Tcirc) reposo entre las ejecuciones, en cuanto a la respuesta del lactato sanguíneo ([la]). Métodos: Once hombres (21,0 ± 2,3 años, 76,7 ± 5,4 kg, 179,5 ± 7,0 cm) fueron sometidos a la prueba de repetición máxima. El Tcirc y Tconv se han prescrito a 60% 1RM, 12 repeticiones, siendo tres pasajes con pausa de 300 s para Tcirc y tres series de cada ejercicio con 180 s de pausa para el Tconv. Los ejercicios que compusieron ambos protocolos de entrenamiento fueron press de banca, extensión unilateral de piernas, aperturas en contractor de pecho, curl de piernas acostado, polea al pecho, prensa de piernas 45º, remo en polea y gemelos en maquina. La prueba de ANOVA (Bonferroni post hoc) comparó el [la] en el 1º, 3º y 5º minuto después de de los pasajes en el Tcirc y después de cada serie en el Tconv. La prueba t independiente comparó los promedios del pico de lactato entre Tcirc y Tconv. En todos los análisis se adoptó P ≤ 0,05. Resultados: Se observaron diferencias entre el 1o (10,6 ± 1,0 mmol/l) y el 2o pasaje (13,5 ± 1,8 mmol/l, P = 0,01) y entre el 1o y el 3º pasaje (15,0 ± 2,5 mmol/l, P < 0,01) en el Tcirc. Durante Tconv, los valores medios más altos de [la] fueron observados en los ejercicios de polea al pecho (11,2 ± 2,2 mmol/l) y prensa de piernas 45º (11,9 ± 2,6 mmol/l). Se observó una diferencia (P < 0,01) al comparar el pico de [la] después de Tconv (12,8 ± 2,2 mmol/l) y Tcirc (15,9 ± 2,0 mmol/l). Conclusión: El Tcirc demanda mayor respuesta glucolítica, enfatizando su efectividad en el aumento de la capacidad anaeróbica muscular. Además, la ejecución no intermitente de Tcirc puede explicar su mayor demanda glucolítica, una vez que Tconv y Tcirc fueron proporcionalmente delineados en cuanto al volumen y la carga del protocolo. Nivel de Evidencia I; Estudios de diagnósticos - Investigación de un examen para diagnóstico.