Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
J Strength Cond Res ; 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32149887

RESUMO

Brandão, L, de Salles Painelli, V, Lasevicius, T, Silva-Batista, C, Brendon, H, Schoenfeld, BJ, Aihara, AY, Cardoso, FN, de Almeida Peres, B, and Teixeira, EL. Varying the order of combinations of single- and multi-joint exercises differentially affects resistance training adaptations. J Strength Cond Res XX(X): 000-000, 2020-Our study aimed to compare the effects of multi-joint (MJ) and single-joint (SJ) exercises, either isolated or in combination, and in different orders, on cross-sectional area (CSA) of the pectoralis major (PM) and different heads of the triceps brachii (TB), as well as on the one-repetition maximum (1-RM) in the bench press and lying barbell triceps press. Forty-three young men were randomly assigned to one of 4 possible RT protocols: barbell bench press plus lying barbell triceps press (MJ + SJ, n = 12); lying barbell triceps press plus barbell bench press (SJ + MJ, n = 10); barbell bench press (MJ, n = 10); or lying barbell triceps press (SJ, n = 11). Results showed significant within-group increases in 1-RM bench press for MJ, MJ + SJ, and SJ + MJ but not for SJ. Conversely, significantly greater within-group increases in elbow extension 1-RM were noted for SJ, MJ + SJ, and SJ + MJ but not for MJ. Significantly greater increases in PM CSA were observed for MJ, MJ + SJ, and SJ + MJ compared with SJ. Significant increases in TB CSA were noted for SJ, MJ + SJ, and SJ + MJ, but not for MJ, without observed between-group differences. Individual analysis of TB heads showed significantly greater CSA increases in the lateral head for MJ, MJ + SJ, and SJ + MJ compared with SJ. Alternatively, significantly greater increases in the long head were observed for SJ, MJ + SJ, and SJ + MJ compared with MJ. CSA increases for the medial head were statistically similar between conditions. Our findings indicate that muscular adaptations are differentially affected by performance of MJ and SJ exercises.

2.
J Physiol ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32020612

RESUMO

KEY POINTS: Individuals with freezing of gait (FoG) due to Parkinson's disease (PD) have small and long anticipatory postural adjustments (APAs) associated with delayed step initiation. Individuals with FoG ('freezers') may require functional reorganization of spinal mechanisms to perform APAs due to supraspinal dysfunction. As presynaptic inhibition (PSI) is centrally modulated to allow execution of supraspinal motor commands, it may be deficient in freezers during APAs. We show that freezers presented PSI in quiet stance (control task), but they presented loss of PSI (i.e. higher ratio of the conditioned H-reflex relative to the test H-reflex) during APAs before step initiation (functional task), whereas non-freezers and healthy control individuals presented PSI in both the tasks. The loss of PSI in freezers was associated with both small APA amplitudes and FoG severity. We hypothesize that loss of PSI during APAs for step initiation in freezers may be due to FoG. ABSTRACT: Freezing of gait (FoG) in Parkinson's disease involves deficient anticipatory postural adjustments (APAs), resulting in a cessation of step initiation due to supraspinal dysfunction. Individuals with FoG ('freezers') may require functional reorganization of spinal mechanisms to perform APAs. As presynaptic inhibition (PSI) is centrally modulated to allow execution of supraspinal motor commands, here we hypothesized a loss of PSI in freezers during APA for step initiation, which would be associated with FoG severity. Seventy individuals [27 freezers, 22 non-freezers, and 21 age-matched healthy controls (HC)] performed a 'GO'-commanded step initiation task on a force platform under three conditions: (1) without electrical stimulation, (2) test Hoffman reflex (H-reflex) and (3) conditioned H-reflex. They also performed a control task (quiet stance). In the step initiation task, the H-reflexes were evoked on the soleus muscle when the amplitude of the APA exceeded 10-20% of the mean baseline mediolateral force. PSI was quantified by the ratio of the conditioned H-reflex relative to the test H-reflex in both the tasks. Objective assessment of FoG severity (FoG-ratio) was performed. Freezers presented lower PSI levels during quiet stance than non-freezers and HC (P < 0.05). During step initiation, freezers presented loss of PSI and lower APA amplitudes than non-freezers and HC (P < 0.05). Significant correlations were only found for freezers between loss of PSI and FoG-ratio (r = 0.59, P = 0.0005) and loss of PSI and APA amplitude (r = -0.35, P < 0.036). Our findings suggest that loss of PSI for step initiation in freezers may be due to FoG.

3.
Scand J Med Sci Sports ; 29(11): 1713-1726, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31281989

RESUMO

We sought to determine whether early increases in cross-sectional area (CSA) of different muscles composing the quadriceps with low-load resistance training with blood flow restriction (LL-BFR) were mainly driven by muscle hypertrophy or by edema-induced swelling. We also compared these changes to those promoted by high-load resistance training (HL-RT). In a randomized within-subject design, fifteen healthy, untrained men were submitted to magnetic resonance imaging (MRI) for CSA and edema-induced muscle swelling assessment (fast spin echo inversion recovery, FSE-STIR). MRI was performed in LL-BFR and HL-RT at baseline (W0) and after 3 weeks (W3), with a further measure after 6 weeks (W6) for HL-RT. Participants were also assessed at these time points for indirect muscle damage markers (range of motion, ROM; muscle soreness, SOR). CSA significantly increased for all the quadriceps muscles, for both LL-BFR and HL-RT at W3 (all P < .05) compared to W0. However, FSE-STIR was elevated at W3 for all the quadriceps muscles only for HL-RT (all P < .0001), not LL-BFR (all P > .05). Significant increases and decreases were shown in SOR and ROM, respectively, for HL-RT in W3 compared to W0 (both P < .05), while these changes were mitigated at W6 compared to W0 (both P > .05). No significant changes in SOR or ROM were demonstrated for LL-BFR across the study. Early increases in CSA with LL-BFR seem to occur without the presence of muscle edema, whereas initial gains obtained by HL-RT were influenced by muscle edema, in addition to muscle hypertrophy.


Assuntos
Edema , Músculo Quadríceps/irrigação sanguínea , Músculo Quadríceps/fisiologia , Adaptação Fisiológica , Adolescente , Adulto , Constrição , Humanos , Imagem por Ressonância Magnética , Masculino , Força Muscular , Mialgia , Fluxo Sanguíneo Regional , Treinamento de Resistência , Adulto Jovem
4.
PM R ; 2019 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-31278834

RESUMO

BACKGROUND: Minimal detectable change (MDC) when assessing balance using the Biodex Balance System (BBS) in patients with Parkinson disease (PD) is currently unknown, limiting the interpretability of the scores. OBJECTIVE: To determine the MDC on the Anterior/Posterior Stability Index (APSI), Medial/Lateral Stability Index (MLSI), and Overall Stability Index (OSI) from postural stability and fall risk protocols of the BBS in patients with PD. DESIGN: This was a repeated-measures design (at a 1-week interval). SETTING: Strength training laboratory of a public university. PATIENTS: 46 patients with PD (men and women) at stages 2 and 3 (67.9 ± 7.4 years old) were assessed in the "on" state (fully medicated). METHODS: Patients performed three trials of 20 s for each protocol. MAIN OUTCOME MEASUREMENTS: Absolute and relative MDC (MDC%) calculated for APSI, MLSI, and OSI from the postural stability (stable condition) and fall risk protocols (unstable condition). RESULTS: For the postural stability, the MDC and MDC% were 0.26° and 17% for APSI, 0.41° and 21% for MLSI, and 0.22° and 12% for OSI, respectively. For the fall risk, the MDC and MDC% were 0.51° and 18% for APSI, 0.21° and 15% for MLSI, and 0.41° and 20% for OSI, respectively. These results were considered acceptable, despite indices with high MDC for MLSI (postural stability) and APSI (fall risk). CONCLUSIONS: Patients with PD have more mediolateral and anteroposterior changes in the stable and unstable conditions, respectively. These abnormal balance strategies can occur principally due to postural instability of PD. However, our results demonstrated acceptable MDCs in both conditions in all of the assessed axes. Thus, BBS should be incorporated into the clinical evaluation to help therapists to determine if intervention-induced changes in balance are clinically significant or due to measurement error. LEVEL OF EVIDENCE: II.

5.
J Appl Physiol (1985) ; 127(1): 89-97, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31306047

RESUMO

This study had two objectives: 1) to compare the effects of 3 wk of resistance training (RT) and resistance training with instability (RTI) on evoked reflex responses at rest and during maximal voluntary isometric contraction (MVIC) of individuals with Parkinson's disease (PD) and 2) to determine the effectiveness of RT and RTI in moving values of evoked reflex responses of individuals with PD toward values of age-matched healthy control subjects (HCs) (z-score analysis). Ten individuals in the RT group and 10 in the RTI group performed resistance exercises twice a week for 3 wk, but only the RTI group included unstable devices. The HC group (n = 10) were assessed at pretest only. Evoked reflex responses at rest (H reflex and M wave) and during MVIC [supramaximal M-wave amplitude (Msup) and supramaximal V-wave amplitude (Vsup)] of the plantar flexors were assessed before and after the experimental protocol. From pretraining to posttraining, only RTI increased ratio of maximal H-reflex amplitude to maximal M-wave amplitude at rest (Hmax/Mmax), Msup, Vsup/Msup, and peak torque of the plantar flexors (P < 0.05). At posttraining, RTI was more effective than RT in increasing resting Hmax and Vsup and in moving these values to those observed in HCs (P < 0.05). We conclude that short-term RTI is more effective than short-term RT in modulating H-reflex excitability and in increasing efferent neural drive, approaching average values of HCs. Thus short-term RTI may cause positive changes at the spinal and supraspinal levels in individuals with PD. NEW & NOTEWORTHY Maximal H-reflex amplitude (Hmax) at rest and efferent neural drive [i.e., supramaximal V-wave amplitude (Vsup)] to skeletal muscles during maximal contraction are impaired in individuals with Parkinson's disease. Short-term resistance training with instability was more effective than short-term resistance training alone in increasing Hmax and Vsup of individuals with Parkinson's disease, reaching the average values of healthy control subjects.

6.
J Strength Cond Res ; 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-31009425

RESUMO

Teixeira, EL, de Salles Painelli, V, Silva-Batista, C, de Souza Barros, T, Longo, AR, Lasevicius, T, Schoenfeld, BJ, Aihara, AY, and de Almeida Peres, B. Blood flow restriction does not attenuate short-term detraining-induced muscle size and strength losses after resistance training with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2019-After a short-term resistance training with blood flow restriction (BFR), we investigated the effects of 12 days of detraining (DET), without an exercise stimulus, on quadriceps cross-sectional area (QCSA) and muscle strength (1 repetition maximum [1RM]), with 1 leg receiving daily intermittent BFR during DET vs. the same nonexercise condition without BFR (CON) in the contralateral leg. Both subjects' legs were evaluated for QCSA and 1RM before (PRE) and after (POST) both legs being unilaterally submitted to 3 weeks (4 days per week) of low-load (3 sets of 15 repetitions, 30% 1RM) resistance training with BFR. The DET period started immediately after POST, where each leg was randomly submitted to a daily intermittent BFR protocol or CON, without any associated exercise stimulus. Quadriceps cross-sectional area and 1RM were reassessed after DET. Both legs at CON and BFR conditions increased QCSA (6.3 and 6.8%, respectively; both p < 0.0001) and 1RM (9.5 and 10.1%, respectively; both p < 0.05) from PRE to POST. Both legs at CON and BFR conditions reduced QCSA (-4.6 and 4.9%, respectively; both p < 0.0001) and 1RM (-9.0 and -8.2%, respectively; both p < 0.05) from POST to DET, with no significant differences between conditions (p > 0.05). We conclude that muscle strength and hypertrophy gains obtained in 3 weeks of resistance training with BFR are not maintained after 12 days of DET. Moreover, the application of BFR, without an associated exercise stimulus, does not attenuate such losses.

7.
J Strength Cond Res ; 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31895290

RESUMO

Lasevicius, T, Schoenfeld, BJ, Silva-Batista, C, Barros, TdS, Aihara, AY, Brendon, H, Longo, AR, Tricoli, V, Peres, BdA, and Teixeira, EL. Muscle failure promotes greater muscle hypertrophy in low-load but not in high-load resistance training. J Strength Cond Res XX(X): 000-000, 2019-The purpose of this study was to investigate the effects of an 8-week resistance training program at low and high loads performed with and without achieving muscle failure on muscle strength and hypertrophy. Twenty-five untrained men participated in the 8-week study. Each lower limb was allocated to 1 of 4 unilateral knee extension protocols: repetitions to failure with low load (LL-RF; ∼34.4 repetitions); repetitions to failure with high load (HL-RF; ∼12.4 repetitions); repetitions not to failure with low load (LL-RNF; ∼19.6 repetitions); and repetitions not to failure with high load (HL-RNF; ∼6.7 repetitions). All conditions performed 3 sets with total training volume equated between conditions. The HL-RF and HL-RNF protocols used a load corresponding to 80% 1 repetition maximum (RM), while LL-RF and LL-RNF trained at 30% 1RM. Muscle strength (1RM) and quadriceps cross-sectional area (CSA) were assessed before and after intervention. Results showed that 1RM changes were significantly higher for HL-RF (33.8%, effect size [ES]: 1.24) and HL-RNF (33.4%, ES: 1.25) in the post-test when compared with the LL-RF and LL-RNF protocols (17.7%, ES: 0.82 and 15.8%, ES: 0.89, respectively). Quadriceps CSA increased significantly for HL-RF (8.1%, ES: 0.57), HL-RNF (7.7%, ES: 0.60), and LL-RF (7.8%, ES: 0.45), whereas no significant changes were observed in the LL-RNF (2.8%, ES: 0.15). We conclude that when training with low loads, training with a high level of effort seems to have greater importance than total training volume in the accretion of muscle mass, whereas for high load training, muscle failure does not promote any additional benefits. Consistent with previous research, muscle strength gains are superior when using heavier loads.

8.
Trials ; 19(1): 545, 2018 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-30305151

RESUMO

BACKGROUND: Patients with major depression disorder presents increased rates of cognitive decline, reduced hippocampal volume, poor sleep quality, hypertension, obesity, suicidal ideation and behavior, and decreased functionality. Although continuous aerobic exercise (CAE) improves some of the aforementioned symptoms, comorbidities, and conditions, recent studies have suggested that performing aerobic exercise with motor complexity (AEMC) may be more beneficial for cognitive decline, hippocampal volume, and functionality. Therefore, this randomized controlled trial will compare the effects of CAE and AEMC on depression score, cognitive function, hippocampal volume, brain-derived neurotrophic factor expression, sleep parameters, cardiovascular risk parameters, suicidal behavior, functionality, and treatment costs in patients with depression. METHODS/DESIGN: Seventy-five medicated patients with depression will be recruited from a Basic Healthcare Unit to participate in this prospective, parallel group, single blinded, superiority, randomized controlled trial. Patients with depression according to DSM-V criteria will be balanced and randomly assigned (based on depression scores and number of depressive episodes) to a non-exercising control (C), CAE, and AEMC groups. The CAE and AEMC groups will exercise for 60 min, twice a week for 24 weeks (on non-consecutive days). Exercise intensity will be maintained between 12 and 14 points of the rating of perceived exertion scale (~ 70-80% of the maximum heart rate). The CAE group will perform a continuous aerobic exercise while the AEMC group will perform exercises with progressively increased motor complexity. Blinded raters will assess patients before and after the intervention period. The primary outcome measure will be the change in depression score measured by the Montgomery-Asberg Depression Rating Scale. Secondary outcomes will include measures of cognitive function, hippocampal volume, brain-derived neurotrophic factor expression, sleep parameters, cardiovascular risk parameters, suicidal behavior, functionality, and treatment costs. DISCUSSION: This study was selected in the call of public policy programs for the Brazilian Unified National Health System - "PPSUS 2015". To our knowledge, this is the first pragmatic trial to test the effect of adding AEMC to the pharmacological treatment of patients with depression and to evaluate the possible reductions in depression symptoms and healthcare costs. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (ReBec) - RBR-9zgxzd - Registered on 4 Jan. 2017.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/terapia , Terapia por Exercício/métodos , Atividade Motora , Brasil , Terapia Combinada , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Estudos de Equivalência como Asunto , Humanos , Ensaios Clínicos Pragmáticos como Assunto , Estudos Prospectivos , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento
9.
PM R ; 10(11): 1145-1152, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29753113

RESUMO

BACKGROUND: Patients with Parkinson disease (PD) present cardiovascular autonomic dysfunction that impairs blood pressure control. However, cardiovascular responses during resistance exercise are unknown in these patients. OBJECTIVE: To investigate cardiovascular responses during resistance exercise performed with different muscle masses in patients with PD. DESIGN: Prospective, repeated-measures. SETTING: Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo. PARTICIPANTS: Thirteen patients with PD (4 women, 62.7 ± 1.3 years, stages 2-3 of the modified Hoehn and Yahr scale; "on" state of medication) and 13 paired control patients without PD (7 women, 66.2 ± 2.0 years). INTERVENTIONS: Both groups performed, in a random order, bilateral and unilateral knee extension exercises (2 sets, 10-12 maximal repetition, 2-minute intervals). MAIN OUTCOME MEASUREMENTS: Systolic blood pressure (SBP) and heart rate (HR) were assessed before (pre) and during the exercises. RESULTS: Independent of set and exercise type, SBP and HR increases were significantly lower in PD than the control group (combined values: +45 ± 2 versus +73 ± 4 mm Hg and +18 ± 1 versus +31 ± 2 bpm, P = .003 and .007, respectively). Independently of group and set, the SBP increase was greater in the bilateral than the unilateral exercise (combined values: +63 ± 4 versus +54 ± 3 mm Hg, P = .002), whereas the HR increase was similar. In addition, independently of group and exercise type, the SBP increase was greater in the second than the first set (combined values: +56 ± 4 versus +61 ± 4 mm Hg, P = .04), whereas the HR increases were similar. CONCLUSIONS: Patients with PD present attenuated increases in SBP and HR during resistance exercise in comparison with healthy subjects. These results support that resistance exercise is safe and well tolerated for patients with PD from a cardiovascular point of view supporting its recommendation for this population. LEVEL OF EVIDENCE: II.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Doença de Parkinson/fisiopatologia , Treinamento de Resistência , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
10.
Gait Posture ; 61: 90-97, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29310015

RESUMO

Resistance training with instability (RTI) uses exercises with high motor complexity that impose high postural control and cognitive demands that may be important for improving postural instability and fear of falling in subjects with Parkinson's disease (PD). Here, we hypothesized that: 1) RTI will be more effective than resistance training (RT) in improving balance (Balance Evaluation Systems Test [BESTest] and overall stability index [Biodex Balance System®]) and fear of falling (Falls Efficacy Scale-International [FES-I] score) of subjects with Parkinson's disease (PD); and 2) changes in BESTest and FES-I after RTI will be associated with changes in cognitive function (Montreal Cognitive Assessment [MoCA] score - previously published) induced by RTI. Thirty-nine subjects with moderate PD were randomly assigned to a nonexercising control, RT, and RTI groups. While RT and RTI groups performed progressive RT twice a week for 12 weeks, the RTI group added progressive unstable devices to increase motor complexity of the resistance exercises. There were significant group × time interactions for BESTest, overall stability index, and FES-I scores (P < 0.05). Only RTI improved BESTest, overall stability index and FES-I scores, and RTI was more effective than RT in improving biomechanical constraints and stability in gait (BESTest sections) at post-training (P < 0.05). There were strong correlations between relative changes in BESTest and MoCA (r = 0.72, P = 0.005), and FES-I and MoCA (r = -0.75, P = 0.003) after RTI. Due to the increased motor complexity in RTI, RTI is recommended for improving balance and fear of falling, which are associated with improvement in cognitive function of PD.


Assuntos
Acidentes por Quedas/prevenção & controle , Cognição/fisiologia , Terapia por Exercício/métodos , Medo/psicologia , Marcha/fisiologia , Doença de Parkinson/reabilitação , Equilíbrio Postural/fisiologia , Idoso , Idoso de 80 Anos ou mais , Exercício/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia
11.
Muscle Nerve ; 57(1): 107-111, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28214295

RESUMO

INTRODUCTION: We investigated differences in metabolic stress (lactate) and muscle activation (electromyography; EMG) when high-load resistance exercise (HL) is compared with a condition in which blood flow restriction (BFR) is applied during the exercise or during the rest interval. METHODS: Twelve participants performed HL with BFR during the intervals (BFR-I), during the set (BFR-S), and without BFR. Each condition consisted of 3 sets of 8 repetitions with knee extension at 70% of 1-repetition maximum. Lactate and root mean square (RMS) from the surface EMG of the vastus lateralis were calculated. RESULTS: Lactate increased in all protocols but was higher with BFR-I than with BFR-S and HL. RMS decreased under all conditions, with a larger effect size in BFR-I (1.47) than in BFR-S (0.66) and HL (0.59). DISCUSSION: BFR-I increases lactate, possibly as a result of reduced restoration of ATP. Muscle activation seems to be impacted by mechanical stress but may be reduced by metabolic stress. Muscle Nerve 57: 107-111, 2018.


Assuntos
Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/metabolismo , Treinamento de Resistência , Estresse Fisiológico/fisiologia , Trifosfato de Adenosina/metabolismo , Adulto , Eletromiografia , Feminino , Humanos , Joelho/fisiologia , Ácido Láctico/metabolismo , Perna (Membro)/fisiologia , Masculino , Músculo Quadríceps/fisiologia , Fluxo Sanguíneo Regional
12.
Clin Physiol Funct Imaging ; 37(5): 530-535, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28776928

RESUMO

Patients with Parkinson disease (PD) present blunted nocturnal blood pressure fall and similar ambulatory blood pressure variability (ABPV) measured by standard deviation (SD) and coefficient of variation (CV) compared with healthy subjects. However, these classical indices of ABPV have limited validity in individuals with circadian blood pressure alterations. New indices, such as the average of daytime and night-time standard deviation weighted by the duration of the daytime and night-time intervals (SDdn ) and the average real variability (ARV), remove the influence of the daytime and the night-time periods on ABPV. This study assessed ABPV by SDdn and ARV in PD. Twenty-one patients with PD (11 men, 66 ± 2 years, stages 2-3 of modified Hoehn & Yahr) and 21 matched controls without Parkinson disease (9 men, 64 ± 1 years old) underwent blood pressure monitoring for 24 h. ABPV was analysed by 24 h, daytime and night-time SD and CV, and by the SDdn and ARV. Systolic/diastolic 24-h and night-time SD and CV were similar between the patients with PD and the controls. The patients with PD presented higher daytime systolic/diastolic CV and SD than the controls (10·4 ± 0·9/12·3 ± 0·8 versus 7·0 ± 0·3/9·9 ± 0·5%, P<0·05; 12·6 ± 1·0/9·1 ± 0·5 versus 8·6 ± 0·4/7·5 ± 0·3 mmHg, P<0·05, respectively) as well as higher systolic/diastolic SDdn (10·9 ± 0·8/8·2 ± 0·5 versus 8·2 ± 0·3/7·1 ± 0·2 mmHg, P<0·05, respectively) and ARV (8·8 ± 0·6/6·9 ± 0·3 versus 7·2 ± 0·2/6·0 ± 0·2 mmHg, P<0·05, respectively). In conclusion, patients with PD have higher ABPV than control subjects as assessed by SDd , CVd , SDdn and AVR.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Sistema Cardiovascular/inervação , Ritmo Circadiano , Doença de Parkinson/fisiopatologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Valor Preditivo dos Testes , Fatores de Tempo
13.
Arch Phys Med Rehabil ; 98(11): 2134-2141, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28705551

RESUMO

OBJECTIVE: To evaluate the effects of a progressive resistance training (RT) on cardiac autonomic modulation and on cardiovascular responses to autonomic stress tests in patients with Parkinson disease (PD). DESIGN: Randomized clinical trial. SETTING: The Brazil Parkinson Association. PARTICIPANTS: Patients (N=30) with PD (modified Hoehn & Yahr stages 2-3) were randomly divided into 2 groups: a progressive RT group (PD training [PDT] group) and a control group (PD control [PDC] group). In addition, a group of paired healthy control (HC) subjects without PD was evaluated. INTERVENTIONS: The PDT group performed 5 resistance exercises, 2 to 4 sets, 12 to 6 repetitions maximum per set. Individuals in the PDC group maintained their usual lifestyle. MAIN OUTCOME MEASURES: The PDT and PDC groups were evaluated before and after 12 weeks. The HC group was evaluated once. Autonomic function was assessed by spectral analysis of heart rate variability and cardiovascular responses to autonomic stress tests (deep breathing, Valsalva maneuver, orthostatic stress). RESULTS: Compared with baseline, the normalized low-frequency component of heart rate variability decreased significantly after 12 weeks in the PDT group only (PDT: 61±17 normalized units [nu] vs 47±20nu; PDC: 60±14nu vs 63±10nu; interaction P<.05). A similar result was observed for systolic blood pressure fall during orthostatic stress that also was reduced only in the PDT group (PDT: -14±11mmHg vs -6±10mmHg; PDC: -12±10mmHg vs -11±10mmHg; interaction P<.05). In addition, after 12 weeks, these parameters in the PDT group achieved values similar to those in the HC group. CONCLUSIONS: In patients with PD, progressive RT improved cardiovascular autonomic dysfunction.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/reabilitação , Treinamento de Resistência/métodos , Fatores Etários , Idoso , Pressão Sanguínea , Brasil , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Estudos Prospectivos , Sexo
14.
Med Sci Sports Exerc ; 49(4): 652-660, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27851668

RESUMO

PURPOSE: This study compared the effects of resistance training (RT) and RT with instability (RTI) on neuromuscular and total training volume (TTV) outcomes obtained as part of the Instability Resistance Training Trial in Parkinson's disease. It also used a linear multiple regression (forward stepwise method) to identify the contribution of neuromuscular outcomes to previously published improvements in the timed-up-and-go test and the Unified Parkinson's Disease Rating Scale, motor subscale score. METHODS: Thirty-nine patients with moderate to severe Parkinson's disease were randomly assigned to three groups: control (C), RT, and RTI. RT and RTI groups performed resistance exercises twice a week for 12 wk, and only the RTI group used unstable devices to perform resistance exercises. The following neuromuscular outcomes were assessed: quadriceps muscle cross-sectional area, root mean square and mean spike frequency of electromyographic signal, peak torque, rate of torque development, and half relaxation time of the knee extensors and plantarflexors during maximum ballistic voluntary isometric contractions. TTV was calculated for lower limb exercises. RESULTS: From pre- to posttraining, RTI improved all of the neuromuscular outcomes (P < 0.05) except half relaxation time of the knee extensors (P = 0.068), despite the lower TTV than RT (P < 0.05). RTI was more effective than RT in increasing the root mean square values of vastus medialis, mean spike frequency of gastrocnemius medialis, and rate of torque development of plantarflexors (P < 0.05). Stepwise regression identified the changes in mean spike frequency of gastrocnemius medialis as the best predictor of improvements in timed-up-and-go test (R = 0.58, P = 0.002) and on-medication Unified Parkinson's Disease Rating Scale, motor subscale scores (R = 0.40, P = 0.020). CONCLUSION: RTI optimizes neuromuscular adaptations, which partially explains mobility and motor sign improvements in patients with Parkinson's disease.


Assuntos
Neurônios Motores/fisiologia , Músculo Esquelético/fisiologia , Doença de Parkinson/fisiopatologia , Treinamento de Resistência/métodos , Adaptação Fisiológica , Eletromiografia , Feminino , Humanos , Contração Isométrica/fisiologia , Extremidade Inferior/fisiologia , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/reabilitação , Estudos Prospectivos , Torque
15.
J Strength Cond Res ; 31(8): 2270-2277, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27787472

RESUMO

Silva-Batista, C, de Brito, LC, Corcos, DM, Roschel, H, de Mello, MT, Piemonte, MEP, Tricoli, V, and Ugrinowitsch, C. Resistance training improves sleep quality in subjects with moderate Parkinson's disease. J Strength Cond Res 31(8): 2270-2277, 2017-The objectives of this study were to test if 12 weeks of progressive resistance training (RT) improves sleep quality and muscle strength in subjects with moderate Parkinson's disease (PD) and if sleep quality values of subjects with moderate PD are closer to those of age-matched healthy controls (HC) at posttraining. This was a randomized controlled trial conducted between March 2013 and September 2014. Twenty-two subjects with moderate PD were randomly assigned to a nonexercising control group (n = 11) or an RT group (n = 11). Thirty-one HC were not randomized to any group. The RT group performed a RT program twice a week for 12 weeks, whereas the control group made no change to their weekly routine. For subjects with PD, sleep quality (i.e., Pittsburgh Sleep Quality Index [PSQI]) and knee-extensor peak torque were assessed before and after 12 weeks of intervention; for HC, these outcomes were assessed at pretest only. There were differences between RT and control groups in PSQI scores, PSQI subscores(i.e., subjective sleep quality and daytime dysfunction), and knee-extensor peak torque at posttraining (p ≤ 0.05). After RT, the average subjects with PD showed lower (i.e., improved) PSQI scores than the average HC (p ≤ 0.05). A negative association was observed between changes in PSQI scores and changes in knee-extensor peak torque at posttraining (r = -0.58, p = 0.028). No adverse events were reported. The RT is recommended as an adjunct therapeutic method for improving sleep quality of subjects with moderate PD and moving these levels to those observed in HC.


Assuntos
Doença de Parkinson/complicações , Doença de Parkinson/terapia , Treinamento de Resistência/métodos , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/terapia , Idoso , Feminino , Humanos , Articulação do Joelho/fisiologia , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Estudos Prospectivos , Sono/fisiologia
16.
J Appl Physiol (1985) ; 122(1): 1-10, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27834670

RESUMO

This study assessed 1) the effects of 12 wk of resistance training (RT) and resistance training with instability (RTI) on presynaptic inhibition (PSI) and disynaptic reciprocal inhibition (DRI) of patients with Parkinson's disease (PD); 2) the effectiveness of RT and RTI in moving PSI and DRI values of patients toward values of age-matched healthy controls (HC; Z-score analysis); and 3) associations between PSI and DRI changes and clinical outcomes changes previously published. Thirteen patients in RT group, 13 in RTI group, and 11 in a nonexercising control group completed the trial. While RT and RTI groups performed resistance exercises twice a week for 12 wk, only the RTI group used unstable devices. The soleus H reflex was used to evaluate resting PSI and DRI before and after the experimental protocol. The HC (n = 31) was assessed at pretest only. There were significant group × time interactions for PSI (P < 0.0001) and DRI (P < 0.0001). RTI was more effective than RT in increasing the levels of PSI (P = 0.0154) and DRI (P < 0.0001) at posttraining and in moving PSI [confidence interval (CI) 0.1-0.5] and DRI (CI 0.6-1.1) levels to those observed in HC. There was association between DRI and quality of life changes (r = -0.69, P = 0.008) and a strong trend toward association between PSI and postural instability changes (r = 0.60, P = 0.051) after RTI. RTI increased PSI and DRI levels more than RT, reaching the average values of the HC. Thus RTI may cause plastic changes in PSI and DRI pathways that are associated with some PD clinical outcomes. NEW & NOTEWORTHY: Patients with Parkinson's disease (PD) have motor dysfunction. Spinal inhibitory mechanisms are important for modulating both supraspinal motor commands and sensory feedback at the spinal level. Resistance training with instability was more effective than resistance training in increasing the levels of presynaptic inhibition and disynaptic reciprocal inhibition of lower limb at rest of the patients with PD, reaching the average values of the healthy controls.


Assuntos
Exercício/fisiologia , Doença de Parkinson/fisiopatologia , Coluna Vertebral/fisiopatologia , Idoso , Estudos de Casos e Controles , Terapia por Exercício/métodos , Feminino , Reflexo H/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Estudos Prospectivos , Qualidade de Vida , Treinamento de Resistência/métodos , Descanso/fisiologia
17.
Med Sci Sports Exerc ; 48(9): 1678-87, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27054681

RESUMO

PURPOSE: This randomized controlled trial compared the effects of resistance training (RT) and RT with instability (RTI) on the timed up and go test (TUG), on-medication Unified Parkinson's Disease Rating Scale part III motor subscale score (UPDRS-III), Montreal Cognitive Assessment (MoCA) score, Parkinson's Disease Questionnaire (PDQ-39) score, and muscle strength in the leg press exercise (one-repetition maximum) of patients with Parkinson's disease (PD). METHODS: Thirty-nine patients with moderate to severe PD were randomly assigned to a nonexercising control group (C), RT group, and RTI group. The RT and RTI groups performed progressive RT twice a week for 12 wk. However, only the RTI group used high motor complexity exercises (i.e., progressive RT with unstable devices), for example, half squat exercise on the BOSU® device. The primary outcome was mobility (TUG). The secondary outcomes were on-medication motor signs (UPDRS-III), cognitive impairment (MoCA), quality of life (PDQ-39), and muscle strength (one-repetition maximum). RESULTS: There were no differences between RTI and RT groups for any of the outcomes at posttraining (P > 0.05). However, there were differences between RTI and C groups in the TUG, MoCA, and muscle strength values at posttraining (P < 0.05). Only the RTI group improved the TUG (-1.9 s), UPDRS-III score (-4.5 score), MoCA score (6.0 score), and PDQ-39 score (-5.2 score) from pre- to posttraining (P < 0.001). Muscle strength improved for both training groups (P < 0.001). No adverse events were reported during the trial. CONCLUSIONS: Both training protocols improved muscle strength, but only RTI improved the mobility, motor signs, cognitive impairment, and quality of life, likely because of the usage of high motor complexity exercises. Thus, RTI may be recommended as an innovative adjunct therapeutic intervention for patients with PD.


Assuntos
Terapia por Exercício/métodos , Doença de Parkinson/terapia , Treinamento de Resistência , Idoso , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Força Muscular , Estudos Prospectivos , Qualidade de Vida
18.
Arch Phys Med Rehabil ; 97(5): 720-5, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26780469

RESUMO

OBJECTIVE: To investigate submaximal and maximal responses during maximal cardiopulmonary exercise tests in subjects with Parkinson disease (PD). DESIGN: Cross-sectional. SETTING: A PD association. PARTICIPANTS: A sample (N=68) of subjects with PD (n=48; mean age, 66±8y; modified Hoehn and Yahr stage between 2 and 3; "on" state of medication) and age-matched controls without PD (n=20; mean age, 64±9y). INTERVENTIONS: Maximal cardiopulmonary exercise test on a cycle ergometer. MAIN OUTCOME MEASURES: Oxygen uptake (V˙o2), systolic blood pressure (SBP), and heart rate assessed at rest, submaximal intensities (ie, anaerobic threshold [AT] and respiratory compensation point), and maximal intensity (peak exercise). RESULTS: Compared with control subjects, subjects with PD had lower V˙o2, heart rate, and SBP at respiratory compensation point and peak exercise (V˙o2: 14.6±3.6mL⋅kg⋅min vs 17.9±5.5mL⋅kg⋅min and 17.7±4.8mL⋅kg⋅min vs 21.5±6.6mL⋅kg⋅min; heart rate: 119±17beats/min vs 139±12beats/min and 132±20beats/min vs 158±13beats/min; SBP: 151±17mmHg vs 172±20mmHg and 166±21mmHg vs 187±24mmHg; P≤.05). They also had lower heart rate at AT (102±14beats/min vs 110±13beats/min; P≤.05), whereas V˙o2 and SBP at this intensity were similar to those of control subjects. CONCLUSIONS: Subjects with PD demonstrated blunted metabolic and cardiovascular responses to submaximal and maximal exercise tests, especially at intensities above AT, which are in line with autonomic disturbances present in patients with PD. Future studies need to determine how this affects performance, participation, and responses of these patients to exercise training at different intensities.


Assuntos
Teste de Esforço/estatística & dados numéricos , Exercício/fisiologia , Doença de Parkinson/fisiopatologia , Idoso , Limiar Anaeróbio , Pressão Sanguínea , Estudos de Casos e Controles , Estudos Transversais , Tolerância ao Exercício , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio
19.
J Sports Sci Med ; 13(3): 597-603, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25177187

RESUMO

This case report assessed quality of life, activities of daily living, motor symptoms, functional ability, neuromuscular parameters and mRNA expression of selected genes related to muscle protein synthesis and degradation in a patient with Multiple System Atrophy (MSA). The patient underwent resistance training with instability devices (i.e., bosu, dyna disk, balance disk, Swiss ball) for six months twice a week. After the six months training, the patient's left and right quadriceps muscle cross-sectional area and leg press one-repetition maximum increased 6.4%, 6.8%, and 40%, respectively; the patient's timed up and go, sit to stand, dynamic balance, and activities of daily living improved 33.3%, 28.6%, 42.3%, and 40.1%, respectively; the patient's severity of motor symptoms and risk of falls decreased 32% and 128.1%, respectively. Most of the subscales of quality of life demonstrated improvements as well, varying from 13.0% to 100.0%. mRNA expression of mechanogrowth factor and mammalian target of rapamycin increased 12.7-fold and 1.5-fold, respectively. This case report describes likely the first nonpharmacological therapeutic tool that might be able to decrease the severity of motor symptoms and risk of falls, and to improve functional ability, neuromuscular parameters, and quality of the life in a patient with MSA. Key pointsSix months of resistance training with instability alleviate the MSA-related effects and improve the quality of life in a patient with MSA.High complexity exercise intervention (i.e., resistance training with instability) may be very beneficial to individuals with impaired motor control and function as MSA patients.Caution should be exercised when interpreting our findings as they cannot be generalized to the entire MSA population and they do not allow establishing causal conclusions on the effects of this mode of exercise on MSA.

20.
J Strength Cond Res ; 28(11): 3215-23, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24832980

RESUMO

Concurrent training (CT) seems to impair training-induced muscle hypertrophy. This study compared the effects of CT, strength training (ST) and interval training (IT) on the muscle fiber cross-sectional area (CSA) response, and on the expression of selected genes involved in the myostatin (MSTN) signaling mRNA levels. Thirty-seven physically active men were randomly divided into 4 groups: CT (n = 11), ST (n = 11), IT (n = 8), and control group (C) (n = 7) and underwent an 8-week training period. Vastus lateralis biopsy muscle samples were obtained at baseline and 48 hours after the last training session. Muscle fiber CSA, selected genes expression, and maximum dynamic ST (1 repetition maximum) were evaluated before and after training. Type IIa and type I muscle fiber CSA increased from pre- to posttest only in the ST group (17.08 and 17.9%, respectively). The SMAD-7 gene expression significantly increased at the posttest in the ST (53.9%) and CT groups (39.3%). The MSTN and its regulatory genes ActIIb, FLST-3, FOXO-3a, and GASP-1 mRNA levels remained unchanged across time and groups. One repetition maximum increased from pre- to posttest in both the ST and CT groups (ST = 18.5%; CT = 17.6%). Our findings are suggestive that MSTN and their regulatory genes at transcript level cannot differentiate muscle fiber CSA responses between CT and ST regimens in humans.


Assuntos
Expressão Gênica , Miostatina/metabolismo , Músculo Quadríceps/metabolismo , Treinamento de Resistência , Corrida/fisiologia , Adolescente , Adulto , Teste de Esforço , Proteína Forkhead Box O3 , Fatores de Transcrição Forkhead/genética , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Masculino , Fibras Musculares de Contração Rápida/citologia , Fibras Musculares de Contração Lenta/citologia , Miostatina/genética , Consumo de Oxigênio , Condicionamento Físico Humano/métodos , Condicionamento Físico Humano/fisiologia , Proteínas/genética , Músculo Quadríceps/citologia , RNA Mensageiro/metabolismo , Transdução de Sinais/genética , Proteína Smad7/genética , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA