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1.
Support Care Cancer ; 29(1): 359-367, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32367227

RESUMO

PURPOSE: Cardiorespiratory fitness (CRF) seems to be prognostic prior to allogeneic stem cell transplantation (allo-HSCT). Influencing factors of CRF in allo-HSCT candidates have not been studied so far. Aim was to identify potentially influencing factors on CRF. METHODS: To assess CRF, a maximal cardiopulmonary exercise test (CPET) was performed on average 2.6 ± 7.2 days prior to admission. A regression analysis was conducted, with the following predictors: gender, age, body mass index (BMI), time between last therapy and allo-HSCT (t_Therapies), number of cardiotoxic therapies (n_Cardiotox), number of transplantations (n_Transplantations), comorbidity index (HCT-CI), hemoglobin level of the last 3 months (area under the curve), and physical activity. RESULTS: A total of 194 patients performed a CPET. VO2peak was significantly reduced compared with reference data. In total, VO2peak was 21.4 ml/min/kg (- 27.5%, p < 0.05). Men showed a significant larger percentage difference from reference value (- 29.1%, p < 0.05) than women (- 24.4%). VO2peak was significantly (p < 0.05) influenced by age (ß = - 0.11), female gender (ß = - 3.01), BMI (ß = - 0.44), n_Cardiotox (ß = - 0.73), hemoglobin level (ß = 0.56), and physical activity prior to diagnosis (ß = 0.10). CONCLUSIONS: Our study demonstrates a decreased CRF indicating the potential need of prehabilitative exercise. We revealed some influencing factors on CRF. Those patients could benefit the most from exercise.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Teste de Esforço/métodos , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , Adulto , Idoso , Índice de Massa Corporal , Exercício Físico , Feminino , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Regressão , Adulto Jovem
2.
Anaesthesia ; 76(1): 72-81, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32592218

RESUMO

Cardiopulmonary exercise testing is performed increasingly for cardiorespiratory fitness assessment and pre-operative risk stratification. Lower limb osteoarthritis is a common comorbidity in surgical patients, meaning traditional cycle ergometry-based cardiopulmonary exercise testing is difficult. The purpose of this study was to compare cardiopulmonary exercise testing variables and subjective responses in four different exercise modalities. In this crossover study, 15 patients with osteoarthritis scheduled for total hip or knee arthroplasty (mean (SD) age 68 (7) years; body mass index 31.4 (4.1) kg.m-2 ) completed cardiopulmonary exercise testing on a treadmill, elliptical cross-trainer, cycle and arm ergometer. Mean (SD) peak oxygen consumption was 20-30% greater on the lower limb modalities (treadmill 21.5 (4.6) (p < 0.001); elliptical cross-trainer (21.2 (4.1) (p < 0.001); and cycle ergometer (19.4 (4.2) ml.min-1 .kg-1 (p = 0.001), respectively) than on the arm ergometer (15.7 (3.7) ml.min-1 .kg-1 ). Anaerobic threshold was 25-50% greater on the lower limb modalities (treadmill 13.5 (3.1) (p < 0.001); elliptical cross-trainer 14.6 (3.0) (p < 0.001); and cycle ergometer 10.7 (2.9) (p = 0.003)) compared with the arm ergometer (8.4 (1.7) ml.min-1 .kg-1 ). The median (95%CI) difference between pre-exercise and peak-exercise pain scores was greater for tests on the treadmill (2.0 (0.0-5.0) (p = 0.001); elliptical cross-trainer (3.0 (2.0-4.0) (p = 0.001); and cycle ergometer (3.0 (1.0-5.0) (p = 0.001)), compared with the arm ergometer (0.0 (0.0-1.0) (p = 0.406)). Despite greater peak exercise pain, cardiopulmonary exercise testing modalities utilising the lower limbs affected by osteoarthritis elicited higher peak oxygen consumption and anaerobic threshold values compared with arm ergometry.


Assuntos
Aptidão Cardiorrespiratória , Teste de Esforço/métodos , Osteoartrite/diagnóstico , Osteoartrite/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Limiar Anaeróbio , Braço , Artroplastia de Quadril , Artroplastia do Joelho , Índice de Massa Corporal , Estudos Cross-Over , Ergometria/métodos , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Medição da Dor , Cuidados Pré-Operatórios , Medição de Risco/métodos
3.
Am Fam Physician ; 102(12): 721-727, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320506

RESUMO

Approximately 1% of primary care office visits are for chest pain, and 2% to 4% of these patients will have unstable angina or myocardial infarction. Initial evaluation is based on determining whether the patient needs to be referred to a higher level of care to rule out acute coronary syndrome (ACS). A combination of age, sex, and type of chest pain can predict the likelihood of coronary artery disease as the cause of chest pain. The Marburg Heart Score and the INTERCHEST clinical decision rule can also help estimate ACS risk. Twelve-lead electrocardiography is recommended to look for ST segment changes, new-onset left bundle branch block, presence of Q waves, and new T-wave inversions. Patients with suspicion of ACS or changes on electrocardiography should be transported immediately to the emergency department. Those at low or intermediate risk of ACS can undergo exercise stress testing, coronary computed tomography angiography, or cardiac magnetic resonance imaging. In those with low suspicion for ACS, consider other diagnoses such as chest wall pain or costochondritis, gastroesophageal reflux disease, and panic disorder or anxiety states. Other less common, but important, diagnostic considerations include acute pericarditis, pneumonia, heart failure, pulmonary embolism, and acute thoracic aortic dissection.


Assuntos
Síndrome Coronariana Aguda/diagnóstico , Infarto do Miocárdio/diagnóstico , Pacientes Ambulatoriais/estatística & dados numéricos , Dor no Peito/etiologia , Angiografia Coronária , Eletrocardiografia/métodos , Teste de Esforço/métodos , Feminino , Humanos , Masculino , Medição de Risco/métodos
4.
Ned Tijdschr Geneeskd ; 1642020 10 29.
Artigo em Holandês | MEDLINE | ID: mdl-33331718

RESUMO

OBJECTIVE: To safely and effectively train the exercise capacity of post-COVID-19 patients it is important to test for cardiopulmonary risk factors and to assess exercise limitations. The goal of this study was to describe the exercise capacity and underlying exercise limitations of mechanically ventilated post-COVID-19 patients in clinical rehabilitation. DESIGN: A retrospective cohort study. METHOD: Twenty-four post-COVID-19patients that were mechanically ventilated at ICU and thereafter admitted for clinical rehabilitation performed a symptom-limited cardiopulmonary exercise test (CPET) with breath-by-breath gas-exchange monitoring, ECG-registration, blood pressure- and saturation monitoring. In absence of a primary cardiac or ventilatory exercise limitation patients were considered to be limited primarily by decreased peripheral muscle mass. RESULTS: Twenty-three patients could perform a maximal exercise test and no adverse events occurred. Cardiorespiratory fitness was very poor with a median peak oxygen uptake of 15.0 [10.1-21.4] mlO2/kg/min (57% of predicted values). However, we observed large differences within the group in both exercise capacity and exercise limitations. While 7/23 patients were primarily limited by ventilatory function, the majority (70%) was limited primarily by the decreased peripheral muscle mass. CONCLUSION: Cardiorespiratory fitness of post-COVID-19 patients in clinical rehabilitation is strongly deteriorated. The majority of patients seemed primarily limited for exercise by the decreased peripheral muscle mass.


Assuntos
Teste de Esforço/métodos , Tolerância ao Exercício , Hospitais de Reabilitação/métodos , /reabilitação , Adulto , /reabilitação , Aptidão Cardiorrespiratória/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Seleção de Pacientes , Respiração Artificial/métodos , /virologia , Estudos Retrospectivos
5.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370998

RESUMO

Coronary artery fistulas are abnormal vascular conduits, rarely related to atrioventricular conduction abnormalities. We report the case of a 52-year-old woman who presented with dyspnoea on exertion. Her ECG revealed advanced atrioventricular block and left bundle branch block. CT scans confirmed two fistulas, from the conus branch of right coronary artery and from the left anterior descending coronary artery, into the pulmonary artery. The patient underwent pacemaker implantation. To date, only nine patients with different degrees of heart blocks associated with coronary artery fistulas have been reported. Herein, we review and summarise previously reported cases of different degrees of heart blocks associated with coronary artery fistulas.


Assuntos
Bloqueio Atrioventricular/diagnóstico , Bloqueio de Ramo/diagnóstico , Anomalias dos Vasos Coronários/complicações , Fístula/complicações , Marca-Passo Artificial , Bloqueio Atrioventricular/etiologia , Bloqueio Atrioventricular/terapia , Bloqueio de Ramo/etiologia , Bloqueio de Ramo/terapia , Anomalias dos Vasos Coronários/diagnóstico , Vasos Coronários/diagnóstico por imagem , Ecocardiografia , Eletrocardiografia , Teste de Esforço/métodos , Feminino , Fístula/diagnóstico , Humanos , Pessoa de Meia-Idade , Tecnécio Tc 99m Sestamibi/administração & dosagem , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do Tratamento
6.
JAMA Netw Open ; 3(12): e2028312, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315111

RESUMO

Importance: Both noninvasive anatomic and functional testing strategies are now routinely used as initial workup in patients with low-risk stable chest pain (SCP). Objective: To determine whether anatomic approaches (ie, coronary computed tomography angiography [CTA] and coronary CTA supplemented with noninvasive fractional flow reserve [FFRCT], performed in patients with 30% to 69% stenosis) are cost-effective compared with functional testing for the assessment of low-risk SCP. Design, Setting, and Participants: This cost-effectiveness analysis used an individual-based Markov microsimulation model for low-risk SCP. The model was developed using patient data from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial. The model was validated by comparing model outcomes with outcomes observed in the PROMISE trial for anatomic (coronary CTA) and functional (stress testing) strategies, including diagnostic test results, referral to invasive coronary angiography (ICA), coronary revascularization, incident major adverse cardiovascular event (MACE), and costs during 60 days and 2 years. The validated model was used to determine whether anatomic approaches are cost-effective over a lifetime compared with functional testing. Exposure: Choice of index test for evaluation of low-risk SCP. Main Outcomes and Measures: Downstream ICA and coronary revascularization, MACE (death, nonfatal myocardial infarction), cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) of competing strategies. Results: The model cohort included 10 003 individual patients (median [interquartile range] age, 60.0 [54.4-65.9] years; 5270 [52.7%] women; 7693 [77.4%] White individuals), who entered the model 100 times. The Markov model accurately estimated the test assignment, results of anatomic and functional index testing, referral to ICA, revascularization, MACE, and costs at 60 days and 2 years compared with observed data in PROMISE (eg, coronary CTA: ICA, 12.2% [95% CI, 10.9%-13.5%] vs 12.3% [95% CI, 12.2%-12.4%]; revascularization, 6.2% [95% CI, 5.5%-6.9%] vs 6.4% [95% CI, 6.3%-6.5%]; functional strategy: ICA, 8.1% [95% CI, 7.4%-8.9%] vs 8.2% [95% CI, 8.1%-8.3%]; revascularization, 3.2% [95% CI, 2.7%-3.7%] vs 3.3% [95% CI, 3.2%-3.4%]; 2-year MACE rates: coronary CTA, 2.1% [95% CI, 1.7%-2.5%] vs 2.3% [95% CI, 2.2%-2.4%]; functional strategy, 2.2% [95% CI, 1.8%-2.6%] vs 2.4% [95% CI, 2.3%-2.4%]). Anatomic approaches led to higher ICA and revascularization rates at 60 days, 2 years, and 5 years compared with functional testing but were more effective in patient selection for ICA (eg, 60-day revascularization-to-ICA ratio, CTA: 53.7% [95% CI, 53.3%-54.0%]; CTA with FFRCT: 59.5% [95% CI, 59.2%-59.8%]; functional testing: 40.7% [95% CI, 40.4%-50.0%]). Over a lifetime, anatomic approaches gained an additional 6 months in perfect health compared with functional testing (CTA, 25.16 [95% CI, 25.14-25.19] QALYs; CTA with FFRCT, 25.14 [95% CI, 25.12-25.17] QALYs; functional testing, 24.68 [95% CI, 24.66-24.70] QALYs). Anatomic strategies were less costly and more effective; thus, CTA with FFRCT dominated and CTA alone was cost-effective (ICERs ranged from $1912/QALY for women and $3,559/QALY for men) compared with functional testing. In probabilistic sensitivity analyses, anatomic approaches were cost-effective in more than 65% of scenarios, assuming a willingness-to-pay threshold of $100 000/QALY. Conclusions and Relevance: The results of this study suggest that anatomic strategies may present a more favorable initial diagnostic option in the evaluation of low-risk SCP compared with functional testing.


Assuntos
Dor no Peito/diagnóstico , Angiografia por Tomografia Computadorizada , Estenose Coronária/diagnóstico , Vasos Coronários/diagnóstico por imagem , Teste de Esforço , Reserva Fracionada de Fluxo Miocárdico , Revascularização Miocárdica , Angiografia por Tomografia Computadorizada/economia , Angiografia por Tomografia Computadorizada/métodos , Estenose Coronária/fisiopatologia , Análise Custo-Benefício/métodos , Teste de Esforço/economia , Teste de Esforço/métodos , Feminino , Humanos , Masculino , Cadeias de Markov , Pessoa de Meia-Idade , Modelos Teóricos , Revascularização Miocárdica/métodos , Revascularização Miocárdica/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Medição de Risco/economia , Medição de Risco/métodos
7.
Rev. andal. med. deporte ; 13(4): 257-260, dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-195074

RESUMO

La actual situación de pandemia producida por el SARS-CoV-2, obliga a los laboratorios de fisiología del ejercicio a tomar una serie de medidas adicionales para la realización segura de las pruebas de esfuerzo, tanto diagnósticas como de rendimiento. El objetivo del presente trabajo es exponer las medidas a adoptar, para la prevención del contagio por el SARS-CoV-2, durante la realización de pruebas de esfuerzo a deportistas, propuestas por los profesionales del Centro Andaluz de Medicina del Deporte, basadas en la evidencia científica disponible, y que están orientadas hacia su aplicación en el propio laboratorio, a los atletas y a todos los profesionales que participan en su evaluación


The current pandemic situation, produced by SARS-CoV-2, forces exercise physiology laboratories to take a series of additional measures for the safe performance of stress tests, both diagnostic and performance. The objective of this report is to present preventive measures to be taken to avoid contagion by SARS-CoV-2 during exercise tests on athletes, proposed by the professionals of the Andalusian Center for Sports Medicine, based on scientific evidence available, and oriented towards its application in the laboratory itself, to athletes and to all professionals who participate in its evaluation


A atual situação de pandemia produzida pelo SARS-CoV-2 obriga os laboratórios de fisiologia do exercício a tomar uma série de medidas adicionais para a realização segura dos testes de esforço, tanto de diagnóstico quanto de desempenho. O objetivo deste trabalho é apresentar as medidas a serem adotadas para a prevenção do contágio pelo SARS-CoV-2 durante testes de exercício em atletas, propostas pelos profissionais do Centro Andaluz de Medicina do Esporte, com base em evidências científicas disponíveis, e que são orientados para a sua aplicação no próprio laboratório, aos atletas e a todos os profissionais que participam na sua avaliação


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Teste de Esforço/métodos , Gasometria/métodos , Atletas/estatística & dados numéricos , Desempenho Atlético/fisiologia , Controle de Doenças Transmissíveis/organização & administração , Pandemias , Quarentena , Distância Social , Esportes/fisiologia , Precauções Universais/métodos
8.
Apunts, Med. esport (Internet) ; 55(208): 128-136, oct.-dic. 2020. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-ET2-7588

RESUMO

INTRODUCTION: In periods of confinement, people cannot be assessed in training centers. Therefore, it is essential to have valid and reliable tests to evaluate physical capacities remotely and with their respective valuation tables. OBJECTIVE: To determine the validity and reliability of the Muscular Fitness Test (MFT) to evaluate the body strength-resistance with self-loading in healthy young adults. Secondly, to create qualitative scales to evaluate the different levels of this physical capacity. MATERIAL AND METHODS: 489 participants performed the MFT (test), and 77 performed it twice (re-test). The MFT included 60seconds (s) of sit-ups, push-ups, deep squats, and burpees, always in that order, with a micropause of 10s. The validity of the MFT was evaluated with the final heart rate (FHR), % of the reserve HR (%) and Rating of Perceived Exertion (RPE); the reliability included the Coefficient of Variation (CV), Intra-Class Correlation Coefficient (ICC) and the standard error of the mean (SEM) (p < 0.05). The qualitative scales were constructed with the percentiles ≤25: poor, ≤50: fair, ≤75: good, ≤90: very good, and >90: excellent. RESULTS: Participants performed 91.7±26.5 total repetitions, with a FHR of 172.7bpm (81.7%) and RPE of 8.1; CV=2.81%, ICC=0.97 and SEM=0.77 (p < 0.001). CONCLUSION: MFT proved to be valid and reliable to assess self-loaded body strength-resistance in healthy young adults. The creation of the MFT qualitative scales allows evaluating the level of body strength-resistance in this population


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Treinamento de Resistência , Teste de Esforço/instrumentação , Atividade Motora/fisiologia , Músculo Esquelético/fisiologia , Força Muscular/fisiologia , Antropometria/métodos , Teste de Esforço/métodos , Inquéritos e Questionários
9.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(9): 586-593, nov. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-197340

RESUMO

BACKGROUND: Excessive screen time (ST) and lower physical activity (PA) patterns have been reported to have an impact on cardiometabolic risk (CMR); however, their impact on physical fitness needs in-depth study. OBJECTIVE: To determine the association between lifestyle (i.e. ST and PA after school) with physical fitness related to health and CMR (i.e. abdominal obesity and hypertension) in Chilean schoolchildren. METHODS: The sample for this cross-sectional study comprised 263 girls (11.87±0.83 years) and 319 boys (12.02±0.88 years). The body mass index (BMI), waist circumference (WC), waist to height ratio (WtHR), CMR (WtHR≥0.5), body fat (BF), systolic (SBP) and diastolic blood pressure (DBP), physical fitness, ST (h/day), and PA after school (h/week) were evaluated. RESULTS: Schoolchildren with good lifestyle had a lower BMI, WC, and WtHR (P<0.001) as well as a better VO2max (P<0.001) and standing long jump test (SLJ) (P=0.002). The schoolchildren with bad lifestyle had the highest proportion of students with abdominal obesity (WtHR≥0.5) (30.6%, P=0.009) and hypertension. (40.9%, P<0.001). Likewise, PA after school (β; −0.02, P=0.002) and cardiorespiratory fitness (β; −0.02, P=0.002) adjusted by age and sex reported inverse associations with abdominal obesity (WtHR≥0.5). Likewise, ST presented a positive association with SBP (β; 0.14, P=0.030). Moreover, handgrip strength (β; −0.17, P=0.010) and SLJ (β; −0.05, P=0.023) reported inverse associations with SBP. CONCLUSION: In schoolchildren, a bad lifestyle was associated with low physical fitness related to health and CMR (i.e. abdominal obesity and hypertension)


ANTECEDENTES: Se ha informado que el tiempo de pantalla (TP) excesivo y los patrones de actividad física (AF) más bajos tienen un impacto en el riesgo cardiometabólico (RCM); sin embargo, su impacto en la aptitud física necesita un estudio en profundidad. OBJETIVO: Determinar la asociación entre el estilo de vida (es decir, TP y AF después de la escuela) con la condición física relacionada con la salud y el RCM (es decir, obesidad abdominal e hipertensión) en escolares chilenos. MÉTODOS: La muestra para este estudio transversal comprendió 263 niñas (11,87± 0,83 años) y 319 niños (12,02±0,88 años). Se evaluó el índice de masa corporal (IMC), la circunferencia de la cintura (CC), la relación cintura/altura (RCE), el RCM (RCE≥0,5), la grasa corporal (GC), la presión arterial sistólica (PAS) y la diastólica (PAD), la condición física, el TP (h/día) y la AF después de la escuela (h/semana). RESULTADOS: Los escolares con hábitos saludables de vida tenían un IMC, una CC y una RCE más bajos (p < 0,001), así como un mejor VO2 máx (p < 0,001) y prueba de salto de longitud (SLJ) (p = 0,002). Los escolares con malos hábitos de vida tenían la mayor proporción de estudiantes con obesidad abdominal (RCE≥0,5) (30,6%, p = 0,009) e hipertensión (40,9%, p < 0,001). Asimismo, la AF después de la escuela (β; −0,02, p = 0,002) y el CRF (β; −0,02, p = 0,002) ajustados por edad y sexo se asociaron de forma inversa con la obesidad abdominal (RCE≥0,5). Asimismo, el TP presentó una asociación positiva con la PAS (β; 0,14, p = 0,030). Además, la fuerza de prensión (β; −0,17, p = 0,010) y SLJ (β; −0,05, p = 0,023) mostró una relación inversa con la PAS. CONCLUSIÓN: En los escolares, el estilo de vida malo se asoció con una baja aptitud física relacionada con la salud y la RCM (es decir, obesidad abdominal e hipertensión)


Assuntos
Humanos , Masculino , Feminino , Criança , Teste de Esforço/métodos , Doenças Cardiovasculares/epidemiologia , Atividade Motora , Obesidade/complicações , Estilo de Vida Saudável/fisiologia , Fatores de Risco , Limiar Anaeróbio , Obesidade/fisiopatologia , Hipertensão/fisiopatologia , Chile/epidemiologia , Estudos Transversais , Antropometria , Índice de Massa Corporal
10.
PLoS One ; 15(10): e0239203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33112909

RESUMO

BACKGROUND: There currently is no field test available for measuring maximal exercise capacity in people with stroke. OBJECTIVE: To determine the feasibility, reproducibility and validity of the Shuttle Test (ST) to measure exercise capacity in people with stroke. DESIGN: Longitudinal study design. SETTING: Rehabilitation department, day care centres from a nursing home and private practices specialized in neuro rehabilitation. SUBJECTS: People with subacute or chronic stroke. INTERVENTIONS: A standardized protocol was used to determine feasibility, reproducibility and validity of the 10-meter Shuttle Test (10mST). MAIN MEASURES: Number of shuttles completed, 1stVentilatory Threshold (1stVT). RESULTS: The associations of the number of shuttles completed and cardiopulmonary capacity as measured with a portable gas analyser were r > 0.7, confirming good convergent validity in subacute and chronic people with stroke. Criterion validity, however, indicates it is not a valid test for measuring maximal cardiopulmonary capacity (VO2max). Only 60% of participants were able to reach the 1stVT. Higher cardiopulmonary capacity and a higher total score of the lower extremity Motricity Index contributed significantly to a higher number of shuttles walked (p = 0.001). CONCLUSIONS: The Shuttle Test may be a safe and useful exercise test for people after stroke, but may not be appropriate for use with people who walk slower than 2 km/h or 0.56 m/s.


Assuntos
Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Limiar Anaeróbio , Teste de Esforço/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos , Consumo de Oxigênio , Reprodutibilidade dos Testes , Reabilitação do Acidente Vascular Cerebral , Caminhada/fisiologia
11.
PLoS One ; 15(8): e0238569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866216

RESUMO

Validation of heart rate responses in wearable technology devices is generally composed of laboratory-based protocols that are steady state in nature and as a result, high accuracy measures are returned. However, there is a need to understand device validity in applied settings that include varied intensities of exercise. The purpose was to determine concurrent heart rate validity during trail running. Twenty-one healthy participants volunteered (female n = 10, [mean (SD)]: age = 31 [11] years, height = 173.0 [7] cm, mass = 75.6 [13] kg). Participants were outfitted with wearable technology devices (Garmin Fenix 5 wristwatch, Jabra Elite Sport earbuds, Motiv ring, Scosche Rhythm+ forearm band, Suunto Spartan Sport watch with accompanying chest strap) and completed a self-paced 3.22 km trail run while concurrently wearing a criterion heart rate strap (Polar H7 heart rate monitor). The trail runs were out-and-back with the first 1.61 km in an uphill direction, and the 1.61 return being downhill in nature. Validity was determined through three methods: Mean Absolute Percent Error (MAPE), Bland-Altman Limits of Agreement (LOA), and Lin's Concordance Coefficient (rC). Validity measures overall are as follows: Garmin Fenix 5 (MAPE = 13%, LOA = -32 to 162, rC = 0.32), Jabra Elite Sport (MAPE = 23%, LOA = -464 to 503, rC = 0.38), Motiv ring (MAPE = 16%, LOA = -52 to 96, rC = 0.29), Scosche Rhythm+ (MAPE = 6%, LOA = -114 to 120, rC = 0.79), Suunto Spartan Sport (MAPE = 2%, LOA = -62 to 61, rC = 0.96). All photoplethysmography-based (PPG) devices displayed poor heart rate agreement during variable intensity trail running. Until technological advances occur in PPG-based devices allowing for acceptable agreement, heart rate in outdoor environments should be obtained using an ECG-based chest strap that can be connected to a wristwatch or other comparable receiver.


Assuntos
Determinação da Frequência Cardíaca/instrumentação , Determinação da Frequência Cardíaca/métodos , Frequência Cardíaca/fisiologia , Corrida/fisiologia , Tecnologia/instrumentação , Tecnologia/métodos , Adulto , Exercício Físico/fisiologia , Teste de Esforço/instrumentação , Teste de Esforço/métodos , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Fotopletismografia/métodos , Dispositivos Eletrônicos Vestíveis
12.
Sensors (Basel) ; 20(18)2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32899946

RESUMO

Gait deterioration caused by prolonged walking represents one of the main consequences of multiple sclerosis (MS). This study aims at proposing quantitative indices to measure the gait deterioration effects. The experimental protocol consisted in a 6-min walking test and it involved nine patients with MS and twenty-six healthy subjects. Pathology severity was assessed through the Expanded Disability Status Scale. Seven inertial units were used to gather lower limb kinematics. Gait variability and asymmetry were assessed by coefficient of variation (CoV) and symmetry index (SI), respectively. The evolution of ROM (range of motion), CoV, and SI was computed analyzing data divided into six 60-s subgroups. Maximum difference among subgroups and the difference between the first minute and the remaining five were computed. The indices were analyzed for intra- and inter-day reliability and repeatability. Correlation with clinical scores was also evaluated. Good to excellent reliability was found for all indices. The computed standard deviations allowed us to affirm the good repeatability of the indices. The outcomes suggested walking-related fatigue leads to an always more variable kinematics in MS, in terms of changes in ROM, increase of variability and asymmetry. The hip asymmetry strongly correlated with the clinical disability.


Assuntos
Fadiga/fisiopatologia , Transtornos Neurológicos da Marcha/diagnóstico , Marcha/fisiologia , Esclerose Múltipla/diagnóstico , Índice de Gravidade de Doença , Caminhada/fisiologia , Adulto , Idoso , Fenômenos Biomecânicos/fisiologia , Estudos de Casos e Controles , Avaliação da Deficiência , Progressão da Doença , Teste de Esforço/métodos , Feminino , Transtornos Neurológicos da Marcha/etiologia , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Reprodutibilidade dos Testes , Projetos de Pesquisa , Fatores de Tempo
13.
PLoS One ; 15(9): e0238937, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915891

RESUMO

BACKGROUND: Breathlessness is a major cause of physical limitation. Recalled breathlessness intensity may differ from experienced intensity and be influenced by the intensity trajectory including the 'peak-end rule'. The primary aim was to test if adding two minutes of low intensity exercise at the end of an exercise test would change the recalled breathlessness. Secondary aims included to analyse the impact of the peak and end exertional breathlessness intensity on breathlessness recall. METHODS: Randomized controlled trial of 92 adults referred for exercise testing who were randomized (1:1), at test end, to 2 minutes of additional low intensity exercise (intervention; n = 47) or stopping at peak exertion (control; n = 45). Experienced breathlessness during the test and recalled intensity (30 min after the test) was assessed using the Borg CR10 scale. RESULTS: Participants were aged a mean 59 years; 61% men; 79% reported a mMRC ≥1. There was no between-group difference in recalled breathlessness intensity, 5.51 ([95% CI] 5.00 to 6.01) vs. 5.73 (5.27 to 6.20; p = 0.52) in controls, even though the intervention group had a significantly lower end breathlessness (mean difference 0.96; 0.24 to 1.67; p = 0.009). Recalled exertional breathlessness was most strongly related to peak breathlessness (r2 = 0.43). When analyzed together, end breathlessness did not add any explanatory value above that of peak breathlessness. CONCLUSION: Adding an episode of two minutes of lower exercise and breathlessness intensity at the end of an exercise test did not affect symptom recall, which was most strongly related to peak breathlessness intensity. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03468205).


Assuntos
Dispneia/fisiopatologia , Teste de Esforço/métodos , Exercício Físico , Pulmão/fisiopatologia , Rememoração Mental/fisiologia , Mecânica Respiratória , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio
14.
PLoS One ; 15(9): e0238863, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886730

RESUMO

A progressive, treadmill-based VO2max is the gold standard of cardiorespiratory fitness determination but is rarely used in pediatric clinics due to time requirements and cost. Simpler and shorter fitness tests such as the Squat Test or Step Test may be feasible and clinically useful alternatives. However, performance comparisons of these tests to treadmill VO2max tests are lacking. The primary aim of this cross-sectional study was to assess the correlation between Squat and Step Test scores and VO2max in a pediatric population. As secondary outcomes, we calculated correlations between Rated Perceived Exertion Scale (RPE) scores, NIH PROMIS Physical Activity scores, and BMI z-score with VO2max, and we also evaluated the ability of each fitness test to discriminate low and high-risk patients based on the FITNESSGram. Forty children aged 10-17 completed these simple cardiorespiratory fitness tests. Statistically significant correlations were observed between VO2max and the Step Test (r = -0.549) and Squat Test (r = -0.429) scores, as well as participant BMI z-score (r = -0.458). RPE and PROMIS scores were not observed to be correlated with VO2max. Area Under the Receiver Operator Curve was relatively high for BMI z-scores and the Step Test (AUC = 0.813, 0.713 respectively), and lower for the Squat Test (AUC = 0.610) in discriminating risk according to FITNESSGram Scores. In this sample, the Step Test performed best overall. These tests were safe, feasible, and may add great value in assessing cardiorespiratory fitness in a clinical setting.


Assuntos
Aptidão Cardiorrespiratória , Fenômenos Fisiológicos Cardiovasculares , Teste de Esforço/métodos , Exercício Físico , Consumo de Oxigênio , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Valor Preditivo dos Testes
15.
Apunts, Med. esport (Internet) ; 55(207): 97-103, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194710

RESUMO

It appears that little consistent information is available on medical interventions and the use of appropriate intensity and exercise mode to improve physiological and psychological menopause complications. The aim of this study was to compare the effect of eight weeks of low, moderate and high intensity TRX training on hot flashes, mood, fat percentage and muscular endurance of postmenopausal women. Forty non-athletic postmenopausal healthy women participated in the study and were randomly and equally divided into four groups: (1) control, (2) low-intensity TRX training (LI TRX) (40–55% HHR), (3) moderate-intensity TRX training (MI TRX) (55-70 HHR), and (4) high-intensity TRX training (HI TRX) (70-85 HHR). The research variables were measured 48 h before and after the intervention. The experimental groups performed their own training program for 8 weeks, 3 sessions per week, and 60min each session. Symptoms of hot flashes, mood, fat percentage, and muscular endurance in the experimental groups significantly improved compared to the control group (P ≤ 0.05). A decrease in fat percentage was observed in the MI TRX group compared to other training groups (P = 0.045). Adaptation to regular exercise training reduced menopausal symptoms. There was no significant difference between using different intensity of exercise. Probably due to the physiological and psychological aspects of menopause, the most important factor in improving menopausal symptoms is participating in exercise and the frequency of exercise training. Also, TRX can be used as a safe method in different intensities in this group of women


No disponible


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Esforço Físico/fisiologia , Teste de Esforço/métodos , Resistência Física/fisiologia , Treinamento de Resistência/métodos , Inquéritos e Questionários , Protocolos
16.
Rev. esp. cardiol. (Ed. impr.) ; 73(9): 725-733, sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET1-6272

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Se comparó los efectos de 12 semanas de ejercicio interválico de alta intensidad y de bajo volumen (EIAI-BV) frente a un ejercicio continuo de intensidad moderada (ECIM), sobre los parámetros de la prueba de esfuerzo cardiopulmonar y la proporción de no respondedores o con baja respuesta (NBR) al ejercicio físico en pacientes que sufrieron un síndrome coronario agudo (SCA). MÉTODOS: Se aleatorizó a pacientes con un SCA reciente a EIAI-BV, ECIM y a cuidados habituales. EIAI-BV constó de 2 a 3 sesiones de 6-10 minutos con periodos de repetición de 15 a 30 s al 100% de la carga de trabajo alternados con 15-30 segundos de recuperación pasiva. Los parámetros de la prueba de ejercicio cardiopulmonar se evaluaron y se calcularon las variables claves. La respuesta al ejercicio se evaluó con la mediana de VO2 pico de cambio (post- frente a preejercicio) en toda la cohorte estratificada en NBR al ejercicio frente a alta respuesta. RESULTADOS: Se incluyó a 50 pacientes en el análisis (EIAI-BV, n=23; ECIM, n=18; cuidados habituales, n=9), el 74% eran varones. La proporción de NBR fue mayor en el EIAI-BV en comparación con el grupo ECIM y el grupo de cuidados habituales (el 61 frente al 21 y el 80%, respectivamente; p = 0,0040). Las variables dependientes del VO2 (VO2 pico y porcentaje VO2 pico predicho) mejoraron en ambos grupos de entrenamiento (p = 0,002 y p <0,0001 para EIAI-BV y ECIM, respectivamente), pero la mejora fue más pronunciada con ECIM (p = 0,004 y p = 0,001 para la interacción, respectivamente). El ΔVO2 /Δ pendiente de la carga de trabajo ha mejorado únicamente con ECIM (p = 0,021). CONCLUSIONES: En pacientes con un SCA reciente, varias variables pronósticas dependientes del VO2 pico mejoraron después de EIAI-BV, pero la mejora fue más pronunciada o bien mejoró únicamente después de ECIM. El EIAI-BV resultó en una mayor proporción de NBR en comparación con el ECIM isocalórico


INTRODUCTION AND OBJECTIVES: We compared the effects of 12 weeks of low-volume high-intensity interval training (LV-HIIT) vs moderate-intensity continuous exercise training (MICET) on cardiopulmonary exercise test parameters and the proportion of non/low responders (NLR) to exercise training in post-acute coronary syndrome (ACS) patients. METHODS: Patients with a recent ACS were randomized to LV-HIIT, MICET, or a usual care group. LV-HIIT consisted of 2 to 3 sets of 6 to 10minutes with repeated bouts of 15 to 30seconds at 100% of peak workload alternating with 15 to 30seconds of passive recovery. Cardiopulmonary exercise test parameters were assessed, and key exercise variables were calculated. Training response was assessed according to the median VO2peak change post vs pretraining in the whole cohort (stratification NLR vs high response). RESULTS: Fifty patients were included in the analysis (LV-HIIT, n=23; MICET, n=18; usual care, n=9) and 74% were male. The proportion of NLR was higher in the LV-HIIT group than in the MICET group (LV-HIIT 61%, MICET 21%, and usual care 80%; P=.0040). VO2peak-dependent variables (VO2peak, percent-predicted VO2peak) improved in both training groups (P=.002 and P <.0001 for time with LV-HIIT and MICET, respectively), but the improvement was more pronounced with MICET (P=.004 and P=.001 for interaction, respectively). The ΔVO2/Δworkload slope improved only with MICET (P=.021). CONCLUSIONS: In patients with a recent ACS, several prognostic VO2peak-dependent variables were improved after LV-HIIT, but the improvement was more pronounced or only found after MICET. Low-volume HIIT resulted in a higher proportion of NLR than isocaloric MICET


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Síndrome Coronariana Aguda/reabilitação , Treinamento de Resistência/métodos , Treinamento Intervalado de Alta Intensidade/métodos , Reabilitação Cardíaca/métodos , Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Volume de Ventilação Pulmonar/fisiologia , Frequência Cardíaca/fisiologia , Resultado do Tratamento , Fatores de Risco , Avaliação de Eficácia-Efetividade de Intervenções , Manejo da Obesidade/métodos
17.
Chron Respir Dis ; 17: 1479973120952418, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32840385

RESUMO

OBJECTIVES: To identify exercise tests that are suitable for home-based or remote administration in people with chronic lung disease. METHODS: Rapid review of studies that reported home-based or remote administration of an exercise test in people with chronic lung disease, and studies reporting their clinimetric (measurement) properties. RESULTS: 84 studies were included. Tests used at home were the 6-minute walk test (6MWT, two studies), sit-to-stand tests (STS, five studies), Timed Up and Go (TUG, 4 studies) and step tests (two studies). Exercise tests administered remotely were the 6MWT (two studies) and step test (one study). Compared to centre-based testing the 6MWT distance was similar when performed outdoors but shorter when performed at home (two studies). The STS, TUG and step tests were feasible, reliable (intra-class correlation coefficients >0.80), valid (concurrent and known groups validity) and moderately responsive to pulmonary rehabilitation (medium effect sizes). These tests elicited less desaturation than the 6MWT, and validated methods to prescribe exercise were not reported. DISCUSSION: The STS, step and TUG tests can be performed at home, but do not accurately document desaturation with walking or allow exercise prescription. Patients at risk of desaturation should be prioritised for centre-based exercise testing when this is available.


Assuntos
Infecções por Coronavirus , Teste de Esforço/métodos , Serviços de Assistência Domiciliar/organização & administração , Pneumopatias , Pandemias , Pneumonia Viral , Telemedicina/métodos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Pneumopatias/reabilitação , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Reprodutibilidade dos Testes
18.
PLoS One ; 15(8): e0237010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780739

RESUMO

This study analyzed the physiological adjustments caused by the use of the Elevation training mask® (2.0), an airflow restriction mask (ARM) during continuous exercise. Eighteen physically active participants (12 men and 6 women) were randomized to two protocols: continuous exercise with mask (CE-ARM) and continuous exercise without mask (CE). Exercise consisted of cycling for 20 minutes at 60% of maximum power. Metabolic variables, lactate, and gas concentration were obtained from arterialized blood samples at pre and post exercise. Continuous expired gases and myoelectric activity of the quadriceps were performed at rest and during the test. We observed no reduction in oxygen saturation in CE-ARM, leading to lower pH, higher carbon dioxide, and greater hematocrit (all p <0.05). The expired gas analysis shows that the CE-ARM condition presented higher oxygen uptake and expired carbon dioxide concentrations (p <0.05). The CE-ARM condition also presented lower ventilatory volume, ventilatory frequency, and expired oxygen pressure (p <0.05). No changes in electromyography activity and lactate concentrations were identified. We conclude that using ARM does not induce hypoxia and represents an additional challenge for the control of acid-base balance, and we suggest the use of ARM as being suitable for respiratory muscle training.


Assuntos
Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Ventilação Pulmonar/fisiologia , Adulto , Exercícios Respiratórios/métodos , Dióxido de Carbono/sangue , Teste de Esforço/métodos , Feminino , Voluntários Saudáveis , Humanos , Hipóxia/metabolismo , Pulmão/metabolismo , Masculino , Máscaras , Oxigênio/sangue , Respiração , Testes de Função Respiratória
20.
Sports Health ; 12(5): 441-448, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32660392

RESUMO

BACKGROUND: Physical activity (PA) and physical fitness (PF) are crucial for bone health. However, children participating in competitive sports with high PA are at a greater risk of fracture from trauma or overuse. Given the importance of bone development during adolescence, associations between commonly used physical fitness tests with distal third radius (R-SoS) and midshaft tibia (T-SoS) speed of sound by quantitative ultrasound were assessed in adolescent athletes and nonathletes. HYPOTHESIS: The relationship between physical fitness tests and R-SoS and T-SoS will differ depending on sex and athletic status. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: Physical fitness of 285 boys (156 athletes) and 311 girls (74 athletes) aged 10 to 18 years was assessed through strength, speed, agility, and cardiorespiratory tests. Linear regression was used to assess the associations of physical fitness tests with R-SoS and T-SoS. RESULTS: For boys, favorable associations were observed between physical fitness tests with R-SoS in athletes and T-SoS in both athletes and nonathletes (P < 0.05). For nonathlete girls, favorable associations were found for handgrip (R-SoS and T-SoS, both P < 0.05), whereas the progressive aerobic cardiovascular endurance run, vertical jump, speed at 20 m and 40 m were only favorably associated with T-SoS. For athlete girls, the association between handgrip (P = 0.03), vertical jump, and 4 × 10 m shuttle run (P < 0.05) with T-SoS was significantly related to a bone outcome. CONCLUSION: The handgrip test and vertical jump were associated with T-SoS in boys and girls independent of sport status. These results suggest that physical fitness is associated with bone health in adolescents, particularly boys, and that the relationship between physical fitness and bone may differ depending on sex and athletic status. CLINICAL RELEVANCE: Physical fitness tests are simple, easy-to-use tools for monitoring bone health and should be used by sport and health professsionals to promote healthy sport participation and prevent bone injuries.


Assuntos
Teste de Esforço/métodos , Aptidão Física/fisiologia , Rádio (Anatomia)/fisiologia , Esportes/fisiologia , Tíbia/fisiologia , Adolescente , Densidade Óssea/fisiologia , Criança , Estudos Transversais , Feminino , Força da Mão , Humanos , Masculino , Rádio (Anatomia)/diagnóstico por imagem , Fatores Sexuais , Tíbia/diagnóstico por imagem , Ultrassonografia
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