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1.
J Int Soc Sports Nutr ; 17(1): 16, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164702

RESUMO

BACKGROUND: The leucine metabolite ß-hydroxy-ß-methylbutyrate (HMB) is widely used as an ergogenic supplement to increase resistance-training induced gains in fat free mass (FFM) and strength in healthy adults. Recent studies have questioned the effectiveness of HMB, particularly when a high protein diet is habitually consumed. To investigate the additive resistance-training induced effects of HMB and protein in untrained individuals, we conducted a randomized double-blind, placebo-controlled study that compared the effects of combined protein and HMB supplementation to protein supplementation alone on FFM and muscle strength after 12-week resistance training. METHODS: Sixteen healthy men (22 ± 2 yrs) performed a periodized resistance-training program for twelve weeks (four sessions per week). The program comprised two mesocycles, characterized by a linear periodization and non-linear periodization, respectively, and separated by a 1-week tapering period. All participants received 60 g of whey protein on training days and 30 g of whey protein (WP) on non-training days. Participants were randomly assigned to additionally receive 3 g of calcium HMB (WP + HMB) or a placebo (WP + PLA). Body composition and physical fitness were tested before and after the 12-week training program. Whole-body and arm and leg fat free mass (FFM) were assessed by bioimpedance spectroscopy; upper arm and leg fat free cross sectional areas were also quantified using magnetic resonance imaging (MRI); upper and lower body strength were measured by One-repetition maximum (1-RM) bench press and leg press. RESULTS: Whole-body and segmental FFM increased in both groups (P <  0.001). However, gains in leg FFM were higher in WP + HMB vs. WP + PLA (arm FFM: + 6.1% vs. + 9.2%, P = 0.2; leg FFM: + 14.2% vs. + 7.0%, P <  0.01). No change in fat mass was observed (P = 0.59). 1-RM increased in both groups (P <  0.001). CONCLUSIONS: Combined protein and HMB supplementation resulted in segmental, but not whole-body increases in FFM compared to protein supplementation alone. These findings could explain some of the controversial effects of HMB reported in previous studies and have practical implications for maximizing training-induced gains in FFM and clinical conditions associated with skeletal muscle deconditioning such as aging, sedentary lifestyles, bed rest and spaceflight.


Assuntos
Cálcio/administração & dosagem , Músculo Esquelético/fisiologia , Substâncias para Melhoria do Desempenho/administração & dosagem , Treinamento de Resistência , Valeratos/administração & dosagem , Proteínas do Soro do Leite/administração & dosagem , Composição Corporal , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Coxa da Perna/fisiologia , Adulto Jovem
2.
Exerc Immunol Rev ; 26: 24-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32139353

RESUMO

INTRODUCTION: The essential amino acid tryptophan (TRP) is primarily degraded through the kynurenine (KYN) pathway, which is dysregulated in several chronic diseases. KYN pathway metabolites have immune- and neuro-modulatory properties and are involved in th de novo synthesis of nicotinamide adenine dinucleotide (NAD+). Currently, little evidence exists demonstrating that physical exercise may influence this pathway. However, differences between acute and chronic stimuli as well as the influence of exercise modalities remain to be investigated. Here, we provide an overview of existing studies and present results of a randomized cross-over trial on acute effects of a single-bout of resistance and endurance exercise. METHODS: 24 healthy male adults conducted both an acute endurance exercise (EE) and resistance exercise (RE) session. Blood samples were collected before, immediately after and one hour after cessation of each exercise session. Outcomes comprised serum levels of TRP, KYN, kynurenic acid (KA), quinolinic acid (QA) and calculated ratios. Gene expression of the enzymes indoleamine 2,3 dioxygenase (IDO) 1 and kynurenine aminotransferase (KAT) 4 was measured in peripheral blood mononuclear cells (PBMCs). Moreover, serum concentrations of the potential KYN pathway mediators interleukin (IL)-6 and cortisol were determined. Finally, we investigated baseline correlations between immune cell subsets, potential mediators and initial KYN pathway activation outcomes. RESULTS: The KYN/TRP ratio correlated positively with IL-6 and CD56bright NK-cells and negatively with CD56dim NKcells. Expression of IDO1 in PBMCs correlated positively with IL-6, regulatory T-cells and CD56bright NK-cells, whereas negative correlations to cytotoxic T-cells and CD56dim NKcells were revealed. A significant time effect on KYN/TRP ratio was detected for RE. Regarding KA and KA/KYN ratio, an increase after exercise followed by a decrease at the follow- up measurement was revealed in EE. KAT4 expression also increased after exercise in EE. Moreover, elevated QA levels were observed after the EE session. CONCLUSIONS: In contrast to chronic exercise interventions, single-bouts of endurance exercise provoke acute alterations on KYN pathway outcomes in humans. Our results indicate that EE induces stronger alterations than RE. Enhanced conversion of KYN to both, KA and QA suggest a peripheral KYN clearance, thereby preventing pathological accumulation within the CNS. Future acute and chronic exercise studies are needed to examine the role of NAD+ synthesis starting with TRP and the interplay between KYN pathway activation and mid- to long-term immunological modulations.


Assuntos
Treino Aeróbico , Cinurenina/sangue , Leucócitos Mononucleares/imunologia , Treinamento de Resistência , Adulto , Estudos Cross-Over , Exercício , Humanos , Hidrocortisona/imunologia , Indolamina-Pirrol 2,3,-Dioxigenase/imunologia , Interleucina-6/imunologia , Ácido Cinurênico/sangue , Leucócitos Mononucleares/enzimologia , Masculino , Ácido Quinolínico/sangue , Transaminases/imunologia , Triptofano/sangue
3.
Unfallchirurg ; 123(3): 170-175, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32095904

RESUMO

Blood flow restriction (BFR) limits arterial and venous blood flow and leads to blood pooling, which could increase exercise-induced training effects. Strength training at lower intensities (20-30% of maximum strength) in combination with BFR showed similar effects on muscle hypertrophy as training with 70% without BFR. Low-intensity cycling endurance training with BFR improves muscle hypertrophy and endurance performance and activates angiogenesis. After determination of the complete occlusion pressure on the corresponding extremity, it is recommended that BFR training should be performed with 40-80% of the measured occlusion pressure. During strength training of the upper extremities, an occlusion of 60-80% leads to a reduction in the arterial blood flow by 20-50%. Local ischemia and hypoxia, a stronger metabolic stimulus, swelling of the muscle cells and the increased oxidative stress are discussed as causes for the increased training effects due to BFR. In short-term studies, comparable adjustments to parameters of fibrinolytic activity, coagulation and inflammation could be observed for strength training with and without BFR. So far, thromboses after BFR have been described only rarely but need to be further clarified by appropriate studies. The BFR training leads to a stronger activation of the muscular metabolic reflex and thus to a relatively greater increase in exercise blood pressure, so that cardiovascular parameters should be controlled during BFR training. First meta-analyses with small numbers of healthy people and patients indicate the effectiveness of BFR training. Standardization or guidelines for clinical use are still lacking.


Assuntos
Músculo Esquelético , Treinamento de Resistência , Exercício , Humanos , Músculo Esquelético/irrigação sanguínea , Fluxo Sanguíneo Regional , Extremidade Superior
4.
Sports Health ; 12(2): 139-148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017660

RESUMO

BACKGROUND: Posterior shoulder stretching exercises (PSSEs) aim to reduce posterior shoulder tightness (PST). Position modification of traditional PSSEs has been suggested to minimize inadequate control of scapular and glenohumeral rotation, possibly leading to increased subacromial impingement. HYPOTHESIS: Modified PSSEs will have positive effects on shoulder mobility, pain, and dysfunction. STUDY DESIGN: Randomized controlled trial. LEVEL OF EVIDENCE: Level 1. METHODS: A total of 67 symptomatic patients with subacromial impingement syndrome (SIS) and shoulder internal rotation asymmetry were randomly assigned to 3 groups: modified cross-body stretch (MCS) (n = 22; treatment program + MCS), modified sleeper stretch (MSS) (n = 22; treatment program + MSS), and a control group (n = 23; treatment program consisting of only modalities, range of motion [ROM], and strength training but no PSSEs) for 4 weeks. Pain, PST, shoulder rotation ROM, and dysfunction were evaluated. RESULTS: Pain, PST, shoulder rotation ROM, function, and disability improved in all groups (P < 0.05). The MCS and MSS groups had better results compared with the control group with regard to pain with activity, internal rotation ROM, function, and disability (P < 0.05). There was no significant difference between the stretching groups (P > 0.05). CONCLUSION: All treatments improved pain, shoulder mobility, function, and disability in patients with SIS. However, modified PSSEs in addition to a treatment program was superior to the treatment program alone (without PSSEs) in improving pain with activity, internal rotation ROM, and dysfunction. Moreover, stretching provided clinically significant improvements. CLINICAL RELEVANCE: Modified PSSEs, in addition to a treatment program, are beneficial for patients with SIS. Both modified cross-body and sleeper stretches are safe and efficacious for improving shoulder mobility, pain, and dysfunction.


Assuntos
Artralgia/prevenção & controle , Exercícios de Alongamento Muscular/métodos , Síndrome de Colisão do Ombro/fisiopatologia , Síndrome de Colisão do Ombro/terapia , Ombro/fisiopatologia , Adulto , Artralgia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Treinamento de Resistência , Rotação
5.
Unfallchirurg ; 123(3): 180-186, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32030478

RESUMO

BACKGROUND: For various reasons many patient groups are unable to perform high-intensity strength training. OBJECTIVE: Is the application of low-intensity strength training under blood flow restriction (BFR) an alternative to high-intensity training for patients? MATERIAL AND METHODS: Overview and summary of possible applications of BFR training in patients with osteoarthritis of the knee joint, after surgery and in patients with reduced performance. Possible contraindications and application recommendations for clinical practice based on the currently available literature are shown. RESULTS: In patients with arthritic joint complaints, muscular hypertrophy and strength improvement were achieved by low-intensity exercise with the aid of BFR. In the postoperative treatment after knee arthroscopy and anterior cruciate ligament reconstruction, BFR can be used to reduce atrophy. CONCLUSION: The effectiveness of low-intensity BFR training is lower than for classical high-resistance training; however, it may be used as additional training method in rehabilitation programs.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Fluxo Sanguíneo Regional , Treinamento de Resistência , Reconstrução do Ligamento Cruzado Anterior/reabilitação , Terapia por Exercício , Humanos , Articulação do Joelho , Músculo Esquelético
6.
Unfallchirurg ; 123(3): 176-179, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32030479

RESUMO

BACKGROUND: Training under conditions of blood flow restriction (BFR) has recently been advocated as an option for alternative training in athletes. OBJECTIVE: Does BFR make sense in athlete training? MATERIAL AND METHODS: An overview of the currently available literature is given. RESULTS: The use of BFR appears to be a possibility to achieve muscle hypertrophy and an increase in muscular strength and can also improve parameters of cardiocirculatory function. CONCLUSION: Various approaches for implementation of BFR in athletes can be found in the literature. These approaches differ in the frequency, force used, duration and finally type of implementation of BFR itself. Clear recommendations for training cannot be given to date and the individual weighing up of possibilities and supervised implementation of BFR in athlete training by the trainer are still necessary.


Assuntos
Fluxo Sanguíneo Regional , Treinamento de Resistência , Esportes , Humanos , Força Muscular , Músculo Esquelético
7.
High Blood Press Cardiovasc Prev ; 27(1): 83-91, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32006255

RESUMO

INTRODUCTION: The effects of resistance exercise on vascular function are unclear. AIM: To investigate the acute haemodynamic (blood pressure and augmentation index) and rate of perceived exertion (RPE) response to two types of resistance exercises of equal workload-a set of unilateral 35% of one repetition maximum (1RM) quadriceps extension and a set of unilateral 70% 1RM quadriceps extension. METHODS: Twenty two young healthy males completed both exercises on separate days. Heart rate, central and peripheral systolic and diastolic blood pressure (BP), augmentation pressure, augmentation index (AIx), augmentation index at a heart rate of 75 beats per minute (AIx75), and RPE were measured using applanation tonometry before exercise, immediately after exercise, 5 min after exercise and 15 min after exercise. RESULTS: AIx75 was significantly lower 5 min after exercising at 35% of 1RM than 70% of 1RM. Systolic blood pressure was significantly lower at 5 min post exercise for both intensities. There was no significant difference in RPE between conditions or time points. CONCLUSIONS: Results suggest that changes in blood pressure and augmentation index vary depending on the intensity of resistance exercise regardless of the volume of exercise carried out. Changes in AIx75 in response to resistance exercise may be independent of changes in BP.


Assuntos
Pressão Sanguínea , Contração Muscular , Músculo Quadríceps/fisiologia , Treinamento de Resistência/métodos , Adolescente , Adulto , Estudos Cross-Over , Voluntários Saudáveis , Frequência Cardíaca , Humanos , Masculino , Projetos Piloto , Distribuição Aleatória , Fatores de Tempo , Adulto Jovem
8.
J Sports Sci ; 38(6): 597-606, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32005085

RESUMO

When new protocols are developed, there is a requirement to investigate test-retest reliability of measures for valid use and interpretation of data in research and practice. Therefore, the aim of this investigation was to determine the inter-day reliability of the cable put and seated rotation assessment protocols. On three occasions, nine resistance-trained men performed cable puts and cable rotations at different loads between 6 and 42 kg on a commercially available cable cross over machine. Load stack movement was recorded using a PT5A linear position transducer from which all kinematic and kinetic variables were calculated. Reliability was excellent for peak velocity and displacement based on intraclass correlation coefficient (ICC) and coefficient of variation (CV) across the majority of loads and movements (cable put: ICC = 0.92 to 0.99, CV = 3.1% to 8.6%; cable seated rotation: ICC = 0.76 to 0.99, CV = -1.7% to 16.1%). However, kinetic variables demonstrated inadequate reliability across the majority of days, loads and movements (ICC = 0.70, CV >10%). It was concluded that peak velocity is a reliable kinematic measure to assess muscular capability from cable put and seated rotation protocols; however, kinetic measures are too variable to provide reliable outputs across testing occasions.


Assuntos
Teste de Esforço/métodos , Atletismo/fisiologia , Adulto , Fenômenos Biomecânicos , Humanos , Cinética , Masculino , Força Muscular/fisiologia , Reprodutibilidade dos Testes , Treinamento de Resistência , Rotação , Adulto Jovem
10.
Sports Health ; 12(2): 124-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31916920

RESUMO

CONTEXT: Recent studies examining return to sport after traumatic shoulder instability suggest faster return-to-sport time lines after bony stabilization when compared with soft tissue stabilization. The purpose of the current study was to define variability across online Latarjet rehabilitation protocols and to compare Latarjet with Bankart repair rehabilitation time lines. EVIDENCE ACQUISITION: Online searches were utilized to identify publicly available rehabilitation protocols from Accreditation Council for Graduate Medical Education (ACGME)-accredited academic orthopaedic surgery programs. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. RESULTS: Of the 183 ACGME-accredited orthopaedic programs reviewed, 14 institutions (7.65%) had publicly available rehabilitation protocols. A web-based search yielded 17 additional protocols from private sports medicine practices. Of the 31 protocols included, 31 (100%) recommended postoperative sling use and 26 (84%) recommended elbow, wrist, and hand range of motion exercises. Full passive forward flexion goals averaged 3.22 ± 2.38 weeks postoperatively, active range of motion began on average at 5.22 ± 1.28 weeks, and normal scapulothoracic motion by 9.26 ± 4.8 weeks postoperatively. Twenty (65%) protocols provided specific recommendations for return to nonoverhead sport-specific activities, beginning at an average of 17 ± 2.8 weeks postoperatively. This was compared with overhead sports or throwing activities, for which 18 (58%) of protocols recommended beginning at a similar average of 17.1 ± 3.3 weeks. CONCLUSION: Similar to Bankart repair protocols, Latarjet rehabilitation protocols contain a high degree of variability with regard to exercises and motion goal recommendations. However, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols. Consequently, variability in the timing of rehabilitation goals may contribute to earlier return to play metrics identified in the broader literature for the Latarjet procedure when compared with arthroscopic Bankart repair. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): Level C.


Assuntos
Artroscopia/reabilitação , Lesões de Bankart/cirurgia , Terapia por Exercício/métodos , Instabilidade Articular/cirurgia , Luxação do Ombro/cirurgia , Artroscopia/métodos , Protocolos Clínicos , Deambulação Precoce , Humanos , Força Muscular/fisiologia , Amplitude de Movimento Articular , Treinamento de Resistência , Restrição Física , Volta ao Esporte , Fatores de Tempo
11.
Int J Sports Med ; 41(3): 168-174, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31952082

RESUMO

The aim of this study was to investigate the risk factors and the incidence of injuries in high-intensity functional training (HIFT) practitioners. A survey was administered to 213 HIFT practitioners. Participants reported the number of injuries, the location of the injuries, and training exposure during the preceding six months and answered questions regarding potential risk factors for injury. We found there were 7.1 injuries for every 1000 hours of training. In addition, we found that individuals with experience in the modality (>2 years) were 3.77 times more likely to be affected by injury when compared with beginner individuals (<6 months) (CI95%=1.59-8.92; p=0.003). When the analysis was performed only for the competitive level, we found that practitioners competing at the national level were 5.69 times more likely to experience an injury than competitors who do not compete (CI95%=1.10-29.54; p=0.038). We also found that the injuries mainly affect the shoulder and lumbar regions. It was possible to conclude that subjects with a higher level of experience in the modality are more likely to be affected by injuries and that the shoulder and lumbar areas are most likely to be injured during HIFT.


Assuntos
Traumatismos em Atletas/epidemiologia , Condicionamento Físico Humano/efeitos adversos , Condicionamento Físico Humano/métodos , Adulto , Lesões nas Costas/epidemiologia , Comportamento Competitivo/fisiologia , Exercício , Feminino , Ginástica/lesões , Humanos , Incidência , Traumatismos do Joelho/epidemiologia , Masculino , Prevalência , Treinamento de Resistência/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Lesões do Ombro/epidemiologia , Traumatismos do Punho/epidemiologia , Adulto Jovem
12.
Int J Sports Med ; 41(2): 82-88, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31902128

RESUMO

Sex differences exist in vascular responses to blood pressure perturbations, such as resistance exercise. Increases in aortic stiffness following acute resistance exercise appear different between sexes, with attenuated increases in females vs. males. Whether sex differences exist in carotid stiffness, following resistance exercise is unknown. This study sought to examine sex differences in carotid stiffness, aortic stiffness, and hemodynamics following acute resistance exercise. Thirty-five participants (18 male) completed 3 sets of 10 repetitions of maximal isokinetic knee extension/flexion. Aortic stiffness and hemodynamics were estimated using an automated oscillometric blood pressure monitor at baseline, 5- and 30-min post-exercise. Carotid stiffness was assessed by ß-stiffness index, pressure-strain elastic modulus and arterial compliance using ultrasonography. Resistance exercise increased aortic stiffness, mean and systolic pressure at 5-min (p<0.01), and pressure-strain elastic modulus at 5-min in both sexes (p<0.05). Arterial compliance decreased at 5- and 30-min post exercise in both sexes (p<0.01). No interaction effects were detected in carotid stiffness, aortic stiffness, and hemodynamics, indicating similar vascular responses between sexes. Our findings indicate that the large arteries appear to stiffen similarly following resistance exercise in males and females when presented with similar blood pressure responses.


Assuntos
Artérias Carótidas/fisiologia , Treinamento de Resistência , Rigidez Vascular/fisiologia , Adulto , Pressão Sanguínea/fisiologia , Composição Corporal , Módulo de Elasticidade/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Joelho/fisiologia , Masculino , Força Muscular/fisiologia , Fatores Sexuais , Adulto Jovem
13.
J Sports Sci ; 38(1): 100-105, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31638481

RESUMO

A common practice in resistance training is to perform sets of exercises at, or close to failure, which can alter movement dynamics. This study examined ankle, knee, hip, and lumbo-pelvis dynamics during the barbell back squat under a moderate-heavy load (80% of 1 repetition maximum (1RM)) when performed to failure. Eleven resistance trained males performed three sets to volitional failure. Sagittal plane movement dynamics at the ankle, knee, hip, and lumbo-pelvis were examined; specifically, joint moments, joint angles, joint angular velocity, and joint power. The second repetition of the first set and the final repetition of the third set were compared. Results showed that while the joint movements slowed (p < 0.05), the joint ranges of motion were not altered There were significant changes in most mean joint moments (p < 0.05), indicating altered joint loading. The knee moment decreased while the hip and lumbo-pelvis moments underwent compensatory increases. At the knee and hip, there were significant decreases (p < 0.05) in concentric power output (p < 0.05). Whilst performing multiple sets to failure altered some joint kinetics, the comparable findings in joint range ofmotion suggest that technique was not altered. Therefore, skilled individuals appear to maintain technique when performing to failure.


Assuntos
Extremidade Inferior/fisiologia , Região Lombossacral/fisiologia , Pelve/fisiologia , Treinamento de Resistência/métodos , Levantamento de Peso/fisiologia , Adulto , Tornozelo/fisiologia , Fenômenos Biomecânicos , Quadril/fisiologia , Humanos , Joelho/fisiologia , Masculino , Análise e Desempenho de Tarefas , Adulto Jovem
14.
Sports Health ; 12(1): 74-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31642726

RESUMO

BACKGROUND: Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. HYPOTHESIS: A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. STUDY DESIGN: Randomized trial. LEVEL OF EVIDENCE: Level 2. METHODS: Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. RESULTS: A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group (P = 0.35). CONCLUSION: There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. CLINICAL RELEVANCE: Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.


Assuntos
Transtornos Traumáticos Cumulativos/prevenção & controle , Extremidade Inferior/lesões , Força Muscular/fisiologia , Resistência Física/fisiologia , Treinamento de Resistência , Corrida/lesões , Adulto , Transtornos Traumáticos Cumulativos/epidemiologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Humanos , Cidade de Nova Iorque/epidemiologia , Fatores de Risco , Corrida/fisiologia
17.
J Stroke Cerebrovasc Dis ; 29(1): 104498, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31732460

RESUMO

BACKGROUND: Cardiorespiratory fitness, measured as peak oxygen consumption, is a potent predictor of stroke risk. Muscle weakness is the most prominent impairment after stroke and is directly associated with reduced walking capacity. There is a lack of recommendations for optimal combined aerobic training and resistance training for those patients. The purpose of this study was to systematically review and quantify the effects of exercise training on cardiorespiratory fitness, muscle strength, and walking capacity after stroke. METHODS: Five electronic databases were searched (until May 2019) for studies that met the following criteria: (1) adult humans with a history of stroke who ambulate independently; (2) structured exercise intervention based on combined aerobic training and resistance training; and (3) measured cardiorespiratory fitness, muscle strength, and/or walking capacity. RESULTS: Eighteen studies (602 participants, average age 62 years) met the inclusion criteria. Exercise training significantly improved all 3 outcomes. In subgroup analyses for cardiorespiratory fitness, longer training duration was significantly associated with larger effect size. Likewise, for muscle strength, moderate weekly frequency and lower training volume were significantly associated with larger effect size. Furthermore, in walking capacity, moderate weekly frequency and longer training duration were significantly associated with larger effect size. CONCLUSIONS: These results suggest that an exercise program consisting of moderate-intensity, 3 days per week, for 20 weeks should be considered for greater effect on cardiorespiratory fitness, muscle strength, and walking capacity in stroke patients.


Assuntos
Aptidão Cardiorrespiratória , Tolerância ao Exercício , Exercício , Força Muscular , Músculo Esquelético/fisiopatologia , Treinamento de Resistência , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Caminhada , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
18.
Br J Sports Med ; 54(5): 263-271, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30728126

RESUMO

OBJECTIVES: To determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises and ii) the type of hip strengthening exercise with the greatest evidence for improving pain, function and quality of life. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Medline, Embase, Cochrane, CINAHL and SportDiscus databases were searched from inception to January 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials investigating the effect of adding hip exercises to quadriceps exercises in people with KOA on pain, function and/or quality of life were included. Three subgroups of hip exercises were included: resistance, functional neuromuscular or multimodal exercise. RESULTS: Eight studies were included. Pooled data provide evidence that combined hip and quadriceps exercise is significantly more effective than quadriceps exercise alone for improving walking function (standardised mean difference -1.06, 95% CI -2.01 to -0.12), but not for outcomes of pain (-0.09, 95% CI -0.96 to 0.79), patient-reported function (-0.74, 95% CI -1.56 to 0.08) or stair function (-0.7, 95% CI -1.67 to 0.26). Subgroup analyses reveal that hip resistance exercises are more effective than functional neuromuscular exercises for improving pain (p<0.0001) and patient-reported function (p<0.0001). Multimodal exercise is no more effective than quadriceps strengthening alone for pain (0.13, 95% CI -0.31 to 0.56), patient-reported function (-0.15, 95% CI -0.58 to 0.29) or stair function (0.13, 95% CI -0.3 to 0.57). CONCLUSION: Walking improved after the addition of hip strengthening to quadriceps strengthening in people with KOA. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function.


Assuntos
Terapia por Exercício/métodos , Força Muscular/fisiologia , Osteoartrite do Joelho/terapia , Dor/prevenção & controle , Músculo Quadríceps/fisiologia , Qualidade de Vida , Humanos , Osteoartrite do Joelho/fisiopatologia , Dor/etiologia , Medidas de Resultados Relatados pelo Paciente , Treinamento de Resistência
19.
Br J Sports Med ; 54(5): 292-297, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30745314

RESUMO

BACKGROUND: Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown. OBJECTIVE: To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA). METHOD: Assessor blinded multicentre randomised controlled trial. 100 patients (aged from their 20s to their 60s) with axSpA were randomly assigned to an exercise group or to a no-intervention control group. The exercise group performed cardiorespiratory and muscular strength exercises at high intensity over 3 months. The control group received standard care and was instructed to maintain their usual physical activity level. Primary outcome was disease activity measured with the Ankylosing Spondylitis (AS) Disease Activity Scale (ASDAS, higher score=worst) and the Bath AS Disease Activity Index (BASDAI, 0-10, 10=worst). Secondary outcomes were inflammatory markers, physical function and cardiovascular (CV)-health. There was patient involvement in the design and reporting of this study. RESULTS: 97 of the 100 (97%) randomised patients completed the measurements after the intervention. There was a significant treatment effect of the intervention on the primary outcome (ASDAS: -0.6 [-0.8 to -0.3], p<0.001 and BASDAI: -1.2 [-1.8 to -0.7], p<0.001). Significant treatment effects were also seen for inflammation, physical function and CV-health. CONCLUSION: High intensity exercises reduced disease symptoms (pain, fatigue, stiffness) and also inflammation in patients with axSpA. It improves patients' function and CV health. This debunks concerns that high intensity exercise might exacerbate disease activity in patients with axSpA. TRIAL REGISTRATION NUMBER: NCT02356874.


Assuntos
Terapia por Exercício/métodos , Treinamento Intervalado de Alta Intensidade , Treinamento de Resistência , Espondilartrite/reabilitação , Adulto , Aptidão Cardiorrespiratória/fisiologia , Progressão da Doença , Terapia por Exercício/efeitos adversos , Fadiga/prevenção & controle , Treinamento Intervalado de Alta Intensidade/efeitos adversos , Humanos , Pessoa de Meia-Idade , Mialgia/prevenção & controle , Dor/prevenção & controle , Treinamento de Resistência/efeitos adversos , Espondilartrite/fisiopatologia , Fatores de Tempo , Adulto Jovem
20.
Sports Health ; 12(2): 200-206, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31850826

RESUMO

CONTEXT: Dosing parameters are needed to ensure the best practice guidelines for knee osteoarthritis. OBJECTIVE: To determine whether resistance training affects pain and physical function in individuals with knee osteoarthritis, and whether a dose-response relationship exists. Second, we will investigate whether the effects are influenced by Kellgren-Lawrence grade or location of osteoarthritis. DATA SOURCES: A search for randomized controlled trials was conducted in MEDLINE, Embase, and CINAHL, from their inception dates, between November 1, 2018, and January 15, 2019. Keywords included knee osteoarthritis, knee joint, resistance training, strength training, and weight lifting. STUDY SELECTION: Inclusion criteria were randomized controlled trials reporting changes in pain and physical function on humans with knee osteoarthritis comparing resistance training interventions with no intervention. Two reviewers screened 471 abstracts; 12 of the 13 studies assessed were included. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Mean baseline and follow-up Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and standard deviations were extracted to calculate the standard mean difference. Articles were assessed for methodological quality using the CONSORT (Consolidated Standards of Reporting Trials) 2010 scale and Cochrane Collaboration tool for assessing risk of bias. RESULTS: The 12 included studies had high methodological quality. Of these, 11 studies revealed that resistance training improved pain and/or physical function. The most common regimen was a 30- to 60-minute session of 2 to 3 sets of 8 to 12 repetitions with an initial resistance of 50% to 60% of maximum resistance that progressed over 3 sessions per week for 24 weeks. Seven studies reported Kellgren-Lawrence grade, and 4 studies included osteoarthritis location. CONCLUSION: Resistance training improves pain and physical function in knee osteoarthritis. Large effect sizes were associated with 24 total sessions and 8- to 12-week duration. No optimal number of repetitions, maximum strength, or frequency of sets or repetitions was found. No trends were identified between outcomes and location or Kellgren-Lawrence grade of osteoarthritis.


Assuntos
Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/reabilitação , Dor/prevenção & controle , Treinamento de Resistência/métodos , Atividades Cotidianas , Humanos , Qualidade de Vida , Levantamento de Peso
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