Muscle lesion treatment in Brazilian soccer players: theory vs. practice

Background: In this study we evaluated the rehabilitation profile of Brazilian soccer players which underwent lower limb muscle lesions. Methods: This is a descriptive investigation. We evaluated 139 professional soccer players (1724 years old). We evaluated the following variables: muscle lesion diagnosis, symptoms, non steroidal anti-inflammatory used, physiotherapy treatment, which physiotherapy recourses was used if treated and train adaptation. Results: In great part of the athletes muscle lesion remained between 2 weeks and 1 month. Around 54% were diagnosed by a physician; the other part was diagnosed by a physical therapist. Non steroidal anti-inflammatory were prescribed by physicians in 42% of the cases; in 7% the physical therapist prescribed the medication while in 49% of the cases the masseur prescribed the drug. More than 1/4 of the athletes received physiotherapy treatement between 48 hours and 5 days. Isometric exercise therapy was applied in 15% of the cases. 63% were not accompanied by the physiotherapist on their return to the field. 48% received massages immediately after injury. Conclusion: We presented discrepancy between the recommended theory described by several researches and the practice. We indicate the necessity of recycling in a general context the rehabilitation of muscle injuries.

Cardiovascular autonomic dysfunction in sickle cell anemia

Sickle cell anemia (SCA) is associated to increased cardiac output, normal heart rate (HR), abnormal QT dispersion and lower diastolic blood pressure (DBP). The mechanisms are still unknown. The objective of this study was to test the hypothesis that there is cardiovascular autonomic dysfunction (CAD) in SCA. The secondary objectives were to distinguish the roles of chronic anemia and hemoglobinopathy and to evaluate the predominance of the sympathetic or parasympathetic systems in the pathogenesis of CAD. Sixteen subjects with SCA, 13 with sickle cell trait (SCT), 13 with iron deficiency anemia (IDA), and 13 healthy volunteers (HV) were evaluated. All subjects were submitted to 24 h-electrocardiogram (24 h-ECG), plasma norepinephrine (NE) measurement before and after isometric exercise (IE), and also Valsalva maneuver (VM), diving maneuver (DV), and tilt test (TT). Baroreflex sensitivity (BRS) was also evaluated. The minimum, average and maximum HR as well as the percentage of bradycardia and tachycardia at 24-h ECG were similar in all groups. NE at baseline and after IE did not differ between groups. The SCA group showed less bradycardia at phase IV of VM, less bradycardia during DV, and also less tachycardia and lower DBP during TT. BRS for bradycardia and tachycardia reflex was decreased in the SCA and SCT groups. In conclusion, 1) there is CAD in SCA, and it is characterized by the reduction of BRS and the limitation of HR modulation mediated by the parasympathetic system; 2) cardiovascular sympathetic activity is preserved in SCA; and 3) hemoglobinopathy is the preponderant ethiopathogenic factor. (C) 2011 Elsevier B.V. All rights reserved.

The effects of a water-based exercise program on strength and functionality of older adults

Objective: To analyze the effects of a water-based exercise program on peak torque (PT) and rate of torque development (RTD) during maximal voluntary ballistic isometric contractions of the lower limb muscles and the performance of a number of functional tests in the elderly. Method: Thirty-seven elderly were randomly assigned to water-based training (3 d/wk for 12 wk) or a control group. Extensor and flexor PT and RTD of the ankle, knee, and hip joints and functional tests were evaluated before and after training. Results: PT increased after training for the hip flexors (18%) and extensors (40%) and the plantar-flexor (42%) muscles in the water-based group. RTD increased after training for the hip-extensor (10%), knee-extensor (11%), and ankle plantar-flexor (27%) muscles in the water-based group. Functional tests also improved after training in the water-based group (p < .05). Conclusion: The water-based program improved PT and RTD and functional performance in the elderly.

Quantitative MRI of Vastus Medialis, Vastus Lateralis and Gluteus Medius Muscle Workload after Squat Exercise: Comparison Between Squatting with Hip Adduction and Hip Abduction

The aim of the present study was to evaluate the use MRI to quantify the workload of gluteus medius (GM), vastus medialis (VM) and vastus lateralis (VL) muscles in different types of squat exercises. Fourteen female volunteers were evaluated, average age of 22 +/- 2 years, sedentary, without clinical symptoms, and without history of previous lower limb injuries. Quantitative MRI was used to analyze VM, VL and GM muscles before and after squat exercise, squat associated with isometric hip adduction and squat associated with isometric hip abduction. Multi echo images were acquired to calculate the transversal relaxation times (T2) before and after exercise. Mixed Effects Model statistical analysis was used to compare images before and after the exercise (Delta T2) to normalize the variability between subjects. Imaging post processing was performed in Matlab software. GM muscle was the least active during the squat associated with isometric hip adduction and VM the least active during the squat associated with isometric hip abduction, while VL was the most active during squat associated with isometric hip adduction. Our data suggests that isometric hip adduction during the squat does not increase the workload of VM, but decreases the GM muscle workload. Squat associated with isometric hip abduction does not increase VL workload.

Resistance exercise acutely enhances mesenteric artery insulin-induced relaxation in healthy rats

AIMS: We evaluated the mechanisms involved in insulin-induced vasodilatation after acute resistance exercise in healthy rats. MAIN METHODS: Wistar rats were divided into 3 groups: control (CT), electrically stimulated (ES) and resistance exercise (RE). Immediately after acute RE (15 sets with 10 repetitions at 70% of maximal intensity), the animals were sacrificed and rings of mesenteric artery were mounted in an isometric system. After this, concentration-response curves to insulin were performed in control condition and in the presence of LY294002 (PI3K inhibitor), L-NAME (NOS inhibitor), L-NAME+TEA (K(+) channels inhibitor), LY294002+BQ123 (ET-A antagonist) or ouabain (Na(+)/K(+) ATPase inhibitor). KEY FINDINGS: Acute RE increased insulin-induced vasorelaxation as compared to control (CT: Rmax=7.3 ± 0.4% and RE: Rmax=15.8 ± 0.8%; p<0.001). NOS inhibition reduced (p<0.001) this vasorelaxation from both groups (CT: Rmax=2.0 ± 0.3%, and RE: Rmax=-1.2 ± 0.1%), while PI3K inhibition abolished the vasorelaxation in CT (Rmax=-0.1±0.3%, p<0.001), and caused vasoconstriction in RE (Rmax=-6.5 ± 0.6%). That insulin-induced vasoconstriction on PI3K inhibition was abolished (p<0.001) by the ET-A antagonist (Rmax=2.9 ± 0.4%). Additionally, acute RE enhanced (p<0.001) the functional activity of the ouabain-sensitive Na(+)/K(+) ATPase activity (Rmax=10.7 ± 0.4%) and of the K(+) channels (Rmax=-6.1±0.5%; p<0.001) in the insulin-induced vasorelaxation as compared to CT. SIGNIFICANCE: Such results suggest that acute RE promotes enhanced insulin-induced vasodilatation, which could act as a fine tuning to vascular tone.