Interactions of age and leg muscle fatigue on unobstructed walking and obstacle crossing

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

Leg Amputation for an Extensive, Severe and Intractable Sickle Cell Anemia Ulcer in a Brazilian Patient

A 35-year-old African Brazilian patient had sickle cell anemia complicated with recurrent vasoocclusive (VOC) crises and refractory painful leg ulcers for 16 years. The ulcers started over both medial malleoli and expanded gradually. The ulcer on the left leg spread from the foot to the knee circumferentially and was refractory to all forms of therapy within the frame work of multi-disciplinary care. The patient agreed to a below the knee amputation of the left leg. He felt much better after the amputation but developed severe neuropathic phantom pain that was well controlled medically. He could differentiate the sickle cell anemia and ulcer pain from the neuropathic pain. About 6 months after the amputation he had dengue fever with fatal outcome. This is the first report of treatment of refractory sickle cell anemia leg ulcer with amputation and probably the first report of a Brazilian patient with sickle cell anemia and dengue fever.

Associação do treinamento resistido e aeróbico em pacientes com doença pulmonar crônica

Introduction: The pulmonary rehabilitation (PR) is composed of aerobic and resisted exercises that improve the functional capacity to the exercise, life quality and decrease respiratory symptoms in subjects with chronic pulmonary disease. Objective: Assess the effects of a combined PR program in the cardiorespiratory function and peripheral muscle strength in subjects with chronic pulmonary disease. Method: Patients with chronic pulmonary disease were submitted to the PR program, which was developed on 24 sessions of 60 minutes (three times per week). The program was composed of aerobic exercises (two times per week) and resisted exercises (once a week). Before and after the PR the patients were submitted to manovacuometry in order to measure the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), ventilometry, peek expiratory flow (PEF), six minute walking test (6MWT) and one maximum repetition (1RM). The data are presented in absolute frequency, percentage and mean±standard deviation. The t Student test was used to compare data before and after the PR and the ANOVA test to compare before, after and predicted distances in the 6MWT (p<0.05). Results: Seven patients were part of this study, 85.70% of women, 71.40% with pulmonary emphysema diagnosis. The mean age was 69.43±5.59 years old, the height was 1.61±0.07 m, the mean weight was 66.20±8.40 kg and the body mass index mean was 25.50±2.48 kg/m². From the variables assessed, the MEP increased from 79.71±13.69 to 84.42±12.83 cmH2O (p=0,03), the PEF increase from 255.71±66.3 to 320.00±93.63 l/min (p=0,03) and the distance in the 6MWT from 415.28±47.90 to 483,79±79,77 m (p=0,02). The load in the 1RM test in the reverse peck deck exercise (before - - 17.10±8.10kg; after – 210.40±9.00kg), knee in leg extension machine (before – 17.10±9.50kg; after – 26.40±13.10kg) and hip extensors (right before – 48.60±22.10kg; after – 62.90±19.30kg; and left before – 46.40±20.10kg; after – 62.10±18.20kg) increased significantly (p<0,05). Conclusion: After the PR program there was improvement in the expiratory muscular strength, in the lower limbs strength and in the functional capacity. Besides that, there was a reduction in the airflow obstruction of the subjects with chronic pulmonary disease.

Efeitos do treinamento isocinético e isométrico sobre a taxa de desenvolvimento de força máxima

The objective of the present study was to compare the effects of a high speed isokinetic training (180°.s-1) and an isometric training (75°) on the maximum rate of force development (RFDmax) measured in the isokinetic and isometric modes. Twenty seven male non active subjects participated of this study (Mean + SD = body mass 78.6 + 14.1 kg; stature 175.1 + 8.9 cm; age 22.6 + 3.8 years). They were randomly divided into three groups: Control (GC); Isokinetic training (GISOC) and; Isometric training (GISOM). The subjects were submitted in different days to the following pre training protocols: 1) Familiarization to the isokinetic dynamometer tests; 2) Five maximum concentric isokinetic contractions of the knee extensors (180°.s-1) to access the maximum concentric torque (TMC) and the concentric RFDmax; 3) Two maximum isometric contractions of the knee extensors (75°) to access the maximum isometric torque (TMI) and the isometric RFDmax. The same tests were repeated after the training period, but without the familiarization session. Eighteen training sessions were performed (3 times per week). The GISOC performed the entire training whit concentric isokinetic contractions whit the speed of 180°.s-1. The GISOM performed the entire training whit isometric contractions whit the angle between the thigh end the leg being 75° (0° = full knee extension). TMI, TMC, concentric RFDmax, isometric RFDmax values of the GC was not different between pre and post training. GISOM increased only the TMI and the GSIOC increased the TMC, concentric RFDmax and isometric RFDmax. Furthermore, the GISOC had a higher percentage increase of the isometric RFDmax than the isokinetic RFDmax. Based on these results, it is possible to conclude that the increase in maximum strength corresponded to the training specificity theory, unlike to the RFDmax. Thus the use of isometric contraction ...(Complete abstract click electronic access below)

Equilíbrio muscular e pico de torque após jogo de futsal

Indoor soccer is a modality of sport similar to football, which is accompanying an increasing of the number of participants. With the growth of this sport, increased as well the number of injuries, which has been requiring greater attention and care from the health professionals. AIMS: To investigate the functional balance before and after an indoor soccer game and analyze the maximum force before and after the game, in order to verify if there is a great loss of muscle strength of knee flexors and extensors during the game. METHODS: The study included seven amateur soccer players. The isokinetic evaluation was made using the Biodex 3 isokinetic dynamometer at velocities of 60°/s and 180°/s with five repetitions at each velocity for each leg. Further, the study analyzed the peak torque of each leg at each speed of the extensor muscles and flexor concentric and eccentric. RESULTS: Compared to the peak torque before and after the game, there were no significant differences. At 60°/s in the non-dominant leg, peak torque decreased after the game of the extensor concentric and eccentric. In the dominant leg there was a decrease of peak torque in eccentric flexion at 60°/s and concentric flexion to 180°/s. Comparing the peak torque between dominance, there was any significant differences in speed. However, in eccentric flexion at 60°/s before the match there was a significant difference. The peak torque of the dominant leg showed better results than the non-dominant leg. Regarding the functional balance there was no statistically significant differences between the muscles involved. CONCLUSION: From the results achieved, it is possible to conclude that the peak torque of flexor eccentric decreases depending on the length of the exercise. This muscle is stronger in the dominant leg, comparing to the non-dominant leg

Hamstrings-to-quadriceps strength and size ratios of male professional soccer players with muscle imbalance

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito agudo do alongamento de diferentes grupos musculares no desempenho muscular de idosas

Among the numerous possibilities of physical exercise, it has been recommended that stretching routines should be incorporated into training programs focused on the elderly population, and that these routines should be preferentially performed on the same strength or aerobic training session. However, studies have shown that muscle strength production can be acutely impaired if it is preceded by static stretching exercises (AE). Although there seems to be a relationship between the number of stretched muscles and strength response, no studies were found examining such relationship in the same study, simultaneously. Thus, the objective of this study is to analyze the acute effect of stretching of different muscle groups on strength performance in older women. Nineteen physically active older women participated in the study (67.8 ± 5.3 years, 68.9 ± 12.4 kg, 157.2 ± 6.4 cm)-usar ponto final em inglês e não vírgula. The participants visited the lab for six consecutive days, three of which were intended to familiarization. Over the next three days, all the participants performed the experimental conditions: control; quadriceps stretching alone and complete stretching, involving the major extensors muscle groups of knees and hips. Both the two stretching conditions were realized with three series of 30s (total volume of 90 seconds for each exercise). All experimental conditions was be performed with an interval of at least 24 hours and order of execution was be randomized. The force transducer was connected to a leg press apparatus, where the isometric force time curve and electromyographic activity of the vastus medial and vastus lateralis were recorded. Measurements were registered immediately after each experimental condition, during five seconds. Statistical analysis comprised descriptive procedures and the One way ANOVA test for repeated measures (p<0.05). No statistically significant differences between the control and the two...