Combining adapted Judo training and pharmacological treatment to improve bone mineral density on postmenopausal women: A two years study

Background & Study Aim: Physical activity has been an important factor to increase bone mineral density (BMD) and, consequently, to prevent and treat osteoporosis. The study aimed the effects of adapted Judo training on BMD in postmenopausal women, during pharmacological treatment. Material & Methods: Eighteen female volunteers participated in this study. They were separated into two groups: Adapted Judo training (AJT) (n=11; 52.2±5.3 years) and control group (CG) (n=7; 53.8±4.4 years). Lunar GE Dual Energy X-Ray Absorptiometry (DXA) measured BMD at lumbar L2-L4, femoral neck and trochanter sites. The training period for AJT was two years, comprised 12 mesocycles with different intensities. ANOVA compared 2 groups in 3 moments of testing and Scheffé Test allowed multiple comparisons between groups for the L2-L4 and femoral neck sites, but at trochanter was Fisher LSD. Results: ANOVA showed significant differences in the AJT group (F(2, 32)=15.187, p=0.000023). Scheffé Test showed significant increase on lumbar BMD after one year of AJT (Δ%=+8.9%, p=0.000017) and after two years this improvement stand still (p=0.33). The CG after one year presented significant decrease in BMD of femoral neck (Δ%=-6.9%, p=0.03) and trochanter (Δ%=-3.7%, p=0.0084). However, the CG recovered the loss of BMD of femoral neck (Δ%=+7.6%, p=0.02) and trochanter (Δ%=+3.8%, p=0.0079) after two years of study. Conclusions: Drug therapy, without the physical activity practice, can aid the maintenance of BMD. AJT may be considered as an efficient physical activity for postmenopausal women with low BMD in pharmacological treatment. © ARCHIVES OF BUDO | SCIENCE OF MARTIAL ARTS.

Effects of elbow flexor muscle resistance training on strength, endurance and perceived exertion

Purpose. To verify the effects of resistance training at the electromyographic fatigue threshold (EMGFT) based on one-repetition maximum strength (1RM), heart rate (HR), rate of perceived exertion (PE) and endurance time (EndT). Methods. Nineteen subjects (training group [TG]: n = 10; control group [CG]: n = 9), performed 1-min bicep curl exercises sets at 25%, 30%, 35% and 40% 1RM. Electromyography (biceps brachii and brachiorradialis), HR and PE were registered. Biceps brachii EMGFT was used to create a load index for an eight-week resistance training programme (three sets until exhaustion/session, two sessions/week) for the TG. The CG only attended one session in the first week and another session in the last week of the eight-week training period for EndT measurement. EndT was determined from the number of repetitions of each of the three sets performed in the first and last training sessions. After training, 1RM, EMGFT, EndT, HR and PE at the different bicep curl load intensities were again measured for both groups. Results. Increases in 1RM (5.9%, p < 0.05) and EndT (> 60%, p < 0.001) after training were found. In addition, PE was reduced at all load intensities (p < 0.05), while no changes were found for HR and EMGFT after training. Conclusions. Strength-endurance training based on the EMGFT improved muscular endurance and also, to a lesser extent, muscular strength. Moreover, the reduced levels of physical exertion after training at the same intensity suggest that endurance training exercises may improve comfort while performing strength exercises.

Insulin concentrations in cerebellum and body balance in diabetic male rats: Aerobic training effects

Brain insulin has had widespread metabolic, neurotrophic, and neuromodulatory functions and has been involved in the central regulation of food intake and body weight, learning and memory, neuronal development, and neuronal apoptosis. Purpose: The present study investigated the role of swimming training on cerebral metabolism on insulin concentrations in cerebellum and the body balance performance of diabetic rats. Methods: Forty Male Wistar rats were divided in four groups: sedentary control (SC), trained control (TC), sedentary diabetic (SD), and trained diabetic (TD). Diabetes was induced by alloxan (32 mg kg b.w.), single dose injection. The mean blood glucose of diabetic groups was 367 ± 40 mg/dl. Training program consisted in swimming 5 days/week, 1 h/day, 8 weeks, supporting a workload corresponding to 90% of maximal lactate steady state (MLSS). For the body balance testing rats were trained to traverse for 5 min daily for 5-7 days. All dependent variables were analyzed by one-way analysis of variance (ANOVA) and a significance level of p < 0.05 was used for all comparisons. Results: The body balance testing scores were different between groups. Insulin concentrations in cerebellum were not different between groups. Conclusion: It was concluded that in diabetic rats, aerobic training does not induce alterations on cerebellum insulin but induces important metabolic, hormonal and behavioral alterations which are associated with an improvement in glucose homeostasis, serum insulin concentrations and body balance. © 2013 Elsevier Inc.

The relationship between training status, blood pressure and uric acid in adults and elderly

Background: Hypertension can be generated by a great number of mechanisms including elevated uric acid (UA) that contribute to the anion superoxide production. However, physical exercise is recommended to prevent and/or control high blood pressure (BP). The purpose of this study was to investigate the relationship between BP and UA and whether this relationship may be mediated by the functional fitness index.Methods: All participants (n = 123) performed the following tests: indirect maximal oxygen uptake (VO2max), AAHPERD Functional Fitness Battery Test to determine the general fitness functional index (GFFI), systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI) and blood sample collection to evaluate the total-cholesterol (CHOL), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), triglycerides (TG), uric acid (UA), nitrite (NO2) and thiobarbituric acid reactive substances (T-BARS). After the physical, hemodynamic and metabolic evaluations, all participants were allocated into three groups according to their GFFI: G1 (regular), G2 (good) and G3 (very good).Results: Baseline blood pressure was higher in G1 when compared to G3 (+12% and +11%, for SBP and DBP, respectively, p<0.05) and the subjects who had higher values of BP also presented higher values of UA. Although UA was not different among GFFI groups, it presented a significant correlation with GFFI and VO2max. Also, nitrite concentration was elevated in G3 compared to G1 (140±29 μM vs 111± 29 μM, for G3 and G1, respectively, p<0.0001). As far as the lipid profile, participants in G3 presented better values of CHOL and TG when compared to those in G1.Conclusions: Taking together the findings that subjects with higher BP had elevated values of UA and lower values of nitrite, it can be suggested that the relationship between blood pressure and the oxidative stress produced by acid uric may be mediated by training status. © 2013 Trapé et al.; licensee BioMed Central Ltd.

Effect of physical training on metabolic and bone profile in weaning rats

Introduction: The practice of moderate-intensity exercise can reduce the risk of infections and improve metabolic aspects of the person. Objective: To investigate the effects of aerobic physical training on endocrine and metabolic aspects, bone and immune systems. Methods: Twenty Wistar rats were divided in two groups: sedentary (SG) and trained group (TG). Training program consisted in swimming, 6 weeks, supporting a workload corresponding to 5% of body weight. At the end of the experiment, were performed counting total and differential leukocyte count and hematocrit. After training period, were analyzed glucose, total protein, triglycerides, cholesterol, liver and muscle samples for the determination of the levels of glycogen, and determination of the tibia length and bone area. All dependent variables were analyzed by one-way analysis of variance (ANOVA) and a significance level of P < 0.05 was used for all comparisons. Results: Hematocrit (%) analyzed showed a significant difference, with higher values ffor TG (54.63 ± 1.41) than for the SG (49.5 ± 1.65). The total leukocyte count was not significantly different, as there was no difference in the differential count. Total cholesterol showed significant decrease in TG (TG = 68.27 ± 13.71 mg/dL; SG = 94.44 ± 28.09), the total protein levels also showed significant reduction (TG = 7.3 ± 0.40 g/dL; SG = 7.74 ± 0.36 g/dL) glucose levels and triglyceride showed no significant differences. The bone length showed significant difference (TG = 40±0.14 mm; SG = 42.10 ± 0.12mm). Tibial area showed a lower value for TG (1.53 ± 0.12cm2) than for SG (1.67 ± 0.18cm2); however, the difference was not statistically significant. Conclusion: It can be concluded that aerobic exercise training is able to produce some unique physiological changes in young rats. There is also the need to prescribe exercises that meet the particular maturational stage of development.

Aquatic Exercise is as Effective as dry Land Training to Blood Pressure Reduction in Postmenopausal Hypertensive Women

Background and Purpose: The evidence of the benefits from regular physical activity to hypertensives is based on dry land training studies. Therefore, the aim of this study is to compare the effect of aquatic exercise with dry land training on hypertensive women. Methods: This is a randomized controlled study with 52 post-menopausal hypertensive women. The patients were randomly allocated in three groups: water aerobic training group (n=19), dry land aerobic training group (n=19) and a non-intervention control group (n=14). The training protocol was performed by 12weeks. Results: There were no differences among the three groups concerning basal blood pressure (BP) and biochemical variables. In water group, there was a statistically significant reduction of systolic BP from 136±16mmHg at zero week to 124±18mm Hg at 11th week and 124±15mmHg at 12th week. In dry land training group, there was a statistically significant reduction of systolic BP from 138±15mmHg at zero week to 125±10mmHg at 7th week, 127±10mmHg at 10th week and 126±9mmHg at 12th week. The control group presented no change in any of the assessed variables. No changes were carried out in any antihypertensive medications during study. Discussion: This is a randomized controlled study that demonstrates the antihypertensive efficacy of aerobic aquatic exercise. © 2013 John Wiley & Sons, Ltd.

Simulation-based ultrasound-guided central venous cannulation training program

PURPOSE: To propose a simulation-based ultrasound-guided central venous cannulation skills' training program, during residency.METHODS: This study describes the strategies for learning the ultrasound-guided central venous cannulation on low-fidelity bench models. The preparation of bench models, educational goals, processes of skill acquisition, feedback and evaluation methods were also outlined. The training program was based on key references to the subject.RESULTS: It was formulated a simulation-based ultrasound-guided central venous cannulation teaching program on low-fidelity bench models.CONCLUSION: A simulation-based inexpensive, low-stress, no-risk learning program on low-fidelity bench models was proposed to facilitate acquisition of ultrasound-guided central venous cannulation skills by residents-in-training before exposure to the living patient.

Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease

Background. The chronic obstructive pulmonary disease (COPD) is associated with the strength and resistance decreasing in addition to the dysfunction on autonomic nervous system (ANS). The aerobic training isolated or in association with the resistance training showed evidence of beneficial effects on an autonomic modulation of COPD; however, there are no studies addressing the effect of isolated resistance training.Aims. This study aims at investigating the influence of resistance training on an autonomic modulation through heart rate variability (HRV), functional capacity and muscle strength in individuals with COPD.Design. Clinical series study.Setting. Outpatients.Population. The study involved 13 individuals with COPD.Methods. The experimental protocol was composed by an initial and final evaluation that consisted in autonomic evaluations (HRV), cardiopulmonary functional capacity evaluation (6-minute walk test) and strength evaluation (dynamometry) in addition by the resistance training performed by 24 sessions lasted 60 minutes each one and on a frequency of three times a week. The intensity was determined initially with 60% of one maximum repetition and was progressively increased in each five sessions until 80%.Results. The HRV temporal and spectral indexes analysis demonstrates improvement of autonomic modulation, with significant statistical increases to sympathetic and parasympathetic components of ANS representing by SDNN, LF and HF. In addition, it was observed significant statistical increases to shoulder abduction and. knee flexion strength and functional capacity.Conclusion. The exclusive resistance training performed was able to positively influence the autonomic modulation; in addition it promoted benefits on cardiorespiratory functional capacity and strength benefits in individuals with COPD.Clinical Rehabilitation Impact. This study could contribute to clinical and professionals researchers that act with COPD, even though the resistance component of pulmonary rehabilitation presents consensual benefits on several healthy indicators parameters. There is no evidence about the effects on HRV before. Moreover, this study showed, on clinical practice, the HRV uses as an ANS activity on sinus node evaluation and highlights further importance on scientific context.

Strength gain through eccentric isotonic training without changes in clinical signs or blood markers

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

Determinant factors for mortality of patients receiving mechanical ventilation and effects of a protocol muscle training in weaning

Introduction: Prognostic factors are used in the Intensive Care Unit (ICU) to predict morbidity and mortality , especially in patients on mechanical ventilation (MV ) . Training protocols are used in MV patients with the aim of promoting the success of the weaning process. Objective: To assess which variables determine the outcome of patients undergoing mechanical ventilation and compare the effects of two protocols for weaning. Method: Patients under MV for more than 48 hours had collected the following information: sex, age , ideal weight, height , Acute Physiology and Chronic Health Evaluation (APACHE II), risk of mortality, Glasgow Coma Scale (GCS) and index Quick and perfunctory (IRRS) breathing. Patients with unsuccessful weaning performed one of weaning protocols: Progressive T - tube or tube - T + Threshold ® IMT. Patients were compared for outcome (death or non- death in the ICU ) and the protocols through the t test or Mann-Whitney test was considered significant when P <0.05. Results: Of 128 patients evaluated 56.25% were men, the mean age was 60.05 ± 17.85 years and 40.62 % patients died, and they had higher APACHE II scores, mortality risk, time VM and IRRS GCS and the lower value (p<0.05). The age, initial and final maximal inspiratory pressure, time of weaning and duration of MV was similar between protocols. Conclusion: The study suggests that the GCS, APACHE II risk of mortality, length of MV and IRRS variables determined the evolution of MV patients in this sample. Not found differences in the variables studied when comparing the two methods of weaning.

High intensity exercise training worsens alveolar destruction in pulmonary emphysema rats

OBJECTIVE: Investigation of standard intensities of physical exercise is important to better comprehend and develop rehabilitation programs for emphysema. We aimed to evaluate the effects of different intensities (moderate and high-intensity) of physical exercise on the development of a protease-induced (papain intratracheal instillation) emphysema in rats. METHODS: Male Wistar rats were randomly separated into five groups that received intratracheal instillation of papain solution or vehicle: (i) papain high intensity exercise, (ii) papain moderate exercise, (iii) saline high intensity exercise, (iv) saline sedentary and (v) papain sedentary. Forty days after intratracheal instillation, the exercise groups were submitted to an exercise-training protocol on a treadmill during 10 weeks, 5 days/week, at 0.9 km/h (Papain and saline high exercise), or at 0.6 km/h (papain moderate exercise).We measured respiratory system elastance and resistance, the collagen fiber lung parenchyma, and the pulmonary mean linear intercept. RESULTS: All animal groups that received papain instillation presented higher alveolar wall destruction compared to animals that received only saline solution. The papain high intensity exercise group presented higher values of mean linear intercept compared to emphysema groups that were trained at a moderate intensity or not submitted to exercise. CONCLUSION: High intensity exercise training worsened alveolar destruction in an experimental model of emphysema in rats when compared to moderate intensity exercise, or to no exercise.

Aerobic Exercise Training Prevents Heart Failure-Induced Skeletal Muscle Atrophy by Anti-Catabolic, but Not Anabolic Actions

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

Greening the work force in Brazilian hotels: The role of environmental training

BACKGROUND: Organizations are increasingly required to reduce their environmental impact through the adoption of environmental management, which requires the support of human resource practices.OBJECTIVE: The objective of this study is to determine whether human resource management practices, especially training, are supporting environmental management practices at four hotels located in Brazil.METHODS: This research is qualitative, based on the analysis of four hotels in Brazil.RESULTS: Based on the systematized empirical evidence collected from four hotels (Hotels A, B, C, and D), it can be concluded that: (1) human resource management is still not fully aligned with environmental objectives at the hotels studied; (2) only Hotel B has implemented environmental management practices and aligned with human resource management in a more developed manner, which may indicate that these two variables of analysis could have interrelations; (3) environmental training as a human resource management practice was verified in all hotels analyzed.CONCLUSIONS: The greening of human resources practices is not fully aligned with environmental objectives in the hotels studied. If these hotels really wish to "go green," environmental training will be necessary. Hotel stakeholders play a major role in implementing the greening of the hotel industry.

Effect of short training on vaginal fluid microscopy (wet mount) learning

Objective: Is it feasible to learn the basics of wet mount microscopy of vaginal fluid in 10 hours?Materials and Methods: This is a pilot project wherein 6 students with different grades of education were invited for being tested on their ability to read wet mount microscopic slides before and after 10 hours of hands-on training. Microscopy was performed according to a standard protocol (Femicare, Tienen, Belgium). Before and after training, all students had to evaluate a different set of 50 digital slides. Different diagnoses and microscopic patterns had to be scored. kappa indices were calculated compared with the expert reading. Results: All readers improved their mean scores significantly, especially for the most important types of altered flora (p < .0001). The mean increase in reading concordance (kappa from 0.64 to 0.75) of 1 student with a solid previous experience with microscopy did not reach statistical significance, but the remaining 5 students all improved their scores from poor performance (all kappa < 0.20) to moderate (kappa = 0.53, n = 1) to good (kappa > 0.61, n = 4) concordance. Reading quality improved and reached fair to good concordance on all microscopic items studied, except for the detection of parabasal cells and cytolytic flora. Conclusions: Although further improvement is still possible, a short training course of 10 hours enables vast improvement on wet mount microscopy accuracy and results in fair to good concordance of the most important variables of the vaginal flora compared to a reference reader.

Aerobic training attenuates nicotinic acetylcholine receptor changes in the diaphragm muscle during heart failure

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)