Avaliação da função pulmonar em obesos mórbidos com sonolência diurna excessiva

Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m², waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance

Treinamento muscular inspiratório para asma: revisão sistemática com metanálise

In asthmatic, the lung hyperinflation leaves the inspiratory muscle at a suboptimal position in length-tension relationship, reducing the capacity of to generate tension. The increase in transversal section area of the inspiratory muscles could reverse or delay the deterioration of inspiratory muscle function. Objective: To evaluate the evidence for the efficacy of inspiratory muscle training (IMT) with an external resistive device in patients with asthma. Methods: A systematic review with meta-analysis was carried out. The sources researched were the Cochrane Airways Group Specialised Register of trials, Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 11 of 12, 2012), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, ClinicalTrials.gov and reference lists of articles. All databases were searched from their inception up to November 2012 and there was no restriction on the language of publication. Randomised controlled trials that involved the use of an external inspiratory muscle training device versus a control (sham or no inspiratory training device) were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated risk of bias in studies and extracted data. Results: A total of five studies involving 113 asthmatic patients were included. Three clinical trials were produced by the same group. The included studies showed a significant increase in maximal inspiratory pressure (MD 13.34 cmH2O, 95% CI 4.70 to 21.98), although the confidence intervals were wide. There was no statistically significant difference between the IMT group and the control group for maximal expiratory pressure, peak expiratory flow rate, forced expiratory volume in one second, forced vital capacity, sensation of dyspnea and use of beta2-agonist. There were no studies describing exacerbation events that required a course of oral and inhaled corticosteroids or emergency department visits, inspiratory muscle endurance, hospital admissions and days of work or school. Conclusions: There is no conclusive evidence in this review to support or refute inspiratory muscle training for asthma, once the evidence was limited by the small number of studies included, number of participants in them together with the risk of bias. More well conducted randomized controlled trials are needed, such trials should investigate respiratory muscle strength, exacerbation rate, lung function, symptoms, hospital admissions, use of medications and days off work or school. IMT should also be assessed in the context of more severe asthma

Efeito de diferentes intervalos de recuperação entre as séries sobre o desempenho muscular no exercício leg-press em idosas não treinadas

OBJETIVO: Verificar a influência de dois diferentes intervalos de recuperação (IR) entre as séries no exercício leg-press sobre o número e sustentabilidade das repetições e no volume total, em idosas não treinadas. MÉTODOS: Onze idosas (66,5 ± 5,0 anos; 59,2 ± 9,1kg; 146,4 ± 34,9cm) foram submetidas a duas sessões experimentais de exercícios com pesos com intensidade de 15 repetições máximas. Cada sessão experimental foi composta por três séries realizadas até a fadiga muscular utilizando IR de um (IR-1) ou três minutos (IR-3). As sessões experimentais foram separadas por, no mínimo, 48 horas. Todas as participantes realizaram ambos os protocolos e um delineamento cross-over balanceado foi utilizado para determinar a ordem das sessões experimentais. RESULTADOS: Para ambos os IR entre as séries, reduções significativas (P < 0,05) no número e na sustentabilidade das repetições foram observadas da primeira para a segunda e terceira séries e da segunda para a terceira séries. Diferenças significativas (P < 0,05) entre os IR foram observadas nas duas séries finais. O volume total da sessão realizada com IR-3 foi estatisticamente superior (20,4%; P < 0,05) quando comparada a sessão IR-1. CONCLUSÃO: O número e a sustentabilidade das repetições e o volume total de treino de idosas não treinadas são influenciados pelo IR empregado entre as séries. Maiores IR devem ser utilizados quando a finalidade for otimizar o volume de treino por meio da sustentabilidade das repetições. Em contrapartida, menores IR devem ser utilizados quando a meta for obter maiores níveis de fadiga muscular.

Análise dos receptores de acetilcolina (nAChRs) na musculatura esquelética de ratos com insuficiência cardíaca submetidos ao treinamento aeróbico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alongamento estático, envelhecimento e desempenho neuromuscular

Pós-graduação em Ciências da Motricidade - IBRC

Discriminant analysis of neuromuscular variables in chronic low back pain

Background: Investigation and discrimination of neuromuscular variables related to the complex aetiology of low back pain could contribute to clarifying the factors associated with symptoms. Objective: Analysing the discriminative power of neuromuscular variables in low back pain. Methods: This study compared muscle endurance, proprioception and isometric trunk assessments between women with low back pain (LBP, n=14) and a control group (CG, n=14). Multivariate analysis of variance and discriminant analysis of the data were performed. Results: The muscle endurance time (s) was shorter in the LBP group than in the CG (p=0.004) with values of 85.81 (37.79) and 134.25 (43.88), respectively. The peak torque (Nm/kg) for trunk extension was 2.48 (0.69) in the LBP group and 3.56 (0.88) in the GG (p=0.001); for trunk flexion, the mean torque was 1.49 (0.40) in the LBP group and 1.85 (0.39) in the CG (p=0.023). The repositioning error (degrees) before the endurance test was 2.66 (1.36) in the LBP group and 2.41 (1.46) in the CG (p=0.664), and after the endurance test, it was 2.95 (1.94) in the LBP group and 2.00 (1.16) in the CG (p=0.06). Furthermore, the variables showed discrimination between the groups (p=0.007), with 78.6% of the individuals with low back pain correctly classified in the LBP group. In turn, variables related to muscle activation showed no difference in discrimination between the groups (p=0.369). Conclusion: Based on these findings, the clinical management of low back pain should consist of both resistance and strength training, particularly in the extensor muscles.

Avaliação de parâmetros de desempenho muscular em jovens sedentárias com dor lombar

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Carbohydrate supplementation increases intramyocellular lipid stores in elite runners

The objective was to determine the effects of carbohydrate (CHO) supplementation on exercise-induced hormone responses and post-training intramyocellular lipid stores (IMCL). Twenty-four elite male athletes (28.0 +/- 1.2 years) were randomized to receive CHO (maltodextrin solution) or zero energy placebo solution (control group). The high-intensity running protocol consisted of 10 x 800 m at 100% of the best 3000-m speed (Vm3 km) and 2 x 1000 m maximal bouts in the morning and a submaximal 10-km continuous easy running in the afternoon of day 9. IMCL concentrations were assessed by H-1-MRS before (-day 9) and after training (day 9) in soleus (SO) and tibialis anterior (TA) muscles. Blood hormones were also measured before, during, and post-exercise. The percent change (Delta%) in TA-IMCL was higher in the CHO group (47.9 +/- 24.5 IMCL/Cr) than in the control group (-1.7 +/- 13.1, respectively) (P=.04). Insulin concentrations were higher in the CHO group post-intermittent running compared to control (P=.02). Circulating levels of free fatty acids and GH were lower in the CHO group (P>.01). The decline in performance in the 2nd 1000-m bout was also attenuated in this group compared to control (P<.001 and P=.0035, respectively). The hormonal milieu (higher insulin and lower GH levels) in the CHO group, together with unchanged free fatty acid levels, probably contributed to the increased IMCL stores. This greater energy storage capacity may have improved post-exercise recovery and thus prevented performance deterioration. (C) 2012 Elsevier Inc. All rights reserved.

Reliability in kimono grip strength tests and comparison between elite and non-elite Brazilian jiu-jitsu players

Background and Study Aim: The grip strength endurance is important for Brazilian Jiu-Jitsu (BJJ). Thus, the aims of this study were: a) to test the reliability of two kimono grip strength tests named maximum static lift (MSL) and maximum number of repetitions (MNR) and b) to examine differences between elite and non-elite BJJ players in these tests. Material/Methods: Thirty BJJ players participated into two phases: "A" to test reliability and "B" to compare elite and non-elite. In phase A, twenty participants performed the MSL and, 15 min later, the MNR in two occasions with 24-h interval. In phase B, ten other BJJ practitioners (non-elite) and ten athletes (elite) performed the same tests. The intraclass correlation coefficient (ICC) two way fixed model (3,1), Bland-Altman plot and the limits of agreement were used to test reliability, correlation between the tests were evaluated by Pearson correlations and independent T test (P<0.05) was utilized to compare elite vs. non-elite. Results: The ICC was high for repeated measurements on different days of phase A (MSL: r=0.99 and MNR: r=0.97). Limits of agreement for time of suspension were -6.9 to 2.4-s, with a mean difference of -2.3 s (CI: -3.3 to -1.2-s), while for number of repetitions the limits of agreement were -2.9 to 2.3-rep, with a mean difference of -0.3-rep (CI: -0.9 to 0.3-rep). In phase B, elite presented better performance for both tests (P<0.05) compared to non-elite (56 +/- 10-s vs. 37 +/- 11-s in MSL and 15 +/- 4-rep vs. 8 +/- 3-rep in MNR). Moderate correlation were found between MSL and MNR for absolute values during test (r=0.475; p=0.034), and retest phases (r=0.489; p=0.029), while moderate and high correlations in the test (r=0.615; p=0.004) and retest phases (r=0.716; p=0.001) were found for relative values, respectively. Conclusions: These proposed tests are reliable and both static and dynamic grip strength endurance tests seem to differentiate BJJ athletes from different levels.

Health and fitness benefits of a resistance training intervention performed in the workplace

Zavanela, PM, Crewther, BT, Lodo, L, Florindo, AA, Miyabara, EH, and Aoki, MS. Health and fitness benefits of a resistance training intervention performed in the workplace. J Strength Cond Res 26(3): 811-817, 2012-This study examined the effects of a workplace-based resistance training intervention on different health-, fitness-, and work-related measures in untrained men (bus drivers). The subjects were recruited from a bus company and divided into a training (n = 48) and control (n = 48) groups after initial prescreening. The training group performed a 24-week resistance training program, whereas the control group maintained their normal daily activities. Each group was assessed for body composition, blood pressure (BP), pain incidence, muscular endurance, and flexibility before and after the 24-week period. Work absenteeism was also recorded during this period and after a 12-week follow-up phase. In general, no body composition changes were identified in either group. In the training group, a significant reduction in BP and pain incidence, along with improvements in muscle endurance and flexibility were seen after 24 weeks (p < 0.05). There were no changes in these parameters in the control group, and the between-group differences were all significant (p < 0.05). A reduction in worker absenteeism rate was also noted in the training (vs. control) group during both the interventional and follow-up periods (p < 0.05). In conclusion, it was found that a periodized resistance training intervention performed within the workplace improved different aspects of health and fitness in untrained men, thereby potentially providing other work-related benefits. Thus, both employers and employees may benefit from the setup, promotion, and support of a work-based physical activity program involving resistance training.

Patients with temporomandibular disorders have increased fatigability of the cervical extensor muscles

To determine whether patients with myogenous and mixed temporomandibular disorders (TMD) have greater fatigability of the cervical extensor muscles while performing a neck extensor muscle endurance test (NEMET) when compared with healthy controls.

Physical fitness of industrial firefighters

Firefighting is widely known to be one of the most physically demanding civilian occupations. A subset of this is Industrial Firefighting, which places similarly high physical demands on Industrial Firefighters. Although there are some studies on community firefighters, literature is scant on Industrial Firefighters and their physical fitness. ^ A cross-sectional study of Industrial Firefighters in Petrochemical companies in Texas was carried out in 1996–98 to assess their physical fitness and to develop a set of physical agility criteria useful in their selection and ongoing fitness for duty evaluations. ^ A physical agility criteria and a fitness scorecard was developed based on seven parameters (resting heart rate, diastolic blood pressure, aerobic capacity, muscle strength, muscle endurance, trunk flexibility and total body fat) of musculoskeletal and cardiorespiratory fitness. Each indicator received a minimum of 0 to a maximum of 20 points, based on individual performance. Therefore a minimum and maximum achievable score for the entire battery of tests was 0 and 140 respectively. Of the 111 study subjects, 5 (4.5%) were far above average, 31 (28%) above average, 46 (41.5 %) average, 29 (26%) below average and 0 (0%) far below average as deemed by the physical fitness scorecard. The mean score was 77 (±23) with a minimum and maximum score of 35 and 135 respectively. ^ Following univariate analysis an exploratory factor analysis to group variables and to assess the overall role of constituent variables in total fitness of a firefighter was developed. This was followed by a stepwise linear regression analysis using aerobic capacity as a dependent variable. ^ Finally, a graded implementation strategy was devised, such that all existing Industrial Firefighters would have an opportunity to improve or maintain their physical fitness at or above average level as deemed by the fitness scorecard. ^

Resistance training and reduction of treatment side effects in prostate cancer patients

Purpose: To examine the effect of progressive resistance training on muscle function, functional performance, balance, body composition, and muscle thickness in men receiving androgen deprivation for prostate cancer. Methods: Ten men aged 59-82 yr on androgen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum (RM) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic. Outcome measures included muscle strength and muscle endurance for the upper and lower body, functional performance (repeated chair rise, usual and fast 6-m walk, 6-m backwards walk, stair climb, and 400-m walk time), and balance by sensory organization test. Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound. Blood samples were assessed for prostate specific antigen (PSA), testosterone, growth hormone (GH), cortisol, and hemoglobin. Results: Muscle strength (chest press, 40.5%; seated row, 41.9%; leg press, 96.3%; P < 0.001) and muscle endurance (chest press, 114.9%; leg press, 167.1%; P < 0.001) increased significantly after training. Significant improvement (P < 0.05) occurred in the 6-m usual walk (14.1%), 6-m backwards walk (22.3%), chair rise (26.8%), stair climbing (10.4%), 400-m walk (7.4%), and balance (7.8%). Muscle thickness increased (P < 0.05) by 15.7% at the quadriceps site. Whole-body lean mass was preserved with no change in fat mass. There were no significant changes in PSA, testosterone, GH, cortisol, or hemoglobin. Conclusions: Progressive resistance exercise has beneficial effects on muscle strength, functional performance and balance in older men receiving androgen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects.

Educação em neurofisiologia da dor e exercício em adolescentes com dor cervical: um estudo piloto da sua efetividade

Enquadramento: A prevalência da dor cervical crónica em adolescentes está a aumentar. Estudos recentes têm comprovado a eficácia de programas de educação com base na neurofisiologia da dor e exercício na diminuição da dor, incapacidade, medo e ansiedade associados à dor crónica. Contudo, apesar deste tipo de programas apresentar resultados promissores em adultos, a sua aplicação e efetividade em populações mais jovens tem sido pouco estudada. Objetivos: Avaliar a efetividade de um programa de educação com base na neurofisiologia da dor associado a exercícios na dor cervical crónica em adolescentes na 1) frequência e intensidade da dor, 2) incapacidade associada, 3) capacidade de resistência dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata, 4) ansiedade e 5) catastrofização. Métodos: Um total de 43 adolescentes com idade entre os 15 e os 18 anos da Escola Secundária Dr. João Carlos Celestino Gomes participaram neste estudo. Foram avaliadas a intensidade, duração e frequência da dor cervical, a incapacidade associada e a resistência dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata através dos testes dos flexores e extensores profundos e estabilizadores da omoplata, respetivamente. Foram também avaliados os níveis de ansiedade, catastrofização e perceção de mudança através do Inventário de Ansiedade Estado-Traço, da Escala de Catastrofização da Dor e da Escala de Perceção Global de Mudança. Resultados: O número de participantes a referir dor na semana que precedeu a avaliação no grupo experimental reduziu em 28,5%. Verificou-se uma interação significativa entre o momento de avaliação (antes da intervenção vs após a intervenção) e o grupo (experimental vs. controlo) para as variáveis resistência dos flexores profundos e catastrofização e um efeito do momento e do grupo (mas não uma interação) para a dor, incapacidade, resistência dos músculos extensores e estabilizadores da omoplata e ansiedade traço (p<0.05). Dos 21 participantes do grupo experimental, 85,7% referiu mudanças significativas na Escala de Perceção Global de Mudança. Conclusão: A educação em neurofisiologia da dor é uma intervenção que poderá ser utilizada em adolescentes com dor crónica, com resultados significativos na redução da dor, melhoria da resistência muscular dos músculos flexores e extensores profundos da cervical e estabilizadores da omoplata e diminuição da catastrofização.

Branched-chain amino acids supplementation enhances exercise capacity and lipid oxidation during endurance exercise after muscle glycogen depletion

Aim. It has been demonstrated that branched-chain amino acids (BCAA) transaminase activation occurs simultaneously with exercise-induced muscle glycogen reduction, suggesting that BCAA supplementation might play an energetic role in this condition. This study aimed to test whether BCAA supplementation enhances exercise capacity and lipid oxidation in glycogen-depleted subjects. Methods. Using a double-blind cross-over design, volunteers (N.=7) were randomly assigned to either the BCAA (300 mg . kg . day (-1)) or the placebo (maltodextrine) for 3 days. On the second day, subjects were submitted to an exercise-induced glycogen depletion protocol. They then performed an exhaustive exercise test on the third day, after which time to exhaustion, respiratory exchange ratio (RER), plasma glucose, free fatty acids (HA), blood ketones and lactate were determined. BCAA supplementation promoted a greater resistance to fatigue when compared to the placebo (+17.2%). Moreover, subjects supplemented with BCAA showed reduced RER and higher plasma glucose levels during the exhaustive exercise test. Results. No significant differences appeared in FFA, blood ketones and lactate concentrations. Conclusion. In conclusion, BCAA supplementation increases resistance to fatigue and enhances lipid oxidation during exercise in glycogen-depleted subjects.