PHYSIOLOGICAL and NEUROMUSCULAR PROFILE DURING A BODYPUMP SESSION: ACUTE RESPONSES DURING A HIGH-RESISTANCE TRAINING SESSION

Oliveira, AS, Greco, CC, Pereira, MP, Figueira, TR, de Araujo Ruas, VD, Goncalves, M, and Denadai, BS. Physiological and neuromuscular profile during a Bodypump session: acute responses during a high-resistance training session. J Strength Cond Res 23(2): 579-586, 2009-The main purposes of this study were 1) to describe and to compare blood lactate ([La]), heart rate (HR), and electromyographic (EMG) parameters during high-repetition training sessions (HRTSs), 2) to analyze the influence of physical fitness levels in these parameters, and, 3) to analyze the relationship between metabolic ([La]) and neuromuscular (EMG) responses during the HRTS. Fifteen healthy untrained women (21.7 +/- 2.1 years) performed an HRTS called Bodypump for 1 hour, which incorporated the use of variable free weights and high repetitions in a group setting. This session involved 10 music selections (M1-M10) containing resistive exercises for different muscle groups. After music selections 2 (M2), 4 (M4), 6 (M6), 7 (M7), and 9 (M9), [La], HR, and EMG (vastus medialis [VM], vastus lateralis [VL], iliocostalis lumborum [IC], and longissimus thoracis <) were determined. The [La] (M2, 4.00 +/- 1.45 mM; M7, 5.02 +/- 1.73 mM) and HR (M2, 153.64 +/- 18.89 bpm; M7, 16.14 +/- 20.14 bpm) obtained at M2 and M7 were similar but were significantly higher than the other moments of the session. However, EMG (root mean square [RMS]) at M2 (VL, VM, and LT) was lower than at M7. There was no significant correlation of strength and aerobic physical fitness with [La], RMS. In the same way, there was no significant correlation of [La] with RMS at M2 and M7. on the basis of our data, we can conclude that metabolic, cardiovascular, and EMG variables present different and independent behavior during an HRTS. Accordingly, for neuromuscular conditions during HRTS, it seems to be enough to induce improvement in the muscular strength of inferior limbs in untrained subjects.

POSITIONING DURING RESISTANCE ELBOW FLEXOR EXERCISE AFFECTS ELECTROMYOGRAPHIC ACTIVITY, HEART RATE, and PERCEIVED EXERTION

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da estrutura organizacional da assistência ambulatorial em HIV/Aids no Brasil

OBJETIVO: No contexto de acesso universal à terapia antiretroviral, os resultados do Programa de Aids dependem da qualidade do cuidado prestado. O objetivo do estudo foi avaliar a qualidade do cuidado dos serviços ambulatoriais que assistem pacientes de Aids. MÉTODOS: Estudo realizado em sete Estados brasileiros, em 2001 e 2002. Foi avaliada a qualidade do atendimento a pacientes com Aids quanto à disponibilidade de recursos e a organização do trabalho de assistência. Um questionário com 112 questões estruturadas abordando esses aspectos, foi enviado a 336 serviços. RESULTADOS: A taxa de resposta foi de 95,8% (322). Os indicadores de disponibilidade de recursos mostram uma adequação maior do que os indicadores de organização do trabalho. Não faltam antiretrovirais em 95,5% dos serviços, os exames de CD4 e Carga Viral estão disponíveis em quantidade adequada em 59 e 41% dos serviços, respectivamente. em 90,4% dos serviços há pelo menos um profissional não médico (psicólogo, enfermeiro ou assistente social). Quanto à organização, 80% não agendavam consulta médica com hora marcada; 40,4% agendavam mais que 10 consultas médicas por período; 17% não possuíam gerentes exclusivos na assistência e 68,6% não realizavam reuniões sistemáticas de trabalho com a equipe. CONCLUSÕES: Os resultados apontam que além de garantir a distribuição mais homogênea de recursos, o programa precisa investir no treinamento e disseminação do manejo do cuidado, conforme evidenciado nos resultados da organização de trabalho.

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.

Are early and late rate of force development differently influenced by fast-velocity resistance training?

This study examined the effect of fast-velocity concentric isokinetic resistance training (FV) on the rate of force development (RFD) at early (<100 ms) and late phases (>100 ms) of rising muscle force. Nine men participated in a 6-week resistance training intervention for the lower body, and nine matched subjects participated as controls (CON). During concentric isokinetic (180°s-1) knee extension training, subjects were instructed to do each contraction 'as fast and forcefully as possible'. Maximal muscle strength (MVC) and RFD (0-10, 0-20, ..., 0-250 ms from the onset of contraction) were measured during maximal voluntary isometric contraction of the knee extensors (KE). There were no significant changes in MVC of KE in both groups after intervention (FV = 314·2 ± 101·1 versus 338·7 ± 88·0 N{bullet operator}m, P>0·05; CON = 293·3 ± 94·8 versus 280·0 ± 72·2 N{bullet operator}m, P>0·05). The RFD increased 39-71% at time intervals up to 90 ms from the onset of the contraction (P<0·05), whereas no change occurred at later time intervals. Similarly, relative RFD (i.e.%MVC{bullet operator}s-1) (RFDr) increased 33-56% at time intervals up to 70 ms from the onset of the contraction (P<0·05). It can be concluded that a short period of resistance training performed with concentric fast-velocity isokinetic muscle contractions is able to enhance RFD and RFDr obtained at the early phase of rising muscle force. © 2013 The Authors Clinical Physiology and Functional Imaging © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Resistance training for explosive and maximal strength: Effects on early and late rate of force development

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

Age Affects Exercise-Induced Improvements in Heart Rate Response to Exercise

The aim of the present study was to analyze the effects of age on cardiorespiratory fitness (CRF), muscle strength and heart rate (HR) response to exercise adaptation in women in response to a long-term twice-weekly combined aerobic and resistance exercise program. 85 sedentary women, divided into young (YG; n=22, 30.3±6.2 years), early middle-aged (EMG; n=28, 44.1±2.5 years), late middle-aged (LMG; n=20, 56.7±3.5 years) and older (OG; n=15, 71.4±6.9 years) groups, had their CRF, muscle strength (1-repetition maximum test) and HR response to exercise (graded exercise test) measured before and after 12 months of combined exercise training. Exercise training improved CRF and muscle strength in all age groups (P<0.05), and no significant differences were observed between groups. Exercise training also improved resting HR and recovery HR in YG and EMG (P<0.05), but not in LMG and OG. Maximal HR did not change in any group. Combined aerobic and resistance training at a frequency of 2 days/week improves CRF and muscle strength throughout the lifespan. However, exercise-induced improvements in the HR recovery response to exercise may be impaired in late middle-aged and older women. © Georg Thieme Verlag KG.

Atividade física e lipodistrofia em portadores de HIV/AIDS submetidos à terapia anti-retroviral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Using exercise training to counterbalance chronotropic incompetence and delayed heart rate recovery in systemic lupus erythematosus: a randomized trial

Objective. To evaluate the efficacy of a 3-month exercise training program in counteracting the chronotropic incompetence and delayed heart rate recovery in patients with systemic lupus erythematosus (SLE). Methods. A 12-week randomized trial was conducted. Twenty-four inactive SLE patients were randomly assigned into 2 groups: trained (T; n = 15, 3-month exercise program) and nontrained (NT; n = 13). A sex-, body mass index-, and age-matched healthy control (C) group (n = 8) also underwent the exercise program. Subjects were assessed at baseline and at 12 weeks after training. Main measurements included the chronotropic reserve (CR) and the heart rate (HR) recovery (Delta HRR) as defined by the difference between HR at peak exercise and at both the first (Delta HRR1) and second (Delta HRR2) minutes after the exercise test. Results. Neither the NT SLE patients nor the C group presented any change in the CR or in Delta HRR1 and Delta HRR2 (P > 0.05). The exercise training program was effective in promoting significant increases in CR (P = 0.007, effect size [ES] 1.15) and in Delta HRR1 and Delta HRR2 (P = 0.009, ES 1.12 and P = 0.002, ES 1.11, respectively) in the SLE T group when compared with the NT group. Moreover, the HR response in SLE patients after training achieved parameters comparable to the C group, as evidenced by the analysis of variance and by the Z score analysis (P > 0.05, T versus C). Systemic Lupus Erythematosus Disease Activity Index scores remained stable throughout the study. Conclusion. A 3-month exercise training program was safe and capable of reducing the chronotropic incompetence and the delayed Delta HRR observed in physically inactive SLE patients.

Body changes: antiretroviral therapy and lipodystrophy syndrome in people living with HIV/aids

Objective: to identify the different types of morphological alterations from lipodystrophy syndrome (LS) in outpatients and relate them to the therapeutic regimen used. Method: a cross-sectional study which recruited 60 patients with HIV and LS and 79 without LS, who consented to interview and data collection from their medical notes. Results: the region most affected by lipoatrophy was the face; by lipohypertrophy, the abdomen, and by the mixed form, the alterations to the abdomen, face, and upper and lower limbs. Conclusion: among the therapeutic regimens, that comprised of zidovudine, lamivudine and efavirenz seemed to protect against LS. Nursing can act in the early identification of the changes, as well as providing guidance and support for patients affected by the changes in their body image.

Combined endurance/resistance training early on, after a first myocardial infarction, does not induce negative left ventricular remodelling

BACKGROUND: Resistance training (RT) is safe and practicable in low-risk populations with coronary artery disease. In patients with left ventricular (LV) dysfunction after an acute ischaemic event, few data exist about the impact of RT on LV remodelling. METHODS: In this prospective, randomized, controlled study, 38 patients, after a first myocardial infarction and a maximum ejection fraction (EF) of 45%, were assigned either to combined endurance training (ET)/RT (n=17; 15 men; 54.7+/-9.4 years and EF: 40.3+/-4.5%) or to ET alone (n=21; 17 men; 57.0+/-9.6 years and EF: 41.9+/-4.9%) for 12 weeks. ET was effectuated at an intensity of 70-85% of peak heart rate; RT, between 40 and 60% of the one-repetition maximum. LV remodelling was assessed by MRI. RESULTS: No statistically significant differences between the groups in the changes of end-diastolic volume (P=0.914), LV mass (P=0.885) and EF (P=0.763) were observed. Over 1 year, the end-diastolic volume increased from 206+/-41 to 210+/-48 ml (P=0.379) vs. 183+/-44 to 186+/-52 ml (P=0.586); LV mass from 149+/-28 to 155+/-31 g (P=0.408) vs. 144+/-36 to 149+/-42 g (P=0.227) and EF from 49.1+/-12.3 to 49.3+/-12.0% (P=0.959) vs. 51.5+/-13.1 to 54.1% (P=0.463), in the ET/RT and ET groups, respectively. Peak VO2 and muscle strength increased significantly in both groups, but no difference between the groups was noticed. CONCLUSION: RT with an intensity of up to 60% of the one-repetition maximum, after an acute myocardial infarction, does not lead to a more pronounced LV dilatation than ET alone. A combined ET/RT, or ET alone, for 3 months can both increase the peak VO2 and muscle strength significantly.

A summative evaluation of a HIV/AIDS Early Childhood Care, Education and Development Teacher Training Workshop in Mongu, Zambia

Objective. To conduct a summative evaluation of an Early Childhood Care, Education and Development (ECCED) Teacher Training Workshop in Mongu, Zambia by assessing changes in knowledge, attitudes and intent to use the information. ^ Study design. A matched cohort survey design was used with additional qualitative data collected by structured observation of workshop sessions, daily facilitator and participant debriefs and participant interviews. ^ Results. Matching pre and post tests were completed by 27 individuals in addition to daily debriefs, structured workshop observation and participant interviews with 22% of the group. The participant population was predominantly female individuals aged 15-44 years old that had completed high school and additional post-secondary training, been teaching children aged 0 – 8 years for 2-5 years in the Western Province and received other HIV/AIDS and ECCED education. Pre-tests indicated a strong understanding of ECCED principles and misconceptions regarding HIV transmission, prevention and the disease's impact on early childhood development. The workshop was found to significantly increase the participants' knowledge of topics covered by the curriculum (paired t-test, N=27, p = 0.004, 95% CI 1.8, 8.6). Participants began with a more limited understanding of HIV/AIDS than ECCED, but the mean gain was much greater at 7.4 +/- 12.3 points. Significantly more participants believed at post-test that HIV/AIDS education should increase for future educators. The 77.8% of participants that increased their knowledge scores at post-test expressed significantly less fear of having a child with HIV/AIDS in the classroom (Independent Samples t-test, N= 27, p = 0.011). Overall participant fear decreased 15.5%. 92.6% and 88.9% of participants planned at post-test to respectively use and share the taught information in their daily professional lives and reported on innovative strategies to communicate with the community. ^ Conclusions. Teacher training workshops can significantly increase HIV/AIDS awareness and promote positive attitudes in educators working with children affected by HIV/AIDS. Using participant suggested teaching techniques such as poems and songs and translating the materials to the local language could assist future facilitators to both culturally and professionally relate to the workshop audience as well as increase participant capacity to share the information with the local community. ^

Capitalizing on success against childhood HIV/AIDS in Botswana: Towards a comprehensive healthcare policy for pediatric oncology in Botswana

Pediatric HIV/AIDS in sub-Saharan Africa has been a major public health crisis with an estimated 3.5 million children infected. Baylor International Pediatric AIDS Initiative (BIPAI) has created a network of centers providing care and treatment for these children in several countries. In Botswana, where the first BIPAI center in Africa was opened, childhood mortality from HIV/AIDS is now less than 1%. Botswana is a middle-income country that previously held the highest HIV prevalence rate in the world. Efforts against HIV/AIDS have resulted in the building of a strong medical infrastructure with clear success against pediatric HIV/AIDS. The WHO predicts the next global health crisis will be cancer. Given the increased incidence of cancer in the setting of HIV/AIDS, Botswana has already implemented strategies to combat HIV-related malignancies in adults, but efforts in pediatrics have been lagging. This policy paper describes the importance of building on success against pediatric HIV/AIDS and extending this success to pediatric cancer in general. Specifically, it outlines a comprehensive pediatric cancer policy for the education and training of health professionals, the development of a pediatric cancer program, a pediatric cancer registry, public awareness efforts, and an appropriate, country specific pediatric cancer research agenda.^

Literature review of estimation of prevalence rate of HIV/AIDS in India using population survey and sentinel surveillance based data

HIV/AIDS is a treatable although incurable disease that presents immense challenges to those infected including physical, social and psychological effects. As of 2009, an estimated 2.4 million people were living with HIV or AIDS in India, 0.3% of the country's population. In India, it is difficult to not only treat but also to track because it is associated with socio-economic factors such as illiteracy, social biases, poor sanitation, malnutrition and social class. Nevertheless, it is important to know the prevalence of HIV/AIDS for several reasons. At the individual level, the quality of life of people living with HIV/AIDS is markedly lower than their counterparts without the disease and is associated with challenges. At the community level, it is important to identify high risk groups, monitor prevention efforts, and allocate appropriate resources to target programs for the reduction of transmission of HIV. ^

Risco cardiovascular e sua associação com variáveis demográficas, clínicas e psicossociais em pessoas vivendo com HIV/aids

Trata-se de um estudo analítico de corte transversal, que visa avaliar o risco cardiovascular de PVHA segundo o Escore de Framingham e identificar a associação entre o risco e as variáveis demográficas, comportamentais, psicossociais e clínicas de PVHA. O estudo foi aprovado na Secretaria Municipal de Saúde e no Comitê de Ética da Escola de Enfermagem de Ribeirão Preto, a coleta de dados foi realizada no período de outubro de 2014 a agosto de 2015 em cinco Serviços de Atendimento Especializado às PVHA utilizando questionário sociodemográfico, clínico e comportamental, avaliação da alimentação saudável, Inventário de Sintomas de Stress para Adultos de Lipp e avaliação do risco cardiovascular por meio do Escore de Framingham. A análise dos dados ocorreu através de estatística descritiva e teste de associação entre as variáveis, onde foi adotado nível de significância com valor de p<0,05. Identificou-se que 58,3% pertenciam ao sexo masculino, 69,1% apresentavam idade acima de 40 anos, com média de 44,4 anos, 40,6% referiram ser brancos e 40,0% pardos, e 70,9% eram heterossexuais. Observou-se que 64,0% eram sedentários, 35,4% tabagistas e 40,0% faziam uso de bebida alcóolica regularmente. Do mesmo modo, 73,7% consideraram sua alimentação saudável, no entanto, ao ser avaliado de acordo com o escore da alimentação saudável, 70,9% obtiveram score intermediário para alimentação. Com relação às variáveis psicossociais, foi identificado que 52,0% tinham menos de oito anos de estudo, e 80,6% referiram receber até três salários mínimos por mês. Quanto aos sintomas de estresse, foi visto que 29,1% e 22,3% estavam nas fases de resistência e exaustão, respectivamente. Além disso, identificou-se que 15,4% da amostra tinha diagnóstico médico para depressão e que 71,4% não realizavam atividades de lazer regularmente. Com relação às variáveis clínicas gerais, 57,7% referiram antecedentes familiares para HAS, 40,6% para DM, 21,7% para IAM e 27,4% para AVE. Quanto aos antecedentes pessoais, foi visto que 15,4% eram hipertensos, 8,0% eram diabéticos e 8,0% tinham dislipidemia. Desta mesma amostra, 45,2% apresentavam IMC maior que 25,0 kg/m² e 41,7% estavam em síndrome metabólica. Com relação às variáveis clínicas relacionadas ao HIV, observou-se que 42,2% e 32,0% possuíam o diagnóstico de soropositividade e fazem uso de TARV há mais de dez anos, respectivamente. A contagem de células TCD4+ e carga viral mostrou que 82,8% dos participantes apresentaram contagem maior que 350 cels/mm³, e 80,6% tinham carga viral indetectável. Foi identificado que 25,8% dos sujeitos apresentam risco cardiovascular de médio a alto, segundo o Escore de Framingham. Apenas as variáveis sociodemográficas sexo (p=0,006), idade (p<0,001) e estado civil (p=0,003) apresentaram associação com o risco cardiovascular calculado pelo Escore de Framingham. Nas variáveis comportamentais, as fases de estresse (p=0,039) tiveram associação com o risco cardiovascular, e com relação às variáveis clínicas, antecedentes familiares para DM (p=0,035), HAS, DM e SM (p<0,001) e DLP (p=0,030) apresentaram significância estatística. Nas variáveis clínicas relacionadas ao HIV, o tempo de diagnóstico (p=0,005) e o tempo de TARV (p=0,038) também apresentaram associação. Conclui-se que 25,8% de PVHA no município de Ribeirão Preto apresentam risco cardiovascular de moderado a alto, medido pelo Escore de Framingham