Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: A controlled trial

Aim: The objective of the present study was to investigate the effect of a multimodal exercise intervention on frontal cognitive functions and kinematic gait parameters in patients with Alzheimer's disease. Methods: A sample of elderly patients with Alzheimer's disease (n=27) were assigned to a training group (n=14; aged 78.0±7.3years) and a control group (n=13; aged 77.1±7.4years). Multimodal exercise intervention includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week for 16weeks, and the control participants maintained their regular daily activities during the same period. The frontal cognitive functions were evaluated using the Frontal Assessment Battery, the Clock Drawing Test and the Symbol Search Subtest. The kinematic parameters of gait-cadence, stride length and stride speed were analyzed under two conditions: (i) free gait (single task); and (ii) gait with frontal cognitive task (walking and counting down from 20 - dual task). Results and discussion: The patients in the intervention group significantly increased the scores in frontal cognitive variables, Frontal Assessment Battery (P<0.001) and Symbol Search Subtest (P<0.001) after the 16-week period. The control group decreased the scores in the Clock Drawing Test (P=0.001) and increased the number of counting errors during the dual task (P=0.008) after the same period. Conclusion: The multimodal exercise intervention improved the frontal cognitive functions in patients with Alzheimer's disease. © 2012 Japan Geriatrics Society.

Predição da potência aeróbia (VO 2máx) de crianças e adolescentes em teste incremental na esteira rolante

The maximal oxygen uptake (VO2max) is the maximal quantity of energy that can be produced by the aerobic metabolism in certain time unity. It can be determined direct or indirectly by predictive equations. The objective of this study was to make a specific predictive equation to determine the VO 2max from boys aged 10-16 years-old. Forty-two boys underwent a treadmill running ergospirometric test, with the initial velocity set at 9 km/h, until voluntary exhaustion. By the multiple linear regression was possible to develop the following equation for the indirect determination of the VO 2max: VO2max (ml/min) = -1574.06 + (141.38 x Vpeak) + (48.34 * Body mass), with standard error of estimate = 191.5 ml/min (4.10 ml/kg/min) and coefficient of determination = 0.934. We suggest that this formula is appropriate to predict VO2max for this population.

Aerobic and anaerobic performances in tethered swimming

The purpose of this study was to investigate whether the critical force (CritF) and anaerobic impulse capacity (AIC) - estimated by tethered swimming - reflect the aerobic and anaerobic performance of swimmers. 12 swimmers performed incremental test in tethered swimming to determine lactate anaerobic threshold (AnTLAC), maximal oxygen uptake (̇VO2MAX) and force associated with the ̇VO2MAX (i ̇VO2MAX). The swimmers performed 4 exhaustive (tlim) exercise bouts (100, 110, 120 and 130% i ̇VO2MAX) to compute the CritF and AIC (F vs. 1/tlim model); a 30-s all-out tethered swimming bout to determine their anaerobic fitness (ANF); 100, 200, and 400-m time-trials to determine the swimming performance. CritF (57.09±11.77 N) did not differ from AnTLAC (53.96±11.52 N, (P>0.05) but was significantly lower than i ̇VO2MAX (71.02±8.36 N). In addition, CritF presented significant correlation with AnTLAC (r=0.76; P<0.05) and i ̇VO2MAX (r=0.74; P<0.05). On the other hand, AIC (286.19±54.91 N.s) and ANF (116.10±13.66 N) were significantly correlated (r=0.81, p<0.05). In addition, CritF and AIC presented significant correlations with all time-trials. In summary, this study demonstrates that CritF and AIC can be used to evaluate AnTLAC and ANF and to predict 100, 200, and 400-m free swimming. © Georg Thieme Verlag KG Stuttgart . New York.

Acute exercise decreases PTP-1B protein level and improves insulin signaling in the liver of old rats

It is now commonly accepted that chronic inflammation associated with obesity during aging induces insulin resistance in the liver. In the present study, we investigated whether the improvement in insulin sensitivity and insulin signaling, mediated by acute exercise, could be associated with modulation of protein-tyrosine phosphatase 1B (PTP-1B) in the liver of old rats. Aging rats were subjected to swimming for two 1.5-h long bouts, separated by a 45 min rest period. Sixteen hours after the exercise, the rats were sacrificed and proteins from the insulin signaling pathway were analyzed by immunoblotting. Our results show that the fat mass was increased in old rats. The reduction in glucose disappearance rate (Kitt) observed in aged rats was restored 16 h after exercise. Aging increased the content of PTP-1B and attenuated insulin signaling in the liver of rats, a phenomenon that was reversed by exercise. Aging rats also increased the IRβ/PTP-1B and IRS-1/PTP-1B association in the liver when compared with young rats. Conversely, in the liver of exercised old rats, IRβ/PTP-1B and IRS-1/PTP-1B association was markedly decreased. Moreover, in the hepatic tissue of old rats, the insulin signalling was decreased and PEPCK and G6Pase levels were increased when compared with young rats. Interestingly, 16 h after acute exercise, the PEPCK and G6Pase protein level were decreased in the old exercised group. These results provide new insights into the mechanisms by which exercise restores insulin signalling in liver during aging. © 2013 Moura et al; licensee BioMed Central Ltd.

Estimation of the metabolic equivalent (MET) of an exercise protocol based on indirect calorimetry

Objective: This study aimed to determine the energy expenditure (EE) in terms of caloric cost and metabolic equivalents (METs) of two sessions of an exercise protocol. Methods: Fifteen subjects (51.0 ± 5.5years) performed the exercise sessions (80min), which were composed by (warming, walking and flexibility exercises; Session A) and (warming, walking and local muscular endurance exercises; Session B). Heart hate (HR) was measured during each part of the sessions. In laboratory environment, maximal oxygen consumption (VO2max) and oxygen uptake in rest and exercise conditions (using mean HR obtained in classes) were measured on different days, using indirect calorimetry. Exercise METs were obtained by dividing VO2 in exercise (mL.kg-1.min-1) by VO2 in rest (mL.kg-1.min-1). The EE of the exercises was calculated by the formula: MET x Weight(kg) x Time(min)/60. The results were analyzed by ANOVA with Tuckey post hoc test (p < 0.05). Results: One MET for this group was 2.7 ± 0.1mL.kg-1.min-1. The mean METs of exercises were 4,7 ± 0,8 (warming), 5,8 ± 0,9 (walking) and 3,6 ± 0,7 (flexibility) on session A, and 4,6 ± 1,2 (warming), 5,6 ± 1,0 (walking) and 4.8 ± 1,0 (local muscular endurance exercises) on Session B. The training sessions showed similar energy cost (A: 398 ± 86.72 kcal and B: 404 ± 38.85 kcal; p > 0,05). None of activities were classified into vigorous intensity (> 7 METs). There were no differences on VO2 between walking (15,6 ± 2,8 or 15,4 ± 2,6 mL.kg-1.min-1) and local muscular endurance exercises (13,2 ± 2,9 mL.kg-1.min-1), although both were higher (p > 0.05) than flexibility exercises (10.1 ± 2.2 mL.kg-1.min-1). Conclusion: The proposed protocol achieves the physical activity needed by healthy adults to improve and maintain health, by their structure, moderate intensity, duration, frequency and caloric expenditure.

Recovery of pulmonary structure and exercise capacity by treatment with granulocyte-colony stimulating factor (G-CSF) in a mouse model of emphysema

Emphysema is a chronic obstructive pulmonary disease characterized abnormal dilatation of alveolar spaces, which impairs alveolar gas exchange, compromising the physical capacity of a patient due to airflow limitations. Here we tested the effects of G-CSF administration in pulmonary tissue and exercise capacity in emphysematous mice. C57Bl/6 female mice were treated with elastase intratracheally to induce emphysema. Their exercise capacities were evaluated in a treadmill. Lung histological sections were prepared to evaluate mean linear intercept measurement. Emphysematous mice were treated with G-CSF (3 cycles of 200 μg/kg/day for 5 consecutive days, with 7-day intervals) or saline and submitted to a third evaluation 8 weeks after treatment. Values of run distance and linear intercept measurement were expressed as mean ± SD and compared applying a paired t-test. Effects of treatment on these parameters were analyzed applying a Repeated Measures ANOVA, followed by Tukey's post hoc analysis. p < 0.05 was considered statistically significant. Twenty eight days later, animals ran significantly less in a treadmill compared to normal mice (549.7 ± 181.2 m and 821.7 ± 131.3 m, respectively; p < 0.01). Treatment with G-CSF significantly increased the exercise capacity of emphysematous mice (719.6 ± 200.5 m), whereas saline treatment had no effect on distance run (595.8 ± 178.5 m). The PCR cytokines genes analysis did not detect difference between experimental groups. Morphometric analyses in the lung showed that saline-treated mice had a mean linear intercept significantly higher (p < 0.01) when compared to mice treated with G-CSF, which did not significantly differ from that of normal mice. Treatment with G-CSF promoted the recovery of exercise capacity and regeneration of alveolar structural alterations in emphysematous mice. © 2013.

Comparison of the lactate minimum speed and the maximal lactate steady state to determine aerobic capacity in purebred Arabian horses

AIM: To compare five different protocols for estimating the lactate minimum speed (LMS) with that for estimating the maximal lactate steady state (MLSS) in Arabian horses, in order to obtain a more rapid method for monitoring aerobic capacity and prescribing training schedules. METHODS: Eight purebred Arabian horses were conditioned to exercise on a treadmill for 12 days then submitted to three to five exercise sessions to determine the MLSS. Blood samples were collected from a jugular catheter at specific intervals for measurement of lactate concentrations. The MLSS was the velocity maintained during the last 20 minutes of constant submaximal exercise, at which the concentration of lactate increased by no more than 1.0 mmol/L. The LMS test protocols (P1 - P5) included a warm-up period followed by a high-intensity gallop. The speed was then reduced to 4 m/s, and the incremental portion of the test was initiated. In P1, P2, and P3, the velocity increment was 0.5 m/s, and the duration of each incremental stage was three, five and seven minutes, respectively. In P4 and P5, the velocity increments were 1.0 and 1.5 m/s, respectively, and the duration of the stages was fixed at five minutes each. A second-degree polynomial function was fitted to the lactate-velocity curve, and the velocity corresponding to the lowest concentration of lactate was the LMS. RESULTS: Only the mean LMS determined by P1 and P2 did not differ from the velocity determined by the MLSS test (p > 0.1). There was a strong correlation (r >0.6) between P1 and the MLSS velocity. A limits of agreement plot revealed that the best agreement occurred between the MLSS test and P1 (mean bias = 0.14 m/s), followed by P2 (bias = -0.22 m/s). The lactate concentrations associated with the various LMS protocols did not differ. CONCLUSIONS: This study shows the variation between protocols of the LMS test for determining the onset of blood lactate accumulation but also reveals that, at least for Arabian horses, the P1 protocol of the LMS has good agreement with the MLSS. © 2013 Copyright New Zealand Veterinary Association.

Relationship between running intensity, muscle activation, and stride kinematics during an incremental protocol

Objective: To analyze the effect of running intensity on stride length (SL), stride frequency (SF), stride time (ST) and the electromyographic signal of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), tibialis anterior (TA), biceps femoris (BF) and gastrocnemius lateralis (GL) muscles. Methods: Nine well-trained runners performed an incremental protocol with an initial velocity of 10km.h-1, and increments of 1km.h-1 every 3minutes until exhaustion. The electromyographic activity, SL, SF, ST, inter-stride coefficient of variation, and association between kinematic and electromyographic parameters were calculated at 60%, 80% and 100% of maximum running velocity. Results: SL, SF and electromyographic activity of the RF, VM, VL and GL increased and the ST decreased with increased running speed. Electromyographic variability of VL and VM was higher than GL, and variability was lower in TA than all other muscles. The inter-stride variability of muscle activation was associated with kinematic parameters, and their variability, differently as running speed increased. Conclusion: The incremental protocol increased electromyographic activity differently among lower limb muscles; increased SF and SL, and decreased ST, without changing the variability of these variables. Muscle activation variability was correlated with kinematic parameters, but the relationships among these measures varied with running intensity. © 2013 .

Effects of square-stepping exercise on cognitive functions of older people

Aim: Cognitive functions can decline with age, and interventions focusing on stimulating them may have positive results. Previous studies have shown that square-stepping exercise (SSE) has a good influence on balance, but this exercise also seems to promote cognitive stimulation. Therefore, the purpose of the present study was to analyse the effect of 16 weeks of SSE on cognitive functions in non-demented community-dwelling older people. Methods: This was a longitudinal, non-randomized study. Forty-one older adults (60 years and older) were recruited, and 21 participated in the SSE group (practised only SSE sequences) and 20 were in the control group (continued with their activities of daily living). Both groups were evaluated using the Mini-Mental State Examination, the Digit Span test, the Toulouse-Pierón Attention Test and the Modified Card Sorting Test. Results: The SSE group showed a significant improvement in global cognitive status, concentrated attention and mental flexibility after 16 weeks of the SSE intervention. Conclusion: Evidence shows that SSE is a physical activity that positively influences cognitive functions in non-demented older people. © 2013 Japanese Psychogeriatric Society.

Diastolic function is associated with quality of life and exercise capacity in stable heart failure patients with reduced ejection fraction

Exercise capacity and quality of life (QOL) are important outcome predictors in patients with systolic heart failure (HF), independent of left ventricular (LV) ejection fraction (LVEF). LV diastolic function has been shown to be a better predictor of aerobic exercise capacity in patients with systolic dysfunction and a New York Heart Association (NYHA) classification >II. We hypothesized that the currently used index of diastolic function E/e' is associated with exercise capacity and QOL, even in optimally treated HF patients with reduced LVEF. This prospective study included 44 consecutive patients aged 55±11 years (27 men and 17 women), with LVEF,0.50 and NYHA functional class I-III, receiving optimal pharmacological treatment and in a stable clinical condition, as shown by the absence of dyspnea exacerbation for at least 3 months. All patients had conventional transthoracic echocardiography and answered the Minnesota Living with HF Questionnaire, followed by the 6-min walk test (6MWT). In a multivariable model with 6MWT as the dependent variable, age and E/e' explained 27% of the walked distance in 6MWT (P=0.002; multivariate regression analysis). No association was found between walk distance and LVEF or mitral annulus systolic velocity. Only normalized left atrium volume, a sensitive index of diastolic function, was associated with decreased QOL. Despite the small number of patients included, this study offers evidence that diastolic function is associated with physical capacity and QOL and should be considered along with ejection fraction in patients with compensated systolic HF.

Influência da seleção dos estágios incrementais sobre a intensidade de lactato mínimo: Estudo piloto

The purposes of this study were to assess the influence of stage selection from the incremental phase and the use of peak lactate after hyperlactatemia induction on the determination of the lactate minimum intensity (iLACmin). Twelve moderately active university students (23±5 years, 78.3±14.1 kg, 175.3±5.1 cm) performed a maximal incremental test to determine the respiratory compensation point (RCP) (initial intensity at 70 W and increments of 17.5 W every 2 minutes) and a lactate minimum test (induction with the Wingate test, the incremental test started at 30 W below RCP with increments of 10 W every 3 minutes) on a cycle ergometer. The iLACmin was determined using second order polynomial adjustment applying five exercise stage selection: 1) using all stages (iLACmin P); 2) using all stages below and two stages above iLACminP(iLACminA); 3) using two stages below and all stages above iLACminP(iLACminB); 4) using the largest and same possible number of stages below and above the iLACminP(iLACminI); 5) using all stages and peak lactate after hyperlactatemia induction (iLACminD). No differences were found between the iLACminP(138.2±30.2 W), iLACminA(139.1±29.1 W), iLACminB(135.3±14.2 W), iLACminI(138.6±20.5 W) and iLACmiD(136.7±28.5 W) protocols, and a high level of agreement between these intensities and iLACminPwas observed. Oxygen uptake, heart rate, rating of perceived exertion and lactate corresponding to these intensities was not different and was strongly correlated. However, the iLACminBpresented the lowest success rate (66.7%). In conclusion, stage selection did not influence the determination of iLACmin but modified the success rate. © Creative Commom.

Validation of the lactate minimum test as a specific aerobic evaluation protocol for table tennis players

The purpose of this study was to validate the lactate minimum test as a specific aerobic evaluation protocol for table tennis players. Using the frequency of 72 balls·min-1 for 90 sec, an exercise-induced metabolic acidosis was determined in 8 male table tennis players. The evaluation protocol began with a frequency of 40 balls·min-1 followed by an increase of 8 balls·min-1 every 3 min until exhaustion. The mean values that corresponded to the subjects' lactate minimum (Lacmin) were equal to 53.1 ± 1.5 balls·min-1 [adjusted for the time test (Lacmin_time)] and 51.6 ± 1.6 balls·min-1 [adjusted for the frequency of balls (Lacmin_Freq)], which resulted in a high correlation between the two forms of adjustment (r = 0.96 and (P = 0.01). The mean maximum lactate steady state (MLSS) was 52.6 ± 1.6 balls·min-1. Pearson's correlations between Lacmin_time vs. MLSS and Lacmin_freq vs. MLSS were statistically significant (P = 0.03 and r = 0.86, P = 0.03 and r = 0.85, respectively). These findings indicate that the Lacmin test predicts MLSS. Therefore, it is an excellent method to obtain the athletes' anaerobic threshold. Also, there is the advantage that it can be performed in 1 day in the game area. However, the Lacmin value does not depend on the Lacpeak value.

Test-retest reliability of a 3-min isokinetic all-out test using two different cadences

Objectives: To investigate the test-retest reliability of mechanical parameters derived from a 3-min isokinetic all-out test, performed at 60 and 100 rpm. Reliability and validity of the peak oxygen uptake derived from 3-min isokinetic all-out test were also tested. Design: 14 healthy male subjects completed an incremental ramp testing and four randomized 3-min isokinetic all-out test (two at 60 rpm and two at 100 rpm). Methods: The absolute and relative reliability of the following parameters were analyzed: peak power, mean power, end power, fatigue index, work performed above end power and peak oxygen uptake. Results: No difference was found between each two sets of data, although there were between-cadence differences for peak power, mean power, end power, and fatigue index. Higher intra-class correlation (ICC) and lower coefficient of variation (CV) were found for end power (ICC = 0.91 and 0.95; CV = 5.6 and 5.7%) and mean power (ICC = 0.97 and 0.98; CV = 2.4 and 3.1%), than for peak power (ICC = 0.81 and 0.84; CV = 8.7 and 10%) and work performed above end power (ICC = 0.79 and 0.84; CV = 7.9 and 10.6%; values reported for 60 rpm and 100 rpm, respectively). High reliability scores were also observed for peak oxygen uptake at both cadences (60 rpm, CV = 3.2%; 100 rpm, CV = 2.3%,) with no difference with the incremental ramp testing peak oxygen uptake. Conclusions: The power profile and peak oxygen uptake of a 3-min isokinetic all-out test are both highly reliable, whether the test is performed at 60 or 100 rpm. Besides, peak oxygen uptake and work performed above end power were not affected by the change in cadence while peak power, mean power, end power, and fatigue index were. © 2013.

Relação entre parâmetros fisiológicos aeróbios e anaeróbios com o desempenho de ciclistas

Pós-graduação em Fisioterapia - FCT

Influência do square stepping exercise nos componentes da capacidade funcional e funções cognitivas de idosos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)