Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial

Background: Currently 1 in 11 women over the age of 60 in Australia are diagnosed with breast cancer. Following treatment, most breast cancer patients are left with shoulder and arm impairments which can impact significantly on quality of life and interfere substantially with activities of daily living. The primary aim of the proposed study is to determine whether upper limb impairments can be prevented by undertaking an exercise program of prolonged stretching and resistance training, commencing soon after surgery. Methods/design: We will recruit 180 women who have had surgery for early stage breast cancer to a multicenter single-blind randomized controlled trial. At 4 weeks post surgery, women will be randomly assigned to either an exercise group or a usual care ( control) group. Women allocated to the exercise group will perform exercises daily, and will be supervised once a week for 8 weeks. At the end of the 8 weeks, women will be given a home-based training program to continue indefinitely. Women in the usual care group will receive the same care as is now typically provided, i.e. a visit by the physiotherapist and occupational therapist while an inpatient, and receipt of pamphlets. All subjects will be assessed at baseline, 8 weeks, and 6 months later. The primary measure is arm symptoms, derived from a breast cancer specific questionnaire (BR23). In addition, range of motion, strength, swelling, pain and quality of life will be assessed. Discussion: This study will determine whether exercise commencing soon after surgery can prevent secondary problems associated with treatment of breast cancer, and will thus provide the basis for successful rehabilitation and reduction in ongoing problems and health care use. Additionally, it will identify whether strengthening exercises reduce the incidence of arm swelling. Trial Registration: The protocol for this study is registered with the Australian Clinical Trials Registry (ACTRN012606000050550).

Investigating the Outcomes of a Physical Activity Program offered to Older Adults in South Florida and Understanding the Correlates of Completion

Despite the well-known benefits of physical activity, in 2012, only 37.5% of older adults aged 60 years or older met recommended aerobic physical activity levels and 16.1% met muscle-strengthening guidelines. Effective exercise programs can help combat the problem of inactivity but 50% of those who start participating in an exercise program drop out within first few weeks, preventing them from gaining any health benefits. Since fall 2008, the Healthy Aging Regional Collaborative of South Florida has offered EnhanceFitness (EF), an evidence-based physical activity program to older adults. This dissertation compared EF effectiveness at 4-, 8-, and 12-months and examined the factors that were associated with program completion. A paired sample t-test identified changes at 4-months and repeated measures design was used to identify changes from baseline to 4-, 8-, and 12- months. Logistic regression was used to identify correlates associated with completion. Between October 1, 2008 and December 31, 2012, 4,531 older adults (>=60 years) attended one or more EF sessions. Participants showed significant improvement in the number of chair stands performed in 30-seconds with mean change of 1.7, 1.6, and 2.0 respectively at 4-,8-,and 12- months (pp<0.001). Results suggest Black, non-Haitian men were less likely to complete the program when compared to white, non-Hispanic men (OR=0.41, p=0.02). Men who self-reported having at least one risk factor were more likely to complete the program (OR=1.81, p= 0.03). In addition, women who lived in Miami-Dade County (OR=2.13, ppppp<0.01). Effectiveness results revealed that all participants improved on outcome measures. However, improvement is more than double for those who completed recommended sessions (p

Impacto do exercício físico na qualidade de vida e do sono em pessoas vivendo com HIV/AIDS

The increased incidence along to new therapies for the treatment of HIV/AIDS bring way up exercise as a treatment option, as this promotes relevant changes in the general functioning of the body. The objective of this study was to evaluate in different periods the influence of exercise on quality of life and quality of sleep people living with HIV/AIDS, Natal/RN. The sample consisted of 17 people living with HIV/AIDS participating in physical exercise program, along accompanied by 25 months during the period January 2013 to April 2015. We evaluated through specific instruments quality of life, sleep quality and immunological parameters, which were evaluated before starting the exercise program and reassessed during periods of 2-4 months (short), 5-17 months (average period or intermediate) and finally to 19-25 months (long period). The results showed significant differences in five of the nine areas of quality life, pointing positive behaviors, specifically in the areas overall function, life satisfaction, health concerns, concerns about the medication and acceptance to HIV. We conclude that physical exercise promoted benefits both in short and long term, especially for the areas of quality of life of people living with HIV/AIDS and also demonstrated positive behavior changes and to aspects of sleep quality.

Expertise sportive et entraînement perceptivo-cognitif de l’athlète

Pour être performant au plus haut niveau, les athlètes doivent posséder une capacité perceptivo-cognitive supérieure à la moyenne. Cette faculté, reflétée sur le terrain par la vision et l’intelligence de jeu des sportifs, permet d’extraire l’information clé de la scène visuelle. La science du sport a depuis longtemps observé l’expertise perceptivo-cognitive au sein de l’environnement sportif propre aux athlètes. Récemment, des études ont rapporté que l’expertise pouvait également se refléter hors de ce contexte, lors d’activités du quotidien par exemple. De plus, les récentes théories entourant la capacité plastique du cerveau ont amené les chercheurs à développer des outils pour entraîner les capacités perceptivo-cognitives des athlètes afin de les rendre plus performants sur le terrain. Ces méthodes sont la plupart du temps contextuelles à la discipline visée. Cependant, un nouvel outil d’entraînement perceptivo-cognitif, nommé 3-Dimensional Multiple Object Tracking (3D-MOT) et dénué de contexte sportif, a récemment vu le jour et a fait l’objet de nos recherches. Un de nos objectifs visait à mettre en évidence l’expertise perceptivo-cognitive spécifique et non-spécifique chez des athlètes lors d’une même étude. Nous avons évalué la perception du mouvement biologique chez des joueurs de soccer et des non-athlètes dans une salle de réalité virtuelle. Les sportifs étaient systématiquement plus performants en termes d’efficacité et de temps de réaction que les novices pour discriminer la direction du mouvement biologique lors d’un exercice spécifique de soccer (tir) mais également lors d’une action issue du quotidien (marche). Ces résultats signifient que les athlètes possèdent une meilleure capacité à percevoir les mouvements biologiques humains effectués par les autres. La pratique du soccer semble donc conférer un avantage fondamental qui va au-delà des fonctions spécifiques à la pratique d’un sport. Ces découvertes sont à mettre en parallèle avec la performance exceptionnelle des athlètes dans le traitement de scènes visuelles dynamiques et également dénuées de contexte sportif. Des joueurs de soccer ont surpassé des novices dans le test de 3D-MOT qui consiste à suivre des cibles en mouvement et stimule les capacités perceptivo-cognitives. Leur vitesse de suivi visuel ainsi que leur faculté d’apprentissage étaient supérieures. Ces résultats confirmaient des données obtenues précédemment chez des sportifs. Le 3D-MOT est un test de poursuite attentionnelle qui stimule le traitement actif de l’information visuelle dynamique. En particulier, l’attention sélective, dynamique et soutenue ainsi que la mémoire de travail. Cet outil peut être utilisé pour entraîner les fonctions perceptivo-cognitives des athlètes. Des joueurs de soccer entraînés au 3D-MOT durant 30 sessions ont montré une amélioration de la prise de décision dans les passes de 15% sur le terrain comparés à des joueurs de groupes contrôles. Ces données démontrent pour la première fois un transfert perceptivo-cognitif du laboratoire au terrain suivant un entraînement perceptivo-cognitif non-contextuel au sport de l’athlète ciblé. Nos recherches aident à comprendre l’expertise des athlètes par l’approche spécifique et non-spécifique et présentent également les outils d’entraînements perceptivo-cognitifs, en particulier le 3D-MOT, pour améliorer la performance dans le sport de haut-niveau.

Graded Exercise Therapy Guided Self-Help Trial for Patients with Chronic Fatigue Syndrome (GETSET): Protocol for a Randomized Controlled Trial and Interview Study

Background: Chronic fatigue syndrome, also known as myalgic encephalomyelitis (CFS/ME), is characterized by chronic disabling fatigue and other symptoms, which are not explained by an alternative diagnosis. Previous trials have suggested that graded exercise therapy (GET) is an effective and safe treatment. GET itself is therapist-intensive with limited availability. Objective: While guided self-help based on cognitive behavior therapy appears helpful to patients, Guided graded Exercise Self-help (GES) is yet to be tested. Methods: This pragmatic randomized controlled trial is set within 2 specialist CFS/ME services in the South of England. Adults attending secondary care clinics with National Institute for Health and Clinical Excellence (NICE)-defined CFS/ME (N=218) will be randomly allocated to specialist medical care (SMC) or SMC plus GES while on a waiting list for therapist-delivered rehabilitation. GES will consist of a structured booklet describing a 6-step graded exercise program, supported by up to 4 face-to-face/telephone/Skype™ consultations with a GES-trained physiotherapist (no more than 90 minutes in total) over 8 weeks. The primary outcomes at 12-weeks after randomization will be physical function (SF-36 physical functioning subscale) and fatigue (Chalder Fatigue Questionnaire). Secondary outcomes will include healthcare costs, adverse outcomes, and self-rated global impression change scores. We will follow up all participants until 1 year after randomization. We will also undertake qualitative interviews of a sample of participants who received GES, looking at perceptions and experiences of those who improved and worsened. Results: The project was funded in 2011 and enrolment was completed in December 2014, with follow-up completed in March 2016. Data analysis is currently underway and the first results are expected to be submitted soon. Conclusions: This study will indicate whether adding GES to SMC will benefit patients who often spend many months waiting for rehabilitative therapy with little or no improvement being made during that time. The study will indicate whether this type of guided self-management is cost-effective and safe. If this trial shows GES to be acceptable, safe, and comparatively effective, the GES booklet could be made available on the Internet as a practitioner and therapist resource for clinics to recommend, with the caveat that patients also be supported with guidance from a trained physiotherapist. The pragmatic approach in this trial means that GES findings will be generalizable to usual National Health Service (NHS) practice.

Remolding a company through a compliance program : the case of Siemens

Abstract : Since at least the 1980's, a growing number of companies have set up an ethics or a compliance program within their organization. However, in the field of study of business management, there is a paucity of research studies concerning these management systems. This observation warranted the present investigation of one company's compliance program. Compliance programs are set up so that individuals working within an organization observe the laws and regulations which pertain to their work. This study used a constructivist grounded theory methodology to examine the process by which a specific compliance program, that of Siemens Canada Limited, was implemented throughout its organization. In conformity with this methodology, instead of proceeding with the investigation in accordance to a particular theoretical framework, the study established a number of theoretical constructs used strictly as reference points. The study's research question was stated as: what are the characteristics of the process by which Siemens' compliance program integrated itself into the existing organizational structure and gained employee acceptance? Data consisted of documents produced by the company and of interviews done with twenty-four managers working for Siemens Canada Limited. The researcher used QSR-Nvivo computer assisted software to code transcripts and to help with analyzing interviews and documents. Triangulation was done by using a number of analysis techniques and by constantly comparing findings with extant theory. A descriptive model of the implementation process grounded in the experience of participants and in the contents of the documents emerged from the data. The process was called "Remolding"; remolding being the core category having emerged. This main process consisted of two sub-processes identified as "embedding" and "appraising." The investigation was able to provide a detailed account of the appraising process. It identified that employees appraised the compliance program according to three facets: the impact of the program on the employee's daily activities, the relationship employees have with the local compliance organization, and the relationship employees have with the corporate ethics identity. The study suggests that a company who is entertaining the idea of implementing a compliance program should consider all three facets. In particular, it suggests that any company interested in designing and implementing a compliance program should pay particular attention to its corporate ethics identity. This is because employee's acceptance of the program is influenced by their comparison of the company's ethics identity to their local ethics identity. Implications of the study suggest that personnel responsible for the development and organizational support of a compliance program should understand the appraisal process by which employees build their relationship with the program. The originality of this study is that it points emphatically that companies must pay special attention in developing a corporate ethics identify which is coherent, well documented and well explained.

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes

Objectives: Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic + resistance + agility/balance + flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. Methods: This was a non-experimental pre-post evaluation study. Participants (N = 43; 62.92 ± 5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70 min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Results: Significant improvements in the performance of the 6-Minute Walk Test (Δ = 8.20%, p < 0.001), 30-Second Chair Stand Test (Δ = 28.84%, p < 0.001), Timed Up and Go Test (Δ = 14.31%, p < 0.001), and Chair Sit and Reach Test (Δ = 102.90%, p < 0.001) were identified between baseline and end-exercise intervention time points. Conclusions: A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.

Expertise sportive et entraînement perceptivo-cognitif de l’athlète

Pour être performant au plus haut niveau, les athlètes doivent posséder une capacité perceptivo-cognitive supérieure à la moyenne. Cette faculté, reflétée sur le terrain par la vision et l’intelligence de jeu des sportifs, permet d’extraire l’information clé de la scène visuelle. La science du sport a depuis longtemps observé l’expertise perceptivo-cognitive au sein de l’environnement sportif propre aux athlètes. Récemment, des études ont rapporté que l’expertise pouvait également se refléter hors de ce contexte, lors d’activités du quotidien par exemple. De plus, les récentes théories entourant la capacité plastique du cerveau ont amené les chercheurs à développer des outils pour entraîner les capacités perceptivo-cognitives des athlètes afin de les rendre plus performants sur le terrain. Ces méthodes sont la plupart du temps contextuelles à la discipline visée. Cependant, un nouvel outil d’entraînement perceptivo-cognitif, nommé 3-Dimensional Multiple Object Tracking (3D-MOT) et dénué de contexte sportif, a récemment vu le jour et a fait l’objet de nos recherches. Un de nos objectifs visait à mettre en évidence l’expertise perceptivo-cognitive spécifique et non-spécifique chez des athlètes lors d’une même étude. Nous avons évalué la perception du mouvement biologique chez des joueurs de soccer et des non-athlètes dans une salle de réalité virtuelle. Les sportifs étaient systématiquement plus performants en termes d’efficacité et de temps de réaction que les novices pour discriminer la direction du mouvement biologique lors d’un exercice spécifique de soccer (tir) mais également lors d’une action issue du quotidien (marche). Ces résultats signifient que les athlètes possèdent une meilleure capacité à percevoir les mouvements biologiques humains effectués par les autres. La pratique du soccer semble donc conférer un avantage fondamental qui va au-delà des fonctions spécifiques à la pratique d’un sport. Ces découvertes sont à mettre en parallèle avec la performance exceptionnelle des athlètes dans le traitement de scènes visuelles dynamiques et également dénuées de contexte sportif. Des joueurs de soccer ont surpassé des novices dans le test de 3D-MOT qui consiste à suivre des cibles en mouvement et stimule les capacités perceptivo-cognitives. Leur vitesse de suivi visuel ainsi que leur faculté d’apprentissage étaient supérieures. Ces résultats confirmaient des données obtenues précédemment chez des sportifs. Le 3D-MOT est un test de poursuite attentionnelle qui stimule le traitement actif de l’information visuelle dynamique. En particulier, l’attention sélective, dynamique et soutenue ainsi que la mémoire de travail. Cet outil peut être utilisé pour entraîner les fonctions perceptivo-cognitives des athlètes. Des joueurs de soccer entraînés au 3D-MOT durant 30 sessions ont montré une amélioration de la prise de décision dans les passes de 15% sur le terrain comparés à des joueurs de groupes contrôles. Ces données démontrent pour la première fois un transfert perceptivo-cognitif du laboratoire au terrain suivant un entraînement perceptivo-cognitif non-contextuel au sport de l’athlète ciblé. Nos recherches aident à comprendre l’expertise des athlètes par l’approche spécifique et non-spécifique et présentent également les outils d’entraînements perceptivo-cognitifs, en particulier le 3D-MOT, pour améliorer la performance dans le sport de haut-niveau.

Investigating the outcomes of a physical activity program offered to older adults in South Florida and understanding the correlates of completion

Despite the well-known benefits of physical activity, in 2012, only 37.5% of older adults aged 60 years or older met recommended aerobic physical activity levels and 16.1% met muscle-strengthening guidelines. Effective exercise programs can help combat the problem of inactivity but 50% of those who start participating in an exercise program drop out within first few weeks, preventing them from gaining any health benefits. Since fall 2008, the Healthy Aging Regional Collaborative of South Florida has offered EnhanceFitness (EF), an evidence-based physical activity program to older adults. This dissertation compared EF effectiveness at 4-, 8-, and 12-months and examined the factors that were associated with program completion. A paired sample t-test identified changes at 4-months and repeated measures design was used to identify changes from baseline to 4-, 8-, and 12- months. Logistic regression was used to identify correlates associated with completion.^ Between October 1, 2008 and December 31, 2012, 4,531 older adults (>=60 years) attended one or more EF sessions. Participants showed significant improvement in the number of chair stands performed in 30-seconds with mean change of 1.7, 1.6, and 2.0 respectively at 4-,8-,and 12- months (p<0.001). Results suggest Black, non-Haitian men were less likely to complete the program when compared to white, non-Hispanic men (OR=0.41, p=0.02). Men who self-reported having at least one risk factor were more likely to complete the program (OR=1.81, p= 0.03). In addition, women who lived in Miami-Dade County (OR=2.13, p<0.001) and were 80 years or older (OR=1.46, p<0.05) were more likely to complete the program. When compared with non-Hispanic whites, Black women were less likely to complete the program (OR=0.613, p<0.01). Women who did not report depression were 1.6 times more likely to complete the program (OR=1.62, p<0.05). Absence of risk factors for chronic conditions increased completion rates among women (OR=1.63, p<0.01).^ Effectiveness results revealed that all participants significantly improved on all outcome measures. However, improvement is more than double for those who completed recommended sessions (p<0.01). Study findings reaffirm the successful translation of EF in community-based settings. Our findings suggest that participants should attend the minimum recommended sessions to attain greater health benefits.^

Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

Exercise intervention in pediatric patients with solid tumors: The PAPEC trial

The randomized controlled trial ‘Physical Activity in Pediatric Cancer’ (PAPEC) determined the effects of an in-hospital exercise intervention combining aerobic and muscle strength training on pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy. Methods. Participants were allocated to an exercise (n=24, 17 boys; mean±SEM age 10±1y) or control group (n=25, 18 boys; 11±1y). Training included three sessions/week for 19±2 weeks. Participants were assessed at treatment initiation, termination, and two months after end-treatment. The primary endpoint was muscle strength (as assessed by upper and lower-body five-repetition-maximum (5RM) tests). Secondary endpoints included cardiorespiratory fitness, functional capacity during daily life activities, physical activity, body mass and body mass index, and quality of life. Results. Most sessions were performed in the hospital’s gymnasium. Adherence to the program averaged 68±4% and no major adverse events or health issues were noted. A significant interaction (group*time) effect was found for all 5RM tests. Performance significantly increased after training (leg press: 40% (95% CI=15–41 kg); bench press: 24% (95% CI=6–14 kg); lateral row 25% (95%CI=6–15 kg)), whereas an opposite trend was found in controls. Two-month post values tended to be higher than baseline for leg (P=0.017) and bench press (P=0.014). In contrast, no significant interaction effect was found for any of the secondary endpoints. Conclusion. An in-hospital exercise program for pediatric cancer patients with solid tumors undergoing neoadjuvant treatment increases muscle strength despite the aggressiveness of such therapy. Key words: Cancer, exercise, muscle strength, fitness, quality of life.

Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

El ejercicio y el desempeño musical: doce semanas de actividad física mejoran la capacidad de ejecución de un instrumento musical en estudiantes de conservatorio

Con el fin de evaluar los cambios que produce un programa de actividad física en la percepción que tienen los músicos sobre su capacidad de ejecución de un instrumento musical, se realizó una intervención con un programa de actividad física basado en la técnica Pilates, durante 12 semanas, en el Conservatorio de Música de la Universidad Nacional de Colombia, con estudiantes del programa de música instrumental. Se midieron parámetros de la aptitud física (capacidad cardiorrespiratoria, fuerza, flexibilidad y composición corporal) y de la percepción de la capacidad de ejecución (fatiga muscular, nivel de esfuerzo, dolor y fluidez) antes y después de la intervención. Los resultados arrojaron cambios positivos en la aptitud física logrando un aumento significativo en la flexibilidad y resistencia de los miembros inferiores en 14 participantes (70% de la muestra), y en la percepción de la capacidad de ejecución instrumental con el retraso en la aparición de la fatiga muscular mientras se está ejecutando el instrumento (30 minutos en promedio). Esto permite a los músicos abordar un repertorio extenso con menor fatiga, minimizando el riesgo de lesión o alteraciones musculo-esqueléticas que influyan directamente en su desempeño técnico y artístico.

El concepto y la práctica de la actividad física y su relación con calidad de vida en los modelos teóricos de la salud

Los estudios acerca del concepto actividad física (AF) son diversos, presentando diferentes concepciones; su relación con calidad de vida suele estar generada dentro del discurso médico, que propende por la ejecución de la Actividad Física desde una mirada netamente biológica. Si bien esta disertación es importante, se debe tener en cuenta que los estudios relacionados con calidad de vida y la AF se basan en la condición de bienestar y percepción frente al estado de salud; dichos estudios no se han realizado desde las condiciones de vida y del contexto social. Si bien es cierto que la mirada médica y lo estudios objetivos son relevantes, ya que arrojan estadísticas que permiten abordar recomendaciones en cuanto a la actividad física, en este documento se elaboró una investigación de tipo cualitativo por medio de la revisión documental del concepto de actividad física, sus prácticas y su relación con calidad de vida, que abordan diferentes autores. Para ello se elige la base de datos PubMed por su énfasis en las publicaciones de salud; se seleccionan artículos publicados del 2004 y 2014, que estudien el concepto de actividad física, sus prácticas y relaciones con calidad de vida, para finalmente hacer un análisis desde los modelos de determinación y determinantes sociales. De esta forma se analiza la posición de los autores con respecto al concepto, sus prácticas y las relaciones que puede llegar a surgir con la calidad de vida. En esta investigación se obtuvo como resultados tendencias biológicas, psicológicas, sociales y culturales, en los cuales los autores dejan clara la posición médica ya que en la mayoría de investigaciones centran sus relaciones en la funcionalidad, y es a través de la visión terapéutica donde buscan el bienestar, la satisfacción de los pacientes que padecen cualquier enfermedad. Además, aparecen categorías emergentes como: cuerpo como medio de publicidad, cibernética que avanza vertiginosamente y el papel del poder en la actividad física que pueden ser contempladas para otros estudios.

Metformina interage com o treinamento físico diminuindo a glicemia e aumentando o armazenamento de glicogênio em ratos diabéticos

INTRODUCTION: Like in humans, lower amounts of glycogen are present in tissues of diabetic rats. However, training or drugs that lower glycemia can improve the metabolic control. Metformin increased glycogen while decreased glycemia in normal rats stressed by exercise. OBJECTIVE: In this work we investigated if regular exercise and metformin effects improve the metabolism of diabetic rats. METHODS: Alloxan diabetic Wistar rats treated with metformin (DTM) or not (DT) were trained. Training consisted of 20 sessions of 30 min, 5 days a week. Sedentary diabetic rats served as control (SD and SDM). Metformin (5.6 µg/g) was given in the drinking water. After 48 h resting, glucose (mg/dl) and insulin (ng/mL) was measured in plasma and glycogen (mg/100 mg of wet tissue) in liver, soleus and gastrocnemius. RESULTS: Glycemia decreased in DM group from 435±15 to 230±20, in DT group to 143±8.1 and in DTM group to 138±19 mg/dl. DM group had proportional increase in the hepatic glycogen from 1.69±0.22 to 3.53±0.24, and the training increased to 3.36 ± 0.16 mg/100 mg. Metformin induced the same proportional increase in the muscles (soleus from 0.21±0.008 to 0.42±0.03 and gastrocnemius from 0.33±0.02 to 0.46±0.03), while the training promoted increase on gastrocnemius to 0,53 ± 0,03, only. A high interaction was observed in liver (glycogen increased to 6.48±0.34). CONCLUSION: Very small oral doses of metformin and/or, partially restored glycemia in diabetic rats and decreased glycogen in tissues. Its association with an exercise program was beneficial, helping lower glycemia further and increase glycogen stores on liver of diabetic rats.