Assessment of Cardiorespiratory Fitness without Exercise in Elderly Men with Chronic Cardiovascular and Metabolic Diseases

Low cardiorespiratory (CRF) is associated with health problems in elderly people, especially cardiovascular and metabolic disease. However, physical limitations in this population frequently preclude the application of aerobic tests. We developed a model to estimate CRF without aerobic testing in older men with chronic cardiovascular and metabolic diseases. Subjects aged from 60 to 91 years were randomly assigned into validation (n = 67) and cross-validation (n = 29) groups. A hierarchical linear regression model included age, self-reported fitness, and handgrip strength normalized to body weight (R2 = 0.79; SEE = 1.1 METs). The PRESS (predicted residual sum of squares) statistics revealed minimal shrinkage in relation to the original model and that predicted by the model and actual CRF correlated well in the cross-validation group (r = 0.85). The area under curve (AUC) values suggested a good accuracy of the model to detect disability in the validation (0.876, 95% CI: 0.793–0.959) and cross-validation groups (0.826, 95% CI: 0.677–0.975). Our findings suggest that CRF can be reliably estimated without exercise test in unhealthy elderly men

Cardiovascular responses to passive static flexibility exercises are influenced by the stretched muscle mass and the Valsalva maneuver

BACKGROUND: The respiratory pattern is often modified or even blocked during flexibility exercises, but little is known about the cardiovascular response to concomitant stretching and the Valsalva maneuver (VM) in healthy subjects. OBJECTIVES: This study evaluated the heart rate (HR), systolic blood pressure (SBP), and rate-pressure product (RPP) during and after large and small muscle group flexibility exercises performed simultaneously with the VM. METHODS: Asymptomatic volunteers (N = 22) with the following characteristics were recruited: age, 22 ± 3 years; weight, 73 ± 6 kg; height, 175 ± 5 cm; HR at rest, 66 ± 9 BPM; and SBP at rest, 113 ± 10 mmHg. They performed two exercises: four sets of passive static stretching for 30 s of the dorsi-flexion (DF) of the gastrocnemius and the hip flexion (HF) of the ischio-tibialis. The exercises were performed with (V+) or without (V-) the VM in a counterbalanced order. The SBP and HR were measured, and the RPP was calculated before the exercise session, at the end of each set, and during a 30-min post-exercise recovery period. RESULTS: The within-group comparisons showed that only the SBP and RPP increased throughout the sets (p<0.05), but no post-exercise hypotension was detected. The between-group comparisons showed that greater SBP increases were related to the VM and to a larger stretched muscle mass. Differences for a given set were identified for the HR (the HFV+ and HFV- values were higher than the DFV+ and DFV- values by approximately 12 BPM), SBP (the HFV+ value was higher than the DFV+ and DFV- values by approximately 12 to 15 mmHg), and RPP (the HFV+ value was higher than the HFV- value by approximately 2000 mmHGxBPM, and the HFV+ value was higher than the DFV+ and DFV- values by approximately 4000 mmHGxBPM). CONCLUSION: Both the stretched muscle mass and the VM influence acute cardiovascular responses to multiple-set passive stretching exercise sessions

Identification of sarcopenic obesity in postmenopausal women : a cutoff proposal

Sarcopenic obesity is the combination of reduced fat-free mass (FFM) and increased fat mass (FM) with advancing age but there is lack of clear criteria for its identification. The purposes of the present investigation were: 1) to determine the prevalence of postmenopausal women with reduced FFM relative to their FM and height, and 2) to examine whether there are associations between the proposed classification and health-related variables. A total of 607 women were included in this cross-sectional study and were separated into two subsets: 258 older women with a mean age of 66.8 ± 5.6 years and 349 young women aged 18-40 years (mean age, 29.0 ± 7.5 years). All volunteers underwent body composition assessment by dual-energy X-ray absorptiometry. The FFM index relative to FM and height was calculated and the cutoff value corresponded to two standard deviations below the mean of the young reference group. To examine the clinical significance of the classification, all older participants underwent measurements of quadriceps strength and cardiorespiratory fitness. Values were compared between those who were classified as low FFM or not, using an independent samples t-test and correlations were examined. The cutoff corresponded to a residual of -3.4 and generated a sarcopenic obesity prevalence of 19.8% that was associated with reduced muscle strength and aerobic fitness among the older participants. Also, the index correlated significantly with the health-related fitness variables. The results demonstrated reduced functional capacity for those below the proposed cutoff and suggested applicability of the approach as a definition for sarcopenic obesity

Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions.

BACKGROUND: The physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life. OBJECTIVES: The objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature. METHODS: Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function. RESULTS: Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions. CONCLUSIONS: Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks

Análise crítica da Carta Brasileira de Prevenção Integrada na Área da Saúde na Perspectiva da Educação Física através do enfoque radical de promoção da saúde

O presente trabalho pretende contribuir para que a área profissional e o campo do saber referente à Educação Física apreendam a saúde de forma ampliada, superando o enfoque biologicista hegemônico. Possui caráter qualitativo e baseou-se em pesquisa de fontes bibliográficas para a confecção de monografia de conclusão do curso de especialização em Saúde Pública, na Escola Nacional de Saúde Pública Sergio Arouca da Fundação Oswaldo Cruz. Analisou-se criticamente a Carta Brasileira de Prevenção Integrada na área da Saúde na perspectiva da Educação Física - publicação do Conselho Federal de Educação Física (CONFEF), em 2006, a partir do enfoque radical da Promoção da Saúde. Esse enfoque pode ser sintetizado na proposta de articulação entre saúde e condições de vida, ressaltando as inter-relações de equidade social, através do aumento da capacidade da participação popular, intersetorialidade, fomento de políticas públicas saudáveis, criação de ambientes favoráveis à saúde e reorientação do sistema de saúde, baseando-se numa visão ampliada do processo saúde-doença e reconhecendo a multideterminação desse processo (OMS, 1986; Buss, 2000, 2001, 2007; Pedrosa, 2004). Concluiu-se que o documento analisado biologiza e medicaliza a Educação Física em sua relação com a sociedade. Recomenda-se que o mesmo seja revisto a partir da perspectiva crítica ligada à área da Educação Física, a qual relaciona a atividade física e a saúde com questões sociais mais amplas que impedem que os sujeitos tomem decisões mais saudáveis, tais como os condicionantes econômicos, culturais, étnicos e políticos.This work intends to provide a contribution so that the professional area and the field of knowledge referring to Physical Education view health in a broader way, overcoming the biological focus which usually occurs. It has a qualitative character and was based on research into bibliographic sources in order to develop a monograph upon the completion of the Public Health specialization course at the National School of Public Health Sergio Arouca, of the Oswaldo Cruz Foundation. The Brazilian Charter of Integrated Prevention in the Field of Health in the Perspective of Physical Education, a document written by the Federal Council of Physical Education (CONFEF) in 2006, was critically analyzed based on the radical focus of Health Promotion. This focus can be summarized as an articulation between health and life conditions, emphasizing social equity interrelations, through the increase in the capacity for popular participation, intersectoriality, promotion of healthy public policies, creation of environments that are favorable to health, and through a reorientation of the health system, based on a broader view of the health-disease process and on the recognition of the multi-determination of this process (OMS, 1986; Buss, 2000, 2001, 2007; Pedrosa, 2004). We concluded that the document that we analyzed assumes a biological and medical view concerning the relation between Physical Education and society. We recommend that this document is revised based on the critical perspective connected with the Physical Education field, which relates physical activities and health to broader social issues which prevent subjects from making healthier decisions, such as economic, cultural, ethnic and political conditioning factors

Blood pressure response to muscle metaboreflex activation is impaired in men living with HIV

We investigated the muscle metaboreflex contribution to blood pressure response during dynamic handgrip exercise in men living with HIV (MLHIV) vs. without HIV (Controls). Pressor and heart rate responses were evaluated during metaboreflex activation through post-exercise muscle ischemia (PEMI) method and control exercise session (CER) in 17 MLHIV and 21 Controls. Protocols were performed randomly on the same day, being both sessions composed of 12 min, as follows: a) 3 min at rest, b) 3 min of dynamic handgrip exercise at 30 % of maximal voluntary contraction, c) 3 min of recovery post-exercise with vascular occlusion (occlusion only in PEMI), and d) 3 min of recovery post-exercise without vascular occlusion. To assess metaboreflex response, differences between PEMI and CER in recovery post-exercise were calculated for blood pressure and heart rate. Systolic and mean blood pressure (P &lt; 0.01) were superior in the last 2 min of recovery with vascular occlusion at PEMI in relation to CER for both groups. No difference was found between groups for blood pressure and heart rate (P &gt; 0.05). However, metaboreflex response for systolic blood pressure was lower in MLHIV vs. Controls (4.05 ± 4.63 vs. 7.61 ± 3.99 mmHg; P = 0.01). In conclusion, pressor response during metaboreceptor stimulation was attenuated in men living with HIV, which may suggest loss of muscle metaboreflex sensibility