Knee osteoarthritis and obesity : effectiveness of PICO aquatic exercise program on symptoms, physical fitness and quality of life

Doutoramento em Motricidade Humana na especialidade de Atividade Física e SaúdeBackground: Aquatic exercise is a nonpharmacologic intervention recommended for knee osteoarthritis (KOA) management. This study aimed to determine the effectiveness of 3-months of aquatic exercise program on KOA symptoms, physical fitness, and quality of life in overweight/obese adults with KOA. Methods: Eligibility criteria were 40 ≤ age ≤ 65 years; BMI ≥ 28 kg/m2; clinical and radiographic KOA. Participants were randomized in aquatic exercise group (AEG) and control group (CG). Physical Fitness was assessed by Six Minutes Walking Test (6MWT), Chair Sit and Reach Test (CSR), Five-Repetition Sit-To-Stand Test (FRSTST), Handgrip Strength Test (HST) and isokinetic and isometric knee strength tests. KOA symptoms and quality of life were assessed by self-reported questionnaires (Knee Injury and Osteoarthritis Outcome (KOOS), Brief Pain Inventory (BPI), Beck Depression Inventory (BDI), International Physical Activity Questionnaire (IPAQ), Weight and Lifestyle Inventory (WALLI). Body composition and morphology was measured by DXA scanner and waist, hip and thigh circumferences. Descriptive statistics and Pearson Correlation Coefficient were used for baseline analyses; Univariate Analyses of Covariance (ANCOVA) was used as primary analyses. Results: Final sample included 48 adults (BMI: 35.0±4.9 kg/m2; age: 55±7 years.), 23 in the CG and 25 in AEG. Regarding physical function, significant group effect was found for 6MWT, FRSTST (p<.001) and Isokinetic flexion peak torque, in both knees (p<.05). Regarding KOOS; BPI and BDI, significant group effect was found in all dimensions. Conclusion: PICO aquatic program was effective in improving KOA symptoms, physical fitness and health-related quality of life of its practitioners. Trial Registration: NCT01832545.RESUMO: Introdução: O exercício aquático é considerado uma opção não farmacológica no tratamento e controlo dos sintomas da osteoartrose do joelho (OAJ). O principal objetivo deste estudo foi determinar a eficácia de um programa de 3 meses de exercício aquático nos sintomas, aptidão física e qualidade de vida de adultos com sobrepeso ou obesos com OAJ. Métodos: Os critérios de elegibilidade foram 40 ≤ idade ≤ 65 anos; IMC ≤ 28 Kg/m2 e diagnóstico clínico e radiológico de OAJ. Os participantes foram randomizados em grupo de exercício aquático (GEA) e grupo controlo (GC). Aptidão física foi avaliada pelos testes de Seis Minutos Marcha (6MM), Sentar e levantar da Cadeira 5X (SLC), Sentar e alcançar, Alcançar atras das costas, força de preensão manual e avaliação isométrica e isocinética da força dos músculos do joelho. Os sintomas e qualidade de vida foram avaliados por questionários de autorrelato: Questionário KOOS sobre o Joelho, Inventário Breve da Dor (IBD), Inventario de Depressão de Beck (IDB), Questionário Internacional de Atividade Física (IPAQ), Inventário do Peso e estilo de vida (IPEV). A composição corporal e morfologia foram avaliados por DEXA scanner e medidas de circunferência. Estatística descritiva, coeficiente de correlação de Pearson, análise Univariada de covariância (ANCOVA) e regressão linear múltipla foram os métodos estatísticos utilizados. Resultados: 48 adultos (IMC: 35.0±4.9 Kg/m2, idade: 55±7 anos) completaram o estudo, 23 no GC e 25 no EAG. Quanto à função física, foi encontrado efeito de grupo significativo no 6MM, SLC (p<.001), no pico de torque da força de joelho na flexão, em ambos os joelhos (p<.05). Efeito de grupo significativo foi encontrado nas dimensões do KOOS; IBD e IDB. Conclusão: O programa aquático PICO foi eficaz para promover a melhoria dos sintomas da OAJ, da aptidão física, estado psicológico e qualidade de vida relacionada com a saúde de seus praticantes. Registro de Clinical Trial: NCT01832545FCT - Fundação para a Ciência e a Tecnologi

The ergogenic effect of beta-alanine combined with sodium bicarbonate on high-intensity swimming performance

We investigated the effect of beta-alanine (BA) alone (study A) and in combination with sodium bicarbonate (SB) (study B) on 100- and 200-m swimming performance. In study A, 16 swimmers were assigned to receive either BA (3.2 g·day−1 for 1 week and 6.4 g·day−1 for 4 weeks) or placebo (PL; dextrose). At baseline and after 5 weeks of supplementation, 100- and 200-m races were completed. In study B, 14 were assigned to receive either BA (3.2 g·day−1 for 1 week and 6.4 g·day−1 for 3 weeks) or PL. Time trials were performed once before and twice after supplementation (with PL and SB), in a crossover fashion, providing 4 conditions: PL-PL, PL-SB, BA-PL, and BA-SB. In study A, BA supplementation improved 100- and 200-m time-trial performance by 2.1% (p = 0.029) and 2.0% (p = 0.0008), respectively. In study B, 200-m time-trial performance improved in all conditions, compared with presupplementation, except the PL-PL condition (PL-SB, +2.3%; BA-PL, +1.5%; BA-SB, +2.13% (p < 0.05)). BA-SB was not different from BA-PL (p = 0.21), but the probability of a positive effect was 78.5%. In the 100-m time-trial, only a within-group effect for SB was observed in the PL-SB (p = 0.022) and BA-SB (p = 0.051) conditions. However, 6 of 7 athletes swam faster after BA supplementation. The probability of BA having a positive effect was 65.2%; when SB was added to BA, the probability was 71.8%. BA and SB supplementation improved 100- and 200-m swimming performance. The coingestion of BA and SB induced a further nonsignificant improvement in performance

Effect of three months detraining on functional capacity of elderlys

Mestrado em Exercício e SaúdeAs interrupções nos programas de exercícios para férias deixam os níveis de aptidão física dos idosos à mercê do estilo de vida por eles praticado. Objectivos: Avaliar a magnitude de 3 meses de destreino na capacidade funcional de idosos. Métodos: 20 idosos saudáveis, participantes há 2 anos do mesmo programa de exercícios foram avaliados antes das férias de Verão (AF), após 3 meses de férias (PF) e após 3 meses de destreino(Rtr). O teste de 6MM foi realizado com analisador de gases, a força máxima isométrica (FMI) foi avaliada em prensa de pernas e a actividade física (Afi) com IPAQ versão curta. Análise estatística: ANOVA MR e teste T para amostras emparelhadas e independentes. Resultados: Houve redução significativa na Afi (45%), na velocidade (7%) e na distância do 6MM (≤72 anos: 675,7±82,3 para 633,7±90,1m; >72anos:641,8±86,9 para 594,5±96,5 m). O VO2 e a FMI diminuíram no grupo> 72anos (p <0,05): 7020±2808 para 6069±1917ml e de 1689±645 para 1518±509N, respectivamente. Conclusão: Houve destreino na velocidade da marcha e na força. A Afi mostrou-se estar inversamente relacionada com o destreino. Deve-se estimular a prática autónoma de exercícios pelos idosos que contribuam para a manutenção da sua capacidade funcional.The cessation of training exercise program for holydays leaves the functional capacity of elderly subjects dependent of their own lifestyle. Purpose: Evaluate the detraining on functional capacity of elderlys Methods: 20 long term pre-trained elderly subjects were tested before 3-months summer holidays (BSH), after summer holidays (ASH) and after 3 months of retraining, (RET). Assesments: Six Minutes Walking Test (6MWT) with a portable gas analyzer (Cosmed K4b2); maximal lower limb isometric force (MF) and total physical activity by the IPAQ Portuguese short version. Statistical analysis: ANOVA RM, Paired T-tests and independent T-test. Results: Physical activity decreased in both groups ASH (p<0.05). The 6MWT distance decreased (p<0,05) (YG: 675,7±82,3 to 633,7±90,1 m) and(OG:641,8±86,9 m to 594,5±96,5 m) with mean gait speed in YG decreasing from 1,88±0,23 to 1,76 ±0,25 m/s (p<0,05) and from 1,78± 0,24 to 1,65±0,27 m/s in OG (p72yrs) showed more severe effect of detraining. The results reinforce the needs to stimulate self-home exercise programs targeting specific physical capacities for elderlys

RESPONSIVENESS OF PAIN AND SYMPTOM’S ITEMS OF KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCORE (KOOS) TO THE AQUATIC EXER

Resumen Background: Pain is the main symptom of Knee Osteoarthritis (KOA) and aquatic exercise has been indicated as an effective non-pharmacological treatment for KOA symptoms. In general, KOA pain is assessed by simple scales or by multicomponent self-reported questionnaires, mainly the Knee Injury and Osteoarthritis Outcome Score (KOOS) and WOMAC Osteoarthritis Index. Some studies had reported the effectiveness of aquatic exercise on KOOS pain dimension but not on each pain item. Objectives: This study aimed to investigate how pain items of KOOS questionnaire are affected by 3 months’ aquatic exercise program for overweight and obese individuals with KOA (PICO). Method: Eligibility criteria were 40 ≤ age ≤ 65 years; BMI ≥ 28kg/m²; clinical and radiographic KOA. Participants were randomized in aquatic exercise group (AEG) and control group (CG). Pain was assessed by KOOS. Descriptive statistics and Univariate Analyses of Covariance (ANCOVA) were used as primary analyses. Results: Final sample included 48 adults (BMI: 35.0±4.9 kg/m², age: 55±7 years), 23 in the CG and 25 in AEG. Table 1 presents ANCOVA analysis for each item of Pain dimension of KOOS. Significant group effect was found in all pain items (p <.05), except for pain frequency (P1) and pain on bending knee fully (P4). Better group effect was found in the item pain on walking (P5) (p <.001). Conclusions: PICO aquatic program was effective in improving knee pain in seven of nine activities in individuals with KOA