Atualização de conhecimentos sobre a prática de exercícios resistidos por indivíduos idosos

A associação da piora da condição funcional e aumento de comorbidades em idades mais avançadas, faz do atual envelhecimento populacional um quadro que merece atenção crescente por parte do profissional médico. Este profissional está certamente entre os mais questionados sobre recomendações de atividades físicas adequadas para pessoas idosas ou debilitadas. No entanto, a formação generalista não têm abrangido aspectos atuais relacionados à fisiologia do exercício e prescrição de atividades físicas adequadas para estas populações. Exercícios resistidos têm ganhado crescente importância na comunidade científica como forma de exercícios seguros e eficazes, trazendo benefícios de caráter preventivo e terapêutico para pessoas idosas ou debilitadas. Assim, objetivando que mais indivíduos possam se beneficiar da recomendação de exercícios resistidos, fez se necessária uma atualização destes conhecimentos para o profissional médico.The combination of worsening of the functional condition and the increase in comorbidities at more advanced ages makes the aging of the current population a setting that deserves increased attention from the medical professional. This professional is certainly the most frequently asked about recommendations regarding suitable physical activities for elderly or debilitated individuals. However, the generalist training has not included current issues related to the exercise physiology and prescription of appropriate physical activities to these populations. Resistance exercises have gained increasing importance in the scientific community as a safe and effective form of exercise, resulting in preventive and therapeutic benefits for elderly or debilitated persons. Thus, an update of this knowledge is necessary for the medical professional, aiming at extending the benefits of recommending resistance exercises to an increasing number of individuals

Effect of progressive resistance exercise on strength evolution of elderly patients living with HIV compared to healthy controls

OBJECTIVES: Human Immunodeficiency Virus (HIV) infection worsens the frailty of elderly people, compromising their quality of life. In this study we prospectively evaluated eleven patients living with HIV and 21 controls older than 60 years and without prior regular physical activity, who engaged in a one-year progressive resistance exercise program to compare its effects on muscular strength, physical fitness and body composition. METHODS: Exercises for major muscular groups were performed 2 times/week, under professional supervision. Strength increase was evaluated bimonthly, while body composition, lipid and glycaemic profiles (only of those living with HIV) and physical fitness were evaluated before and after the one-year training. RESULTS: The participants living with HIV were lighter, had smaller Body Mass Index and were initially much weaker than controls. However, their strength increased more (1.52-2.33 times the baseline values for those living with HIV x 1.21-1.48 times for controls, p<0.01), nullifying the differences initially seen. These effects were seen independently of gender, age or baseline physical activity. In addition, those living with HIV improved their fasting glucose levels and showed a tendency to improve their lipids after the one year training program. These effects were slightly more pronounced among those not using protease inhibitors, although not significantly. CONCLUSIONS: Resistance exercise safely increased the strength of older patients living with HIV adults, allowing them to achieve performance levels observed among otherwise healthy controls. These findings favor the recommendation of resistance exercise for elderly adults living with HIV adults

Progressive Resistance Training in Elderly HIV-Positive Patients: Does it Work?

BACKGROUND: Elderly people present alterations in body composition and physical fitness, compromising their quality of life. Chronic diseases, including HIV/AIDS, worsen this situation. Resistance exercises are prescribed to improve fitness and promote healthier and independent aging. Recovery of strength and physical fitness is the goal of exercise in AIDS wasting syndrome. OBJECTIVE: This study describes a case series of HIV-positive elderly patients who participated in a progressive resistance training program and evaluates their body composition, muscular strength, physical fitness and the evolution of CD4+ and CD8+ cell counts. METHODS: Subjects were prospectively recruited for nine months. The training program consisted of three sets of 8-12 repetitions of leg press, seated row, lumbar extension and chest press, performed with free weight machines hts, twice/week for one year. Infectious disease physicians followed patients and reported all relevant clinical data. Body composition was assessed by anthropometric measures and dual-energy x-ray absorptiometry before and after the training program. RESULTS: Fourteen patients, aged 62-71 years old, of both genders, without regular physical activity who had an average of nine years of HIV/AIDS history were enrolled. The strengths of major muscle groups increased (74%-122%, p=0.003-0.021) with a corresponding improvement in sit-standing and walking 2.4 m tests (p=0.003). There were no changes in clinical conditions and body composition measures, but triceps and thigh skinfolds were significantly reduced (p=0.037). In addition, there were significant increases in the CD4+ counts (N=151 cells; p=0.008) and the CD4+/CD8+ ratio (0.63 to 0.81, p=0.009). CONCLUSION: Resistance training increased strength, improved physical fitness, reduced upper and lower limb skinfolds, and were associated with an improvement in the CD4+ and CD4+/CD8+ counts in HIV positive elderly patients without significant side effects

Resistance exercises in peripheral arterial diseased elders

The aging of the world population has provoked an increase of chronic degenerative diseases, facing the scientific community with the challenge to search and choose the best and most feasible treatments. Peripheral arterial disease, which appears as a complication of arteriosclerosis, shows increased and continuous incidence as age progresses, therefore adding to several other diseases that ensue this portion of the population. The conclusive evidence of efficiency and cost-benefits in the use of exercise as a primary indication for the treatment of aging patients has become an excellent alternative for this population group, which already uses various medications due to other chronic diseases. The benefits of resistance exercise still have not been fully explored as an isolated treatment for peripheral arterial disease in aged persons, however has already indicated that this form of exercising can and should be used for the treatment of the referred pathology, since it can reverts or delays the associated degenerative alterations which commits their carriers, diminishing significantly the many limitations imposed by the disease in association with sedentary agingO envelhecimento da população mundial propiciou o incremento das doenças crônico degenerativas, colocando a comunidade científica diante de um grande desafio na busca e escolha dos melhores e mais econômicos tratamentos. A doença arterial periférica, que surge como complicação da aterosclerose, apresenta incidência que aumenta linearmente com o avançar da idade, somando-se, portanto, a diversas outras patologias que já acometem este grupo populacional. A documentação dos benefícios em custo e eficácia, da utilização de exercícios como indicação primária para o tratamento de pacientes idosos, tornou-se excelente alternativa para este grupo populacional, que já utiliza diversas medicações, devido a outras doenças crônicas. Os benefícios dos exercícios resistidos foram ainda pouco explorados como forma isolada de tratamento da doença arterial periférica em idosos, mas já deixam indícios que esta forma de exercícios pode e deve ser utilizada para o tratamento da patologia referida, pois pode reverter ou retardar as concomitantes alterações degenerativas que acometem seus portadores, diminuindo de forma significativa as muitas limitações impostas pela doença em associação com o envelhecimento sedentário

Post‐resistance exercise hypotension in patients with intermittent claudication

OBJECTIVE: To verify the acute effects of resistance exercise on post-exercise blood pressure in patients with intermittent claudication. METHODS: Eight patients randomly underwent two experimental sessions: a session of resistance exercise (R: 6 exercises, 3 sets of 12, 10 and 8 reps with a perceived exertion of 11 to 13 on the 15-grade Borg scale) and a control session (C: resting on exercise machines). RESULTS: Before and for 60 min following an intervention, auscultatory blood pressure was measured while subjects rested in a sitting position. After the C session, systolic, diastolic and mean blood pressures did not change from the pre-intervention values, while these values decreased significantly after the R session throughout the entire recovery period (greatest decreases = -14 ± 5, -6±5, and -9 ± 4 mmHg, respectively, P < 0.05). CONCLUSION: After a single bout of resistance exercise patients with intermittent claudication exhibited reduced systolic, diastolic and mean blood pressures, suggesting that acute resistance exercise may decrease cardiovascular load in these patients

Assessment of muscular function in peripheral arterial obstructive disease with the use of isokinetic dynamometry

Individuals with peripheral arterial obstructive disease present functional deficits, mainly in the lower limbs, generating an impaired walking capacity. In order to assess this deficit and ambulatory follow-up, walking tests are routinely used. In elderly patients, who present associated multiple and limiting comorbidities, in addition to the symptoms of intermittent claudication, the evaluation by walking tests becomes difficult, mainly in cases of bilateral disease with different affection, where the more severely affected limb limits the evaluation of the less severely affected one. The muscular isokinetic assessment is an alternative method to individually evaluate the disease-generated deficits of the different muscular groupings in ischemic territories, thus overcoming the difficulties and deficits presented by patients at the walking tests.Indivíduos com doença arterial obstrutiva periférica apresentam perda funcional, principalmente em membros inferiores, gerando prejuízo da capacidade de caminhada. Os testes de caminhada são rotineiramente utilizados para avaliação e seguimento desses pacientes. Em pacientes idosos, com comorbidades e limitações associadas à claudicação intermitente, torna-se difícil a avaliação pela caminhada, principalmente nos casos de doença bilateral com acometimento desigual, onde o membro mais afetado limita a avaliação do menos afetado. A avaliação muscular isocinética é uma metodologia alternativa aos testes de caminhada para avaliar de forma individualizada as perdas funcionais geradas pela doença nos diferentes grupamentos musculares em territórios isquêmicos

Morphological profile of elite brazilian bodybuilders in competitive season

O objetivo deste estudo foi analisar o perfil morfológico de culturistas brasileiros de elite que competiram no XXVII Campeonato Brasileiro de Culturismo-Musculação. Um total de 28 atletas (27,0 ± 7,4 anos; 78,2 ± 8,7kg; 170,1 ± 6,9cm), do sexo masculino, foram voluntariamente estudados. Medidas antropométricas (massa corporal, estatura, espessura de dobras cutâneas, perímetros e diâmetros) foram coletadas de todos os sujeitos no período da manhã, no dia da competição. Os valores estimados da composição corporal dos atletas foram os seguintes: gordura corporal relativa, 5,8 ± 0,5%; massa corporal magra, 73,6 ± 8,2kg; massa muscular, 54,3 ± 6,7kg; área muscular do braço, 108,51 ± 15,19cm². Por outro lado, o somatótipo médio encontrado foi: endomorfia, 1,11 ± 0,29; mesomorfia, 8,26 ± 0,67; ectomorfia, 0,95 ± 0,53 (mesomorfo balanceado). Além de os culturistas apresentarem elevados níveis de desenvolvimento muscular (~70%) e baixos depósitos de gordura corporal, verificou-se uniformidade nos acúmulos de gordura localizada. A predominância do componente mesomorfo confirmou a estrutura muscular acentuadamente desenvolvida encontrada nos atletas investigados. Portanto, os resultados do presente estudo demonstram que atletas de culturismo de elite apresentam no dia da competição grande volume muscular, bem como excelente definição muscular, proporcionalidade e simetria.The aim of this study was to analyze the morphological profile of elite Brazilian bodybuilders who participated in the XXVII Brazilian Championship of Body Building. A total of 28 male athletes (27.0 ± 7.4 years; 78.2 ± 8.7 kg; 170.1 ± 6.9cm), were voluntarily assessed. Anthropometric measures (body mass, stature, skinfolds thickness, perimeters and diameters) were collected from all subjects in the morning shift, at the competition day. The estimated values of the body composition of the athletes were the following: relative body fat, 5.8 ± 0.5%; lean body mass, 73.6 ± 8.2 kg; muscular mass, 54.3 ± 6.7 kg and arm muscular area, 108.51 ± 15.19 cm². Conversely, the mean somatotype found was: endomorphy, 1.11 ± 0.29; mesomorphy, 8.26 ± 0.67; ectomorphy, 0.95 ± 0.53 (balanced mesomorphy). Besides high levels of muscular development (~70%) and low body fat buildup, the bodybuilders also presented uniformity in the accumulation of located fat. Predominance of the mesophormic component confirmed muscular structure remarkably developed found in the investigated athletes. Therefore, the results of the present study demonstrate that elite body building athletes present large amount of muscular volume, as well as excellent muscular definition, proportionality and symmetry at the day of the competition

Cardiovascular responses during isokinetic muscle assessment in claudicant patients

FUNDAMENTO: A dinamometria isocinética tem tido crescente importância para avaliação da função muscular em indivíduos com claudicação intermitente. No entanto, ainda há escassez de informações sobre as respostas cardiovasculares desses doentes durante este tipo de avaliação. OBJETIVO: Avaliar e comparar as respostas cardiovasculares na avaliação da força e resistência muscular de dois exercícios comumente utilizados para de pacientes com CI (flexão plantar/dorsiflexão e flexão/extensão de joelhos). MÉTODOS: Dezessete claudicantes com doença estável há pelo menos 6 meses compuseram a amostra avaliada no dinamômetro isocinético. Frequência cardíaca, pressão arterial e duplo produto foram mensurados não invasivamente em repouso e no pico do esforço, em protocolos específicos para avaliação de força e resistência muscular. RESULTADOS: Com exceção da pressão arterial diastólica, a frequência cardíaca, pressão arterial sistólica e o duplo produto aumentaram durante o exercício em comparação ao repouso (p < 0,05). A frequência cardíaca e o duplo produto sofreram maior elevação durante o exercício de extensão/flexão de joelho, em comparação ao exercício de flexão plantar/dorsiflexão (P < 0,05). Maiores incrementos na frequência cardíaca foram observados durante o protocolo de avaliação da resistência em comparação ao da avaliação da força muscular. CONCLUSÃO: Os testes isocinéticos de avaliação da força e resistência musculares em pacientes com CI promovem aumento da frequência cardíaca, da pressão arterial sistólica e do duplo produto durante sua execução. Estes aumentos são maiores nos testes de resistência muscular e nos que envolvem maior massa muscular, sugerindo que testes de força de pequenos grupamentos musculares promovem menor sobrecarga cardiovascular nesses pacientes.BACKGROUND: Isokinetic dynamometry is becoming increasingly important for the assessment of muscle function in individuals with intermittent claudication. However, there is still little information available about the cardiovascular responses of these patients during this type of assessment. OBJECTIVE: To assess and compare the cardiovascular responses recorded during the assessment of muscle strength and endurance for two exercises commonly used in patients with IC (plantar flexion/dorsiflexion and knee flexion/extension). METHODS: The sample consisted of 17 claudicant patients with stable disease for at least 6 months. During the isokinetic dynamometer testing, non-invasive measurements of heart rate, blood pressure and double product at rest and at peak exertion were obtained according to specific protocols established for muscle strength and endurance assessment. RESULTS: Except for diastolic blood pressure, heart rate, systolic blood pressure and double product values rose during the exercise compared to the resting stage (p < 0.05). Elevations in heart rate and double product values were higher during knee extension/flexion than during plantar flexion/dorsiflexion (p < 0.05). Increases in heart rate were also higher during the endurance assessment protocol than during muscle strength assessment. CONCLUSION: Isokinetic strength and endurance testing in patients with IC results in elevation of heart rate, systolic blood pressure and double product values during the exercises. These increases are higher during the muscle endurance exercises and in those involving greater muscle mass, suggesting that strength testing of small muscle groups causes less cardiovascular overload in these patients