A dança como estratégia de promoção da saúde cardiometabólica e independência funcional no envelhecimento

INTRODUÇÃO: O envelhecimento biológico é caracterizado, dentre outros fatores, por uma diminuição de massa muscular concomitante a um aumento de tecido adiposo visceral, elevando o risco do desenvolvimento de doenças cardiovasculares e dependência física. A dança tem sido sugerida como uma intervenção de exercício potencial para melhorias cardiometabólicas e funcionais com o envelhecimento. Além disso, é uma atividade amplamente praticada pelos idosos como lazer, sendo uma intervenção de baixo custo e grande aderência por essa população. Entretanto, conclusões acerca dos efeitos da dança como forma de exercício para saúde ainda são limitadas, principalmente devido à falta de comparação com outros tipos de exercício físico, bem como ao número limitado de ensaios clínicos randomizados controlados analisando marcadores de risco cardiovascular (RCV). OBJETIVO GERAL: Verificar os efeitos de uma intervenção de dança, comparada a um exercício aeróbio tradicional (caminhada) e a um grupo controle (alongamento), sobre marcadores RCV e capacidade funcional de mulheres idosas, em um ensaio clínico randomizado controlado (ECRc). Adicionalmente, verificar as respostas cardiorrespiratórias agudas de uma aula de dança para idosas, em um estudo de respostas agudas (antes e depois). MÉTODOS: Trinta mulheres sedentárias (655 anos, índice de massa corporal (IMC) 274) foram randomizadas em três grupos de intervenção (n=10/grupo): dança, caminhada e alongamento (controle ativo) com duração de oito semanas (grupos dança ou caminhada 3x/sem, 60 min; grupo alongamento 1x/sem, 60 min). Intervenções: Dança: elementos técnicos (ballet, jazz, etc), estilos variados (danças latinas, dança aeróbica, etc), sem par. Caminhada: esteira, intensidade 60% VO2pico. Alongamento: grandes grupos musculares, sem desconforto. Intervenções incluíam aquecimento, parte principal (35-40 min), e volta à calma. Foram avaliados no período pré e pós intervenção: consumo de oxigênio de pico (VO2pico, desfecho primário); insulina, CRP, TNF-α, circunferências da cintura e quadril, tecido adiposo visceral, colesterol total, HDL-C, LDL-C, glicose, espessura muscular do quadríceps, força máxima e potência muscular, equilíbrio estático e dinâmico, marcha, flexibilidade, habilidade de sentar e levantar, e nível de atividade física. Os resultados estão descritos em média e IC (95%). As comparações intra e entre grupos foram realizadas pelo método de Equações de Estimativas Generalizadas, post hoc LSD (p<0,05), utilizando o software SPSS 22.0 Tamanho de efeito (TE) da intervenção de dança vs. alongamento (D vs. A) e caminhada vs. alongamento (C vs. A) também foram calculados. RESULTADOS: ECRc (pré vs. pós): Efeito de interação grupo vs. tempo mostrou aumentos no VO2pico (mL.kg-1.min-1) após a intervenção de dança 23,3 (20,8-25,8) vs 25,6 (23,4-27,8), e caminhada 23,4 (21,3-25,5) vs 27,0 (25,4-28,6), sem diferenças no grupo alongamento 23,5 (21,3-25,7) vs 23,0 (21-24,9). Não houve diferença entre os grupos dança e caminhada. O grupo caminhada foi superior ao grupo alongamento no momento pós-intervenção. TE: D vs. A = 0,72, C vs. A = 1,28. Altura do salto vertical (cm) também melhorou para os grupos dança 11,2 (9,3-13,1) vs 12,2 (10,3-14), e caminhada 10,3 (9-11,6) vs 11,3 (9,7-13), sem diferença para o grupo alongamento 9,8 (8,6 to 11,3) vs 9,3 (7,8 to 10,7). Não houve diferença entre os grupos dança e caminhada. O grupo dança foi superior ao grupo alongamento no momento pós-intervenção. TE: D vs. A = 1,00, C vs. A = 0,74. Equilíbrio estático (s) também melhorou para os grupos dança 5,44 (2,34-8,55) vs 11,07 (6,53-15,62) e caminhada 5,67 (2,91-8,42) vs 14,46 (9,09-19,84), sem diferença para o grupo alongamento 4,05 (2,28-5,82) vs 4,04 (3,12-4,97). Não houve diferença entre os grupos dança e caminhada. Ambos os grupos dança e caminhada foram superiores ao grupo alongamento no momento pós-intervenção. TE: D vs. A = 1,22, C vs. A = 1,55. Habilidade de marcha e equilíbrio dinâmico melhoraram apenas para o grupo caminhada. Efeito tempo (efeitos agrupados) mostrou melhoras em relação aos marcadores inflamatórios CRP (mg/L)1,65 (1,56-1,73) vs 1,55 (1,44-1,65) e TNFα (pg/mL) 6,69 (6,36-7,02) vs 6,04 (5,82-6,25), LDL-C (mg/dL) 139,1 (126,6-151,7) vs 130,7 (117,1-144,4), HDL-C (mg/dL) 43,3 (38,9-47,7) vs 47,4 (42,6-52,3), gordura visceral (mm) 48,1 (40,1-56,0) vs 42,9 (35,9-50,0), habilidade de sentar e levantar (s) 10,23 (9,71-10,75) vs 8,32 (7,88-8,76), flexibilidade (cm) -0,60 (-2,44-1,24) vs 1,71 (-0,51-3,92), e nível de atividade física (tempo de caminhada em min.semana) 85 (39-131) vs 233 (154-313). Não foram encontradas diferenças para perfil glicêmico, triglicerídeos, colesterol total, força e espessura muscular do quadríceps. Estudo de respostas agudas (n=10 participantes do grupo dança, resultados em média ± desvio padrão): Teste de esforço máximo: VO2 (mL.kg-1. min-1): VO2pico (23,3 ± 4,3), primeiro limiar ventilatório (LV1) (17,2 ± 3,5) e segundo limiar ventilatório (20,9 ± 3,4). Aula de dança; VO2 (mL.kg-1. min-1, %VO2pico ): aquecimento (12,8 ± 2,4, 55%), deslocamento (14,2 ± 2,4, 62%), coreografia (14,6 ± 3,2, 63%) e show (16,1 ± 3,3, 69%). A parte do show (coreografia aprendida) foi igual ao LV1 das participantes. CONCLUSÕES: Os resultados do ECRc mostraram que a intervenção de dança foi capaz de induzir ganhos cardiorrespiratórios, potência de membros inferiores e equilíbrio estático iguais à caminhada, enquanto o grupo alongamento não apresentou mudanças. Ganhos adicionais em marcha e equilíbrio dinâmico foram verificados após a intervenção de caminhada. O engajamento em quaisquer das intervenções (alongamento, dança ou caminhada) foi capaz de atenuar marcadores inflamatórios e perfil lipídico, bem como induzir mudanças positivas na composição corporal. Os resultados do estudo de respostas cardiorrespiratórias agudas mostraram que a aula de dança elaborada para idosas foi de baixa intensidade aeróbia (LV1).INTRODUCTION: Biological aging is characterized, among many factors, by reductions in lean mass simultaneously to increases in visceral adipose tissue. This is connected to the development of cardiovascular diseases and physical dependence. Dancing has been suggested as a potential exercise intervention for cardiometabolic and functional improvements with aging. Moreover, it is a low-cost leisure activity, widely practiced among the older, with great adherence rates. However, conclusions on the effects of dancing as a type of exercise for improving health are still limited, mainly due to the lack of comparisons with other types of exercise. There is also a limited number of randomized controlled trials analyzing cardiovascular risk (CVR) markers as result of dance practice by the elderly. AIMS: Verifying the effects of a dance intervention, compared to a traditional aerobic exercise (walking), and to a control group (stretching), on CVR markers and functional capacity of older women, in a randomized controlled trial (RCT). Additionally, verifying the acute cardiorespiratory responses of a dance session for older women, in a study of acute cardiorespiratory responses (before and after). METHODS: Thirty sedentary women (65±5 yrs, BMI 27±4 kg/m2) were randomized into three groups (n=10/group): dancing, walking or stretching (active control). All interventions lasted 8 weeks (60 min sessions): dancing/walking 3x/wk, stretching 1x/wk. Dancing: technical elements (ballet, jazz, etc), several styles (latin dances, aerobics, etc), no partner. Walking: treadmill, 60% peak oxygen consumption (VO2peak). Stretching: large muscle groups, no discomfort. Interventions included a warm-up, main part (35-40 min) and cool-down. Before and after interventions assessments: VO2peak (primary outcome), insulin, CRP, TNF-α, waist and hip circumferences, visceral adipose tissue (VAT), total cholesterol, HDL-C, LDL-C, glucose, quadriceps thickness, maximal muscle strength/power, static and dynamic balance, gait ability, flexibility, chair-raise and level of physical activity. Results are described as mean and CI (95%). Statistics: Generalized estimating equations, post-hoc LSD (p<0.05), SPSS 22.0. Effect sizes (ES) of dancing vs. stretching (D vs. S) and walking vs. stretching (W vs. S) were also calculated. RESULTS (mean-CI): RCT (before vs after): Group vs time interaction showed increases in VO2peak (mL.kg-1.min-1) for dancing 23.3 (20.8-25.8) vs. 25.6 (23.4-27.8), and walking 23.4 (21.3-25.5) vs 27.0 (25.4-28.6), with no differences for stretching 23.5 (21.3-25.7) vs 23.0 (21.0-24.9). There was no difference in between dancing and walking groups. Walking was superior to stretching after the interventions. ES: D vs. S = 0.72, W vs. S = 1.28. Lower body muscle power also improved for dancing 11.2 (9.3-13.1) vs 12.2 (10.3-14), and walking 10.3 (9-11.6) vs 11.3 (9.7-13), but not for stretching 9.8 (8.6 to 11.3) vs 9.3 (7.8 to 10.7). There was no difference in between dancing and walking groups. Dancing was superior to stretching after the interventions. ES: D vs. W = 1.00, W vs. S = 0.74. Static balance (s) also improved for dancing 5.44 (2.34-8.55) vs 11.07 (6.53-15.62) and walking groups 5.67 (2.91-8.42) vs 14.46 (9.09-19.84), with no differences for the stretching group 4.05 (2.28-5.82) vs 4.04 (3.12-4.97). There was no difference in between dancing and walking. Both dancing and walking were superior to stretching after the interventions. ES: D vs. S = 1.22, W vs. S = 1.55. Gait ability and dynamic balance improved only for the walking group. Main time effect (polled effects) showed improvements in CRP (mg/L)1.65 (1.56-1.73) vs 1.55 (1.44-1.65) and TNFα (pg/mL) 6.69 (6.36-7.02) vs 6.04 (5.82-6.25), LDL-C (mg/dL) 139.1 (126.6-151.7) vs 130.7 (117.1-144.4), HDL-C (mg/dL) 43.3 (38.9-47.7) vs 47.4 (42.6-52.3), visceral fat (mm) 48.1 (40.1-56.0) vs 42.9 (35.9-50.0), chair raise (s) 10.23 (9.71-10.75) vs 8.32 (7.88-8.76), flexibility (cm) -0.60 (-2.44-1.24) vs 1.71 (-0.51-3.92), and level of physical activity (walking time in min.week) 85 (39-131) vs 233 (154-313). No differences were found for glycaemic profile, triglycerides, total cholesterol, quadriceps thickness and muscular strength. Acute responses study: (n=10 participants from the dancing group, results in mean ± standard deviation): Maximum effort test: VO2 (mL.kg-1 .min-1): VO2peak (23.3 ± 4.3). first ventilatory threshold (VT1) (17.2 ± 3.5) and second ventilatory threshold (20.9 ± 3.4). Dance class: VO2 (mL.kg-1 .min-1. %VO2peak): warm-up (12.8 ± 2.4, 55%), across-the-floor (14.2 ± 2.4, 62%), choreography (14.6 ± 3.2, 63%) and show (16.1 ± 3.3, 69%). The show part (choreography learned) was equal to participants’ VT1. CONCLUSIONS: Results from the RCT showed that dancing induced similar increases in VO2peak, lower body muscle power and static balance as walking, while the stretching group remained unchanged. Additional gains for gait ability and dynamic balance were observed for the walking group. The engagement in any of the interventions (stretching, dancing or walking) attenuated inflammatory markers and lipid profile, as well as induced positive changes in body composition. Results from the acute cardiorespiratory responses study showed that the dance class designed for older women was at low aerobic intensity (VT1)

Effects of dancing on physical activity levels of children and adolescents : a systematic review

Background: Dancing has been suggested to increase the levels of physical activity of the youth. However, it is not clear what are the physiological characteristics of the dance classes for young people, mainly regarding the levels of moderate to vigorous physical activity (MVPA) during classes. It is also unclear if regular engagement in dance practices can contribute with increases in the amounts of daily/weekly MVPA, recommended by health organizations. Objectives: To conduct a systematic review verifying the amount of time spent at MVPA (primary outcome), by children and adolescents in the following situations: i) During dance classes, and ii) Before and after dance in- terventions. Secondary outcomes included: markers of exercise intensity during class, such as oxygen con- sumption (VO2) and heart rate (HR); VO2peak and lipid profile before and after dance interventions. Methods: Six data sources were accessed (MEDLINE, EMBASE, Cochrane Wiley, PEDRO and SCOPUS). Study selection included different designs (acute, cohort, randomized controlled trials and others). Participants were from 6 to 19 years old, regularly engaged in dance practices. Methodological quality was assessed using the Downs and Black checklist. Two independent reviewers extracted characteristics and results of each study. Results: 3216 articles were retrieved, and 37 included. Studies indicated that dance classes do not achieve 50% of total class time at MVPA. However, there are peaks of HR and VO2 during dance classes, which reach moderate and vigorous intensities. MVPA/daily/weekly did not improve before and after dance interventions for most of the studies, also VO2peak did not. The few results on lipid profile showed improvements only in overweight and obese participants. Limitations: Lack of meta-analysis, because there were not enough articles to be analyzed on any given outcome of interest, neither under the same study design. Conclusions: Results of individual studies indicated that dance classes did not active 50% of the total time at MVPA levels. This may be related to the absence of improvements in daily/weekly MVPA before and after dance interventions. VO2 and HR attained peaks of moderateto vigorous intensity during dance classes, suggesting that the structure of the classes may be manipulated to maintain longer periods at MVPA levels. Lack of data on cardiorespiratory fitness and metabolic outcomes limit conclusions on these parameters. Implications of Keys Finds: Considering there are peaks of HR and VO2 during dance classes, we suggest that the structure of a dance class can be manipulate in order to induce cardiorespiratory and metabolic adaptations. Thus, dancing is a potential strategy to contribute with a healthy life style since the earliest ages. Prospero registration: CRD4202014460

The effects of aerobic exercise training at two different intensities in obesity and type 2 diabetes: implications for oxidative stress, low-grade inflammation and nitric oxide production

Aims To investigate the effect of 16 weeks of aerobic training performed at two different intensities on nitric oxide (tNOx) availability and iNOS/nNOS expression, oxidative stress (OS) and inflammation in obese humans with or without type 2 diabetes mellitus (T2DM). Methods Twenty-five sedentary, obese (BMI > 30 kg/m(2)) males (52.8 +/- 7.2 years); 12 controls versus 13 T2DM were randomly allocated to four groups that exercised for 30 min, three times per week either at low (Fat-Max; 30-40 % VO2max) or moderate (T-vent; 55-65 % VO2max) intensity. Before and after training, blood and muscle samples (v. lateralis) were collected. Results Baseline erythrocyte glutathione was lower (21.8 +/- 2.8 vs. 32.7 +/- 4.4 nmol/ml) and plasma protein oxidative damage and IL-6 were higher in T2DM (141.7 +/- 52.1 vs. 75.5 +/- 41.6 nmol/ml). Plasma catalase increased in T2DM after T-vent training (from 0.98 +/- 0.22 to 1.96 +/- 0.3 nmol/min/ml). T2DM groups demonstrated evidence of oxidative damage in response to training (elevated protein carbonyls). Baseline serum tNOx were higher in controls than T2DM (18.68 +/- 2.78 vs. 12.34 +/- 3.56 mu mol/l). Training at T-vent increased muscle nNOS and tNOx in the control group only. Pre-training muscle nNOS was higher in controls than in T2DMs, while the opposite was found for iNOS. No differences were found after training for plasma inflammatory markers. Conclusion Exercise training did not change body composition or aerobic fitness, but improved OS markers, especially when performed at T-vent. Non-diabetics responded to T-vent training by increasing muscle nNOS expression and tNOx levels in skeletal muscle while these parameters did not change in T2DM, perhaps due to higher insulin resistance (unchanged after intervention)

Superior Effects of High-Intensity Interval vs. Moderate-Intensity Continuous Training on Endothelial Function and Cardiorespiratory Fitness in Patients With Type 1 Diabetes: A Randomized Controlled Trial

This study aimed to compare the effect of high-intensity interval training (HIIT) with moderate-intensity continuous training (MCT) on endothelial function, oxidative stress and clinical fitness in patients with type 1 diabetes. Thirty-six type 1 diabetic patients (mean age 23.5 ± 6 years) were randomized into 3 groups: HIIT, MCT, and a non-exercising group (CON). Exercise was performed in a stationary cycle ergometers during 40 min, 3 times/week, for 8 weeks at 50–85% maximal heart rate (HRmax) in HIIT and 50% HRmax in MCT. Endothelial function was measured by flow-mediated dilation (FMD) [endothelium-dependent vasodilation (EDVD)], and smooth-muscle function by nitroglycerin-mediated dilation [endothelium-independent vasodilation (EIVD)]. Peak oxygen consumption (VO2peak) and oxidative stress markers were determined before and after training. Endothelial dysfunction was defined as an increase &lt; 8% in vascular diameter after cuff release. The trial is registered at ClinicalTrials.gov, identifier: NCT03451201. Twenty-seven patients completed the 8-week protocol, 9 in each group (3 random dropouts per group). Mean baseline EDVD was similar in all groups. After training, mean absolute EDVD response improved from baseline in HIIT: + 5.5 ± 5.4%, (P = 0.0059), but remained unchanged in MCT: 0.2 ± 4.1% (P = 0.8593) and in CON: −2.6 ± 6.4% (P = 0.2635). EDVD increase was greater in HIIT vs. MCT (P = 0.0074) and CON (P = 0.0042) (ANOVA with Bonferroni). Baseline VO2peak was similar in all groups (P = 0.96). VO2peak increased 17.6% from baseline after HIIT (P = 0.0001), but only 3% after MCT (P = 0.055); no change was detected in CON (P = 0.63). EIVD was unchanged in all groups (P = 0.18). Glycemic control was similar in all groups. In patients with type 1 diabetes without microvascular complications, 8-week HIIT produced greater improvement in endothelial function and physical fitness than MCT at a similar glycemic control

Respostas cardiorrespiratórias, oxidativas e de lesão muscular em bailarinas após aulas e ensaios de ballet

Introdução: As aulas de ballet parecem apresentar intensidades cardiorrespiratórias (CR) mais baixas do que os ensaios e espetáculos. Além disso, o ballet é caracterizado como um exercício intermitente, que envolve uma variedade de ações excêntricas, as quais podem estar relacionadas à lesão muscular (LM) e ao estresse oxidativo (EO). Objetivos: Descrever, comparar e correlacionar as respostas CR, de EO e LM em bailarinas após uma aula e um ensaio de ballet. Variáveis CR: consumo de oxigênio (VO2); frequência cardíaca (FC) e concentração sanguínea de lactato (La). Variáveis EO: estado redox (GSSH/GSH) e concentração sanguínea de lipoperóxidos (LPO). Variável de LM: concentração sanguínea de creatina quinase (CK). Métodos: Doze bailarinas voluntárias, de nível técnico avançado foram avaliadas. Teste de consumo máximo de oxigênio (VO2máx) e avaliação da composição corporal foram realizados. Em duas sessões separadas, as bailarinas realizaram uma aula e um ensaio de ballet, os quais foram previamente filmados na escola de dança e reproduzidos nas sessões de coleta de dados. VO2 e FC foram mensurados continuamente em todas as sessões. La foi verificado antes e depois do teste de VO2máx; e em repouso, aos 15 e 30 minutos da aula e do ensaio. Coletas de sangue foram realizadas em repouso, imediatamente após e 48h após a aula e o ensaio. As variáveis CR da aula (barra, centro e aula toda) e do ensaio (ensaio todo) foram também relacionadas aos dados do primeiro e segundo limiares ventilatorios (LV1 e LV2). La pós teste VO2max, pós aula e pós ensaio foram também comparados entre si. Dados expressos em média e desvio padrão. Estatística: ANOVA Two-way; ANOVA medidas repetidas; Post hoc Bonferroni (p<0,05). Resultados: VO2máx=37,3±4,7; LV1=24,92,7 e LV2=31,9±3,8 ml.kg-1.min-1. VO2 (aula=14,5±2,1 / ensaio=19,11,7 ml.kg-1.min-1); FC (aula=145,7±17,9 / ensaio=174,5±13,8 bpm) e La (aula=4,2±1,1 / ensaio=5,5 ± 2,7 mmol.l-1) foram significativamente diferentes entre si. Resultados Os resultados do VO2 (ml.kg-1.min-1 ) comparando-se aula, ensaio, LV1 e LV2 foram: aula barra (14,4±2,0); aula toda (14,5±2,1); aula centro (16,7±2,5); ensaio todo (19,1±1,7); LV1 (24,9 ± 2,7) e LV2 (31,9 ± 3,8). Aula barra e aula toda foram iguais entre si e diferentes de aula centro e ensaio todo, os quais não foram diferentes entre si. LV1 e LV2 foram diferentes entre si e de todos os demais parâmetros. Para FC, o ensaio todo se localizou entre LV1 e LV2. La (mmol.l-1) da aula (4,2±1,1) foi significativamente menor do que o La máximo (8,1±2,3), sendo o ensaio (5,5±2,7) estatisticamente igual a ambos. CK foi significativamente mais elevada pós aula do que ensaio, sendo os valores pós e 48h iguais entre si e ambos diferentes do pré. A razão GSSG/GSH diminuiu significativamente 48h pós aula e ensaio, mas não foi diferente entre os dois tipos de exercício. Os valores de LPO foram maiores para a aula do que para o ensaio, não apresentando diferenças em relação ao efeito tempo. Conclusão: A aula apresenta intensidade mais baixa do que o ensaio em relação às variáveis CR, entretanto, a aula foi mais intensa no que se refere aos parâmetros de dano celular. Parece que as bailarinas avaliadas estão adaptadas em relação aos parâmetros de dano celular, mas necessitam de treinamento mais específico do ponto de vista CR.Introduction: Ballet classes (BC) seem to have lower cardiorespiratory (CR) intensities than ballet reharshal (BR) and spectacles. Besides that, the ballet is characterized as an intermittent exercise that involves several eccentric avtions, which could be related to muscle damage (MD) and oxidative stress (OS). Aims: To describe, compare and correlate ballet dancers` CR, MD and OS responses after a BC and a BR. CR variables: oxygen consumption (VO2); heart rate (HR) and lactate blood concentration (La). OS variables: redox state (GSSH/GSH) and lipoperoxides blood concetration (LPO). MD variable: creatine kinase blood concentration (CK). Methods: Twelve female advanced ballet dancers volunteered this study. Maximum oxygen consumption (VO2max) test and body composition assessment were performed. In two separated sessions, the dancers performed a BC and a BR, which were previously recorded in their dance school, and further transmited during the data colecttion sessions. VO2 and HR were continually measured during all sessions. La was verified before and after the VO2max test; and in rest, in 15 and 30 minutes of the BC and BR. Blood colections were performed in rest, immediately after and 48h after the BC and BR. CR responses during BC (barre, center floor and whole BC) and during BR (whole BR) were also compared to the CR responses in the first and second ventilatory threshold (VT1 and VT2). The La was also compered after VO2max test, after the BC and after BR. Data were expressed in average and standart deviation. Statistics: ANOVA Two-way; ANOVA repeated measures and Post hoc Bonferroni (p<0.05). Results: VO2max=37.3±4.7; VT1=24.92.7 and VT2=31.93.8 ml.kg-1.min-1. VO2 (BC=14.5±2.1 / BR=19.1±1.7 ml.kg-1.min-1); HR (BC=145.7±17.9 / BR=175±13.8 bpm) e La (BC=4.2±1.1 / BR=5.5 ± 2.7 mmol.l-1) were significantly different among themselves. VO2 (ml.kg-1.min-1) results comparing BC, BR, VT1 and VT2 were: barre (14.4±2.0); whole BC (14.5±2.1); center floor (16.7±2.5); whole BR (19.11.7); VT1 (24.9 ± 2.7) and VT2 (31.9 ± 3.8). For FC results, the whole BR was located between VT1 and VT2. La (mmol.l-1) in the BC (4.2±1.1) was significantly lower than La in the VO2max test (8.1±2.3), being the BR (5.5±2.7) statistically equal to both. CK was significantly higher after the BC than the BR, being the values post and 48h post equal between themselves and both significantly different from before BC and BR. The ratio GSSG/GSH was significantly lower in 48h after BC and BR, but it was not different in relation to the type of exercise (BC or BR). LPO values were higher in the BC than the BR, however they did not show any differences related to the time. Conclusion: BC showed lower CR responses than BR, nevertheless, BC was more intense concerning the cell damage parameters. It appears that the dancers evaluated are well adapeted in relation to cell damage parameters, but they need more specific training from the CR point of view

Respostas cardiorrespiratórias, oxidativas e de lesão muscular em bailarinas após aulas e ensaios de ballet

Introdução: As aulas de ballet parecem apresentar intensidades cardiorrespiratórias (CR) mais baixas do que os ensaios e espetáculos. Além disso, o ballet é caracterizado como um exercício intermitente, que envolve uma variedade de ações excêntricas, as quais podem estar relacionadas à lesão muscular (LM) e ao estresse oxidativo (EO). Objetivos: Descrever, comparar e correlacionar as respostas CR, de EO e LM em bailarinas após uma aula e um ensaio de ballet. Variáveis CR: consumo de oxigênio (VO2); frequência cardíaca (FC) e concentração sanguínea de lactato (La). Variáveis EO: estado redox (GSSH/GSH) e concentração sanguínea de lipoperóxidos (LPO). Variável de LM: concentração sanguínea de creatina quinase (CK). Métodos: Doze bailarinas voluntárias, de nível técnico avançado foram avaliadas. Teste de consumo máximo de oxigênio (VO2máx) e avaliação da composição corporal foram realizados. Em duas sessões separadas, as bailarinas realizaram uma aula e um ensaio de ballet, os quais foram previamente filmados na escola de dança e reproduzidos nas sessões de coleta de dados. VO2 e FC foram mensurados continuamente em todas as sessões. La foi verificado antes e depois do teste de VO2máx; e em repouso, aos 15 e 30 minutos da aula e do ensaio. Coletas de sangue foram realizadas em repouso, imediatamente após e 48h após a aula e o ensaio. As variáveis CR da aula (barra, centro e aula toda) e do ensaio (ensaio todo) foram também relacionadas aos dados do primeiro e segundo limiares ventilatorios (LV1 e LV2). La pós teste VO2max, pós aula e pós ensaio foram também comparados entre si. Dados expressos em média e desvio padrão. Estatística: ANOVA Two-way; ANOVA medidas repetidas; Post hoc Bonferroni (p<0,05). Resultados: VO2máx=37,3±4,7; LV1=24,92,7 e LV2=31,9±3,8 ml.kg-1.min-1. VO2 (aula=14,5±2,1 / ensaio=19,11,7 ml.kg-1.min-1); FC (aula=145,7±17,9 / ensaio=174,5±13,8 bpm) e La (aula=4,2±1,1 / ensaio=5,5 ± 2,7 mmol.l-1) foram significativamente diferentes entre si. Resultados Os resultados do VO2 (ml.kg-1.min-1 ) comparando-se aula, ensaio, LV1 e LV2 foram: aula barra (14,4±2,0); aula toda (14,5±2,1); aula centro (16,7±2,5); ensaio todo (19,1±1,7); LV1 (24,9 ± 2,7) e LV2 (31,9 ± 3,8). Aula barra e aula toda foram iguais entre si e diferentes de aula centro e ensaio todo, os quais não foram diferentes entre si. LV1 e LV2 foram diferentes entre si e de todos os demais parâmetros. Para FC, o ensaio todo se localizou entre LV1 e LV2. La (mmol.l-1) da aula (4,2±1,1) foi significativamente menor do que o La máximo (8,1±2,3), sendo o ensaio (5,5±2,7) estatisticamente igual a ambos. CK foi significativamente mais elevada pós aula do que ensaio, sendo os valores pós e 48h iguais entre si e ambos diferentes do pré. A razão GSSG/GSH diminuiu significativamente 48h pós aula e ensaio, mas não foi diferente entre os dois tipos de exercício. Os valores de LPO foram maiores para a aula do que para o ensaio, não apresentando diferenças em relação ao efeito tempo. Conclusão: A aula apresenta intensidade mais baixa do que o ensaio em relação às variáveis CR, entretanto, a aula foi mais intensa no que se refere aos parâmetros de dano celular. Parece que as bailarinas avaliadas estão adaptadas em relação aos parâmetros de dano celular, mas necessitam de treinamento mais específico do ponto de vista CR.Introduction: Ballet classes (BC) seem to have lower cardiorespiratory (CR) intensities than ballet reharshal (BR) and spectacles. Besides that, the ballet is characterized as an intermittent exercise that involves several eccentric avtions, which could be related to muscle damage (MD) and oxidative stress (OS). Aims: To describe, compare and correlate ballet dancers` CR, MD and OS responses after a BC and a BR. CR variables: oxygen consumption (VO2); heart rate (HR) and lactate blood concentration (La). OS variables: redox state (GSSH/GSH) and lipoperoxides blood concetration (LPO). MD variable: creatine kinase blood concentration (CK). Methods: Twelve female advanced ballet dancers volunteered this study. Maximum oxygen consumption (VO2max) test and body composition assessment were performed. In two separated sessions, the dancers performed a BC and a BR, which were previously recorded in their dance school, and further transmited during the data colecttion sessions. VO2 and HR were continually measured during all sessions. La was verified before and after the VO2max test; and in rest, in 15 and 30 minutes of the BC and BR. Blood colections were performed in rest, immediately after and 48h after the BC and BR. CR responses during BC (barre, center floor and whole BC) and during BR (whole BR) were also compared to the CR responses in the first and second ventilatory threshold (VT1 and VT2). The La was also compered after VO2max test, after the BC and after BR. Data were expressed in average and standart deviation. Statistics: ANOVA Two-way; ANOVA repeated measures and Post hoc Bonferroni (p<0.05). Results: VO2max=37.3±4.7; VT1=24.92.7 and VT2=31.93.8 ml.kg-1.min-1. VO2 (BC=14.5±2.1 / BR=19.1±1.7 ml.kg-1.min-1); HR (BC=145.7±17.9 / BR=175±13.8 bpm) e La (BC=4.2±1.1 / BR=5.5 ± 2.7 mmol.l-1) were significantly different among themselves. VO2 (ml.kg-1.min-1) results comparing BC, BR, VT1 and VT2 were: barre (14.4±2.0); whole BC (14.5±2.1); center floor (16.7±2.5); whole BR (19.11.7); VT1 (24.9 ± 2.7) and VT2 (31.9 ± 3.8). For FC results, the whole BR was located between VT1 and VT2. La (mmol.l-1) in the BC (4.2±1.1) was significantly lower than La in the VO2max test (8.1±2.3), being the BR (5.5±2.7) statistically equal to both. CK was significantly higher after the BC than the BR, being the values post and 48h post equal between themselves and both significantly different from before BC and BR. The ratio GSSG/GSH was significantly lower in 48h after BC and BR, but it was not different in relation to the type of exercise (BC or BR). LPO values were higher in the BC than the BR, however they did not show any differences related to the time. Conclusion: BC showed lower CR responses than BR, nevertheless, BC was more intense concerning the cell damage parameters. It appears that the dancers evaluated are well adapeted in relation to cell damage parameters, but they need more specific training from the CR point of view

Association of <span style="font-variant: small-caps">l</span>-Arginine Supplementation with Markers of Endothelial Function in Patients with Cardiovascular or Metabolic Disorders: A Systematic Review and Meta-Analysis

l-Arginine supplementation is a potential therapy for treating cardiovascular and metabolic diseases. However, the use of distinct l-arginine sources, intervened populations, and treatment regimens may have yielded confusion about their efficacy. This research constitutes a systematic review and meta-analysis summarizing the effects of l-arginine supplementation compared to placebo in individuals with cardiovascular disease (CVD), obesity, or diabetes. Eligibility criteria included randomized clinical trials and interventions based on oral supplementation of l-arginine with a minimum duration of three days; comparison groups consisted of individuals with the same disease condition receiving an oral placebo substance. The primary outcome was flow-mediated dilation, and secondary outcomes were nitrite/nitrate (NOx) rate and asymmetric dimethylarginine (ADMA). Statistical heterogeneity among studies included in the meta-analyses was assessed using the inconsistency index (I2). Fifty-four full-text articles from 3761 retrieved references were assessed for eligibility. After exclusions, 13 studies were included for data extraction. There was no difference in blood flow after post-ischemic hyperemia between the supplementation of l-arginine and placebo groups before and after the intervention period (standardized mean difference (SMD) = 0.30; 95% confidence intervals (CIs) = &#8722;0.85 to 1.46; I2 = 96%). Sensitivity analysis showed decreased heterogeneity when the studies that most favor arginine and placebo were removed, and positive results in favor of arginine supplementation were found (SMD = 0.59; 95% CIs = 0.10 to 1.08; I2 = 75%). No difference was found in meta-analytical estimates of NOx and ADMA responses between arginine or placebo treatments. Overall, the results indicated that oral l-arginine supplementation was not associated with improvements on selected variables in these patients (PROSPERO Registration: CRD42017077289)

Divergence of intracellular and extracellular HSP72 in type 2 diabetes: does fat matter?

Mammalian cells have developed a range of adaptations to survive against acute and prolonged (but not lethal) stresses (Beckmann et al. 1992). Among these adaptations, the heat shock response is the most conserved, being found in all prokaryotes and eukaryotes (Locke and Noble 1995). Heat shock proteins (HSPs) are considered part of a family of proteins known as "stress proteins" since their expression is induced by a wide range of stressors, such as oxidative stress (Krause et al. 2007), thermal stress (Yang et al. 1996), ischaemia (Richard et al. 1996), exercise (Krause et al. 2007), metabolic stress (Beckmann et al. 1992) and many others. The genes encoding Hsps are highly conserved, and many of these genes and their protein products can be assigned to different families on the basis of their typical molecular weight (kDa): HSP110 (or officially named HSPH), HSP90 (or HSPC), HSP70 (or HSPA), HSP60 (or HSPD1), HSP40 (or DNAJ) and small hsp families (HSPB) (Kampinga et al. 2009). In eukaryotes, many families comprise multiple members that differ in inducibility, intracellular localization and function (Feder and Hofmann 1999)