Influência do posicionamento de membros superiores sobre os efeitos do treinamento muscular inspiratório de curta duração e alta intensidade em indivíduos jovens sadios

The purpose of the study was to analyse the effects of a short-term, high-intensity inspiratory muscle training (IMT) on healthy youth maximal respiratory pressures, with and without arm bracing postures. Thirty young women were randomly assigned to three groups: control group (CG); group training with no arm bracing (NAB); and group training with arm bracing (AB). The IMT consisted of three 10-minute daily supervised sessions for three consecutive days. Before, at the end, and one month after the end of training, subjects' maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) were assessed. In NAB group a significant increase in MIP was found, from -75±10 to -97±14 cmH2O (pO objetivo do estudo foi analisar os efeitos de um treinamento muscular inspiratório (TMI) de curta duração e alta intensidade, com e sem o apoio de membros superiores, sobre as pressões respiratórias máximas em jovens saudáveis. Trinta jovens do sexo feminino foram aleatoriamente distribuídas em três grupos: o grupo controle (GC) fez treinamento placebo na posição sentada; o grupo GSA treinou em pé sem apoio de membros superiores; e o grupo GCA treinou com apoio de membros superiores. O TMI consistiu em três sessões diárias de 10 minutos em três dias consecutivos. Antes, ao final e após um mês do final do treino foram avaliadas a pressão inspiratória máxima (PImáx) e a pressão expiratória máxima (PEmáx). No GSA, houve aumento significante da PImáx após o treino de -75±10 para -97±14 cmH2O (

Energy expenditure during daily activities as measured by two motion sensors in patients with COPD

SummaryBackgroundIn patients with chronic obstructive pulmonary disease (COPD), energy expenditure (EE) assessment during the performance of daily activities is not yet studied in depth. The aim of this study was to determine which daily activities are more demanding to patients with COPD and to compare the accuracy of EE estimation given by the pedometer Digiwalker SW701 (DW) and the multisensor SenseWear Armband (SAB).MethodsThirty-six patients with COPD (20 men; FEV1 48 ± 15%predicted; BMI 25.7 ± 8 kg/m2) were submitted to a modified version of the Glittre ADL-test, which included five activities performed for 1 min each: walking on the level, walking on the level carrying a backpack, walking up/downstairs, rising/sitting in chairs and moving objects in and out of a shelf. During the protocol subjects wore both devices concomitantly, and indirect calorimetry (IC) was simultaneously performed as the criterion method to assess EE.ResultsThe most demanding daily activity for individuals with COPD was walking up/downstairs (4.9 ± 1.7 kcal versus 3.7 ± 1.4 to 4.2 ± 1.8 kcal for the other tasks; p < 0.05). EE estimation by the SAB did not show difference in comparison to IC for the sum of the five activities (SAB = 22.7±7 kcal versus IC = 21±8 kcal; p > 0.05), although overestimation was found in activities involving walking. DW showed significant EE underestimation in the sum of the activities (9.6 ± 4.3kcal; p < 0.05 versus IC) and for each activity.ConclusionWalking up/downstairs was the most energy-demanding daily activity for patients with COPD. Furthermore, during daily activities, the multisensor showed adequate overall estimation of energy expenditure, as opposed to the pedometer

Improvement of heart rate variability after exercise training and its predictors in COPD

SummaryBackgroundCurrent literature lacks solid evidence on the improvement of heart rate variability (HRV) after exercise training in patients with COPD.ObjectivesWe aimed to investigate changes in HRV after two exercise training programs in patients with COPD and to investigate the determinants of these eventual changes.MethodsForty patients with COPD (FEV1 39±13%pred) were randomized into high (n=20) or low (n=20) intensity exercise training (3-month duration), and had their HRV assessed by the head-up tilt test before and after either protocols. Baseline spirometry, level of daily physical activity, exercise capacity, body composition, functional status, health-related quality of life and muscle force were also assessed to investigate the determinants of improvement in HRV after the training program.ResultsThere was a significant improvement in HRV only after the high-intensity protocol (pre versus post; SDNN 29±15ms versus 36±19ms; rMSSD 22±14ms versus 28±22ms; p<0.05 for both). Higher values of biceps brachialis strength, time spent walking in daily life and SDNN at baseline were determinants of improvement in HRV after the training program.ConclusionsHigh-intensity exercise training improves HRV at rest and during orthostatic stimulus in patients with COPD. Better baseline total HRV, muscle force and daily physical activity level are predictors of HRV improvements after the training program

Effect of low-level phototherapy on delayed onset muscle soreness: a systematic review and meta-analysis

To determine the effectiveness of low-level phototherapy (i.e. light-emitting diode therapy [LEDtherapy] or light amplification by stimulated emission of radiation therapy [LASERtherapy]) on pain, skeletal muscle injury (creatine kinase [CK] levels and edema) and skeletal muscle function (range of movement and strength) in people undergoing an exercise protocol. (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, SciELO and LILACS up to May 2014), we included randomized controlled trials, quasi-randomized controlled trials and crossover studies in which study participants were allocated to receive either low-level phototherapy or placebo treatment. Phototherapy should have been applied in a single treatment session, either before or after an exercise protocol. We identified 15 studies involving 317 participants. Meta-analyses were limited by substantial heterogeneity. Compared to the placebo group, reduction in CK levels was only observed when LASERtherapy was applied before an exercise protocol (standardized mean difference = -0.66; 95 % CI = -1.30, -0.02). No between-group difference in edema, range of movement and strength were detected when phototherapy was applied before or after exercise. Evidence from this review suggests that low-level phototherapy may not have substantial effect in the treatment of skeletal muscle injury and pain caused by exercise. Definitive conclusions are limited due to the small number of included studies in each meta-analysis, disparities across the included studies and small sample sizes

Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength

Introduction: People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength. Methods: This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster. Results: One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p &lt; 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes. Conclusions: Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients

Low-level phototherapy to improve exercise capacity and muscle performance: a systematic review and meta-analysis

The aim of this study was to evaluate the effectiveness of pre-exercise low-level phototherapy (Light-Emitting Diode therapy [LEDtherapy] or Light Amplification by Stimulate Emission of Radiation therapy [LASERtherapy]) in increasing exercise capacity and muscle performance of people undergoing exercise when compared to placebo treatment. Randomized controlled trials and crossover studies were sought on CENTRAL, MEDLINE, EMBASE, SciELO, PEDro and LILACS from its inception up to February 2015. References lists of included studies were sought for additional relevant research. Two authors independently extracted data on study design, treatment parameters, exercise capacity (number of repetitions, time to exhaustion, blood lactate concentration and lactate dehydrogenase activity) and muscle performance (torque, power and strength) using an structured table. Agreement should be reached by consensus or by a third reviewer. Sixteen studies involving 297 participants were included. Improvement of number of repetitions (mean difference [MD] [95 % confidence interval] = 3.51 repetitions [0.65–6.37]; P = 0.02), delay in time to exhaustion (MD = 4.01 s [2.10–5.91]; P < 0.0001), reduction in lactate levels (MD = 0.34 mmol/L [0.19–0.48]; P < 0.00001) and increased peak torque (MD = 21.51 Nm [10.01–33.01]; P < 0.00001) were observed when LASERtherapy was applied. LEDtherapy meta-analyses were performed with two studies and retrieved no between-group statistically significant difference in power, lactate levels or time to exhaustion. Although our results suggest that LASERtherapy is effective in improving skeletal muscle exercise capacity, the quality of the current evidence is limited