Functional training: functional for what and for whom?

The prescription of neuromuscular conditioning programs aimed at the development and maintenance of activities of daily living (ADLs) has been based on functionality. The functional training proposal needs further academic discussion. The present study presents a critical view on the functional training, assumptions, characteristics and definitions. The mere exercise selection does not make it a functional training, as there are no exercises that have greater or lesser functionality. For training to be functional, variables must be controlled and monitored, so that the prescription has the proper dose of exercise that the individual must perform in the training unit. Furthermore, a well-planned and objective training does not depend on a name, method, system, program, exercise or equipment.A prescrição de programas de condicionamento neuromuscular voltados ao desenvolvimento e manutenção das atividades da vida diária (AVD’s) tem-se baseado na funcionalidade. A proposta de treinamento funcional carece de maior discussão acadêmica. O presente texto apresenta visão crítica sobre o treinamento funcional, as premissas, características e definições. A mera seleção de exercícios não torna um treinamento funcional, assim como não existem exercícios que possuam maior ou menor funcionalidade. Para um treinamento ser funcional, deve-se controlar e manipular as variáveis para que a prescrição contenha a dose adequada de exercício que o indivíduo deve realizar na unidade de treinamento. Ademais, um treinamento bem planejado e objetivo não depende de um nome, método, sistema, programa, exercício ou material

The effects of weight categories on the time-motion analysis of female high-level judo athletes between the 2016 and 2020 Olympic cycles

This study compared the time of female judo combat phases in international competitions between two Olympic cycles (2016; 2020) according to weight divisions (48 kg = 132; 52 kg = 72; 57 kg = 109; 63 kg = 96; 70 kg = 69; 78 kg = 106; >78 kg = 82; total = 666 combats/cycle). The behaviors of 1,332 high-level female judo combats were randomly observed over two Olympic cycles (2016 = 666; 2020 = 666) from the top 20 athletes in the world ranking by weight division. We performed time-motion analysis according to the combat phase and sequential judo actions (approach, gripping, attack, defense, groundwork, pause, and effort: pause ratio) considering the moment when the combat ended (Regular time = RT; Golden score = GS). The weight division groups were compared between Olympic cycles (2016; 2020), and p < 0.05 was defined as significant. The main results showed that 2020 athletes spent less time in the gripping (p = 0.005), attack (p < 0.001), defense (p < 0.001), groundwork (p<0.001) and pause (p = 0.002) phases than 2016 athletes. However, compared by the end-of-combat, 2020 female athletes spent less time in all combat phases for RT combats (p < 0.001), and more time in the approach phase for GS combats (p < 0.05) than in 2016. The 2016 weight divisions showed a higher diversity in the effort: pause ratio (2.5:1–3.4:1), whereas the 2020 weight divisions had values closer to each other (2.8,1–3:1). Analyzing each weight division separately and by the end-of-combat, the main results showed that (p < 0.05): 48, 63, 70, and 78 kg reduced the time in almost every phase of RT combat (except for: 63 kg = gripping and attack; 70 kg = approach and groundwork; 78 kg = approach); 48 and 57 kg increased the groundwork time in GS combats whereas 78 kg decreased; 52 kg and 78 kg increased the GS approach time. The temporal behavior of the combats changed between the Olympic cycles with different rules. These data must be considered to understand the characteristics of each group and to prescribe specialized training in female judo

Thermographic imaging in sports and exercise medicine: a Delphi study and consensus statement on the measurement of human skin temperature

The importance of using infrared thermography (IRT) to assess skin temperature (tsk) is increasing in clinical settings. Recently, its use has been increasing in sports and exercise medicine; however, no consensus guideline exists to address the methods for collecting data in such situations. The aim of this study was to develop a checklist for the collection of tsk using IRT in sports and exercise medicine. We carried out a Delphi study to set a checklist based on consensus agreement from leading experts in the field. Panelists (n = 24) representing the areas of sport science (n = 8; 33%), physiology (n = 7; 29%), physiotherapy (n = 3; 13%) and medicine (n = 6; 25%), from 13 different countries completed the Delphi process. An initial list of 16 points was proposed which was rated and commented on by panelists in three rounds of anonymous surveys following a standard Delphi procedure. The panel reached consensus on 15 items which encompassed the participants’ demographic information, camera/room or environment setup and recording/analysis of tsk using IRT. The results of the Delphi produced the checklist entitled “Thermographic Imaging in Sports and Exercise Medicine (TISEM)” which is a proposal to standardize the collection and analysis of tsk data using IRT. It is intended that the TISEM can also be applied to evaluate bias in thermographic studies and to guide practitioners in the use of this technique

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Methods of body-mass reduction by combat sport athletes

The aim of this study was to investigate the methods adopted to reduce body mass (BM) in competitive athletes from the grappling (judo, jujitsu) and striking (karate and tae kwon do) combat sports in the state of Minas Gerais, Brazil. An exploratory methodology was employed through descriptive research, using a standardized questionnaire with objective questions self-administered to 580 athletes (25.0 +/- 3.7 yr, 74.5 +/- 9.7 kg, and 16.4% +/- 5.1% body fat). Regardless of the sport, 60% of the athletes reported using a method of rapid weight loss (RWL) through increased energy expenditure. Strikers tend to begin reducing BM during adolescence. Furthermore, 50% of the sample used saunas and plastic clothing, and only 26.1% received advice from a nutritionist. The authors conclude that a high percentage of athletes uses RWL methods. In addition, a high percentage of athletes uses unapproved or prohibited methods such as diuretics, saunas, and plastic clothing. The age at which combat sport athletes reduce BM for the first time is also worrying, especially among strikers

Waist circumference percentile curves as a screening tool to predict cardiovascular risk factors and metabolic syndrome risk in Brazilian children

The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children

Prevalence and factors associated with metabolic syndrome in 6-10-year-old children

Abstract Aims: to identify the prevalence of metabolic syndrome (MetS) and associated risk factors in children. Methods: a total of 1,480 Brazilian children aged 6-10 years old (52.2% girls) participated in this population-based, epidemiological cross-sectional study. The inclusion criteria were children born between the years 2001 and 2006, of both sexes, who did not use remedy, were not on a calorie restriction diet, and who respected the 12-hour fast for blood collection. Anthropometric measurements, blood pressure, blood collection, and completion of the Previous Day Food Questionnaire and interview using a Physical Activity List were held at school. Parents were asked to complete a questionnaire on socioeconomic status and lifestyle habits of their child. Chi-square test compared proportions and factors associated with MetS were identified using Poisson Regression. Results: Girls had significantly higher MetS prevalence compared with boys (12.6% vs. 8.5%, p=0.046). After multivariable analysis, body fat percentage (p=0.001), fat mass (p<0.001), lean body mass (p< 0.001) and sedentary behavior (p= 0.050) were positively associated with MetS. Conclusions: Modifiable factors such as body fat percentage, fat mass, lean body mass and sedentary behavior were associated with MetS in children. Thus, interventions targeted for weight management, and adopting healthy habits such as reducing time in front of TV/computer/video game need to be part of the lifestyle of children

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)