Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease / Efeitos do treinamento resistido sobre as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo na doença de Parkinson

ABSTRACT: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. Methods: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.

RESUMO Objetivo: Avaliar os efeitos do treinamento resistido nas respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo em pacientes com doença de Parkinson. Métodos: Vinte e quarto pacientes com doença de Parkinson (estágios 2 a 3 de Hoehn e Yahr modificado) foram aleatoriamente randomizados em dois grupos: Controle e Treinamento Resistido. O Grupo Treinamento Resistido realizou, duas vezes por semana, cinco exercícios resistidos, duas a quatro séries, seis a 12 repetições máximas por série. O Grupo Controle manteve seu estilo de vida. No início e após 12 semanas, consumo de oxigênio, pressão arterial sistólica e frequência cardíaca foram avaliados em repouso e durante um teste de esforço cardiopulmonar máximo realizado em um cicloergômetro. As avaliações durante o exercício foram realizadas nas intensidades submáximas (a inclinação da regressão linear entre as variáveis fisiológicas e as cargas absolutas), nas intensidades submáximas relativas (limiar anaeróbico e ponto de compensação respiratória) e na intensidade máxima (pico do exercício). Adicionalmente, foi avaliada a força muscular. Resultados: Comparado com o início, o consumo de oxigênio pico aumentou, de forma semelhante, em ambos os grupos após 12 semanas. A frequência cardíaca e a pressão arterial sistólica avaliadas nas intensidades submáximas absolutas e relativas, assim como no pico do exercício, não se modificaram em nenhum dos grupos. Finalmente, diferente do Grupo Controle, a força muscular aumentou no Grupo Treinamento Resistido após 12 semanas. Conclusão: Em pacientes com doença de Parkinson sem comorbidades cardiovasculares, o treinamento resistido aumenta a força muscular, mas não modifica as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo.

Association of health vulnerability with adverse outcomes in older people with COVID-19: a prospective cohort study

OBJECTIVES: Health vulnerability is associated with a higher risk of mortality and functional decline in older people in the community. However, few studies have evaluated the role of the Vulnerable Elders Survey (VES-13) in predicting clinical outcomes of hospitalized patients. In the present study, we tested the ability of the VES-13 to predict mortality and the need for invasive mechanical ventilation in older people hospitalized with coronavirus disease 2019 (COVID-19). METHODS: This prospective cohort included 91 participants aged ≥60 years who were confirmed to have COVID-19. VES-13 was applied, and the demographic, clinical, and laboratory variables were collected within 72h of hospitalization. A Poisson generalized linear regression model with robust variance was used to estimate the relative risk of death and invasive mechanical ventilation. RESULTS: Of the total number of patients, 19 (21%) died and 15 (16%) required invasive mechanical ventilation. Regarding health vulnerability, 54 (59.4%) participants were classified as non-vulnerable, 30 (33%) as vulnerable, and 7 (7.6%) as extremely vulnerable. Patients classified as extremely vulnerable and male sex were strongly and independently associated with a higher relative risk of in-hospital mortality (p<0.05) and need for invasive mechanical ventilation (p<0.05). CONCLUSION: Elderly patients classified as extremely vulnerable had more unfavorable outcomes after hospitalization for COVID-19. These data highlight the importance of identifying health vulnerabilities in this population.

Sex and exercise-mode differences in post-exercise blood pressure and heart rate variability responses during a workday

To assess the influences of sex and exercise mode on post-exercise Blood pressure (BP) immediately after exercise and during daily work. METHODS 20 healthy adults (9F/11M), randomly underwent three experimental sessions prior to their work routine: RE- Circuit resistance exercise at 40% of 1RM, AE- Aerobic exercise at 60-70% of heart rate (HR) reserve and CON- Control session. BP was assessed before and along the 1st hour of the post-intervention period (i.e. laboratory phase), and intermittently for 9h in the workplace. Results: RE promoted great BP reductions, but only in men, and this reduction persisted along the daily work (Men-RE: SBP= -1069±695 mmHg.540min; DBP= -612±325 mmHg.540min). On the other hand, AE produced slight DBP reduction in men during daily work (Men-AE: DBP= -241±730 mmHg.540min), and in women only in the laboratory phase (Women-AE: SBP= -108±65mmHg.60min). CONCLUSION Resistance exercise promotes a significant positive impact on BP in men but does not seem to be effective for women. On the other hand, AE produces moderate BP reductions in men and women.(AU)

Effect of water intake on postexercise cardiovascular recovery / Efeito da ingestao hidrica sobre a recuperacao cardiovascular pos-exercicio

Physical exercise elicits an increase in heart rate (HR), blood pressure (BP) and, consequently, in the rate-pressure product (RPP). Recovery of HR immediately after exercise indicates cardiovascular health. Blood pressure also decreases after exercise, occasionally reaching values lower than pre-exercise levels (postexercise hypotension). Studies have shown a positive effect of water intake on HR recovery after exercise. However, little is known about the effect of water intake on postexercise BP and RPP responses. The objective of this study was to evaluate the effects of water intake on postexercise cardiac work assessed by HR, BP and RPP. Fourteen healthy volunteers (22 ± 1.4 years) participated in the study. The experimental session consisted of HR, systolic (SBP) and diastolic BP (DBP) recording at rest, followed by submaximal exercise on a cycle ergometer. Next, the subjects consumed water and the cardiovascular variables were recorded during recovery. In addition, a control session without postexercise water intake was performed. The RPP was calculated from the product of HR and SBP. Water intake prevented a postexercise hypotensive effect on DBP, but accelerated postexercise HR and RPP reduction during recovery when compared to the control session. It was concluded that water intake is an effective strategy to reduce postexercise cardiac work.

O exercício físico promove a elevação da frequência cardíaca (FC), pressão arterial (PA) e, por consequência, do duplo produto (DP). Imediatamente após o término do exercício, há a recuperação da FC; resposta que indica boa saúde cardiovascular. A PA também apresenta queda pós-exercício, atingindo, eventualmente, valores abaixo do repouso (hipotensão pós-exercício; HPE). Estudos têm demonstrado efeito positivo da ingestão hídrica (IH) sobre a recuperação da FC pós-exercício. Pouco se sabe a respeito do efeito dessa estratégia sobre o comportamento da PA e do DP nesse período. O objetivo do estudo foi investigar o efeito da IH sobre o trabalho cardiovascular pós-exercício, por meio da avaliação da FC, PA e DP. Quatorze voluntários saudáveis (22 ± 1,4 anos) participaram desse estudo. A sessão experimental constou do registro da FC e PA sistólica (PAS) e diastólica (PAD) de repouso, seguido de exercício físico submáximo em cicloergômetro. Posteriormente, realizou-se a IH e registro das variáveis cardiovasculares na recuperação. Adicionalmente, realizou-se uma sessão controle, excluindo-se a IH pós-exercício. O DP foi calculado a partir do produto da FC pela PAS. A IH impediu a ocorrência de HPE na PAD, porém acelerou a redução da FC e do DP, no período da recuperação pós-exercício, quando comparada à sessão controle. Pode-se concluir que a IH é uma estratégia eficiente na redução do trabalho cardiovascular pós-exercício.

Influência do grupamento muscular na recuperação da frequência cardíaca após o exercício resistido / Influence of the muscle group in heart rate recovery after resistance exercise

INTRODUÇÃO: O exercício resistido (ER) é um tipo de exercício amplamente praticado, sendo recomendado para a manutenção ou aprimoramento da força e massa musculares e utilizado com fins estéticos e de saúde. Apesar disto, pouco se sabe sobre o impacto deste tipo de exercício sobre o controle autonômico cardíaco, tampouco da influência do grupamento muscular nesta resposta. OBJETIVO: Verificar a influência do grupamento muscular utilizado durante o ER, na recuperação da frequência cardíaca (REC-FC) pós-exercício. MÉTODOS: Participaram deste estudo 14 indivíduos do sexo masculino (27,4 ± 6,1 anos; 79,4 ± 10,4 kg; 1,77 ± 0,1 m; 10,5 ± 4,6 %G) experientes na prática de ER. O protocolo experimental constou da realização de teste e reteste de 1RM nos exercícios supino horizontal e meio agachamento para determinação da força dinâmica máxima e execução do número máximo de repetições a 80% de 1RM com avaliação da REC-FC durante um minuto pós-exercício. RESULTADOS: Os resultados encontrados indicam menor REC-FC nos 10, 20, 30 e 40 segundos após o exercício meio agachamento em comparação ao supino horizontal. CONCLUSÃO: Os achados confirmam a influência do grupamento muscular na resposta autonômica cardíaca pós-esforço, no ER.

INTRODUCTION: Resistance exercise (RE) is a widely practiced type of exercise and is recommended for strength and muscle mass maintenance or improvement, being used for esthetic and health purposes. Despite this, little is known about the impact of this type of exercise on cardiac autonomic control, nor the influence of muscle group in this response. OBJECTIVE: The objective of this study was to investigate the influence of muscle group used during RE, on post-resistance exercise heart rate recovery (HRR). METHODS: The study included 14 males (27.4 ± 6.1 years, 79.4 ± 10.4 kg, 1.77 ± 0.1 m) experienced in ER practice. The experimental protocol consisted in performing the 1-RM test and re-test on bench press and half squat to determine the maximum dynamic force; and execution of maximum number of repetitions at 80% 1RM with assessment of HRR for 1 minute post-exercise. RESULTS: The results indicate lower HRR at 10, 20, 30 and 40 seconds after meio squat compared to horizontal bench press (p < 0.05). CONCLUSION: The findings confirm the influence of muscle group on post-resistance exercise cardiac autonomic response.