External iliac artery endofibrosis in an elite female endurance cyclist / Endofibrose da artéria ilíaca externa em uma ciclista de resistência de elite

Abstract External iliac artery endofibrosis is a rare pathology that affects high-level endurance athletes, especially cyclists. Classical symptoms include pain, loss of power, and/or cramp in the affected limb while training at maximal effort. The patient's lack of atherosclerotic risk factors makes clinical suspicion of arteriopathy challenging. Moreover, the best management of such patients is still a subject of discussion. We report the case of a 36-year-old professional female endurance cyclist who presented with lower extremity pain during training. Right external iliac artery endofibrosis was diagnosed and the patient underwent surgical treatment. At two-months follow-up, she reported significant improvement in symptoms. This case highlights the importance of diagnosing peripheral vascular disease in young patients and athletes, who do not fit the ordinary profile of patients with atherosclerotic risk factors.

Resumo A endofibrose da artéria ilíaca externa é uma doença rara que afeta atletas de resistência (endurance) de nível competitivo, principalmente ciclistas. Os sintomas clássicos incluem dor, perda de força e/ou câimbras no membro afetado ao fazer esforço máximo durante o treino. A ausência de fatores de risco ateroscleróticos nesses pacientes torna a suspeita clínica de arteriopatia desafiadora. Além disso, o melhor manejo ainda é motivo de debate. Relatamos o caso de uma ciclista de resistência profissional, de 36 anos, que apresentou dor nos membros inferiores durante o treino. Foi diagnosticada endofibrose da artéria ilíaca externa, e a paciente foi submetida a tratamento cirúrgico. Após seguimento por dois meses, a paciente relatou melhora significativa dos sintomas. Este caso destaca a importância do diagnóstico de doença vascular periférica em pacientes jovens e atletas, os quais não se encaixam no perfil comum do paciente com fatores de risco ateroscleróticos.

Performance comparison in the Wingate test between standing and seated positions in competitive cyclists

Abstract Aims: The current study aimed to compare the anaerobic power output through the Wingate test in different positions, i.e., standing and seated, and identify the relationship between power-output and body mass. Methods: Eleven male competitive cyclists (age: 30.3 ± 4.7 years; body mass: 73.7 ± 7.7 kg; body fat: 11.3 ± 4.2%) were submitted to two sessions of the Wingate test (WT) in different positions, on different days. Results: The peak power (W), average power (W), relative peak power (W·kg-1), relative average power (W·kg-1), average cadence (rpm), and average velocity (km·h-1) presented significant differences in the standing position compared with the seated position (p < 0.05), 1155 ± 130 vs. 1082 ± 182 (W), 875 ± 96 vs. 818 ± 116 (W), 15.9 ± 1 vs. 15.0 ± 2 (W kg-1), 12.1 ± 1 vs. 11.3 ± 1 (W kg-1), 117.5 ± 7 vs. 109.8 ± 10 (rpm), 37.0 ± 2 vs. 34.6 ± 3 (km·h-1), respectively. However, when controlled the body mass, the differences in variables power output ceased to exist (p > 0.05). The fatigue and peak heart rate (bpm) indices did not present significant differences between the tests (p > 0.05). Conclusions: Sprint performance was improved when the WT was performed in a standing position in competitive cyclists. The study also reports the important relationship between body mass and anaerobic production capacity in the WT, emphasizing that it is desirable an increase in lean body mass and a reduction in fat mass, similar in competitions. We suggest that, for anaerobic assessment in cyclists, the standing position should be used during the WT, to determine the maximum power-output capacity.

Association between active commuting and elevated blood pressure in adolescents / Associação entre deslocamento ativo e pressão arterial elevada em adolescentes

ABSTRACT Objective: To analyze the association between active commuting and blood pressure in adolescents. Methods: This is a cross-sectional study with high school students from public education network in the state of Pernambuco, Brazil. Data from 6039 students (14 to 19 years) were collected using a questionnaire. "Physically inactive" were considered those who reported not to walk or ride a bicycle to and from school on any day of the past week, and/or those who, regardless of the weekly frequency of practice this type of activity, reported the duration of commuting to school was less than 20 minutes (round trip). The high blood pressure was obtained by Omron HEM 742 equipment. Adolescents with high blood pressure were defined as those with higher blood pressure or equal to the 95th percentile for age, sex and height. Regression logistic analyses were used to assess the association between active commuting and high blood pressure, considering adjustments for the following confounders: sex, age, overweight, total physical activity, socioeconomic level, place of residence. Results: The prevalence of high blood pressure was 7.3%, and 79.3% were considered insufficiently active in commuting. There was an association between high blood pressure and active commuting only among those living in rural areas (OR = 6.498; 95% CI = 1.513-27.900), and the same was not observed among those living in urban areas (OR = 1.113; 95% CI = 0.812-1.526). Conclusion: Active commuting can be considered a protective factor for high blood pressure in adolescents living in rural areas.

RESUMO Objetivo: Analisar a associação entre o deslocamento ativo e a pressão arterial elevada em adolescentes. Métodos: Trata-se de um estudo transversal com estudantes do Ensino Médio da rede pública estadual de Pernambuco. Os dados de 6.039 estudantes de 14 a 19 anos foram coletados mediante questionário. Foram considerados "insuficientemente ativos" aqueles que relataram que em nenhum dos dias da última semana realizaram deslocamentos a pé ou de bicicleta e/ou aqueles que, independentemente da frequência semanal de prática desta atividade, relataram que a duração do deslocamento para a escola era inferior a 20 minutos (ida e volta). A pressão arterial elevada foi obtida por meio do equipamento Omron HEM 742. Foram definidos como adolescentes com pressão arterial elevada aqueles com pressão arterial maior ou igual ao percentil 95 para idade, sexo e estatura. Recorreu-se à análise de regressão logística para verificar a associação entre deslocamento ativo e pressão arterial elevada, considerando ajustes para os fatores de confusão sexo, idade, sobrepeso, atividade física total, nível socioeconómico e zona de moradia. Resultados: A prevalência de pressão arterial elevada foi de 7,3% e de inatividade física no deslocamento foi de 79,3%. Foi verificada associação entre pressão arterial elevada e deslocamento ativo apenas entre aqueles que moram em zona rural (OR=6,498; IC95%=1,513-27,900). O mesmo não foi verificado entre aqueles que moravam na zona urbana (OR = 1,113; IC95%=0,812-1,526). Conclusão: O deslocamento ativo póde ser considerado fator de proteção para a pressão arterial elevada nos adolescentes que moravam na zona rural.

Efectos agudos del ciclismo indoor en la presión inspiratoria máxima (PIMax) y la presión espiratoria máxima (PEMax) de adultos activos / Acute effects of indoor cycling on maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in active adults

Objetivo: verificar el efecto agudo del ciclismo indoor en el PIM y la PEM. Método: estudio experimental con muestra de 10 sujetos, de sexo masculino, de 20 a 30 años, practicantes de entrenamiento de ciclismo indoor durante al menos ocho semanas, con una frecuencia semanal de dos a tres veces. Las variables PIM y PEM se midieron antes y después del entrenamiento de ciclismo indoor con duración de 40 minutos, a través del método continuo. Resultados: Ambas variables mostraron una reducción significativa en comparación con los valores pre y post entrenamiento. PIM (pre: -117.5 ± 19.61; post: -110 ± 21.08) con p = 0.02, mientras que PEM (pre: 50 ± 00; post: 142.5 ± 4.8) con p = 0.01. Conclusiones: la intervención se realiza de forma continua y gradualmente creciente cuya sobrecarga puede generar adaptaciones crónicas tales como aumento de la PIM y PEM. Sin embargo, es necesario más estudios en la misma línea para verificar las relaciones y correlaciones.

Objective: To verify the acute effects of Indoor Cycling on the MIP and MEP. Method: An experimental study sample of ten male subjects, ranging in age from 20 to 30 years old, and who have practiced indoor cycling training for at least eight weeks, two to three times a week. The MIP and MEP variables were measured before and after the indoor cycling workout, lasting 40 minutes and using the continuous method. Results: Both variables showed a significant reduction when compared to pre and post training values. MIP (pre: -117.5 ± 19.61; post: -110 ± 21.08; p = 0.02) while the MEP (pre: 50 ± 00; post: 142.5 ± 4.8; p = 0.01). Conclusion: A continuous intervention with a gradual overload increase which can generate chronic adaptations such as increased MIP and MEP. However, it is necessary to carry out further studies within the same line to verify the correlation.

Can disordered eating behaviors reduce maximum oxygen consumption in road cyclists? / Comportamentos de risco para os transtornos alimentares pode reduzir o consumo máximo de oxigênio em ciclistas de estrada?

Abstract The aim of this study was to compare the maximum oxygen consumption (VO2max) between road cyclists with and without risk for eating disorders. The sample was composed of 43 cyclists aged 18-25 years, participants of the road cycling championship of the State of Pernambuco. VO2max was measured by a computerized metabolic analyzer during an incremental test in cycleergometer. The initial test load was 50 W, with increments of 25 W every minute until volitional exhaustion or inability to maintain the current load. To evaluate disordered eating behaviors (DEB), the Eating Attitudes Test was used (EAT-26). Univariate analysis of covariance (ANCOVA) was used to compare the VO2max between cyclists with (EAT-26 ≥ 21) and without (EAT-26 < 21) risk for eating disorders. The findings showed statistically significant VO2max difference between cyclists with and without risk to eating disorders (F (2,41)=28.44; p=0.01), indicating moderate effect size (d = 0.6). It was concluded that DEB was related to cyclists with lower VO2max.

Resumo O objetivo da pesquisa foi comparar o consumo máximo de oxigênio (VO2máx) entre ciclistas de estrada com e sem risco para o desencadeamento de transtornos alimentares. A amostra foi composta por 43 ciclistas com idade entre 18 e 25 anos, participantes do campeonato pernambucano de ciclismo de estrada. O VO2máx foi mensurado por um analisador metabólico computadorizado no decorrer de um teste incremental realizado em cicloergômetro. A carga inicial do teste foi 50 W, com incrementos de 25 W a cada minuto até atingir a exaustão voluntária ou impossibilidade de manter a carga atual. Para avaliar os comportamentos de risco para os transtornos alimentares (CRTA) foi utilizado o Eating Attitudes Test (EAT-26). Conduziu-se a análise univariada de covariância (ANCOVA) para comparar o VO2máx entre ciclistas com (EAT-26≥21) e sem riscos (EAT-26<21) para os transtornos alimentares. Os achados revelaram diferença estatisticamente significante do VO2máx entre ciclistas com e sem risco para os transtornos alimentares (F(2,41)=28,44; p=0,01), indicando moderado tamanho do efeito (d=0,6). Concluiu-se que os CRTA estiveram relacionados aos ciclistas com menor VO2máx.

Effects that passive cycling exercise have on muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients: a randomized clinical trial / Efeito do exercício passivo em cicloergômetro na força muscular, tempo de ventilação mecânica e internação hospitalar em pacientes críticos: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. Methods: This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week. The mean age of the patients was 46.42 ± 16.25 years, and 23 were male. The outcomes studied were peripheral muscle strength, as measured by the Medical Research Council scale, duration of mechanical ventilation, and length of hospital stay. Results: There was a significant increase in peripheral muscle strength (baseline vs. final) in both groups (control: 40.81 ± 7.68 vs. 45.00 ± 6.89; and intervention: 38.73 ± 11.11 vs. 47.18 ± 8.75; p < 0.001 for both). However, the range of increase in strength was higher in the intervention group than in the control group (8.45 ± 5.20 vs. 4.18 ± 2.63; p = 0.005). There were no significant differences between the groups in terms of duration of mechanical ventilation or length of hospital stay. Conclusions: The results suggest that the performance of continuous passive mobilization on a cyclical basis helps to recover peripheral muscle strength in ICU patients. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/])

RESUMO Objetivo: Avaliar os efeitos da realização de exercícios passivos com um cicloergômetro, associada à fisioterapia convencional, na força muscular periférica, no tempo de ventilação mecânica e no tempo de internação hospitalar em pacientes críticos internados em UTI de um hospital universitário terciário. Métodos: Ensaio clínico randomizado envolvendo 38 pacientes (idade > 18 anos) em ventilação mecânica e divididos aleatoriamente em grupo controle (n = 16), que realizou fisioterapia convencional, e grupo intervenção (n = 22) submetidos a fisioterapia convencional e exercícios passivos em cicloergômetro cinco vezes por semana. A média de idade dos pacientes foi de 46,42 ± 16,25 anos, e 23 eram homens. Os desfechos analisados foram força muscular periférica, mensurada pela escala Medical Research Council, tempo de ventilação mecânica e tempo de internação hospitalar. Resultados: Houve um aumento significativo da força muscular periférica (basal vs. final) tanto no grupo controle (40,81 ± 7,68 vs. 45,00 ± 6,89; p < 0,001) quanto no grupo intervenção (38,73 ± 11,11 vs. 47,18 ± 8,75; p < 0,001). Entretanto, a variação do aumento da força foi maior no grupo intervenção que no controle (8,45 ± 5,20 vs. 4,18 ± 2,63; p = 0,005). Não foram observadas diferenças significativas entre os grupos quanto ao tempo de ventilação mecânica e tempo de internação hospitalar. Conclusões: Os resultados sugerem que a realização de mobilização passiva contínua de forma cíclica auxilia na recuperação da força muscular periférica de pacientes internados em UTI. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/])

Intensity-dependent effects of cycling exercise on corticospinal excitability in healthy humans: a pilot study

Abstract Aims the aim of this study was to verify the effects of different intensities of locomotor exercise on corticospinal excitability. Methods 18 healthy subjects (27.6 ± 6.5 years,) participated in a design study of three different exercise protocols on a cycle ergometer: (i) 10 min at 75% Wmax (high intensity); (ii) 15min at 60% Wmax (moderate intensity) or (iii) 30 min at 45% Wmax (low intensity). The protocols of lower body cycling were assigned in random order in separate sessions. A control session was done with subjects at rest. Corticospinal excitability was assessed before (baseline) and every 5 min for 15min after the end of exercise/rest (time: 0, 5, 10 and 15) by measurement of the motor evoked potential (MEP) elicited by transcranial magnetic stimulation in the relaxed first-dorsal interosseus muscle. Results Compared to the resting session, a significant decrease (64%) in the motor evoked potential amplitudes was found only in the session of exercise of high intensity. This result seems depend on the level of physical activity of subject. No change was found after rest, low and moderate exercises. Conclusions These findings suggest that changes in the corticospinal excitability depend on exercise intensity and level of physical activity of subjects.(AU)

Electromyographic analysis of riding posture during the bicycling start moment

Abstract Professional cyclists often adopt a competition-start standing posture, which has been shown to improve performance. The biomechanical basis of this is unclear, and might be due to a greater mechanical advantage or increased key muscle activity. Previous observations in steady state cycling showed greater activation of the tibialis anterior, erector spinae, and biceps brachii when adopting a standing vs. seated-riding posture. Little is known regarding the effect of riding posture on activation during a standing start. Eleven cyclists performed standing starts in seated and standing-postures using stationary-cycle and on the track. Electromyography of the gastrocnemius medialis, tibialis anterior, erector spinae, and biceps brachii was recorded during first and subsequent pedal strokes. Results showed that the gastrocnemius medialis did not modify activity. The tibialis anterior, erector spinae, and biceps brachii activity was increased during the standing posture compared to seated, only during the first pedal stroke. These increased activation intensities were accompanied by a corresponding 10% increase in bike speed during the first 5 meters following a standing start in the standing posture compared to the seated one. Adopting a standing posture during a standing start improves performance through greater initial acceleration.

Agreement analysis between critical power and intensity corresponding to 50% ∆ in cycling exercise / Análise de concordância entre a potência crítica e a intensidade correspondente ao 50% ∆ no exercício de ciclismo

Abstract The purpose of this study was to determine the level of agreement between critical power (CP) and intensity corresponding to 50% of the difference (50% ∆) between oxygen uptake (VO2) at lactate threshold (LT) and maximal oxygen uptake (VO2max) in untrained subjects during cycling exercise. Fifteen healthy male subjects (age: 26.0 ± 3.5 years; body weight: 76.6 ± 10.4 kg; height: 178.2 ± 7.6 cm) volunteered to participate in the study. Each subject performed a series of tests to determine LT, VO2LT, CP, VO2CP, 50% ∆, VO250% ∆, and VO2max. The values LT, CP, VO2CP, 50% ∆, VO250% ∆ and VO2max were 109 ± 15 W, 1.84 ± 0.23 L.min-1, 207 ± 17 W, 2.78 ± 0.27 L.min-1, 206 ± 19 W, 2.77 ± 0.29 L.min-1, and 3.71 ± 0.49 L.min-1, respectively. No signficant difference was found between CP and 50% ∆ (t = 0.16; p = 0.87) or between VO2CP and VO250% ∆ (t = 0.12; p = 0.90). However, the bias ± 95% limits of agreement for comparison between CP and 50% ∆ and between VO2CP and VO250% ∆ were 1 ± 27 W (0.3 ± 14.1%) and 0.01 ± 0.24 L.min-1 (0.2 ± 8.9%), respectively. In summary, the mean CP and 50% ∆ values were not significantly different. However, considering the limits of agreement between the two intensities, CP estimated based on 50% ∆ might result in a remarkable error when the absolute variability of individual differences is taken into account.

Resumo A proposta deste estudo foi determinar o nível de concordância entre a potência crítica (PC) e a intensidade correspondente a 50% da diferença (50% ∆) entre o consumo de oxigênio (VO2) no limiar de lactato (LL) e o consumo máximo de oxigênio (VO2max) em sujeitos não treinados durante o exercício de ciclismo. Quinze sujeitos saudáveis do sexo masculino (idade: 26,0 ± 3,5 anos; massa corporal: 76,6 ± 10,4 kg; estatura: 178,2 ± 7,6 cm) participaram deste estudo. Cada sujeito realizou uma série de testes para determinar o LL, VO2.LL, PC, VO2.PC, 50% ∆, VO250% ∆ e VO2max. Os valores de LL, VO2LL, PC, VO2PC, 50% ∆, VO250% ∆ e VO2max foram 109 ± 15 W, 1,84 ± 0,23 L.min-1, 207 ± 17 W, 2,78 ± 0,27 L.min-1, 206 ± 19 W, 2,77 ± 0,29 L.min-1 e 3,71 ± 0,49 L.min-1, respectivamente. Nenhuma diferença significavita foi encontrada entre a PC e o 50% ∆ (t = 0.16; p = 0.87) e entre o VO2PC e o VO250% ∆ (t = 0.12; p = 0.90). Entretanto, o bias ± 95% dos limites de concordância para as comparações entre a PC e o 50% ∆ e entre o VO2PC e o VO250% ∆ foram 1 ± 27 W (0,3 ± 14,1%) e 0,01 ± 0,24 L.min-1 (0,2 ± 8,9%), respectivamente. Em resumo, os valores médios de PC e 50% ∆ não foram significativamente diferentes. No entanto, a PC estimada pelo 50% ∆ pode resultas em um erro significativo quando a cariabilidade individual absoluta é considerada.

Análise da função diastólica e função atrial em ciclistas de alto desempenho por meio da ecocardiografia tridimensional / Analysis of diastolic function and atrial function in high performance cyclists through three-dimensional echocardiography

Objetivos: Avaliar a função diastólica e a função atrial esquerda por meio do estudo com Doppler e ecocardiograma tridimensional em ciclistas de alto desempenho; comparar as variáveis estudadas a controles não esportistas. Métodos: Foram estudados 18 ciclistas profissionais (homens, idade 29, 5±4, 3 anos) e 18 indivíduos controles não esportistas (homens, idade 28, 8±5, 8 anos). Todos os indivíduos foram submetidos a ecocardiograma bidimensional e tridimensional com medidas de variáveis de função diastólica e de esvaziamento atrial como volume atrial esquerdo máximo, mínimo e antes de sua contração. Com base nestes volumes fundamentais foram calculadas a função de esvaziamento ativo, passivo e total, bem como a força de contração atrial. Resultados: Os indivíduos de ambos grupos apresentaram variáveis antropométricas semelhantes. Foi observado no grupo ciclista em relação aos controles: menor velocidade da onda A’ (5,9cm/s ± 2,2 versus 7,6 ± 2,3cm/s, com P=0,03), menor força de contração atrial (4,7 ±1,4Kdyn Vs. 6,2 ± 2,1Kdyn, com P= 0,02) e maior fração de esvaziamento passivo (43,8 ± 12,8% versus 34,8 ± 10,4% com P=0,03). Foi observada correlação linear entre a velocidade da onda A’ e a força de contração atrial no grupo dos ciclistas (r=0,80, P<0,05), entre a força de contração atrial e a fração de esvaziamento passivo (r=-0,88, P<0,05) e entre a força de contração atrial e o volume atrial antes de sua contração (r=0,65, P<0,05). Conclusão: O grupo ciclistas apresentou aumento do componente passivo em detrimento de uma redução do componente ativo no esvaziamento atrial total, o que mostrou estar correlacionado à atividade diastólica supernormal nesse grupo.

Objectives: To assess left ventricular diastolic and atrial function by means of Doppler and three-dimensional echocardiography of high-performance cyclists; To compare the variables studied for non-athlete controls. Methods: The study included 18 professional cyclists (men, age 29, 5±4, 3 years) and 18 non-athlete control individuals (men, age 28, 8±5, 8 years). All individuals underwent two-dimensional and three-dimensional echocardiography including measures of diastolic function variables and atrial emptying, such as maximum, minimum and before contraction left atrial volume. Based on these fundamental volumes, active, passive and total emptying function, and atrial contraction strength were calculated. Results: The individuals of both groups had similar anthropometric variables. The following was observed in the cyclist group as for the controls: lower A’ wave velocity (5.9 cm/s ± 2.2 versus 7.6 ± 2.3 cm/s, with P = 0.03), smaller atrial contraction force (4.7 ± 1,4Kdyn vs. 6.2 ± 2.1Kdyn, P = 0.02) and greater passive emptying fraction (43.8% ± 12.8 versus 34.8 ± 10.4% with P = 0.03). A linear correlation was found between A’ wave velocity and atrial contraction force in the cyclists group (r = 0.65, P <0.05), between atrial contraction force and passive emptying fraction (r = 0.80, P <0.05) and between atrial contraction and volume before contraction (r = 0.65, P < 0.05). Conclusion: The cyclists group showed an increase in the passive component to the detriment of a reduction in the active component in total atrial emptying, which was showed to be correlated with supernormal diastolic activity in this group.

Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds

The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve ( % V ˙ O 2  R ) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and V ˙ O 2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL·kg-1·min-1 (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and % V ˙ O 2  R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and % V ˙ O 2  R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise.

Validade do RAST para avaliar o desempenho da potência anaeróbia em relação ao teste Wingate em ciclistas / Validad del RAST para evaluar el rendimiento de potencia anaeróbica en comparación con el test de Wingate en los atletas de ciclismo / Validity of the RAST for evaluating anaerobic power performance as compared to Wingate test in cycling athletes

The validity of the Running-based Anaerobic Sprint Test (RAST) was investigated to evaluate the anaerobic power performance in comparison to Wingate test in cycling athletes. Ten mountain-bike male cyclists (28.0±7.3 years) randomly performed Wingate Test and RAST with two trials each. After several anthropometric measurements, peak power (PP), mean power (MP) and fatigue index (FI) for RAST and Wingate Test were analyzed using Student's paired t-test, Pearson's linear correlation test (r) and Bland and Altman's plots. Results showed that, with the exception of FI (33.8±4.6% vs. 37.8±7.9%; r=0.172), significant differences were detected between the Wingate and RAST tests with regard to PP and MP. Although there was a strong correlation for PP and MP, or rather, 0.831 and 0.714 respectively, agreement of analysis between Wingate and RAST protocols was low. The above suggested that RAST was not appropriate to evaluate the performance of anaerobic power by Wingate test in cycling athletes.

O objetivo foi investigar a validade do teste de RAST (Running-based Anaerobic Sprint Test) em avaliar o desempenho da potência anaeróbia a partir do teste de Wingate em ciclistas treinados. Participaram do estudo 10 ciclistas do sexo masculino (28,0±7,3 anos) da modalidade de Mountain bike. Após a mensuração das variáveis antropométricas, a potência pico (PP), média (PM) e o índice de fadiga (IF) foram determinados randomicamente a partir de dois testes de Wingate e dois testes de RAST. Foram utilizados o teste t independente de Student, a análise de correlação linear de Pearson (r) e o teste de Bland-Altman. Os resultados demonstraram, exceto para o IF (33.8±4.6% vs. 37.8±7.9%; r=0.172), diferenças significativas entre o teste de Wingate e o RAST para PP e PM (W.kg-1 e W). Embora os valores de correlação para a PP e PM (W) tenham sido fortes (0.831 e 0.714, respectivamente) a concordância entre os protocolos de Wingate e RAST foi baixa, sugerindo que o teste de RAST não é válido para avaliar o desempenho da potência anaeróbica a partir do teste de Wingate em ciclistas.

El objetivo fue investigar la validad del teste de RAST (Running-based Anaerobic Sprint Test) en evaluar el desempeño de la potencia anaeróbica través del uso del teste de Wingate en ciclistas trenados. Participaron del estudio 10 ciclistas masculinos (28,0±7,3 años) de la modalidad de Mountain bike. Después de la mensuración de las variables antropométricas, la potencia pico (PP), media (PM) y el índice de fatiga (IF) fueron determinados al acaso a partir de dos testes de Wingate y de dos testes de RAST. Fueron utilizados el test t independiente de Student, el análisis de correlación linear de Pearson (r) y el test de Bland-Altman. Los resultados demostraron, contrariamente al IF (33.8±4.6% vs. 37.8±7.9%; r=0.172), diferencias significativas entre el teste de Wingate y el RAST para PP y PM (W.kg-1 e W). Mismo que los valores de correlación de PP e PM (W) tengan sido fortes (0,831 e 0,714, respectivamente), la concordancia entre los protocolos de Wingate y RAST fue baja, sugiriendo que el teste de RAST no es válido para evaluar el desempeño de la potencia anaeróbica a partir del teste de Wingate en este grupo.

Caracterização do uso do cicloergômetro para auxiliar no atendimento fisioterapêutico em pacientes críticos / Characterization of the use of a cycle ergometer to assist in the physical therapy treatment of critically ill patients

OBJETIVO: Analisar as alterações cardiorrespiratórias de pacientes durante o exercício ativo com um cicloergômetro e verificar a aceitação dos pacientes para realizar esse tipo de atividade. MÉTODOS: Foi realizada uma única intervenção de exercício ativo de membros inferiores no cicloergômetro (sem carga) durante 5 minutos. As variáveis frequência cardíaca, pressão arterial, frequência respiratória, saturação periférica de oxigênio e escala de dispneia de Borg foram avaliadas em três momentos: antes, durante e imediatamente após o exercício. Ao final, o paciente respondia um questionário avaliando sua satisfação em relação a esse tipo de atividade. RESULTADOS: Participaram do estudo 38 pacientes (65% masculino) com 48±16 anos e SOFA=2 (0-5). Durante o exercício, 55% estavam em ar ambiente e 16% utilizaram algum tipo de suporte ventilatório. Comparando-se os valores iniciais e finais das variáveis analisadas, verificou-se um aumento apenas nas variáveis frequência cardíaca (92±17 e 95±18; p<0,05), frequência respiratória (19±8 e 23±8; p<0,05) e Borg (1,3±1,8 e 2,8±2,2; p<0,05). Além disso, 85% dos pacientes gostaram muito de realizar esse tipo de atividade. Apenas 25% dos pacientes relataram algum tipo de desconforto, entretanto 100% dos pacientes gostariam de repetir esse tipo de atividade em um próximo atendimento. CONCLUSÃO: Nos pacientes estudados, verificaram-se pequenas alterações cardiorrespiratórias durante o exercício com o cicloergômetro. Os pacientes avaliados relataram alta satisfação com esse tipo de atividade.

OBJECTIVE: The objective of this study was to use a cycle ergometer to assess cardiorespiratory changes during active exercise and to verify patients' satisfaction with this type of activity. METHODS: A single intervention involving active lower limb exercise was performed with a cycle ergometer (without load) for 5 minutes. The following variables were measured before, during and immediately after exercise: heart rate, blood pressure, respiratory rate, peripheral oxygen saturation and the Borg dyspnea scale score. Following the exercise, the patients answered a questionnaire to evaluate their satisfaction with this type of activity. RESULTS: A total of 38 patients (65% male) with a mean age of 48 ± 16 years old participated in the study. Enrolled patients presented a sequential organ failure assessment (SOFA) score of 2 (0 - 5 scale). During the exercise, 16% of the patients used ventilation support and 55% of them were breathing at room air. A comparison of the initial and final values of the variables indicated increases in the heart rate (92±17 beats/min vs. 95±18 beats/min; p<0.05), the respiratory rate (19 ± 8 breaths/min vs. 23±8 breaths/min; p<0.05) and the Borg dyspnea scale score (1.3±1.8 vs. 2.8±2.2; p<0.05). In addition, 85% of the patients reported enjoying the activity. Only 25% of the patients reported some discomfort, and 100% of the patients wanted to repeat this type of activity in future treatments. CONCLUSION: During the cycle ergometer exercises, minor cardiorespiratory changes were observed in the patients. The evaluated patients reported high satisfaction with this type of activity.

Changes in skinfold thicknesses and body fat in ultra-endurance cyclists

The present study investigated the changes in single skinfold thicknesses and body fat during an ultra-endurance cycling race. One hundred and nineteen ultra-endurance cyclists in the 'Swiss Cycling Marathon' covering a distance of 600 km were included. Changes in skinfold thickness, fat mass, skeletal muscle mass and total body water were estimated using anthropometric methods. The subjects were riding at a mean speed of 23.5 +/- 4.0 km/h and finished the race within 1,580 +/- 296 min. During the race, body mass decreased by 1.5 +/- 1.2 kg [P<0.001], and fat mass decreased by 1.5 +/- 1.1 kg [P<0.001]. Skeletal muscle mass and total body water remained unchanged [P>0.05]. The decrease in body mass correlated to the decrease in fat mass [r = 0.20, P=0.03]. The skinfold thicknesses at pectoral [-14.7%], abdominal [-14.9%], and thigh [-10.2%] site showed the largest decrease. The decrease in abdominal skinfold was significantly and negatively related to cycling speed during the race [r = -0.31, P<0.001]. Cycling 600 km at 23 km/h led to a decrease in fat mass and in all skinfold thicknesses. The largest decrease in skinfold thickness was recorded for pectoral, abdominal, and thigh site. The decrease in abdominal skinfold thickness was negatively related to cycling speed. The body seems to reduce adipose subcutaneous fat during an ultra-endurance performance at the site of the thickest skinfold

Análise da técnica de pedalada durante o ciclismo até a exaustão / Analysis of pedaling technique during cycling until exhaustion

O objetivo deste estudo foi verificar a influência da fadiga na técnica de pedalada durante teste de ciclismo máximo até a exaustão. Oito ciclistas treinados realizaram um teste incremental máximo e um teste de carga constante até a exaustão com 48 horas de intervalo. As forças resultante (FR) e efetiva (FE) aplicadas no pedal foram calculadas para a determinação do índice de efetividade (IE). A FE apresentou aumento entre o início e fim do teste (de 125 ± 16 para 169 ± 52 N, p=0,03), enquanto o IE e a FR não apresentaram alterações (de 0,55 ± 0,10 para 0,59 ± 0,08, p=0,14; de 230 ± 33 para 284 ± 72 N, p=0,08, respectivamente). O tornozelo apresentou aumento na amplitude de movimento (de 19º ± 4,69 para 28 ± 7,29º, p<0,01). Os resultados sugerem que, durante teste de carga constante até a exaustão, ciclistas treinados mantêm a técnica de pedalada e que esta pode ser uma estratégia para manter a potência.

The aim of this study was to investigate the effects of fatigue on the pedaling technique during maximal cycling test until exhaustion. Eight well-trained cyclists completed an incremental test and a constant workload cycling test until exhaustion with 48 hours of rest. The resultant (FR) and effective (FE) forces were calculated to obtain the index of effectiveness (IE). FE increased from the start to the end of the test (from 125 ± 16 to 169 ± 52 N, p=0.03), whereas no differences were observed for IE and FR (from 0.55 ± 0.10 to 0.59 ± 0.08, p=0.14; from 230 ± 33 to 284 ± 72 N, p=0.08, respectively). Increases in ankle joint range of motion were observed (from 19º ± 4.69 to 28 ± 7.29º, p<0.01). Results suggest that during cycling until exhaustion well-trained cyclists are able to sustain the pedaling technique, which can be an important strategy in order to sustain the power output.

Living and training in a tropical environment: a challenge for aerobic exercise applied knowledge and perspectives / Vivir y entrenar en un ambiente tropical: un reto para las perspectivas y los conocimientos aplicados en relación con el ejercicio aeróbico

The tropical climate is unique in that the seasons are dominated by the movement of the tropical rain belt, resulting in dry and wet seasons rather than the four-seasonal pattern of changes in temperature and day length seen in other parts of the world. Humid tropics are characterized by consistently high monthly temperatures, often exceeding 18°C throughout the year, and rainfall that exceeds evapotranspiration for at least 270 days per year. Although considerable information has been gathered on the physiological adaptation to hot/dry climates, data on acclimation to hot/humid climates are still limited. This review focusses on the effects of the tropical environment on human exercise performance through studies performed in the Caribbean, with a special emphasis on prolonged aerobic exercise such as swimming, cycling and running.

El clima tropical es único en el sentido de que las estaciones están dominadas por el movimiento del cinturón de lluvias tropicales, que trae como consecuencias estaciones de seca y lluvia, antes que el patrón de cuatro estaciones que produce los cambios de temperatura y duración del día, observados en otras partes del mundo. Los trópicos húmedos se caracterizan por temperaturas mensuales consistentemente altas, que a menudo exceden 18°C a lo largo del año, y precipitaciones que exceden la evapotranspiración durante por lo menos 270 días en el año. Aunque se ha reunido considerable información sobre la adaptación fisiológica a los climas cálidos y secos, los datos sobre la aclimatación a los climas calientes y húmedos, son todavía limitados. Esta revisión se centra en los efectos del ambiente tropical sobre el rendimiento de los ejercicios humanos a través de estudios realizados en el Caribe, con un énfasis especial en ejercicios aeróbicos prolongados, tales como la natación, el ciclismo, y la carrera.

Aspectos determinantes do posicionamento corporal no ciclismo: uma revisão sistemática / Aspects determinants of body positioning for cycling: a systematic review

Através de revisão sistemática, fez-se um levantamento de estudos que tratam do posicionamento corporal adequado para o ciclismo. Para isso, buscou-se por referências em língua Portuguesa e Inglesa, nas bases de dados LILACS, ScienceDirect, SciELO e MEDLINE. Os descritores utilizados para a busca dos artigos foram: posicionamento corporal + ciclismo; ajuste + bicicleta; postura + ciclismo; body positioning + cycling; bicycle fitting; cycling posture. Foram considerados artigos originais, de revisão simples, dissertações de mestrado e livros que tratassem de forma clara e objetiva o assunto, desde que publicados entre 1993 e 2009 (outubro). No total 20 estudos atenderam esses requisitos. De modo geral, estes sugerem que o conhecimento e habilidade para ajustar a bicicleta são úteis, no entanto, mesmo existindo protocolos para o ajuste adequado da bicicleta ao ciclista, os estudos denotam que a maioria dos ciclistas ainda as utiliza de forma errônea. Isso sugere a dificuldade de acesso aos estudos.

By means of systematic review a surveying of English and Portuguese language studies concerning the expected body positioning for improvement of cycling. Search engines used were LILACS, ScienceDirect, SciELO and MEDLINE. The keywords used to find relevant papers were: posicionamento corporal + ciclismo; ajuste + bicicleta; postura + ciclismo; body positioning + cycling; bicycle fitting; cycling posture. Original papers, short review papers, master thesis and books published from 1993 to 2009 (October) were considered when the main subject of discussion was the topic of interest. A total of 20 studies were considered. In general, the studies suggest that is will be useful to know about the bicycle fitting. Even so protocols for body positioning evaluation are available, most of studies concluded that cyclists are not able to use this protocol correctly. It suggests the difficult to access studies.

Aspectos fisiológicos do mountain biking competitivo / Physiological aspects of competitive mountain biking

A prática do ciclismo off-road (mountain biking - MTB), cresceu muito nas últimas duas décadas, sendo incluído como esporte olímpico, nos Jogos de Atlanta em 1996, na modalidade Cross Country. Na última década, houve um aumento no número de publicações científicas que verificaram a demanda fisiológica durante competições, assim como o estudo de possíveis preditores da performance nesta modalidade. O objetivo deste estudo de revisão foi descrever alguns aspectos fisiológicos específicos do MTB Cross Country (MTB CC) competitivo (intensidade de provas, perfil fisiológico de atletas de elite, uso de suspensões e determinantes da performance em subidas). Observa-se na literatura analisada que as provas de MTB CC parecem impor uma sobrecarga fisiológica maior, quando analisada através da frequência cardíaca, do que provas de ciclismo de estrada com duração semelhante. Entretanto, quando analisada pela potência de pedalada, observa-se claramente a característica intermitente da modalidade, com variações de potência durante a prova entre zero e 500W, e potência média relativamente baixa em comparação aos valores de FC encontrados. Outro fator importante levantado neste estudo são as alterações fisiológicas decorrentes do uso de suspensões nas bicicletas de MTB CC. O uso deste equipamento reduz o estresse muscular provocado pelo terreno acidentado, embora pareça não afetar o gasto energético total, tanto em percurso plano como em subidas. Entretanto, é fato que o desempenho em circuitos acidentados é melhorado com o uso das suspensões. Com base nos estudos abordados nessa revisão, conclui-se que o MTB CC enquanto modalidade competitiva apresenta uma grande variação de intensidade (avaliada através da potência), sendo esta atribuída principalmente ao tipo de terreno (irregular e com muitas aclives e declives acentuados) em que as provas de MTB CC acontecem.

Off-road cycling (mountain biking- MTB) practice has remarkably increased over the last two decades since its debut as an Olympic summer sport in the 1996 Atlanta Games, in the Cross Country modality. The number of publications devoted to the analysis of the physiological demands and potential performance predictors in the sport has also increased over the last decade. This article provides a review of both the descriptive characteristics (such as intensity) of Cross Country MTB competition (MTBCC), as well as specific aspects related to it (such as the physiological characteristics of elite athletes, the effect of use of suspension frames and the determinants of performance on climbs). It is evident from the literature that MTBCC competitions induce greater physiological stress, when expressed in terms of percent of maximal heart rate, than is observed for cycle road races of equivalent duration. Analysis of power output data clearly demonstrates the intermittent nature of this discipline- with power outputs during competition ranging between 0 and 500W and average power outputs that are relatively low as a percentage of HRmax. Another important finding is the physiological effect of the use of suspension frames in MTB. The use of such equipment reduces the muscular stress provoked by uncertain terrain without apparently influencing energy cost- either on the flat or when climbing. However, the cross country performance is improved with suspension frames. We conclude, therefore, that competitive MTBCC engenders wide variation in exercise intensity (expressed in terms of power output) - mostly as a result of the variations in terrain (i.e. irregular with many steep inclines and declines) that are a quintessential component of the sport.

Efeito da dieta e do ciclismo indoor sobre a composição corporal e nível sérico lipídico / Effect of diet and indoor cycling on body composition and serum lipid

FUNDAMENTO: O ciclismo indoor é um exercício aeróbico no qual se utiliza grandes grupamentos musculares dos membros inferiores, carente de impacto osteoarticular e de elevado gasto calórico, o que o torna interessante para se gerar uma estratégia não farmacológica. OBJETIVO: Analisar a composição corporal e o perfil lipídico sérico de mulheres com sobrepeso após doze semanas de dieta hipocalórica e treinamento de ciclismo indoor. MÉTODOS: Foram randomizadas 40 mulheres (23,90 ± 3,10 anos), subdivididas em quatro grupos: controle (C), ciclismo indoor (CI), ciclismo indoor associado a dieta hipocalórica (CD) e dieta hipocalórica (D). As variáveis analisadas foram: estatura e massa corporal, IMC, percentual de gordura, massa magra, triglicerídeos, colesterol e lipoproteinas (HDL,LDL,VLDL). O treinamento de ciclismo indoor consistiu em três sessões semanais de 45 minutos cada e a uma restrição energética de aproximadamente 1.200 kcal. O estudo teve duração de 12 semanas. Utilizou-se a estatística descritiva (média e desvio padrão) e inferencial (test t de Student). O nível de significância adotado foi de p < 0,05. RESULTADOS: Os grupos CI, CD e D reduziram significativamente as médias das variáveis antropométricas após as 12 semanas de intervenção (massa corporal, percentual de gordura e índice de massa corporal), além dos níveis séricos de colesterol total e triglicerídios. Em relação ao HDL colesterol, houve aumento significativo para os grupos CI e CD. CONCLUSÃO: De acordo com os resultados, o ciclismo indoor e a dieta hipocalórica contribuíram no combate ao sobrepeso bem como no controle do nível sérico dos lipídeos.

BACKGROUND: Indoor cycling is an aerobic exercise that employs large muscle groups of the lower limbs, lacking osteoarticular impact and high energy expenditure, which makes it interesting to generate a non-pharmacological strategy. OBJECTIVE: To assess body composition and lipid profile in overweight women after twelve weeks of low-calorie diet and indoor cycling training. METHODS: We randomly assigned 40 women (23.90 ± 3.10 years), divided into four groups: control (C), indoor cycling (CI), indoor cycling combined with low-calorie diet (CD) and low-calorie diet (D). The variables were: height and body mass, BMI, fat percentage, lean body mass, triglycerides, cholesterol and lipoproteins (HDL, LDL, VLDL). The indoor cycling training consisted of three weekly sessions of 45 minutes each and an energy restriction of about 1,200 kcal. The study lasted 12 weeks. We used descriptive statistics (mean and standard deviation) and inferential statistics (Student's t test). The level of significance was p < 0.05. RESULTS: The groups CI, CD and D significantly reduced the mean anthropometric variables after 12 weeks of intervention (body mass, fat percentage and body mass index), and serum levels of total cholesterol and triglycerides. HDL cholesterol increased significantly for groups CI and CD. CONCLUSION: According to the results, the indoor cycling and the low-calorie diet helped fight overweight and control serum lipids.

Bloqueio inadvertido do neuroeixo durante artroplastia vertebral: relato de caso / Accidental spinal block during vertebral artroplasty: case report

JUSTIFICATIVA E OBJETIVOS: A cirurgia de artroplastia vertebral com uso do cimento ósseo tem suas particularidades e complicações. Na maioria das vezes o procedimento é realizado sob anestesia local com sedação, mas algumas vezes é realizado bloqueio subaracnóideo ou peridural com morfina com o intuito de fornecer analgesia pós-operatória. O objetivo deste relato foi discutir as possíveis complicações em cirurgias de artroplastia vertebral. RELATO DO CASO: Paciente do sexo masculino, 76 anos, apresentando fratura patológica em T12, foi admitido para cirurgia de artroplastia vertebral e biopsia óssea. Foi realizada sedação com midazolam e fentanil, o paciente foi colocado em decúbito ventral e o cirurgião infiltrou anestésico local desde a pele até o corpo vertebral de T12 a seguir biopsiou a vértebra e injetou 6 mL de cimento ósseo em T12. Ao final do procedimento o paciente apresentava paralisia dos membros inferiores. CONCLUSÕES: A intervenção cirúrgica na coluna vertebral não é procedimento isento de complicações. Quando se associa bloqueio espinal pode-se retardar o diagnóstico de complicação cirúrgica; além disto corre-se o risco de se imputar à anestesia um problema proveniente do procedimento cirúrgico.

BACKGROUND AND OBJECTIVES: Vertebral artroplasty with bone cement has its particularities and complications. Most often the procedure is performed under local anesthetic and sedation, but sometimes it is done under subarachnoid or epidural block with morphine to achieve postoperative analgesia. The objective of this report is to discuss the possible complications of vertebroplasties. CASE REPORT: Male patient, 76 years old, presenting pathologic fracture in T12 was admitted for vertebral artroplasty and bone biopsy. Patient was sedated with midazolam and fentanyl, placed in the prone position, and the surgeon injected local anesthetic from the skin until the vertebral body of T12. He then took a biopsy of the vertebra and injected 6 mL of bone cement in T12. At the end of the procedure the patient presented paralysis of the lower limbs. CONCLUSIONS: Surgeries in the spinal column are not free of complications. When it is associated with spinal block, the diagnosis of surgical complications might be delayed. Besides, anesthesia might be blamed for a problem caused by the surgical procedure.

JUSTIFICATIVA Y OBJETIVOS: A cirugía de artroplastia vertebral con uso del cimiento óseo tiene sus particularidades y complicaciones. En la mayoría de las veces el procedimiento se realiza bajo anestesia local con sedación, pero en algunos casos se realiza el bloqueo subaracnoideo o peridural con morfina con el interés de suministrar analgesia postoperatoria. El objetivo de este relato fue el de discutir las posibles complicaciones en cirugías de artroplastia vertebral. RELATO DEL CASO: Paciente del sexo masculino, 76 años, presentando fractura patológica en T12, fue admitido para cirugía de artroplastia vertebral y biopsia ósea. Se realizó sedación con midazolam y fentanil, el paciente fue colocado en decúbito ventral y el cirujano le infiltró el anestésico local desde la piel hasta el cuerpo vertebral de T12; a continuación se realizó la biopsia la vértebra e inyectó 6 mL de cimiento óseo en T12. Al final del procedimiento el paciente presentaba parálisis de los miembros inferiores. CONCLUSIONES: La intervención quirúrgica en la columna vertebral no es un procedimiento exento de complicaciones. Cuando se asocia bloqueo espinal se puede retardar el diagnóstico de complicación quirúrgica; además de eso, se corre el riesgo de imputársele a la anestesia un problema proveniente del procedimiento quirúrgico.