Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial

ABSTRACT Objective: The aim was to evaluate the quality of life (HRQoL) in women with subclinical hypothyroidism (sHT) after 16 weeks of endurance training. Subjects and methods: In the first phase, a cross-sectional study was conducted in which 22 women with sHT (median age: 41.5 (interquartile range: 175) years, body mass index: 26.2 (8.7) kg/m2, thyroid stimulating hormone > 4.94 mIU/L and free thyroxine between 0.8 and 1.3 ng/dL were compared to a group of 33 euthyroid women concerned to HRQoL. In the second phase, a randomized clinical trial was conducted where only women with sHT were randomly divided into two groups: sHT-Tr (n = 10) - participants that performed an exercise program - and sHT-Sed (n = 10) - controls. Exercise training consisted of 60 minutes of aerobic activities (bike and treadmill), three times a week, for 16 weeks. The HRQoL was assessed by the SF-36 questionnaire in the early and at the end of four months. Results: Women with sHT had lower scores on functional capacity domain in relation to the euthyroid ones (770 ± 23.0 vs. 88.8 ± 14.6; p = 0.020). The sHT-Tr group improved functional capacity, general health, emotional aspects, mental and physical component of HRQoL after training period, while the sHT-Sed group showed no significant changes. Conclusion: After 16 weeks of aerobic exercise training, there were remarkable improvements in HRQoL in women with sHT.

Energy expenditure and cardiovascular response to traumatic lower limb amputees’ gait / Gasto energético e resposta cardiovascular da marcha de amputados traumáticos de membros inferiores

Introduction Amputations cause functional, musculoskeletal and cardiovascular alterations and, the more proximal the amputation, the larger the alterations. Objectives To observe the effect of using lower limb prosthetics and that of gait speed on heart rate (HR), blood pressure (BP), oxygen consumption (VO2) and energy cost (EC) during gait in traumatic lower limbs amputees. Materials and methods The sample was composed of 30 men with unilateral amputations, 10 transfemoral and 10 transtibial, compared to 10 people with no amputations. All of them selected a pleasant walking speed (PWS) on the treadmill, and two other speeds were calculated, 20% above and 20% below the original one. The subjects walked for 10 minutes at each of the speeds and, in the last three minutes, the VO2, HR, and BP were assessed. In order to compare variables between groups the variance was performed (ANOVA) followed by the Post Hoc Sheffé test (p < 0.05). Results The amputees selected lower values of PWS and had higher HR, BP, and EC, VO2 during gait when compared to normal individuals. The transfemoral amputees had higher VO2 and EC compared to the transtibial ones. By analyzing the speed effect, it was observed that, although the VO2 did not increase with the increased speed, there was increased cardiovascular response and reduced EC. Conclusions Traumatic lower limb amputees have higher energy expenditure and cardiovascular responses during gait and, at higher speeds, they become more economical, reducing the EC. .

Introdução As amputações provocam alterações funcionais, musculoesqueléticas e cardiovasculares e, quanto mais proximal o nível da amputação, maiores essas alterações. Objetivos Observar o efeito do uso de próteses de membros inferiores e da velocidade de marcha sobre a frequência cardíaca (FC), pressão arterial (PA), consumo de oxigênio (VO2) e custo energético (CE) durante a marcha de amputados traumáticos de membros inferiores. Materiais e métodos Foram estudados 30 indivíduos do sexo masculino, 20 possuíam amputações unilaterais traumáticas, sendo 10 transfemorais e 10 transtibiais, que foram comparados a 10 indivíduos sem amputações. Todos selecionaram uma velocidade de marcha agradável (VMA) na esteira rolante e foram calculadas e testadas outras duas, 20% acima e 20% abaixo da selecionada. Os indivíduos andaram por 10 minutos em cada velocidade e, nos três minutos finais, foram avaliados o VO2, a FC e a PA. Para comparação das variáveis entre os grupos foi realizada análise de variância (ANOVA), seguida do teste Post Hoc de Sheffé (p < 0,05). Resultados Os amputados selecionaram menores valores de VMA e apresentaram maior FC, PA, VO2 e CE durante a marcha ao serem comparados aos indivíduos não amputados. Os transfemorais apresentaram maior VO2 e CE quando comparados aos transtibiais. Ao analisar o efeito velocidade, observou-se que, apesar do VO2 não ter aumentado com aumento da velocidade, houve aumento da resposta cardiovascular e redução do CE. Conclusões Os amputados traumáticos de membros inferiores apresentam maior gasto energético e resposta cardiovascular durante a marcha e, em maiores velocidades, eles tornam-se mais econômicos, reduzindo o CE. .