RESUMO
Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
RESUMO
Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
RESUMO
Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region, which are the earliest signs of OP deterioration in elderly patients. Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength. To OP patients, preventing the occurrence of OP fracture is the primary goal for preventative measures, treatment and research of OP. This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF), and advocates early prevention of OVCF in OP patients, who should avoid activities that might exceed the security scope of the vertebral body load in daily life, so as to prevent subsequent fractures of the vertebral fracture cascade.
RESUMO
Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
RESUMO
Background: Chronic heart failure (CHF) leads to exercise intolerance. However, non-invasive ventilation is able to improve functional capacity of patients with CHF. Objectives: The aim of this study was to evaluate the effectiveness of continuous positive airway pressure (CPAP) on physical exercise tolerance and heart rate variability (HRV) in patients with CHF. Method : Seven men with CHF (62±8 years) and left ventricle ejection fraction of 41±8% were submitted to an incremental symptom-limited exercise test (IT) on the cicloergometer. On separate days, patients were randomized to perform four constant work rate exercise tests to maximal tolerance with and without CPAP (5 cmH2O) in the following conditions: i) at 50% of peak work rate of IT; and ii) at 75% of peak work rate of IT. At rest and during these conditions, instantaneous heart rate (HR) was recorded using a cardiofrequencimeter and HRV was analyzed in time domain (SDNN and RMSSD indexes). For statistical procedures, Wilcoxon test or Kruskall-Wallis test with Dunn's post-hoc were used accordingly. In addition, categorical variables were analysed through Fischer's test (p<0.05). Results: There were significant improvements in exercise tolerance at 75% of peak work rate of IT with CPAP (405±52 vs. 438±58 s). RMSSD indexes were lower during exercise tests compared to CPAP at rest and with 50% of peak work rate of IT. Conclusion: These data suggest that CPAP appears to be a useful strategy to improve functional capacity in patients with CHF. However, the positive impact of CPAP did not generate significant changes in the HRV during physical exercises. .
Contextualização: A insuficiência cardíaca (IC) crônica cursa com intolerância ao exercício físico. A ventilação não invasiva (VNI) tem se mostrado benéfica para a melhora da performance desses pacientes. Objetivos: Avaliar a eficiência da pressão positiva contínua nas vias aéreas (CPAP) sobre a tolerância ao exercício físico e a variabilidade da frequência cardíaca (VFC) de pacientes com IC crônica. Método: Sete homens com IC crônica (62±8 anos) e fração de ejeção do ventrículo esquerdo de 41±8% foram submetidos ao teste incremental (TI) sintoma-limitado em cicloergômetro. Posteriormente, foram aleatorizados para a realização de exercícios físicos de carga constante até a tolerância máxima com e sem CPAP (5 cmH2O) nas condições: i) 50% da carga pico do TI e ii) 75% da carga pico do TI. Em repouso e durante os testes, a frequência cardíaca (FC) instantânea foi obtida pelo cardiofrequencímetro, e a VFC foi analisada no domínio do tempo. A análise estatística foi realizada pelos testes de Wilcoxon ou Kruskall-Wallis com post-hoc de Dunn e as variáveis categóricas, pelo teste de Fischer (p<0,05). Resultados: Durante a CPAP, houve aumento significativo no tempo de exercício físico (405±52 vs. 438±58 s) e da FC pico (97±3 vs. 105±2 bpm) somente na intensidade de 75%. Em relação à VFC, observou-se que o RMSSD foi significativamente menor em exercício físico quando comparado ao repouso com CPAP na intensidade 50%. Conclusão: Em conclusão, a CPAP com 5 cmH20 mostrou-se um útil na melhora da capacidade funcional dos pacientes estudados com pouco impacto sobre a VFC. .