Effect of physical activity on the relationship between adiposity and cardiac autonomic modulation in female breast cancer survivors: a longitudinal study.

This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (ß = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (ß = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.

Effect of physical training on cytokine expression in CD4+ T lymphocytes in subjects with stable COPD.

INTRODUCTION: Although evidence suggests that physical exercise reduces systemic inflammation, at the plasma level, there are still contradictions in chronic obstructive pulmonary disease (COPD). In this sense, analysis of intracellular cytokines could clear off the effect of physical exercise on the inflammatory profile of these subjects. AIM: The aim was to evaluate the effect of physical training on cytokine expression in CD4+ T lymphocytes from subjects with COPD. METHODS: This is a randomized controlled trial. Subjects with stable COPD were grouped into two groups, exercise and control. In total, 23 subjects with stable COPD were evaluated, of which 15 underwent aerobic strength training [physical exercise group (PEG)] and 8 underwent breathing exercises [respiratory physiotherapy group (RPG)]. Intracellular cytokines [interleukin (IL)-8, IL-13, IL-17, IL-6, IL-2, IL-10, and tumor necrosis factor alpha (TNF-α)] from CD4+ T lymphocytes were analyzed from peripheral blood through flow cytometry, before and after 8 weeks of intervention. RESULTS: The PEG and RPG groups had a mean age of 68 ± 5.96 and 72.25 ± 6.86 years and predicted forced expiratory volume in the first second (FEV1) of 58.6 ± 15.99% and 39.75 ± 10.39%, respectively. It was possible to detect a significant reduction in IL-8 (p = 0.0125) and an increase in IL-13 (p = 0.0014) and an increase in TNF-α (p < 0.001) in both groups. CONCLUSION: Eight weeks of physical training, both peripheral and respiratory, were able to reduce concentrations of IL-8 and to increase IL-13, and TNF-α in CD4+ T lymphocytes in subjects with stable COPD. The findings reinforce the benefits of interventions in subjects with COPD, revealing data not previously investigated.

Elastic Resistance Training Produces Benefits Similar to Conventional Resistance Training in People With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this study was to investigate the effectiveness of elastic resistance training on improving muscle strength, functional exercise capacity, health-related quality of life (HRQoL), and dyspnea in people with stable chronic obstructive pulmonary disease (COPD). METHODS: For this systematic review, PubMed, The Cochrane Library, Embase (OVID), PEDro, SciELO, and CINAHL were searched from inception to November 2019. Included studies were randomized clinical trials in which people with stable COPD were allocated to (1) an experimental group that received lower-limb resistance training, upper-limb resistance training, or both using elastic resistance; or (2) a control group that received no or sham resistance training or conventional resistance training using weight machines. Data extraction was performed by 3 review authors. The methodological quality of the studies was assessed using the PEDro scale. Eight studies on 332 participants were included. RESULTS: Knee extensor strength was higher in the experimental group (standardized mean difference = 0.52, 95% CI = 0.09-0.95) compared with the non-exercise control group. Compared with the conventional exercise control, the experimental group presented similar effects for muscle strength, functional exercise capacity, HRQoL, and dyspnea (95% CI overlapped the line of no effect for all). CONCLUSIONS: Elastic resistance training improves muscle strength in people with COPD. The current review suggests elastic resistance as a potential alternative to conventional resistance training using weight machines, as they show similar effects on muscle strength, functional exercise capacity, HRQoL, and dyspnea. IMPACT: Due to its beneficial effects, including reduced risk of exacerbation-related hospitalizations, exercise training is viewed as the cornerstone of pulmonary rehabilitation in people with COPD. This study shows that elastic resistance training can be an effective, portable, practical, and low-cost alternative to conventional weight resistance training. LAY SUMMARY: Training with elastic resistance tubes or bands-which are easy to carry, easy to use, and relatively low cost-can be an effective way to improve strength for people with COPD and promote similar benefits to those achieved with weight machines.

Influence of skeletal muscle mass and fat mass on the metabolic and inflammatory profile in sarcopenic and non-sarcopenic overfat elderly.

BACKGROUND: Sarcopenic elderly present low muscle mass and strength, however, it is not clear if the inflammatory and metabolic profile is more related to low lean mass or high fat mass in sarcopenic and non-sarcopenic overfat elderly. AIM: To verify the difference in inflammatory and metabolic responses in sarcopenic and non-sarcopenic overfat elderly and the relationship between these markers, body composition, and strength in this population. METHODS: Fifty-seven elderly were divided into two groups: sarcopenic (n = 30) and non-sarcopenic (n = 27). Body composition was evaluated with octopolar bioimpedance. Total cholesterol, high-density lipoprotein cholesterol, triacylglycerol, glucose, cortisol, leptin, adiponectin, Plasminogen activator inhibitor-1 (PAI-1), TNF-α, IL-6, IL-8, and IL-10 were assessed. The handgrip test was used to evaluate strength. RESULTS: When comparing the inflammatory profile, sarcopenic individuals showed greater adiponectin concentration (p = 0.019), adiponectin/fat mass ratio (p < 0.001), adiponectin/visceral fat (p < 0.001), and higher PAI-1 (p = 0.019) than non-sarcopenic overfat elderly. After adjusting the inflammatory profile by skeletal muscle mass the significant differences between groups were maintained (p < 0.05) but no significant differences between groups were observed when adjusting by fat mass, despite a tendency to a significant difference for adiponectin concentration (p = 0.06). In addition, after adjusting leptin by fat mass there was a statistically significant lower concentration in the sarcopenic compared to non-sarcopenic overfat elderly. CONCLUSION: Non-sarcopenic overfat elderly presented lower anti-inflammatory and anti-atherogenic responses than sarcopenic elderly. Furthermore, fat mass but not skeletal muscle mass seem to change these responses.

Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength.

INTRODUCTION: People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength. METHODS: This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster. RESULTS: One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p < 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes. CONCLUSIONS: Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients.

Inflammatory and Metabolic Responses to Different Resistance Training on Chronic Obstructive Pulmonary Disease: A Randomized Control Trial.

Background: Low-grade inflammation can be present in chronic obstructive pulmonary disease (COPD), which may affect the regulation of muscle protein and body metabolism. Regular exercise show improvement in muscle strength and dyspnea in patients with COPD, however, the response to training on inflammatory and metabolic disorders is unclear. In this study, we compared the effects of resistance training using weight machines and elastic resistance (bands and tubes) on the inflammatory and metabolic responses in patients with COPD. Methods: Patients with COPD were randomized into three groups: elastic band group (EBG), elastic tube group (ETG), and weight machines equipment group (MG). EBG and ETG were analyzed together [elastic group (EG)]. The participants were evaluated for pulmonary function (spirometry), peripheral muscle strength (digital dynamometry), IL-6, TNF-α, IL-10, IL-15 (Immunoassay), glucose, triacylglycerol, total cholesterol, HDL-c, and albumin levels (Enzymatic colorimetric). Blood samples were collected to assess the acute and chronic exercise responses after 12 weeks of training protocol. Results: The patient's mean age was 71.53 ± 6.97 years old. FEV1 (percent predicted) was 50.69 ± 16.67 and 45.40 ± 15.15% for EG and MG, respectively (p = 0.28). All groups increased muscle strength (p < 0.05) with no differences between groups. The acute response to exercise after 12 weeks of training showed improvement of inflammation when compared to baseline. Regarding the chronic effects, it was observed a decrease of all cytokines, except IL-10 (p < 0.05). After 12 weeks of training, the analysis of the metabolic profile presented a reduction in glucose concentration (p < 0.01), with no differences between groups (p = 0.30) and a decrease in triacylglycerol for the EG (p > 0.01). Conclusions: Training with elastic resistances or conventional weight machines showed improvement of inflammation response after 12 weeks of training. Chronically, both training groups showed anti-inflammatory effects, with the EG showing a strong tendency to improve IL-10/TNF-α ratio and IL-10 levels. TRIAL REGISTRATION: RBR-6V9SJJ.

Resistance Training using Low Cost Elastic Tubing is Equally Effective to Conventional Weight Machines in Middle-Aged to Older Healthy Adults: A Quasi-Randomized Controlled Clinical Trial.

The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p < 0.05 for both), functional exercise capacity (ETG Δ4 ± 4% and CTG Δ6±8%; p < 0.05 for both). Improvement on "pain" domain of HRQOL could only be observed in the CTG (Δ21 ± 26% p = 0.037). CG showed no statistical improvement in any of the variables investigated. Resistance training using elastic tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults.

Analysis of cardiovascular system responses to forced vital capacity in COPD.

BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

Analysis of cardiovascular system responses to forced vital capacity in COPD / Análise das respostas do sistema cardiovascular ao teste de capacidade vital forçada na DPOC

BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

CONTEXTUALIZAÇÃO: O teste de capacidade vital forçada (CVF) é rotineiramente realizado na avaliação da função pulmonar de pacientes com doença pulmonar obstrutiva crônica (DPOC). Entretanto, permanece pouco compreendida a influência do teste de CVF sobre o sistema cardiovascular de pacientes com DPOC. OBJETIVOS: Analisar o comportamento da frequência cardíaca (FC), pressão arterial (PA) e variabilidade da frequência cardíaca (VFC) no teste de CVF na DPOC. MÉTODOS: Dezenove homens com DPOC (72 ± 7 anos, no estágio de gravidade GOLD I=3, II=5, III=7 e IV=4 pacientes) realizaram a manobra de CVF e tiveram sua FC monitorada durante todo o exame, e a VFC analisada nos domínios do tempo (rMSSD) e da frequência (BF, AF e BF/AF) durante o repouso, antes e após a melhor manobra de CVF. A PA foi analisada no repouso, imediatamente ao final da manobra de CVF e 10 minutos após o término de todos os testes. RESULTADOS: Ao início da manobra de CVF, a FC reduziu (p<0,001) e, em seguida, aumentou progressivamente até o final do teste (p<0,001). Após término da manobra, a FC continuou a aumentar até atingir um pico (p<0,001) e depois caiu rapidamente a valores inferiores aos de repouso (p<0,001) e retornou ao seu valor basal. A PA e os índices da VFC não sofreram alterações nos períodos analisados. CONCLUSÃO: O teste de CVF influencia o comportamento da FC, sem alterar o seu controle autonômico, bem como a PA em pacientes com DPOC nos períodos analisados.

Efeito da técnica de oscilação oral de alta frequência aplicada em diferentes pressões expiratórias sobre a função autonômica do coração e os parâmetros cardiorrespiratórios / Effect of oral high-frequency oscillation technique at different expiratory pressures on heart autonomic function and cardiorrespiratory parameters

O objetivo deste estudo foi avaliar o efeito da técnica de oscilação oral de alta freqüência (com o aparelho Shaker), aplicada em diferentes pressões expiratórias (PE), sobre a função autonômica e parâmetros cardiorrespiratórios. Foram coletados dados de 20 voluntários jovens saudáveis (21,6±1,3 anos), que permaneceram em repouso inicial por 10 minutos e, em seguida, fizeram três séries de dez expirações no aparelho (com intervalo de descanso de 2 minutos entre as séries) em três diferentes PE – pressão livre (PL), de 10 (P10) e de 20 (P20) cmH2O – permanecendo por mais 10 minutos em repouso final. Os dados foram analisados estatisticamente, com nível de significância de 5%. Após a aplicação da técnica, constatou-se diferença significante nos índices de variabilidade da freqüência cardíaca em PL e um aumento significante na pressão arterial sistólica em P20. Na pressão arterial diastólica, freqüência respiratória e saturação periférica de oxigênio não foram encontradas diferenças antes, durante e após a técnica, nas diferentes PE. A percepção do esforço aumentou significantemente ao longo das séries em PL e P20 e entre P10 e P20 em cada série. A freqüência cardíaca (FC) aumentou e diminuiu em sincronia com os movimentos de inspiração e expiração, respectivamente. Foram observadas modificações na modulação autonômica do coração em PL. A aplicação da técnica nessa população, nas diferentes PE analisadas, promoveu modificações no comportamento da FC, no esforço percebido e, em PL, na modulação autonômica do coração...

The aim of this study was to analyse the effect of oral high-frequency oscillation technique (with the Shaker device), applied at different expiratory pressures (EP), onto autonomic heart function and cardiorespiratory parameters. Data were collected from 20 young healthy volunteers (aged 21,6±1,3 years old) who remained at initial rest for 10 minutes and then performed three series of ten expirations each with the Shaker device (with rest intervals of 2 minutes between series) in three EP: free pressure (FP) and pressures of 10 (P10) and of 20 cmH2O (P20), then remained at rest for additional 10 minutes. Data were statistically analysed, with significance level set at 5%. After the breathing technique, a statistically significant difference was noticed at heart rate variability indices at FP...

Análise de sinais e sintomas em programas ambulatoriais de exercícios físicos para pacientes cardíacos / Analysis of signs and symptoms in ambulatorial programs of physical exercises for cardiac patients

Este trabalho teve por objetivo analisar os sinais e sintomas em programas ambulatoriais de exercícios físicos para pacientes cardíacos. Para sua realização foram analisados dados de 249 pacientes que freqüentaram dois programas da cidade de Presidente Prudente. Os dados foram coletados dos prontuários (sexo, idade e o diagnóstico principal) e fichas de controle (sinais e sintomas) dos pacientes. Nestes programas os sinais e sintomas são avaliados durante toda a sessão por meio de observações clínicas e mensurações da freqüência cardíaca e pressão arterial. Para sua análise foram verificados o tipo, a freqüência e o momento nos programasem que os sinais e sintomas aconteceram. Foram utilizados para análise dos dados, a estatística descritiva, o teste de Cochran-Mantel-Haenzel, a análise de variância e o teste de Duncan Grouping. Diferenças foram consideradas significativas a 5%. Os resultados mostraram que 58,23% dos indivíduos analisados apresentaram algum tipo de sinal ou sintoma durante a execução desses programas. Foram encontrados 1.104 sinais ousintomas, o que representa um sinal ou sintoma para cada 25,59 horas de freqüência aos programas, sendoque: alterações da freqüência de pulso (35,69%), fadiga (18,39%), dor muscular (12,14%), angina (10,33%) etontura (7,97%) foram os sinais e sintomas mais freqüentes nessa população. Desses sinais e sintomas,52,63% ocorreram na fase de resistência aeróbica, 19,11% na fase de aquecimento, 18,84% durante toda asessão, 8,06% no início da sessão e 1,36% na fase de relaxamento. Os sinais e sintomas foram dependentes donúmero médio de horas trabalhadas pelos pacientes (estatística = 30,40; p < 0,0001) e independentes dodiagnóstico principal (estatística = 5,9103; p = 0,8227). Os resultados permitem concluir que, dos sinais esintomas observados, a alteração na freqüência de pulso foi a mais freqüente, e a maior ocorrência dessessinais e sintomas aconteceu na fase de resistência aeróbia da sessão