Analysis of Muscle Oxygenation after a Normobaric Hypoxia Tolerance Test.

The aim of this work was to analyze the influence of acute normobaric hypoxia on quadricep oxygenation. Muscle oxygen saturation (SmO2) was measured using near-infrared spectrometry (NIRS) technology during a normobaric hypoxia tolerance test (NHTT). SmO2 was measured with a Humon Hex® device. In total, 54 healthy subjects participated, 68.5 of which were males and 31.5% of which were females. They performed an NHTT with the IAltitude® simulator, breathing air with an FiO2 level of 11% (equivalent to 5050 m). The maximum duration of the NHTT was set at 10 min, stopping if it reached 83% SpO2. The initial values (PRE) were compared with those obtained at the end of the test (POST) and after 10 min of recovery. The participants were divided into two groups based on whether (G1) they completed the ten minutes or not (G2). In total, 35.1% of men and 41.2% of women completed the 10 min. In both groups, significant differences were observed in the decrease in SmO2 values (p < 0.0001) (G1: PRE = 59.5 ± 12.48%; POST = 55.95 ± 14.30%; G2: PRE = 60.06 ± 13.46%; POST = 57.2 ± 12.3%). There were no differences between groups in any of the three periods. Exposure to normobaric hypoxia produces a decrease in quadricep levels of SmO2 in both sexes, regardless of whether the test is completed. Two patterns appeared: A.-less time and more hypoxia; B. a longer duration and less hypoxia.

Concurrent Resistance and Cardiorespiratory Training in Patients with Hypertrophic Cardiomyopathy: A Pilot Study.

Background: Exercise training in patients with HCM has evidenced benefits on functional capacity, cardiac function, and a reversion of adverse cardiac remodeling. The objective of this study was to assess the effect of a concurrent resistance and cardiorespiratory training program on functional capacity, biochemical parameters, and echocardiographic variables in a pilot group. Methods: Two HCM patients were evaluated before and after 12 weeks of individualized concurrent training with two sessions/week. Pre- and post-training data were compared for each patient. Evaluations included a cardiopulmonary exercise test (CPET), body composition, echocardiography, electrocardiography, and blood analysis. Results: Training promoted an increase in functional capacity (+4 mL·kg-1·min-1), ventilatory thresholds, and other CPET-derived variables associated with a better prognosis and long-term survival. Muscular mass was augmented (0.8 and 1.2 kg), along with a mean increase of 62% in upper and lower body strength. Echocardiographic features demonstrated the maintenance of cardiac function with signs of positive left ventricular remodeling and an improvement in diastolic function. Blood analyses, including cardiac troponins and NT-proBNP, displayed uneven changes in each patient, but the values fell into normal ranges in both cases. Conclusions: The available data suggest a positive effect of concurrent resistance and cardiorespiratory training on patients' functional capacity and cardiac function that may improve their functional class, quality of life, and long-term prognosis. The replication of this protocol in a larger cohort of patients is warranted to confirm these preliminary results.

The Concept of Neuromuscular Repatterning in Dancers: A Systematic Review.

Repatterning is a term that can be used in different fields, including genetics, molecular biology, neurology, psychology, or rehabilitation. Our aim is to identify the key concept of neuromuscular repatterning in somatic training programmes for dancers. A systematic search of eight databases was conducted using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The Quality Assessment Tool for Quantitative Studies and the Oxford Levels of Evidence scales were used. The search yielded 1218 results, of which 5 met the inclusion criteria. Five studies (n = 5) were related to psychosomatic health (n = 5), two studies highlighted integration and inter-articular connectivity in movement (n = 2), four studies investigated the neurological component of alignment and efficiency in dance practice (n = 4), and two studies investigated self-confidence (n = 2). Five studies (n = 5) used imagery based on the anatomical and physiological experience of body systems as the main analytical method. Four studies (n = 4) used developmental movement through Bartenieff fundamentals as the main technique for this methodology. Developmental movement and imagery are two methodologies strongly connected to the concept of neuromuscular repatterning in somatic training programmes for dancers. The acquisition of further quantitative experimental or quasi-experimental studies is warranted to better define the level of improvement or impact of neuromuscular repatterning in dancers.

HRV-guided training vs traditional HIIT training in cardiac rehabilitation: a randomized controlled trial.

High-intensity interval training is the gold standard for cardiac rehabilitation although current revascularization therapy focuses on the recovery of autonomic nervous system balance through heart rate variability (HRV). The main objective was to analyze the effect of HRV-guided training versus high-intensity interval training on cardiorespiratory fitness, heart rate variability, quality of life, and training volume at high intensity, as well as exercise adherence, safety, and feasibility in ischemic patients. This is an 8-week cluster randomized controlled trial with an HRV-based training group (HRV-G) and a traditional HIIT group (HIIT-G). Maximal oxygen consumption, heart rate, and blood pressure were measured during the Bruce protocol treadmill test. HRV was measured with the HRV4Training application, and quality of life with the MacNew QLMI. The repeated measures ANCOVA was used with the age and the baseline scores as covariables. Forty-six patients (mean age 55 ± 11.03 years) were randomized and assigned either to HRV-G (n = 23) or HIIT-G (n = 23). Both groups improved maximal oxygen consumption and METS (P > .05). However, the resting systolic blood pressure was lower in HRV-G (4.3 ± 1.2 mmHg, P = .05). In HRV-G, the resting diastolic, maximal diastolic, and systolic blood pressure decreased (5.4 ± 5.96 mmHg, P = .007; 11.4 ± 12.46 mmHg, P = .005; and 5 ± 5.98 mmHg, P = .013, respectively) whereas the recovery heart rate increased significantly (-21.5 ± 23.16 beats/min, P = .003). The LnrMSSDcv ([LnrMSSDSD/LnrMSSDMEAN] × 100) was lower in HRV-G (1.23 ± 0.91 mmHg, P = .03) while the training volume at high intensity was higher in HIIT-G (31.4 ± 29.2 min, P = .024). HRV-guided training presents a better cardioprotective effect than HIIT-G at a lower high-intensity training volume.

Ventilatory Pattern Influences Tolerance to Normobaric Hypoxia in Healthy Adults.

INTRODUCTION: Tolerance to breathing in conditions with a decreased oxygen ratio is subject-specific. A normobaric hypoxia tolerance test (NHTT) is performed to assess the ability of each individual, as this may be influenced by genetic or personal factors such as age or gender. The aim of this study is to test the influence of deep breathing on hypoxia tolerance time. MATERIAL AND METHODS: A total of 45 subjects (21 parachutists and 24 students) performed two NHTTs at 5050 m altitude (iAltitude). Arterial (SatO2) and muscle (SmO2) oxygen saturation were monitored with the Humon Hex® device. The first NHTT was performed with free breathing, without any instructions; and the second NHTT was performed with wide, slow, diaphragmatic breathing. The NHTT was terminated at the end of 10 min or when a value of less than 83% was obtained. RESULTS: The first NHTT was completed by 38.1% of parachutist and 33.3% of students while the second NHTT was completed by 85.7% and 75%, respectively. In the second NHTT, both parachutists and students had a significantly (p = 0.001) longer duration compared to the first NHTT. SmO2 and SatO2 values also increased significantly (p < 0.001) in both groups (p < 0.05). CONCLUSION: Performing controlled diaphragmatic breathing is successful in increasing hypoxia tolerance time and/or SatO2 values.

Analysis of Sleep Quality in People With Dementia: A Preliminary Study.

Background: Between 25% and 60% of subjects with dementia have shown sleep disturbances. Causes are diverse and seem to be related to factors such as aging, the presence of psychiatric diseases, or the consumption of drugs. This study aims to determine the influence of dementia on sleep quality and to analyze the factors that influence sleep quality in subjects ≥65 years. Methods: Thirty-one subjects were studied (15 living with dementia). PSQI was administered and statistical analysis compared the results among categories of other variables (age, gender, coffee consumption, drugs, BMI, psychiatric diseases). This study took place in Spain. Results: A prevalence of 46.7% of sleep disturbances was found in subjects with dementia. No significant differences were observed in the total score obtained in the PSQI between the dementia group (6.06 ± 3.78 points) and the group without dementia (7 ± 5.65 points). A significant inverse relationship was found between the sleep quality and the number of daily drugs and the presence of psychiatric diseases. Conclusion: Poor sleep quality affects people with dementia, however, we cannot affirm that dementia is the cause of it. Consumption of daily drugs and psychiatric diseases are factors that influence the sleep quality in subjects aged ≥65 years.

Influences of Intense Physical Effort on the Activity of the Autonomous Nervous System and Stress, as Measured with Photoplethysmography.

Background: The autonomic nervous system, which is composed of the sympathetic and parasympathetic nervous system, is closely related to the cardiovascular system. The temporal variation between each of the intervals between the consecutive "R" waves of an electrocardiogram is known as heart rate variability. Depending on the type of activity, both systems can be activated, and also influence the interval between "R" waves. Currently, with advancements in technology and electronic devices, photoplethysmography is used. Photoplethysmography detects changes in the intensity of reflected light that allow differentiation between systole and diastole and, therefore, determines the heart rate, its frequency and its variations. In this way, changes in the autonomic nervous system can be detected by devices such as the Max Pulse®. Objective: To determine whether the information provided by Max Pulse® on autonomic balance and stress is modified after intense physical exercise, thereby determining whether there is a relationship with body composition, and also whether there are differences with respect to gender. Materials and Methods: Fifty-three runners (38.9% female) with a mean age of 31.3 ± 8.1 years participated in the study. Two measurements (before and after intense physical effort) were performed with the Max Pulse® device. The flotoplethysmography measurement lasted 3 min, and was performed in the supine position. The exercise test was performed on a treadmill. It was initiated at a speed of 6 and 7 km/h for women and men, respectively. Subjects indicated the end of the test by making a hand gesture when unable to continue the test. Results: Autonomic nervous system activity and mental stress values decreased significantly (p < 0.05) in men and women, while autonomic nervous system balance decreased only in women. Physical stress increased (p < 0.05) in both sexes. Conclusions: Intense exercise causes changes in variables that assess autonomic nervous system balance and stress, as measured by a device based on photoplethysmography. The changes are evident in both sexes, and are not related to body composition.

Estudio de la variabilidad de la frecuencia cardiaca tras la exposición a la hipoxia normobárica / Study of heart rate variability after exposure to normobaric hypoxia

La variabilidad de la frecuencia cardiaca (VFC) es una herramienta capaz de analizar y valorar la actividad vegetativa sobre el corazón ante diversas actividades y situaciones. Consiste en medir el tiempo que trascurre entre cada dos latidos cardiacos durante un periodo de tiempo y expresarlo en función de ecuaciones matemáticas y estadísticas. Otros autores han analizado la influencia de diferentes estresores sobre la VFC. En este trabajo buscamos la acción de la hipoxia normobárica (HN) sobre la misma. La HN consiste en respirar aire empobrecido de oxígeno simulando el entrenamiento en altitud. El objetivo del estudio es determinar la influencia de la HN sobre los dominios de tiempo y frecuencia de la VFC. Sometimos a 13 sujetos sanos (deportistas recreacionales) a dos sesiones de HN. Usamos el simulador iAltitude Trainer v2.7®. La primera mediante un test de tolerancia a la hipoxia (TTH) (10 minutos, 11% O2, equivalente a 5.050 m) y, la segunda, con una exposición intermitente (HNI) (14% O2, 3.250 m) en la que se alternaron periodos de 4 minutos de hipoxia con 4 de normoxia durante 64 minutos. Para el análisis de VFC se utilizó un pulsómetro Polar H10®, la aplicación HRV-elite® y el software Kubios-Standard®. Se tomaron los datos de los 5 minutos previos y posteriores a cada sesión, comparándose estos valores mediante el test de T-student para datos pareados. Ninguna de las variables de los dominios de tiempo (RRmedio, SDNN, rMSSD, pNN50) ni de frecuencia (VLF, LF, HF, LF/HF) de la VFC mostró cambios significativos ante ninguna de las dos situaciones. La HN no provocó modificaciones en los niveles de estrés de estos sujetos, siendo bien tolerada, clínica y electrocardiográficamente. Un test de tolerancia y una sesión de exposición a hipoxia normobárica intermitente no son estímulos suficientes para provocar cambios agudos en la VFC

Heart rate variability (HRV) is a tool capable of analysing and assessing the vegetative activity of the heart in various activities and situations. It consists of measuring the time that elapses between every two heartbeats over a period of time and expressing it in terms of mathematical and statistical equations. Other authors have analysed the influence of different stressors on HRV. In this work we are looking for the action of normobaric hypoxia (NH) on HRV. NH consists of breathing oxygen-depleted air simulating altitude training. The aim of the study is to determine the influence of HN on the time and frequency domains of HRV. We subjected 13 healthy subjects (recreational athletes) to two HN sessions. We used the iAltitude Trainer v2.7® simulator. The first was a hypoxia tolerance test (HTT) (10 minutes, 11% O2, equivalent to 5050m) and the second was an intermittent exposure (HNI) (14% O2, 3250m) in which periods of 4 minutes of hypoxia alternated with 4 minutes of normoxia for 64 minutes. For HRV analysis, a Polar H10® heart rate monitor, the HRV-elite® application and the Kubios-Standard® software were used. Data were taken 5 minutes before and after each session, and these values were compared using the Student ́s t- test for paired data. None of the variables in the time (RRmean, SDNN, rMSSD, pNN50) or frequency (VLF, LF, HF, LF/HF) domains of HRV showed significant changes in either situation. HN did not cause changes in the stress levels of these subjects and was well tolerated, clinically and electrocardiographically. A tolerance test and a session of exposure to intermittent normobaric hypoxia are not sufficient stimuli to cause acute changes in HRV.(AU)

The Effect of Normobaric Hypoxia in Middle- and/or Long-Distance Runners: Systematic Review.

BACKGROUND: The use of normobaric hypoxia can bring benefits to sports performance because it improves haematological parameters and/or physical activity tests. Our objective was to conduct a systematic review so as to analyse the methods used in hypoxia and to detect its effects on middle- and/or long-distance runners. METHODS: Research was conducted using five electronic databases (PubMed, SportDiscus, Cochrane Library, Scopus and PEDro) until December 2021. The methodological quality of the included studies was assessed using the PEDro scale. RESULTS: Having analysed 158 studies, 12 were chosen for the qualitative and quantitative synthesis. A significant improvement on time until exhaustion was detected, and oxygen saturation decreased after the intervention. There were no significant changes in the 3000-metre time trial or in the haematocrit percentage. The changes in percentage of reticulocytes, heart rate, maximal heart rate, lactate concentration and erythropoietin were heterogeneous between the different research studies. CONCLUSION: short exposure (less than 3 h to normobaric hypoxia significantly increases the time to exhaustion). However, longer exposure times are necessary to increase haemoglobin. Altitude and exposure time are highly heterogeneous in the included studies.

Comparison of muscle activity while using different input devices in digital pathology.

INTRODUCTION: The high prevalence of musculoskeletal disorders in pathologists, together with the current trend towards the digitization of pathology, prompted us to study the different types of input devices employed during the revision of whole slide images, in order to investigate the pattern and extent of muscle activity involved in their use. MATERIAL AND METHODS: A comparative study was made of 10 input devices (conventional and vertical mouse, three trackballs, the Ergopointer™, the Rollermouse™, an optical pen mouse, a touchpad, and the Leap Motion™). Six medical students performed a standardized circuit using a Fitts' Law based tissue array, digitized. The electrical activity of seven upper limb muscles (adductor pollicis, extensor pollicis longus, extensor digitorum, flexor digitorum, middle deltoid, upper trapezius, and middle trapezius) was measured using surface electromyography. RESULTS: Statistically significant differences in the overall electrical activity among the different input devices, both absolute values in mV as well as normalized values to the upper limb at rest, were observed (p<0.001); the Rollermouse™ (0.1027mV; 139%), Logitech M570 trackball (0.1053mV; 145%), Ergopointer™ (0.1151mV; 167%), conventional mouse (0.1251mV; 191%), and vertical mouse (0.1312mV; 205%) required less activity, while the optical pen mouse (0.1717mV; 299%), Leap Motion™ (0.1803mV; 319%), Expert Mouse trackball (0.1845mV; 329%), EIGIIS trackball (0.2442mV; 468%) and the touchpad (0.2560mV; 496%) required greater muscle mobilization. CONCLUSION: We designed a system based on Fitts' Law to compare input devices in digital pathology. Variability between compared devices and muscle activity was found. Long-term use could result in different muscular fatigue patterns. Even though the selection of an input device is a matter of personal preference, its impact on ergonomics should be considered.

Comparison of muscle activity while using different input devices in digital pathology

Introduction: The high prevalence of musculoskeletal disorders in pathologists, together with the current trend towards the digitization of pathology, prompted us to study the different types of input devices employed during the revision of whole slide images, in order to investigate the pattern and extent of muscle activity involved in their use. Material and methods: A comparative study was made of 10 input devices (conventional and vertical mouse, three trackballs, the Ergopointer™, the Rollermouse™, an optical pen mouse, a touchpad, and the Leap Motion™). Six medical students performed a standardized circuit using a Fitts’ Law based tissue array, digitized. The electrical activity of seven upper limb muscles (adductor pollicis, extensor pollicis longus, extensor digitorum, flexor digitorum, middle deltoid, upper trapezius, and middle trapezius) was measured using surface electromyography. Results: Statistically significant differences in the overall electrical activity among the different input devices, both absolute values in mV as well as normalized values to the upper limb at rest, were observed (p<0.001); the Rollermouse™ (0.1027mV; 139%), Logitech M570 trackball (0.1053mV; 145%), Ergopointer™ (0.1151mV; 167%), conventional mouse (0.1251mV; 191%), and vertical mouse (0.1312mV; 205%) required less activity, while the optical pen mouse (0.1717mV; 299%), Leap Motion™ (0.1803mV; 319%), Expert Mouse trackball (0.1845mV; 329%), EIGIIS trackball (0.2442mV; 468%) and the touchpad (0.2560mV; 496%) required greater muscle mobilization. Conclusion: We designed a system based on Fitts’ Law to compare input devices in digital pathology. Variability between compared devices and muscle activity was found. Long-term use could result in different muscular fatigue patterns. Even though the selection of an input device is a matter of personal preference, its impact on ergonomics should be considered.(AU)

Introducción y objetivos: La alta prevalencia de trastornos musculoesqueléticos entre patólogos y el cambio hacia la digitalización de la Anatomía Patológica, nos ha hecho plantear un estudio comparativo de dispositivos de entrada al manejar preparaciones histológicas digitalizadas, evaluando el patrón y la actividad muscular durante su uso. Material y métodos: se realizó una comparación entre 10 dispositivos: ratón convencional y vertical, 3 trackballs, Ergopointer™, Rollermouse™, lápiz óptico, touchpad, Leap Motion™. Seis estudiantes de medicina realizaron un circuito estandarizado empleando una matriz tisular digitalizada, basada en la ley de Fitts. Se registró con electromiografía superficial la actividad eléctrica de 7 músculos del brazo dominante (aductor y extensor largo del pulgar, extensor y flexor común de los dedos, deltoides medio, y trapecios superior y medio). Resultados: se encontraron diferencias estadísticamente significativas en la actividad muscular, absoluta y relativizada (respecto al reposo), entre los dispositivos (p<0,001); Rollermouse™ (0,1027mV;139%), trackball Logitech M570 (0,1053mV/145%), Ergopointer™ (0,1151mV/167%), ratón convencional (0,1251mV/191%) y ratón vertical (0,1312mV/205%) fueron los que demandaron menor actividad, mientras que el lápiz óptico (0,1717mV/299%), Leap Motion™ (0,1803mV/319%), trackball Expert Mouse (0,1845mV/329%), trackball EIGIIS (0,2442mV/468%) y touchpad (0,2560mV/496%) fueron los que mayor movilización muscular requirieron. Conclusiones: Hemos diseñado un sistema basado en la ley de Fitts para comparar dispositivos de entrada. Se encontró variabilidad entre los dispositivos comparados y la actividad muscular demandada, lo que podría traducirse en diferentes patrones de fatiga muscular a largo plazo. Aunque la elección de un dispositivo es una cuestión de preferencia personal, es importante analizar su impacto desde el punto de vista ergonómico.(AU)

HRV-Guided Training for Professional Endurance Athletes: A Protocol for a Cluster-Randomized Controlled Trial.

Physiological training responses depend on sympathetic (SNS) and parasympathetic nervous system (PNS) balance. This activity can be measured using heart rate variability (HRV). Such a measurement method can favor individualized training planning to improve athletes' performance. Recently, HRV-guided training has been implemented both on professional and amateur sportsmen and sportswomen with varied results. There is a dearth of studies involving professional endurance athletes following a defined HRV-guided training protocol. The objectives of the proposed protocol are: (i) to determine changes in the performance of high-level athletes after following an HRV-guided or a traditional training period and (ii) to determine differences in the athletes' performance after following both training protocols. This will be a 12-week cluster-randomized controlled protocol in which professional athletes will be assigned to an HRV-based training group (HRV-G) or a traditional-based training group (TRAD-G). TRAD-G will train according to a predefined training program. HRV-G training will depend on the athletes' daily HRV. The maximal oxygen uptake (VO2max) attained in an incremental treadmill test will be considered as the primary outcome. It is expected that this HRV-guided training protocol will improve functional performance in the high-level athletes, achieving better results than a traditional training method, and thus providing a good strategy for coaches of high-level athletes.

High-Intensity Interval Circuit Training Versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Middle-Aged and Older Women: A Randomized Controlled Trial.

High-intensity interval training (HIIT) has similar or better effects than moderate-intensity continuous training (MICT) in increasing peak oxygen consumption (VO2max), however, it has not been studied when HIIT is applied in a circuit (HIICT). The aim of this study was to compare the effects of a HIICT versus MICT on VO2max estimated (VO2max-ES), heart rate (HR) and blood pressure (BP) of middle-aged and older women. A quasi-experimental randomized controlled trial was used. Fifty-four women (67.8 ± 6.2 years) were randomized to either HIICT (n = 18), MICT (n = 18) or non-exercise control group (CG; n = 18) for 18 weeks. Participants in HIICT and MICT trained two days/week (one hour/session). Forty-one participants were assessed (HIICT; n = 17, MICT; n = 12, CG; n = 12). Five adverse events were reported. Cardiorespiratory fitness, HR and BP were measured. The tests were performed before and after the exercise intervention programs. VO2max-ES showed significant training x group interaction, in which HIICT and MICT were statistically superior to CG. Moreover, HIICT and MICT were statistically better than CG in the diastolic blood pressure after exercise (DBPex) interaction. For the systolic blood pressure after exercise (SBPex), HIICT was statistically better than CG. In conclusion, both HIICT and MICT generated adaptations in VO2max-ES and DBPex. Furthermore, only HIICT generated positive effects on the SBPex. Therefore, both training methods can be considered for use in exercise programs involving middle-aged and older women.

Estrés cardiaco asociado a la realización de una formación acrobática paracaidista / Cardiac stress associated to the realization of an acrobatic skydiver formation

INTRODUCCIÓN: El paracaidismo acrobático es una actividad de alto riesgo. Este riesgo y la dificultad de las maniobras son factores estresantes que modifican la respuesta cardiaca. Nuestro objetivo es analizar el trazado electrocardiográfico y la evolución de la frecuencia cardiaca (FC) durante esta actividad paracaidista creando una figura de alta dificultad. MÉTODO: Colocamos un monitor electrocardiográfico Nuubo a dos paracaidistas experimentados de la Patrulla Acrobática Paracaidista del Ejército del Aire (PAPEA) durante la ejecución de una formación acrobática en la que cuatro paracaidistas se unen durante el vuelo creando una figura denominada "diamante". Analizamos el electrocardiograma (ECG) durante todo el ejercicio y recogimos la FC en las siguientes fases: 1.- Subiendo al avión; 2.- Despegando; 3.- Antes de saltar; 4.- Preparando la figura; 5.- En formación y 6.- Tomando tierra. Se repitió cinco veces, obteniéndose la media de cada saltador. Previamente se realizó un ECG en reposo y una prueba de esfuerzo máxima (PE) en tapiz rodante. RESULTADOS: Ambos saltadores consiguen la mayor FC mientras vuelan preparando la formación (165 y 143 lat/min), supone el 87% y 77% de la FC máxima alcanzada en la PE. No se recogen FC inferiores a 95 pulsaciones en ninguna fase ni salto. Cada saltador tiene un tipo de respuesta, según le afecte el momento del despegue. En uno la FC aumenta paulatinamente hasta ella llega al pico máximo cuando están en formación y en el otro aparece otro pico, que se repite en los cinco saltos, coincidiendo con el despegue. En el ECG sólo se han observado episodios continuados de taquicardias sinusales. CONCLUSIONES: Concluimos que el estrés cardiaco producido por la realización de este tipo de ejercicios se manifiesta por aumentos importantes de la frecuencia cardiaca, en torno al 80% de la frecuencia cardiaca máxima, sin otras alteraciones electrocardiográficas

INTRODUCTION: Acrobatic skydiving is considered a high risk activity. This risk and the difficulty of the maneuvers are stressors that modify the cardiac activity. Our aim is to analyze the electrocardiographic tracing and the evolution of the heart rate during this paratrooper activity, creating a figure of high difficulty. METHOD: We put a Nuubo electrocardiographic monitor on two experienced paratroopers members of the Acrobatic Patrooper Patrol of the Air Force (PAPEA) during the execution of an acrobatic exercise, called "diamond", in which four parachutists are attached during the flight. We analyzed the electrocardiogram (ECG) during the whole activity and we got the heart rate (HR) in the following phases: 1.- Up to the aircraft; 2.-Taking off; 3.- Before jumping; 4.- Preparing the figure; 5.- Formation flight and 6.- Landing. They jumped five times, obtaining the average of each jumper. Previously we made them an ECG at rest and maximal treadmill stress test (ST ).RESULTS: Both jumpers get the largest HR while they fly preparing the formation (165 and 143 beats/min), it is 87% and 77% of the max HR reached in ST. Beats under 95 b/min are not registered in any stage or jump. Each jumper has a different response, depending on the effect that the take-off has on him. In one of them, HR increases gradually until it reaches the maximum peak when they are in formation, and on the other jumper it appears another peak, that is repeated in the five jumps, coinciding with the taking off. There is no other ECG alterations. CONCLUSIONS: We conclude that cardiac stress caused by carrying out this type of exercises is manifested by significant increases in heart rate, around 80% of the maximum heart rate, without other electrocardiographic abnormalities

High-Intensity Interval Circuit Training Versus Moderate-Intensity Continuous Training on Functional Ability and Body Mass Index in Middle-Aged and Older Women: A Randomized Controlled Trial.

The literature suggests that high-intensity interval training (HIIT) is more effective than moderate-intensity continuous training (MICT) to improve functional ability. However, there is no evidence on including HIIT in a circuit programme (HIICT). Our objective was to determine what type of training (HIICT or MICT) induces greater adaptations in the functional ability and body mass index of middle-aged and older women. The study used a quasi-experimental randomized controlled trial with 54 participants (age = 67.8 ± 6.2 years). Participants were randomly allocated to HIICT (n = 18), MICT (n = 18) or a non-exercise control group (CG; n = 18). The participants in the HIICT or MICT groups trained twice a week (1 h/session) for 18 weeks. Forty-one subjects were analysed (HIICT; n = 17, MICT; n = 12, CG; n = 12). Five subjects presented adverse events during the study. Strength, gait, cardiorespiratory fitness, balance and body mass index were measured. A significant training x group interaction was found in the arm curl test, where HIICT was statistically better than MICT and CG. Likewise, HIICT was statistically better than the CG in the BMI interaction. In lower limb strength, gait/dynamic balance and cardiorespiratory fitness, both HIICT and MICT were statistically better than the CG. In conclusion, HIICT generated better adaptations in upper limb strength than MICT. Likewise, HIICT generated better adaptations in body mass index than CG. Finally, both HIICT and MICT had a similar influence on strength, cardiorespiratory fitness and gait/dynamic balance.

Dosis de ejercicio interválico de alta intensidad en la rehabilitación cardiaca de la insuficiencia cardiaca y la enfermedad arterial coronaria: revisión sistemática y metanálisis / High-intensity interval training dosage for heart failure and coronary artery disease cardiac rehabilitation. A systematic review and meta-analysis

Introducción y objetivos: Se ha propuesto el ejercicio interválico de alta intensidad (EIAI) en programas de rehabilitación cardiaca para mejorar el VO2máx. Sin embargo, no se conoce cuál es el mejor protocolo EIAI. El objetivo es encontrar la mejor dosis de EIAI para optimizar el VO2máx de pacientes con enfermedad arterial coronaria (EAC) e insuficiencia cardiaca (IC). Método: Se llevó a cabo una búsqueda en 6 bases de datos (MEDLINE, Web of Science, LILACS, CINAHL, Academic Search Complete y SportDiscus). Se incluyeron los estudios que usaban el protocolo EIAI y midieron el VO2máx de pacientes con EAC e IC. Se utilizó la escala PEDro y las herramientas de la Colaboración Cochrane. Resultados: El análisis mostró mejoras significativas en el VO2máx tras el EIAI en ambas enfermedades (p = 0,000001), con mayor incremento en los pacientes con IC (p = 0,03). Sin embargo, en estos no hubo mejora si la intensidad de recuperación era ≤ 40% del VO2máx (p = 0,19) o la frecuencia de entrenamiento era ≤ 2 días/semana (p = 0,07). Hubo diferencias significativas según la duración entre los pacientes con EAC, que mostraron resultados superiores cuando era < 12 semanas (p = 0,05). Los pacientes con IC no mostraron mejoras significativas en el VO2máx cuando la duración era < 12 semanas (p = 0,1). Conclusiones: El EIAI es un método efectivo para mejorar el VO2máx de los pacientes con IC o EAC, con mayor diferencia significativa en los pacientes con IC. Los intervalos de recuperación de los pacientes con IC deben ser activos y estar en un 40-60% del VO2máx. La frecuencia de entrenamiento debería ser ≥ 2 días/semana en la EAC y ≥ 3 días/semana en la IC

Introduction and objectives: High-interval intensity training (HIT) has been suggested to improve peak VO2 in cardiac rehabilitation programs. However, the optimal HIT protocol is unknown. The objective of this study was to identify the most effective doses of HIT to optimize peak VO2 in coronary artery disease (CAD) and heart failure (HF) patients. Methods: A search was conducted in 6 databases (MEDLINE, Web of Science, LILACS, CINAHL, Academic Search Complete, and SportDiscus). Studies using a HIT protocol in CAD or HF patients and measuring peak VO2 were included. The PEDro Scale and Cochrane Collaboration tools were used. Results: Analyses reported significant improvements in peak VO2 after HIT in both diseases (P = .000001), with a higher increase in HF patients (P = .03). Nevertheless, in HF patients, there were no improvements when the intensity recovery was ≤ 40% of peak VO2 (P = .19) and the frequency of training was ≤ 2 d/wk (P = .07). There were significant differences regarding duration in CAD patients, with greater improvements in peak VO2 when the duration was < 12 weeks (P = .05). In HF, programs lasting < 12 weeks did not significantly improve peak VO2 (P = .1). Conclusions: The HIT is an effective method for improving peak VO2 in HF and CAD, with a significantly greater increase in HF patients. The recovery intervals should be active and be between 40% and 60% of peak VO2 in HF patients. Training frequency should be ≥ 2 d/wk for CAD patients and ≥ 3 d/wk for HF patients

High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis.

INTRODUCTION AND OBJECTIVES: High-interval intensity training (HIT) has been suggested to improve peak VO2 in cardiac rehabilitation programs. However, the optimal HIT protocol is unknown. The objective of this study was to identify the most effective doses of HIT to optimize peak VO2 in coronary artery disease (CAD) and heart failure (HF) patients. METHODS: A search was conducted in 6 databases (MEDLINE, Web of Science, LILACS, CINAHL, Academic Search Complete, and SportDiscus). Studies using a HIT protocol in CAD or HF patients and measuring peak VO2 were included. The PEDro Scale and Cochrane Collaboration tools were used. RESULTS: Analyses reported significant improvements in peak VO2 after HIT in both diseases (P = .000001), with a higher increase in HF patients (P = .03). Nevertheless, in HF patients, there were no improvements when the intensity recovery was ≤ 40% of peak VO2 (P = .19) and the frequency of training was ≤ 2 d/wk (P = .07). There were significant differences regarding duration in CAD patients, with greater improvements in peak VO2 when the duration was < 12 weeks (P = .05). In HF, programs lasting < 12 weeks did not significantly improve peak VO2 (P = .1). CONCLUSIONS: The HIT is an effective method for improving peak VO2 in HF and CAD, with a significantly greater increase in HF patients. The recovery intervals should be active and be between 40% and 60% of peak VO2 in HF patients. Training frequency should be ≥ 2 d/wk for CAD patients and ≥ 3 d/wk for HF patients.

Fuerza isocinética y test de salto vertical en paracaidistas acrobáticos / Isokinetic strength and vertical jump test in acrobatic skydivers

Introducción: Las rodillas de los paracaidistas pueden sufrir lesiones durante la toma de tierra que se pueden prevenir con una adecuada fuerza muscular. Esta fuerza se puede evaluar de manera directa con dinamómetros isocinéticos y con métodos indirectos mediante el test de salto vertical. Objetivo: El objetivo del estudio fue determinar y analizar, en paracaidistas profesionales, las relaciones entre los valores fuerza isocinética máxima de cuádriceps e isquiosurales con la altura y el tiempo de vuelo en saltos verticales. Material y método: Valoramos a los catorce paracaidistas pertenecientes a la Patrulla Acrobática Paracaidista del Ejército del Aire mediante un dinamómetro isocinético (a 60º/s y 180º/s) tanto para el trabajo concéntrico como excéntrico, obteniéndose los picos máximos de fuerza y las ratios isquiosurales/cuádriceps. Evaluamos, sobre una plataforma de contacto, los siguientes saltos verticales: Squat Jump, Counter Movement Jump y Abalakov Jump. Resultados: Los resultados indican que los picos de fuerza máxima de la musculatura flexo-extensora de la rodilla son mayores en modalidad excéntrica, y en el equipo masculino. Las ratios isquiosurales/cuádriceps muestran un predominio de los primeros. Abalakov Jump es el salto donde mayor altura y tiempo de vuelo se consigue. Existe una correlación positiva entre el tiempo de vuelo de todos los saltos y la fuerza concéntrica del cuádriceps. La altura de salto por el peso corporal (Trabajo = Kg x m) se correlaciona con los picos de fuerza concéntrica y excéntrica del cuádriceps. La relación es mayor en la velocidad más alta. La fuerza excéntrica de isquiosurales no se correlaciona con la altura de vuelo, pero sí la fuerza concéntrica. Conclusiones: Podemos concluir que las rodillas de los paracaidistas presentan un predominio en la fuerza de los isquiosurales, lo que se considera positivo para la actividad que realizan ya que contribuye a mejorar la estabilidad de la rodilla y que hay altas correlaciones entre los picos de fuerza isocinético y el trabajo realizado en los saltos verticales

Introduction: Knees of the parachutists can suffer injuries during the landing that can be avoided with a correct muscular strength. This strength is posible to be evaluated of direct way with isokinetic dynanometers and indirect methods using the test of vertical jump. Objective: The aim of this study was to determine and analyze, in professional skydivers, the relationship between the values of isokinetic force of quadriceps and hamstrings with height and time of flight in vertical jumps. Material and methods: We studied the fourteen paratroopers belonging to the (patrol acrobatic jumper of the air force) using an isokinetic dynamometer (60°/s and 180°/s) both for concentric work as eccentric, obtaining the peaks maximum of strength and hamstrings/quadriceps ratios. Evaluate, on a platform of contact, the following vertical jumps: Abalakov Jump and Squat Jump, Counter Movement Jump. Results: The results indicate that the peaks of maximum strength of flexor and extensor muscles of the knee are greater in eccentric mode, and the men’s team. Hamstrings/quadriceps ratios show a predominance of the first. AJ is the jump where greater height and time of flight is achieved. There is a positive correlation between the flight time of all jumps and concentric quadriceps strength. The height of jump by body weight (Work = Kg x m) correlates with the peaks of concentric and eccentric strength of the quadriceps. The ratio is higher in the higher speed. The eccentric strength of hamstrings does not correlate with the height of flight, but the concentric strength. Conclusions: We can conclude that the knees of the skydivers have a predominance of the hamstrings what is considered positive for the activity carried out, since it helps to improve the stability of the knee and that there are high correlations between the peaks of force isokinetic and the work done in the jumps vertical

Contraindicaciones para la práctica deportiva. Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Contraindications of sports practice. Consensus document of the SPANISH Society of Sports Medicine (SEMED-FEMEDE)

La función principal de la medicina del deporte es el cuidado de la salud del deportista, no solo desde el punto de vista del tratamiento, sino también desde el de la prevención. Los reconocimientos médicos para la aptitud deportiva, una de las atribuciones principales de esta especialidad, están destinados a descubrir patologías, enfermedades o alteraciones que pueden afectar a la salud, y abarcan desde las situaciones que pueden desencadenar incidentes mortales hasta las que, sin poner en riesgo la vida, pueden afectar la salud o el rendimiento del deportista. La realización adecuada de reconocimientos para el deporte implica el diagnóstico de problemas médicos que deben analizarse, entre otros puntos de vista, desde la óptica de la aptitud para la práctica deportiva, y el médico encargado debe disponer de una guía que le oriente sobre la decisión de autorizar o no la práctica de deporte, y en caso de no autorización, la temporalidad de esta y el riesgo asumible de participación en algunos deportes. Las contraindicaciones para la práctica deportiva mejor conocidas son las de origen cardiovascular, tratadas extensamente en la literatura, pero también existen contraindicaciones del resto de aparatos y sistemas del organismo, entendiendo que el deportista es un ser completo y que el ejercicio físico afecta a todo su conjunto. Este documento, además de recoger dichas contraindicaciones, analiza los aspectos legales que afectan a los profesionales en los que recae la responsabilidad de realizar los reconocimientos y los aspectos documentales que les son propios

Main purpose of sports medicine is reaching the health care of the athlete, not only from the point of view of treatment, but also from the point of view of prevention. The performance of preparticipation medical sports evaluation, one of the main attributions of this specialty, is aimed at the discovery of pathologies, diseases or alterations that may affect health. They might range from situations that can trigger deadly incidents, to those without putting life at risk, can affect the health or performance of the athlete. Adequate implementation of preparticipation medical sports evaluation implies the diagnosis of medical problems that must be analyzed, from other points of view such as the perspective of fitness for sport practice. In addition, the doctor in charge must have a guide for clearance for sports practice. In case of non-authorization, time for non-sports activities must be recommended in order to decrease injury risks. Cardiovascular pathologies are the best known contraindications in sport practice, treated extensively in the literature. However, there are also contraindications secondary to problems or issues of the rest of apparatus organs and systems of the organism, knowing that the athlete represents an entity in which physical exercise affects all their sets. This document highlights those contraindications already discussed above and analyzes the legal aspects of sports practice contraindications. Medical professionals are responsible for managing the pre-participation medical sports evaluation as well as the documentary aspects that support it

Daily physical activity impact in old women bone density and grip strength.

INTRODUCTION: Being physically active is related to a better physical functioning in older people, but daily physical activity impact in specific outcomes such as osteoporosis or sarcopenia is still not clear. OBJECTIVE: The main objective of this study is to determine the impact of daily physical activity (DPA) in the bone mineral density and grip strength of old women. The secondary objective is to distinguish between weekday and weekend day scores. METHODS: Forty-two women between 65 and 79 years participated. DPA was monitored with the accelerometer ActiGraph GT3X (Pensacola, FL, USA) placed on the dominant hand wrist. Bone mineral density was measured with dual-energy X-ray absorptiometry (AccuDEXA, SHICK, USA) in the central finger of the dominant hand; and grip strength, with a Takei dynamometer (TKK 5001). RESULTS: There were statistical differences between moderate and vigorous DPA in age, T-score, physical activity counts/min and min/day, and grip strength. Weekend minutes correlated significantly with all the variables. Age was a confounding factor. CONCLUSIONS: Higher DPA intensities accomplished by our old women sample preserve T-score (bone standard deviations respect to young, healthy people) and grip strength in a normal range. These results are strongly influenced by weekend scores. Age should be controlled by shorter ranks.