Ana Carolina Brandt de Macedo

A periodized model for exercise improves the intra-hospital evolution of patients after myocardial revascularization: a pilot randomized controlled trial

Objective: To compare models of the postoperative hospital treatment phase after myocardial revascularization. Design: A pilot randomized controlled trial. Setting: Hospital patients in a hospital setting. Subjects: Thirty-two patients with indications for myocardial revascularization were included between January 2008 and December 2009, with a left ventricular ejection fraction (LVEF) ≥50%, 1-second forced expiratory volume (FEV1) ≥60 and forced vital capacity (FVC) ≥60% of predicted value. Interventions: Patients were randomly placed into two groups: one performed prescribed exercises according to the model proposed by the American College of Sports Medicine (ACSM) and the other according to a periodized model. Main measures: Partial pressure of O2 (Po2) and arterial O2 saturation (Sao2), percentage of predicted FVC and total distance on the six-minute walking test (6MWT). Results: Twenty-seven patients were re-evaluated upon release from the hospital (ACSM = 14 and PP = 13). Five patients extubated for more than 6 hours in the postoperative period were excluded from the sample. In the preoperative period the variables Po2, Sao2, % FVC and 6MWT were similar. In the postoperative period, a reduction was observed for all parameters in both groups. Upon comparison of the groups, a difference was observed in Po2 (ACSM = 68.0 ± 4.3 vs. PP = 75.9 ± 4.8 mmHg; P < 0.001), Sao2 (ACSM = 93.5 ± 1.4 vs. PP = 94.8 ± 1.2%; P = 0.018) and 6MWT (ACSM = 339.3 ± 41.7 vs. PP = 393.8 ± 25.7 m; P < 0.001). There was no difference in % FVC. Conclusion: Patients after myocardial revascularization following a periodized model of exercise presented a better intra-hospital evolution when compared to those using the ACSM model.

Morphologic study of different treatments for gastrocnemius muscle contusion in rats

Objective Evaluate the effects of ultrasound and stretching in morphology after rat muscle contusion. Methods Male Wistar rats (n = 35, 8–9 weeks, 271 ± 14 g) were divided into five groups: control group (CG = 3); lesion group (LG = 8); lesion + ultrasound group (LUG = 8); lesion + stretching group (LSG = 8); lesion + ultrasound + stretching group (LUSG = 8). The ultrasound was applied in LUG and LUSG from the third to the seventh day, the dose used was 50% pulsed, 0.5 W/cm2, 5 min. From the tenth until the twenty first day, passive stretching was performed, in four repetitions lasting 30 s each with 30 s of rest. Initial and final body weight, muscle weight and length, number and sarcomere length, muscle fiber cross-sectional area, and percentage of collagen were evaluated after 22 days. Results The final body weight was higher than the initial in all groups. The number of sarcomeres was statistically higher in LSG than LUG and higher in LUSG than LUS and CG; in sarcomere length was higher in LUG when compared with LSG (p < 0.05). The cross sectional area in LG was higher than LSG, and the percentage of collagen was higher in LG when compared with LSG and CG; in LUG when compared with LSG and CG; and in LUSG when compared with CG. Conclusion The passive stretching protocol induced sarcomerogenesis and antifibrotic effect over the muscle submitted to contusion. Ultrasound, even in association with stretching, was not sufficient to prevent fibrosis in the injured muscle.

Efeitos agudos do alongamento muscular do gastrocnêmio após contusão em ratos

O objetivo do estudo foi avaliar os efeitos agudos do alongamento apos contusao do gastrocnemio de ratos. Foram selecionados 33 ratos Wistar machos (8 semanas, 219±35 g), que foram divididos em 4 grupos: Controle (GC, n=3) - intacto; Lesao (GL, n=10); Alongamento (GA, n=10); Lesao e Alongamento (GLA, n=10). O gastrocnemio direito (GD) foi submetido a contusao. O alongamento do GD foi realizado manualmente, 4 repeticoes de 30 segundos, durante 5 dias, iniciado 72 horas apos a lesao. Apos uma semana, os ratos foram pesados, e os musculos de ambas as patas foram retirados para analise do peso e comprimento muscular, numero e comprimento dos sarcomeros. O peso corporal final aumentou em todos os grupos. O peso, comprimento muscular e numero de sarcomeros em serie (NSS) do GL foram maiores que o GA. Porem, o NSS do GLA foi superior ao GA. O comprimento dos sarcomeros do GA foi maior que os demais grupos. Conclui-se que a contusao e o alongamento nao interferiram no ganho de peso corporal. O alongamento induziu sarcomerogenese em musculos lesados, porem nao modificou o musculo higido.

Superior Cardiovascular Effect of the Periodized Model for Prescribed Exercises as Compared to the Conventional one in Coronary Diseases

Mailing Address: Rafael Michel de Macedo Rua Pedro Collere, 890. Postal Code: 80320-320, Vila Izabel, Curitiba, PR Brazil. E-mail: rafael.macedo@hospitalcostantini.com.br, acbrandt@bol.com.br Superior Cardiovascular Effect of the Periodized Model for Prescribed Exercises as Compared to the Conventional one in Coronary Diseases Rafael Michel de Macedo,1,2 Ana Carolina Brandt de Macedo,3 Jose R. Faria-Neto,2 Costantino R. Costantini,1 Costantino O. Costantini,1 Marcia Olandoski,2 Flavio Sebastião Neto,1 Rafael P. da Silveira,1 Katherine A. Teixeira de Carvalho4, Luiz Cesar Guarita-Souza2 Hospital Cardiológico Costantini,1 Curitiba, PR Brazil Pontifícia Universidade Católica do Paraná,2 Curitiba, PR Brazil Universidade Federal do Paraná,3 Curitiba, PR Brazil Hospital Pequeno Príncipe,4 Curitiba, PR Brazil

Impact of a High-Intensity Training on Ventricular Function in Rats After Acute Myocardial Infarction

Background Physical exercise should be part of the treatment of post-acute myocardial infarction (AMI) patients. Objective To evaluate the effects of two training prescription models (continuous x interval) and its impact on ventricular function in rats after AMI with normal ventricular function. Methods Forty Wistar rats were evaluated by echocardiography 21 days after the AMI. Those with LVEF = 50% (n = 29) were included in the study and randomized to control group (CG n = 10), continuous training group (CTG n = 9) or interval training group (ITG, n = 10). Then, a swimming test with control of lactate production was performed. Based on its result, the lactate threshold (LT) was established to define the training intensities. After six weeks, the animals were reassessed by echocardiography and lactate production. Outcome measures were end-diastolic diameter (EDD), end-systolic diameter (ESD), left ventricular ejection fraction (LVEF, %) lactate at rest, lactate without overload, and lactate with 12g and 13.5g of additional load. Group comparisons of quantitative variables of the study were performed by one-factor analysis of variance (ANOVA). The Newman-Keuls test was used for multiple comparisons of the groups. Within-group comparisons of dependent variables between the two training protocols were performed by Students t-test. Normality of the variables was tested by the Shapiro-Wilks test. Values of p < 0.05 indicated statistical significance. Results EDD, ESD, and LVEF before and after the training period were similar in within-group comparisons. However, EDD was significantly different (p=0.008) in the CG. Significant differences were found for L12g (p=0.002) and L13.5g (p = 0.032) in the ITG, and for L12g (p = 0.014) in the CG. No differences were found in the echocardiographic parameters between the groups. Significant differences were found in lactate without overload (p = 0.016) and L12 (p = 0.031) in the second assessment compared with the first, and between the groups - ITG vs. CG (p = 0.019) and CTG vs. CG (p = 0.035). Conclusion Both methods produced a training effect without altering ventricular function.

Efectos agudos del estiramiento muscular del gastrocnemio tras contusión en ratones

O objetivo do estudo foi avaliar os efeitos agudos do alongamento apos contusao do gastrocnemio de ratos. Foram selecionados 33 ratos Wistar machos (8 semanas, 219±35 g), que foram divididos em 4 grupos: Controle (GC, n=3) - intacto; Lesao (GL, n=10); Alongamento (GA, n=10); Lesao e Alongamento (GLA, n=10). O gastrocnemio direito (GD) foi submetido a contusao. O alongamento do GD foi realizado manualmente, 4 repeticoes de 30 segundos, durante 5 dias, iniciado 72 horas apos a lesao. Apos uma semana, os ratos foram pesados, e os musculos de ambas as patas foram retirados para analise do peso e comprimento muscular, numero e comprimento dos sarcomeros. O peso corporal final aumentou em todos os grupos. O peso, comprimento muscular e numero de sarcomeros em serie (NSS) do GL foram maiores que o GA. Porem, o NSS do GLA foi superior ao GA. O comprimento dos sarcomeros do GA foi maior que os demais grupos. Conclui-se que a contusao e o alongamento nao interferiram no ganho de peso corporal. O alongamento induziu sarcomerogenese em musculos lesados, porem nao modificou o musculo higido.

Acute effects of gastrocnemius muscle stretching after contusion in rats

O objetivo do estudo foi avaliar os efeitos agudos do alongamento apos contusao do gastrocnemio de ratos. Foram selecionados 33 ratos Wistar machos (8 semanas, 219±35 g), que foram divididos em 4 grupos: Controle (GC, n=3) - intacto; Lesao (GL, n=10); Alongamento (GA, n=10); Lesao e Alongamento (GLA, n=10). O gastrocnemio direito (GD) foi submetido a contusao. O alongamento do GD foi realizado manualmente, 4 repeticoes de 30 segundos, durante 5 dias, iniciado 72 horas apos a lesao. Apos uma semana, os ratos foram pesados, e os musculos de ambas as patas foram retirados para analise do peso e comprimento muscular, numero e comprimento dos sarcomeros. O peso corporal final aumentou em todos os grupos. O peso, comprimento muscular e numero de sarcomeros em serie (NSS) do GL foram maiores que o GA. Porem, o NSS do GLA foi superior ao GA. O comprimento dos sarcomeros do GA foi maior que os demais grupos. Conclui-se que a contusao e o alongamento nao interferiram no ganho de peso corporal. O alongamento induziu sarcomerogenese em musculos lesados, porem nao modificou o musculo higido.

Mensuração do ângulo articular do cotovelo no teste de tensão neural em indivíduos com hanseníase

Leprosy is a chronic and granulomatous disease, which affects skin and peripheral nervous system by invasion of Mycobacterium leprae in the immune system. The objective of this study was to evaluate the ulnar neural tension test in leprosy patients. In applying the test of neural tension, it was done goniometry and photometry to measure the angle of the elbow joint, and to perform the photometry we used a Samsung camera, 12.1 Mega pixels, and the data were analyzed using Corel Draw Software X5 (Microsoft®). We selected 44 individuals of Pro-Hansen Foundation, with an average age of 48.13±12.55 years, divided in three groups: G1, G2 and G3. G1 consisted of leprosy volunteers with preserved sensibility; the G2, the ones with leprosy and with no sensibility; and G3 was control group. In goniometry, it was found significant difference (p<0.05) when comparing the G1 and G2 with control of both the right and left limb, but no difference was found when comparing the two leprosy groups. In photometry, it was found difference between G2 and the control and bilaterally between the G1 and control on the left side. Comparing the right and left limbs, difference was not found in any group. Patients with leprosy showed a decrease in range of movement of elbow flexion in ulnar neural tension test in both sides when compared to the control group.