Claudio Rosa

Thermography in Neurologic Practice

One kind of medical images that has been developed in the last decades is thermal images. These images are assessed by infrared cameras and have shown an exponential development in recent years. In this sense, the aim of this study was to describe possibilities of thermography usage in the neurologic practice. It was performed a systematic review in Web of Knowledge (Thompson Reuters), set in all databases which used two combination of keywords as “topic”: “thermography” and “neurology”; and “thermography” and “neurologic”. The chronological period was defined from 2000 to 2014 (the least 15 years). Among the studies included in this review, only seven were with experimental design. It is few to bring thermography as a daily tool in clinical practice. However, these studies have suggested good results. The studies of review and an analyzed patent showed that the authors consider the thermography as a diagnostic tool and they recommend its usage. It can be concluded that thermography is already used as a diagnostic and monitoring tool of patients with neuropathies, particularly in complex regional pain syndrome, and stroke. And yet, this tool has great potential for future research about its application in diagnosis of other diseases of neurological origin.

Using skin temperature and muscle thickness to assess muscle response to strength training

Introduccion:Varios estudios ya relataron la respuesta de muchos biomarcadores despues de entrenamiento de fuerza, pero los estudios que utilizan herramientas de diagnostico por imagen de bajo costo son raros.Objetivo:Evaluar el uso de la temperatura de la piel y del espesor del musculo (EM) para monitorear la respuesta muscular (hasta de 96 horas despues) al entrenamiento de fuerza de alta intensidad.Metodos:Este es un estudio longitudinal de corta duracion con 13 voluntarios entrenados y saludables del sexo masculino. Los voluntarios realizaron cinco conjuntos de ejercicios bi-set para biceps con el brazo dominante, con pesas, con carga de 70% de una repeticion maxima (1RM). Las imagenes de ultrasonido (US) y termicas fueron obtenidas antes e inmediatamente despues de la ultima serie, 24, 48, 72 y 96 horas despues del ejercicio.Resultados:El analisis fue dividido en dos etapas: respuesta muscular aguda (hasta 24 horas despues del entrenamiento) y respuesta muscular tardia (de 24 a 96 horas despues del entrenamiento). El espesor de los flexores del codo mostro el valor de pico inmediatamente despues del ultimo conjunto de entrenamiento. La temperatura de la piel (en los flexores del codo) y el espesor de los flexores del codo aumentaron continuamente de 24 a 96 horas despues del entrenamiento de fuerza. Existe una alta correlacion (r = 0,941, p = 0,017) entre la temperatura de la piel y el espesor del musculo desde el final del ejercicio hasta 96 horas despues del entrenamiento de fuerza.Conclusiones:Las imagenes de US mostraron alta sensibilidad para alteraciones fisiologicas en el musculo en las primeras 24 horas despues del ejercicio. Por otro lado, las imagenes termicas presentaron mayor sensibilidad para alteraciones fisiologicas que las imagenes de US entre 24 y 96 horas despues del entrenamiento.ABSTRACT Introduction: Several studies already reported the response of many biomarkers after strength training, but studies using low cost diagnostic imaging tools are rare. Objective: To evaluate the usage of skin temperature and muscle thickness (MT) to monitor muscle response (until 96 hours after) to high-intensity strength training. Methods: This is a short-term longitudinal study with 13 trained, healthy male volunteers. Volunteers performed five sets of biceps bi-set exercise with their dominant arm with dumbbells, with load of 70% of one-repetition maximum (1RM). The ultrasound (US) and thermal images were acquired before and immediately after the last set, 24, 48, 72 and 96 hours after exercise. Results: The analysis was divided in two stages: acute muscle response (until 24 hours after training) and delayed muscle response (from 24 to 96 hours after training). The elbow flexors thickness showed the peak value immediately after the last set of training. Skin temperature (on elbow flexors) and the elbow flexors thickness grew continuously from 24 to 96 hours after strength training. There is a high correlation (r=0.941, p=0.017) between skin temperature and muscle thickness from the end of exercise until 96 hours after strength training. Conclusions: The US images showed high sensibility for muscle physiological changes on the first 24 hours after exercise. On the other hand, the thermal images had higher sensibility for muscle physiological changes than US images from 24 to 96 hours after training.Keywords: musculoskeletal system, musculoskeletal physiological phenomena, ultrasonics, thermography, resistance training.

The influence of subcutaneous fat in the skin temperature variation rate during exercise

Introduction: Thermography records the skin temperature, which can be influenced by: muscle mass and subcutaneous fat layer. Thus, the aim of this study was to investigate the influence of subcutaneous fat layer in the skin temperature variation rate, during exercise. Methods This is a short-longitudinal study that involved 17 healthy male trained volunteers. Volunteers were divided in two groups. The first called GP1 with nine volunteers (biceps brachii skinfold thickness < 4 mm) and the second called GP2 with eight volunteers (biceps brachii skinfold thickness from 4 to 8 mm). Both groups performed three sets with 16 repetitions of unilateral biceps brachii bi-set exercise with dominant arm (eight repetitions of biceps curls and another eight of biceps hammer curls, with dumbbells), and with load of 70% of 1RM. The rest time between sets was 90s. Results The skin temperature variation rate (variation of temperature / time) was 3.59 × 10-3 ± 1.47 × 10-3 °C/s for GP1 and 0.66 × 10-3 ± 4.83 × 10-3 °C/s for GP2 (p = 0.138) considering all moments. For the period after set 1 until the end of set 3, skin temperature variation rate was 5.11 × 10-3 ± 2.57 × 10-3 °C/s for GP1 and 1.88 × 10-3 ± 3.60 × 10-3 °C/s for GP2 (p = 0.048). Subcutaneous fat layer also influences the skin temperature at resting (p = 0.044). Conclusion Subjects with lower subcutaneous fat layer have a higher skin temperature variation rate during exercise than those with higher subcutaneous fat layer.

Order Effects of Combined Strength and Endurance Training on Testosterone, Cortisol, Growth Hormone, and IGF-1 Binding Protein 3 in Concurrently Trained Men

Abstract Rosa, C, Vilaça-Alves, J, Fernandes, HM, Saavedra, FJ, Pinto, RS, and dos Reis, VM. Order effects of combined strength and endurance training on testosterone, cortisol, growth hormone, and IGF-1 binding protein 3 in concurrently trained men. J Strength Cond Res 29(1): 74–79, 2015—Concurrent training (CT) has been widely used in fitness centers to simultaneously optimize cardiovascular and neuromuscular fitness, and induce a high-energy expenditure. Therefore, the aim of this study was to compare the acute effects of 2 different orders of CT on hormonal responses in concurrently trained men. Fourteen men (mean ± SD: 24.7 ± 5.1 years) were randomly divided into 2 groups: endurance training followed by strength (ES, n = 7) and strength training followed by endurance (SE, n = 7). Serum concentrations of testosterone, cortisol, growth hormone, and IGF-1 binding protein 3 (IGFBP-3) were measured before and after both training orders. A significant interaction between exercise order and time was only found in the IGFBP-3 levels (p = 0.022). The testosterone and IGFBP-3 concentrations significantly increased in the ES group after the exercise trainings (57.7 ± 35.1%, p = 0.013 and 17.0 ± 15.5%, p = 0.032, respectively) but did not change significantly in the SE group (15.5 ± 36.6%, p = 0.527 and −4.2 ± 13.9%, p = 0.421, respectively). Conversely, cortisol and growth hormone concentrations significantly increased in both ES (169.2 ± 191.0%, p = 0.021 and 13,296.8 ± 13,009.5%, p = 0.013, respectively) and SE (92.2 ± 81.5%, p = 0.017 and 12,346.2 ± 9714.1%, p = 0.001, respectively) groups compared with baseline values. No significant correlations were found between the changes in the hormonal concentrations. In conclusion, these results suggest that immediately postexercise testosterone and IGFPB-3 responses are significantly increased only after the ES order. Therefore, an ES training order should be prescribed if the main focus of the training intervention is to induce an acute postexercise anabolic environment.

Different responses of the skin temperature to physical exercise: Systematic review.

Studies suggest that skin temperature behavior varies according to the type of exercise, intensity, duration, muscle mass and subcutaneous fat layer. In this sense, the aim of this study was to investigate the skin temperature behavior in the active muscles and other body segments, during and after exercise, according to the type and intensity of the exercise. A systematic literature review was conducted between November 2014 and March 2015 in the Web of Science database, using the terms “thermography” and “exercise” and “muscle” to achieve the objective of this study. During the research were found 55 scientific articles which were subjected to a selection process. Inclusion criteria were: Studies in human beings and original research. The exclusion criterion was the presence of subjects with some kind of disease. The seven papers that make up the present review are dated between 2008 and 2015. From all analyzed studies, it was possible to understand the general behavior of the active muscle skin temperature during the exercise, immediately after and in the 48h after exercise, according to the type and intensity of the exercise performed, which are illustrated in two figures. It can be concluded that the skin temperature over active muscles increases during high intensity anaerobic exercise, decreases slowly after exercise and increases again in the days after the exercise. On the other hand, during low intensity aerobic exercise, skin temperature over active muscles decreases, returning to normal values a few minutes after it and present a small rise in the following days. With regard to the skin temperature over non-active muscles, it can be seen that it decreases during exercise, returning to normal values a few minutes after it and rise similarly to the skin temperature over active muscles in the following days, in all types of exercises studied.

Cardiorespiratory, enzymatic and hormonal responses during and after walking while fasting

The aim of the present study was to observe whether performing a low intensity endurance exercise following an overnight fasted (FAST) or fed (FED) condition promotes different cardiorespiratory, enzymatic and hormonal responses. Nine male physical active subjects, (age 21.89 ± 2.52 years old, height 175.89 ± 5.16 cm, weight 72.10 ± 4.31 kg, estimated body fat 7.25 ± 2.11%), randomly performed two sessions of 45 minutes’ low intensity exercise (individual ventilator threshold) interspersed by seven days, differentiated only in whether they were provided with a standardized meal or not. The oxygen consumption (VO2) and heart rate (HR) were measured continuously at the 30-min rest, the 45-min during and the 30-min post-exercise. The testosterone (T) and cortisol (C) hormones were measured at rest, immediately post-exercise and 15-min post-exercise. The Glucose (GLU), Free fatty acids (FFA) and enzyme lipase activity (ELP) were measured at rest, 15-min and 30-min exercise, immediately, 15-min and 30-min post-exercise. Significantly lower values were observed in FED compared to FAST with: C (nmol/L) from pre (428.87 ± 120.41; 454.62 ± 148.33, respectively) to immediately post-exercise (285.10 ± 85.86; 465.66 ± 137.70, respectively) and 15-min post-exercise (248.00 ± 87.88; 454.31 ± 112.72, respectively) (p<0.05); and GLU at all times, with an exception at 15-min post-exercise. The testosterone/cortisol ratio (T/C) was significantly higher in the FED compared with FAST from pre (0.05 ± 0.02, 0.05 ± 0.01, respectively) to 15-min post-exercise (0.08 ± 0.03, 0.05 ± 0.02, respectively). No other significant differences were observed between conditions. We conclude that fasting prior to low intensity endurance exercise does not seem be advantageous, when it comes to fat loss, compared with the same exercise performed after a meal.

Sequence effects of combined resistance exercises with step choreography in the same session in women's oxygen uptake during and postexercise

The combination of step choreography (SC) with resistance training exercises (RE) in the same session is common in class fitness rooms populated mainly by women to increase energy expenditure. The aim of this study was to evaluate the differences in the exercise oxygen uptake and postexercise between two different combinations of resistance training exercises and step choreography, regarding the order of execution. Thirteen active women (30·31 ± 4·42 years, 62·02 ± 5·37 kg, 162·65 ± 4·40 cm, 19·14 ± 3·29% body fat) performed two combinations: step choreography before resistance training, where resistance training was divided into two blocks of analysis (10 min each); and step choreography divided into three equal blocks (10 min for each block), before, in the middle and after resistance exercise. There were significant differences (P<0·05) between the two sessions in oxygen uptake postexercise in the period of 0–5 min. A significant increase (P<0·0001) in the oxygen uptake absolute and relative in the heart rate between blocks 1 and 2 of resistance exercise in the two sessions was observed. In the step choreography in blocks, a significant (P = 0·001) decrease between blocks 2 and 3 in the step choreography before resistance exercise and a significant (P<0·05) increase in the heart rate in both sessions between blocks were observed. The combination of step choreography and resistance exercises during the same exercise session is a good strategy to promote an elevation of womens oxygen uptake during and after an exercise session, independent of the sequence used.

Osgood-schlatter Disease Diagnosis by Algometry and Infrared Thermography

Background : The diagnosis of Osgood-Schlatter Disease (OSD) is based on clinical signs and symptoms. However, more objective parameters, like thermal images, have been researched to determine, along algometry, valid parameters. Objective : The aim of this study was to analyze the thermal differences and the painful sensibility between the knees (with SOS and contralateral) of young soccer players. Methods : 6 young men, aged between 12 and 15, members of football schools, composed the sample. Images were taken from an anterior view of both knees, with the volunteer in a seated position, the knees flexed at 90o degrees and both feet flat on the floor. After the thermal image capture, the patients were submitted to an evaluation with the pressure algometer. Results : According to the results, it was found that the knee affected by the OSD showed temperatures significantly higher than the contralateral (p = 0.027) and also greater sensitivity to the pressure algometry (p = 0.027). Conclusion : it can be concluded that the inflammatory process, during OS Syndrome, promotes a local thermal hyper-radiation, identified with the high sensitive thermographic infrared image, producing a significant difference in local temperature between the knees of a single individual. Moreover, this process also increases the pain sensibility, accessed by pressure algometry.

Acute effect of a fight of Mixed Martial Arts (MMA) on the serum concentrations of testosterone, cortisol, creatine kinase, lactate, and glucose

The aim of this study was to analyse the serum concentrations of testosterone (T), cortisol (C), lactate (LAC), creatine kinase (CK) and glucose (GLU) on mixed martial arts (MMA) athletes, before and after a fight. We divided 20 MMA athletes into two groups of 10 fighters each, according to the result of a fight, and were then evaluated four times: 24 hours before (-24h), one hour before (-1h), immediately after (0h) and 24 hours after the fight (+24h). It was observed: a significant decrease in T and T/C between moment -24h and 0h and a subsequent increase between the moment 0h and +24h and a reverse behaviour in variables C, LAC and GLU (p<0.0001); a decrease in CK between moment -24h and -1h and an increase between moment -1h and +24h (p<0.0001); and differences between winners and losers T levels, in moments -24h, -1h, 0h and +24h (p = 0.009 e p < 0.001, p = 0.005 e p = 0,001, T and C, respectively), in T/C in the moments -24h and 0h (p=0.006 and p=0.001, respectively) and in GLU levels (p<0.0001) in the moment 0h. Therefore, it seems that an MMA fight leads to metabolic stress and muscle damage, regardless of the result of the fight. The coaches have now more biochemical and hormonal references and indicators in response to an MMA fight.

Anthropometric profile and diabetic foot risk: a cross-sectional study using thermography

Diabetes is one of the greatest todays public health problems with enormous social and economic implications for society. Diabetic foot disorders represent a substantial economic burden with detrimental effects on quality of life with special impairment in physical domain. Early detection strategies of these complications should be implemented in order to avoid possible wounds, ulcerations and amputations. This work can be characterized as a cross-sectional study with an analytical approach. It involved 44 volunteers of both genders (22 women and 22 men; 66.70 ± 6.26 years of age) with type 2 diabetes (diagnosed at 11.84 ± 8.22 years), selected among the candidates to Diabetes em Movimento® (a community-based exercise program for patients with type 2 diabetes developed in the city of Vila Real, Portugal). Foot plantar thermal images were acquired through a high-resolution infrared camera (FLIR Systems Inc. Model SC2000; 320 × 240 pixels). Three regions of interest (ROI) were defined for evaluation: first finger, fifth finger and the heel. From the three pairs of ROIs evaluated, the higher temperature asymmetry was selected for diabetic foot risk analysis. The results showed the existence of a positive and significant association between BMI and fat mass with asymmetries in feet temperature. Three subjects with diabetes-related foot complications (ROIs higher temperature asymmetry ≥ 2.20 °C) were identified in the sample. All participants with detected diabetes-related foot complications were obese (BMI ≥ 30 kg/m2) with high levels of body fat (≥ 45%). It can be concluded that exist a positive association either of BMI (r=0.399, p=0.007) either of body fat percentage (r=0.432, p=0.003), with diabetic foot risk in patients with type 2 diabetes.