Júlia Maria D’Andréa Greve

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

Exercise training has an important role in the prevention and treatment of hypertension, but its effects on the early metabolic and hemodynamic abnormalities observed in normotensive offspring of hypertensive parents (FH+) have not been studied. We compared high-intensity interval (aerobic interval training, AIT) and moderate-intensity continuous exercise training (CMT) with regard to hemodynamic, metabolic and hormonal variables in FH+ subjects. Forty-four healthy FH+ women (25.0±4.4 years) randomized to control (ConFH+) or to a three times per week equal-volume AIT (80–90% of VO2MAX) or CMT (50–60% of VO2MAX) regimen, and 15 healthy women with normotensive parents (ConFH−; 25.3±3.1 years) had their hemodynamic, metabolic and hormonal variables analyzed at baseline and after 16 weeks of follow-up. Ambulatorial blood pressure (ABP), glucose and cholesterol levels were similar among all groups, but the FH+ groups showed higher insulin, insulin sensitivity, carotid-femoral pulse wave velocity (PWV), norepinephrine and endothelin-1 (ET-1) levels and lower nitrite/nitrate (NOx) levels than ConFH− subjects. AIT and CMT were equally effective in improving ABP (P<0.05), insulin and insulin sensitivity (P<0.001); however, AIT was superior in improving cardiorespiratory fitness (15 vs. 8%; P<0.05), PWV (P<0.01), and BP, norepinephrine, ET-1 and NOx response to exercise (P<0.05). Exercise intensity was an important factor in improving cardiorespiratory fitness and reversing hemodynamic, metabolic and hormonal alterations involved in the pathophysiology of hypertension. These findings may have important implications for the exercise training programs used for the prevention of inherited hypertensive disorder.

Correlation between body mass index and postural balance

OBJECTIVE To evaluate the correlation between body mass index (BMI) and postural balance in unipodal support. METHOD 40 males, age 26 +/- 5 yrs, body mass 72.3 +/- 11 kg, height 176 +/_ 6 cm and BMI 23.3 +/- 3.2 kg/m(2), were submitted to functional stability tests using the Biodex Balance System (stability evaluation protocol level 2, which allows an inclination of up to 20 degrees in the horizontal plane in all directions) to compare stability with BMI. RESULTS The general stability index showed a correlation between BMI and postural balance--measured as imbalance (R=0.723-dominant side and R=0.705-non-dominant side). The anteroposterior stability index--measured as instability--showed correlations on the dominant (R=0.708) and non-dominant side (R=0.656). Lateral instability showed a correlation on the dominant side (R=0.721) and non-dominant side (R=0.728). The comparison of the balance indexes for dominant and non-dominant sides showed no statistically significant differences. CONCLUSION High BMI demands more displacements to maintain postural balance.

Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes

UNLABELLED Participation in intensive sports activities leads to muscular specializations that may generate alterations in involved articular forces and cause static (posture) and dynamic changes (alterations of articular stability, coordination, etc.). Prevention of injury requires specific functional muscular evaluation in all athletes and for any kind of sport. OBJECTIVE To dynamically evaluate, through isokinetic tests, the peak torque, total work, and average power of the knee flexor and extensor muscles of jumper and runner athletes and compare them to those of a non-athletic population, evaluating dominance and balance between agonistic and antagonistic muscle groups. RESULTS In the non-athlete group, we noted a higher asymmetry between the dominant and nondominant members. The jumpers had the highest values of the evaluated parameters of all groups, whereas parameters for the runners were intermediate between non-athletes and jumpers.

Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis

OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis. MATERIALS AND METHODS: Thirty-two patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 was composed of 16 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 was composed of 16 patients who underwent three applications of radial shockwaves (once a week) and received instruction for stretching exercises at home. Pain and ability to function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 47.3 ± 10.3 years (range 25–68); 81% were female, 87% were overweight, 56% had bilateral impairment, and 75% used analgesics regularly. RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment. CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment.

Evaluating the center of gravity of dislocations in soccer players with and without reconstruction of the anterior cruciate ligament using a balance platform

OBJECTIVE The objective of this study was to compare the dislocation of the center of gravity and postural balance in sedentary and recreational soccer players with and without anterior cruciate ligament (ACL) reconstruction using the Biodex Balance System (BBS). METHOD Sixty-four subjects were divided into three groups: a) soccer players who were post- anterior cruciate ligament reconstruction; b) soccer players with no anterior cruciate ligament injuries; and c) sedentary subjects. The subjects were submitted to functional stability tests using the Biodex Balance System. The instability protocols used were level eight (more stable) and level two (less stable). Three stability indexes were calculated: the anteroposterior stability index, the mediolateral stability index, and the general stability index. RESULTS Postural balance (dislocation) on the reconstructed side of the athletes was worse than on the side that had not undergone reconstruction. The postural balance of the sedentary group was dislocated less on both sides than the reconstructed knees of the athletes without anterior cruciate ligament injuries. There were no differences in postural balance with relation to left/right dominance for the uninjured athletes and the sedentary individuals. CONCLUSION The dislocation of the center of gravity and change in postural balance in sedentary individuals and on the operated limb of Surgery Group are less marked than in the soccer players from the Non Surgery Group and on the non-operated limbs. The dislocation of the center of gravity and the change in postural balance from the operated limb of the soccer players is less marked than in their non-operated limbs.

Avaliaçåo isocinética no joelho do atleta

ABSTRACTIsokinetic evaluation of athletes’ kneeThe isokinetic evaluation has been used in the last threedecades as a method to determine both the strength func-tional pattern and the muscle balance. In our environment,this evaluation has been spread over the last 10 years. It ispossible to quantify absolute values of torque, effort, andpower of muscle groups, and to determine relative values,that is, the agonist/antagonist proportion of such groups.Another valuable resource of this evaluation may be usedas an auxiliary method in the rehabilitation of sports le-sions. The examination is performed with a constant andpreset angular speed, that is, low, intermediate, and/or highspeed. Most isokinetic studies are applied to the knee. Inthe sports practice, the agonist/antagonist muscle balance,that is, the flexor/extensor balance represented, respective-ly, by the ischiotibial muscle/quadriceps plays an impor-tant role. On the other hand, the comparison between theabsolute values of the muscle function for the left and rightsides is also relevant. Changed results usually relate tosports lesions or their sequels. The development of an ob-jective and safe method to evaluate the muscle functional-ity which provides for reliable and reproducible results isof utmost importance to athletes and to multidisciplinaryteams. Also significant are the results obtained from isoki-netic tests, which may be useful to establish criteria forathletes to resume and practice sports activities after le-sions. This review aims at addressing some practical as-pects of the isokinetic evaluation in the knee and its use inindividuals performing sports activities.

Drug Use by Truck Drivers in Brazil

In Brazil, those who are suspected of driving under the influence of drugs are tested only for ethanol. Professional drivers, especially truck drivers, use stimulant drugs to prevent sleeping during long-distance driving. Surveys on the patterns of use of illicit drugs in the workplace have rarely been conducted in Brazil, in spite of the high costs and the potential risk to public health. Since 1996, the authors have been compiling the results of tests, performed in their laboratories, for drugs in urine samples from truck drivers. The drugs analyzed were: amphetamine, methamphetamine, cannabinoids and cocaine. Urine samples (728) were collected in three out of the five geographical regions of Brazil: southeast (517 samples), northeast (161 samples) and south (50 samples). Fluorescence polarization immunoassay and capillary gas chromatography/mass spectrometry were utilized for the urinalyses. The results obtained were as follows: 41 samples (5.63% of the total) tested positive for the drugs being studied. The frequency of positivity of samples was quite similar for the three regions: 6% in the south, 6% in the southeast and 4.35% in the northeast. However, distribution of the drugs in the samples showed regional variations. Results such as those that we have obtained can provide an estimation of the extent of drug use by truck drivers in Brazil.

Heart rate response to exercise and cardiorespiratory fitness of young women at high familial risk for hypertension: effects of interval vs continuous training

Exercise training is an effective intervention for treating and preventing hypertension, but its effects on heart rate (HR) response to exercise and cardiorespiratory fitness (CRF) of non-hypertensive offspring of hypertensive parents (FH+) has not been studied. We compared the effects of three times per week equal-volume high-intensity aerobic interval (AIT) and continuous moderate-intensity exercise (CME) on HR response to exercise and CRF of FH+. Forty-four young FH+ women (25.0 ± 4.4 years) randomized to control (CON; n = 12), AIT (80–90% of VO2MAX; n = 16), or CME (50–60% of VO2MAX; n = 16) performed a graded exercise test (GXT) before and after 16 weeks of follow-up to evaluate HR response to exercise and several parameters of CRF. Resting, maximal, and reserve HR did not change after the follow-up in all groups. HR recovery (difference between HRMAX and HR at 1 minute of GXT recovery phase) improved only after AIT (11.8 ± 4.9 vs. 20.6 ± 5.8 bpm, p < 0.01). Both exercise programmes were effective for improving CRF parameters, but AIT was more effective than CME for improving oxygen consumption at the respiratory compensation point (VO2RCP; 22.1% vs. 8.8%, p = 0.008) and maximal effort (VO2MAX; 15.8% vs. 8.0%, p = 0.036), as well as tolerance time (TT) to reach anaerobic threshold (TTAT; 62.0 vs. 37.7, p = 0.048), TTRCP (49.3 vs. 32.9, p = 0.032), and TTMAX (38.9 vs. 29.2, p = 0.042). Exercise intensity was an important factor in improving HR recovery and CRF of FH+women. These findings may have important implications for designing exercise-training programmes for the prevention of an inherited hypertensive disorder.

Isokinetic assessment of knee flexor/extensor muscular strength in elderly women

OBJECTIVE To assess knee flexor-extensor muscular strength in elderly women with no previous history of musculoskeletal disorders on the lower limbs using an isokinetic dynamometer, in order to obtain data that could be used as a comparative parameter in the evaluation of elderly women with knee disorders, thus facilitating a better rehabilitation of these patients. METHODS Twenty-six volunteers aged 75 to 83 years were studied using a Cybex 6000 isokinetic dynamometer. The chosen angular velocity was 60 degrees /s, and concentric exercise was used for either flexion or extension. The studied parameters were: peak torque, angle of peak torque, and flexor-extensor torque rate. RESULTS There were no differences between dominant (D) and nondominant (ND) knee peak torque values. This was true for both flexor (D = 42.46 +/- 9.09 Nm / ND = 40.65 +/- 9.38 Nm) and extensor (D = 76.92 +/- 13.97 Nm / ND = 77.65 +/- 15.21 Nm) movements. The descriptive statistical analysis of the values obtained for the flexor-extensor peak torque rate and for the angle of occurrence of peak torque was the same for the dominant and nondominant sides. CONCLUSIONS The values of peak torque for the contralateral side can be used as a reference during rehabilitation of elderly women with acute disease of the knee, and the angular velocity of 60 degrees /s is proper and safe for isokinetic assessment of elderly people.

Análise comparativa do controle postural de indivíduos com e sem lesão do ligamento cruzado anterior do joelho

Standing balance is the process which keeps the pressure center, vertical projection of the centre of gravity on ground inside the body weight-bearing. This study evaluates posture control in patients with unilateral lesion of anterior cruciate ligament of knee and in healthy individuals (control group), through parameters of pressure center. Nineteen healthy individuals (11 men, 8 women, age ranged from 18 to 30 years) and nineteen patients with unilateral lesion of anterior cruciate ligament of knee (18 men, 1 woman, age ranged from 15 to 33 years) were evaluated by FSCAN MAT® version 3848 (Tekscan® , Boston, MA, USA) sensors. Four different static tests with unilateral bearing were made, alternating the sides (dominant and non dominant) and keeping open or closed eyes. The parameters were calculated: total length path, antero-posterior amplitude, medio-lateral amplitude and maximum speed of pressure center. The results have pointed out that: the dominance of inferior limbs does not affect in a special way the balance of healthy individuals, the vision is an important factor in posture control and the unilateral lesion of anterior cruciate ligament of knee affects the balance in unilateral weight bearing, on both sides, however more evident on the side with the lesion.