Lausanne Barreto de Carvalho Cahú Rodrigues

A single bout of resistance exercise does not modify cardiovascular responses during daily activities in patients with peripheral artery disease.

ObjectiveTo analyze the posteffects of a single bout of resistance exercise on cardiovascular parameters in patients with peripheral artery disease (PAD). DesignRandomized cross-over. Materials and methodsSeventeen PAD patients performed two experimental sessions: control (C) and resistance exercise (R). Both sessions were identical (eight exercises, 3×10 repetitions), except that the R session was performed with an intensity between 5 and 7 in the OMNI-RES scale and the C session was performed without any load. Systolic blood pressure (BP), diastolic BP, heart rate, and rate–pressure product (RPP) were measured for 1 h after the interventions in the laboratory and during 24-h using ambulatory BP monitoring. ResultsAfter the R session, systolic BP (greatest reduction: −6±2 mmHg, P<0.01) and RPP (greatest reduction: −888±286 mmHg×bpm; P<0.01) decreased until 50 min after exercise. From the second hour until 23 h after exercise, BP, heart rate, and RPP product were similar (P>0.05) between R and C sessions. BP load, nocturnal BP fall, and morning surge were also similar between R and C sessions (P>0.05). ConclusionA single bout of resistance exercise decreased BP and cardiac work for 1 h after exercise under clinical conditions, and did not modify ambulatory cardiovascular variables during 24 h in patients with PAD.

Low-intensity resistance exercise does not affect cardiac autonomic modulation in patients with peripheral artery disease

OBJECTIVE: To analyze the effect of a single bout of resistance exercise on cardiac autonomic modulation in patients with peripheral artery disease. METHODS: Fifteen patients with peripheral artery disease (age: 58.3±4.0 years) underwent the following sessions in a random order: resistance exercise (three sets of 10 repetitions of the six resistance exercises with a workload of 5–7 in the OMNI-RES scale) and control (similar to the resistance session; however, the resistance exercises were performed with no load). The frequency domain (low frequency, high frequency and sympathovagal balance) and symbolic analysis (0V, 1V and 2V patterns) of heart rate variability were obtained before and until one hour after the interventions. RESULTS: After the resistance exercise and control sessions, similar increases were observed in the consecutive heartbeat intervals (control: 720.8±28.6 vs. 790.9±34.4 ms; resistance exercise: 712.9±30.1 vs. 756.8±37.9 ms; p<0.05) and in the pattern of the symbolic analysis with no variation (0V) (control: 25.1±3.5 vs. 33.4±4.1%; resistance exercise: 26.1±3.2 vs. 29.7±3.5%; p<0.05) until 50 min after both interventions. The pattern of two variations (2V) decreased similarly (control: 11.2±2.1 vs. 8.3±2.1%; resistance exercise: 9.5±1.7 vs. 7.8±1.7%; p<0.05). In contrast, the pattern of one variation (1V), the low and high frequency bands and sympathovagal balance did not change after the interventions (p>0.05). CONCLUSION: A single bout of resistance exercise did not alter cardiac autonomic modulation in patients with peripheral artery disease.

Sympathetic cardiac modulation and vascular worsening in arteritis: A case report

Increases in sympathetic modulation have been associated with increased risk of acute cardiovascular events in some populations. However, whether altered cardiac autonomic modulation is related to peripheral vascular worsening has not yet been described. In this study, we assessed cardiac autonomic modulation by heart rate variability in two patients with arteritis who were followed up for 5 months. Only the subject who presented high cardiac sympathetic modulation had acute vascular worsening. This case report suggests that cardiac autonomic modulation may be related to vascular worsening in patients with arteritis.

Associação de comorbidades e hábitos não saudáveis com a capacidade de caminhada em pacientes com claudicação intermitente

Individuos com claudicacao intermitente (CI) comumente apresentam comorbidades associadas e habitos nao saudaveis, como o tabagismo e a inatividade fisica. Todavia, o quanto esses fatores contribuem para a intolerância a caminhada desses individuos permanece incerto. Assim, o objetivo deste estudo foi analisar a associacao das comorbidades e habitos nao saudaveis com a capacidade de caminhada de individuos com CI. A amostra foi composta por 66 individuos com CI de ambos os generos. Todos os individuos realizaram teste ergometrico maximo em esteira, sendo registrada o tempo de claudicacao (TC) e o tempo total de caminhada (TTC). Os dados referentes as comorbidades e habitos nao saudaveis foram obtidos por meio de entrevista. Para analise estatistica foi empregada analise de regressao simples univariada, com p < 0,05. A comorbidade mais prevalente foi a hipertensao arterial (86,4%), ao passo que a inatividade fisica foi o habito nao saudavel mais prevalente (47%). Alem disso, 90,9% dos pacientes apresentaram duas ou mais comorbidades e/ou habitos nao saudaveis. A inatividade fisica foi associada com menor TC (β = -154 s; p = 0,02; IC95% = -283; -25 s) e TTC (β = -189 s; p = 0,02; IC95% = -384; -29 s). Alem disso, o maior numero de comorbidades e habitos nao saudaveis tambem foram associados com menor TC (β = -55 s; p = 0,02; IC95% = -102; -8 s). Como conclusao, os resultados deste estudo indicam que a inatividade fisica e o numero de comorbidades e/ou habitos nao saudaveis estao associados com a intolerância a caminhada de individuos com CI.

Effects of walking and strength training on walking capacity in individuals with claudication: meta-analysis

CONTEXT: Over the past few years, several clinical trials have been performed to analyze the effects of exercise training on walking ability in patients with intermittent claudication (IC). However, it remains unclear which type of physical exercise provides the maximum benefits in terms of walking ability. OBJECTIVE: To analyze, by means of a meta-analysis, the effects of walking and strength training on the walking capacity in patients with IC. METHODS: Papers analyzing the effects of walking and strength training programs in patients with IC were browsed on the Medline, Lilacs, and Cochrane databases. Randomized clinical trials scoring >4 on the Physiotherapy Evidence Database (PEDro) scale and assessing claudication distance (CD) and total walking distance (TWD) were included in the review. RESULTS: Walking and strength training yielded increases in CD and TWD (P < 0.05). However, walking training yielded greater increases than strength training (P = 0.02). CONCLUSION: Walking and strength training improve walking capacity in patients with IC. However, greater improvements in TWD are obtained with walking training.

Triagem pré-participação em exercício físico em pacientes com doença arterial periférica

BACKGROUND: Exercise has been recommended as the main treatment for individuals with peripheral artery disease (PAD). However, since these individuals have increased cardiovascular risk, a cardiovascular assessment before onset of exercise program must be performed. OBJECTIVE: The purpose of this study was to compare the efficacy of two screening tools for identifying individuals with PAD. METHODS: Twenty-eight men and women with PAD, who answered the Physical Activity Readiness Questionnaire (PAR-Q) and the stratification of cardiovascular risk questionnaire (SCRQ). RESULTS: The PAR-Q results showed that question six (Has any physician recommended the use of blood pressure or cardiovascular medications?) had higher frequency of positive responses (82.1%). Considering all responses, five individuals had all negative answers (17.9%). The results of the SCRQ showed that the question 11 (Do you have leg cramps or burning sensation cramp when you walk?) and the 2nd (Have you ever been told by a physician you have high blood pressure?) showed higher frequency of positive responses (82.1%). According to the criteria for cardiovascular risk stratification, all individuals were considered to be at high cardiovascular risk. CONCLUSION: The PAR-Q questionnaire was not sensitive enough to identify all subjects with PAD. On the other hand, the SRCQ was more efficient in identifying the subjects with PAD. Therefore, the use of SRCQ for screening PAD patients is suggested.