Pablo Tomas-Carus

Eight months of physical training in warm water improves physical and mental health in women with fibromyalgia: a randomized controlled trial.

OBJECTIVE To evaluate the feasibility of 8 months of supervised exercise therapy in warm water and its effects on the impact of fibromyalgia on physical and mental health and physical fitness in affected women. METHODS Thirty women with fibromyalgia were randomly assigned to an exercise therapy group (n = 15) or a control group (inactive) (n = 15). The impact of fibromyalgia on physical and mental health was assessed using the Fibromyalgia Impact Questionnaire and the anxiety state with State-Trait Anxiety Inventory. Physical fitness was measured using the following tests: Canadian Aerobic Fitness; hand-grip dynamometry; 10-metre walking; 10-step stair-climbing and blind 1-leg stance. RESULTS After 8 months of training, the exercise therapy group improved compared with the control group in terms of physical function (20%), pain (8%), stiffness (53%), anxiety (41%), depression (27%), Fibromyalgia Impact Questionnaire total scores (18%), State-Trait Anxiety Inventory score (22%), aerobic capacity (22%), balance (30%), functional capacity for walking (6%), stair-climbing with no extra weight (14%) and stair-climbing 10 kg-weighted (25%). CONCLUSION Eight months of supervised exercise in warm water was feasible and led to long-term improvements in physical and mental health in patients with fibromyalgia at a similar magnitude to those of shorter therapy programmes.

Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial

OBJECTIVE To evaluate whether changes in muscle strength due to 32 weeks of supervised aquatic training predicted improvements on health-related quality of life (HRQOL). METHODS Thirty women with FM aged 50.8 +/- 8.7 years were randomly assigned to an experimental group (n = 15), performing 3 weekly sessions of 60 min of warm-water exercise; or to a control group (n = 15). HRQOL was evaluated using the Short Form 36 Health Survey (SF-36). Maximal unilateral isokinetic strength was measured at 60 degrees/s and 210 degrees/s in the knee extensors and flexors in concentric action and at 60 degrees/s in knee extensors eccentric action. Postural balance was evaluated using the one-leg stance, eyes closed. RESULTS After 32 weeks of water exercise therapy, statistically significant improvements occurred in concentric knee flexors and extensors strength at 60 degrees/s, in eccentric knee extensors and in postural balance. The treatment led to additional improvements in physical function, role physical problems, body pain, general health, vitality, role emotional problems and mental health dimensions of SF-36. Gains in the concentric knee flexors strength predicted improvements in role of physical problems, whereas those in concentric knee extensors did the same for mental health and role emotional problems. Gains in eccentric knee extensors strength predicted improvements in postural balance. CONCLUSIONS A long-lasting exercise therapy in warm water produced relevant gains in muscle strength at low velocities of movements, some of which predicted improvements in physical problems, emotional problems, mental health and balance. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number ISRCTN53367487, information available in http://www.controlled-trials.com/ISRCTN53367487.

Health-related quality of life and physical activity in persons at high risk for type 2 diabetes

Purpose. The aim of this study was to compare the health-related quality of life (HRQOL) of persons at risk for type 2 diabetes to that of the Finnish general population. In addition, the associations between physical activity and HRQOL at-risk persons were studied. Methods. One hundred thirty-two at-risk persons were recruited from health care centres in Central Finland. Participants filled out questionnaires including demographic characteristics, HRQOL (SF-36), frequency of vigorous physical activity (≤2 times a week, once a week, less than once a week) and comorbidities. Results. HRQOL of at-risk persons differed significantly from that of the Finnish population in four of the eight dimensions of SF-36. Compared with reference values of the general population, the values of at-risk persons were worse for general health and pain, but better for mental health and role limitation (emotional) dimensions. Among at-risk persons those physically more active had less depressiveness and lower body weight. HRQOL decreased linearly with decreasing physical activity in all dimensions. Conclusions. People with elevated risk for type 2 DM have reduced HRQOL in general health and body pain dimensions, but mental health and emotional role dimensions were better compared with that of the population. Among at-risk persons, the benefits of physical activity on HRQOL were seen in all HRQOL dimensions. Regular exercise and body weight control may improve subjective health and reduce risk for type 2 DM and its consequences.

Shoulder rotator cuff balance, strength, and endurance in young swimmers during a competitive season.

Abstract Batalha, NM, Raimundo, AM, Tomas-Carus, P, Barbosa, TM, and Silva, AJ. Shoulder rotator cuff balance, strength, and endurance in young swimmers during a competitive season. J Strength Cond Res 27(9): 2562–2568, 2013—The purpose of this study was to analyze the effects of a competitive swim season on the strength, balance, and endurance of shoulder rotator cuff muscles in young swimmers. A repeated measures design was used with 3 measurements performed during the swim season. A swimmers group (n = 20) of young men with no dry land training and a sedentary group (n = 16) of male students with the same characteristics (age, body mass, height, and maturational state) were evaluated. In both groups, the peak torque of shoulder internal rotator (IRt) and external rotator (ERt) was assessed during preseason, midseason (16 weeks), and postseason (32 weeks). Concentric action at 60 and 180°·s−1 was measured using an isokinetic dynamometer. The ER/IR strength ratios and endurance ratios were also obtained. At 60°·s−1, there were significant training effects in the IRt strength and ER/IR ratio on both shoulders. This trend was the same throughout the competitive season. The same trend was present at 180°·s−1 because the training effects are seen primarily in IRt and ER/IR ratios. With respect to endurance ratios, within-group data were similar in ERt and IRt for both shoulders, with no significant differences between moments. However, between-group differences occurred mostly in the IRt. Results suggest that a competitive swim season favors the increase of muscular imbalances in the shoulder rotators of young competitive swimmers, mainly because of increased levels of IRt strength and endurance that are proportionally larger than those of their antagonists. A compensatory strength training program should be considered.

El tratamiento para la fibromialgia con ejercicio físico en agua caliente reduce el impacto de la enfermedad en la salud física y mental de mujeres afectadas

Introduccion: Los pacientes con fibromialgia (FM) muestran dolor, rigidez muscular, condicion fisica reducida y fatiga que limitan sus actividades de la vida diaria. El proposito de este estudio fue evaluar los efectos de la adicion al tratamiento medico clasico de 12 semanas de ejercicio fisico en agua caliente en el impacto de la FM en la salud fisica y mental de mujeres afectadas. Pacientes, material y metodos: Treinta y cuatro pacientes no entrenadas fisicamente se distribuyeron aleatoriamente en 2 grupos: un grupo experimental (n = 17), que realizo 3 sesiones semanales de 60 min de ejercicio fisico en agua caliente, y un grupo de control (n = 17), que no recibio dicho tratamiento adicional. El impacto de la FM en la salud fisica y mental de las pacientes fue evaluado mediante el Cuestionario del Impacto de la Fibromialgia (Fibromyalgia Impact Questionnaire [FIQ]). Resultados: A las 12 semanas de ejercicio fisico se observaron mejoras significativas en el grupo experimental respecto al grupo de control, en la funcion fisica (35%; p = 0,016), sentirse bien (34%; p = 0,003), la capacidad de trabajo (14%; p = 0,046), el dolor (26%; p = 0,030), la rigidez (33%; p = 0,038), la ansiedad (36%; p = 0,044), la depresion (26%; p = 0,046) y en la escala total del FIQ (27%; p = 0,004). Conclusiones: La adicion del programa de ejercicio fisico acuatico al tratamiento medico usual redujo el impacto de la FM en la salud fisica y mental de las pacientes. Sin embargo, el efecto placebo podria haber contribuido parcialmente en estas mejoras.

Urinary steroid profile after the completion of concentric and concentric/eccentric trials with the same total workload.

High intensity strength training causes changes in steroid hormone concentrations. This could be altered by the muscular contraction type: eccentric or concentric. The aim of this study was to compare the effect of the completion of a short concentric (CON) and concentric/eccentric (CON/ECC) trial on the urinary steroid profile, both with the same total work. 18 males performed the trials on an isokinetic dynamometer (BIODEX III) exercising quadriceps muscles, right and left, on different days. Trial 1(CON): 4×10 Concentric knee extension + relax knee flexion, speed 60°/second; rest 90 seconds between each series and 4 minutes between each leg exercise. Trial 2(CON/ECC): 4×5 concentric knee extension + Eccentric knee flexion under similar conditions. Urine samples were taken before the exercise and one hour after finishing it. Androsterone, Etiocholanolone, DHEA, Androstenedione, Testosterone, Epitestosterone, Dehydrotestosterone, Estrone, B-Estradiol, Tetrahydrocortisone, Tetrahydrocortisol, Cortisone and Cortisol (free, glucoconjugated and sulfoconjugated) urinary values were determined using gas chromatography/mass spectrometry techniques. No significant differences were noted in Total Work and Average Peak Torque, although Maximum Peak Torque in the CON/ECC trial was higher than in the CON trial. These results demonstrate no changes in the steroid profile before and after trials, or when comparing CON to CON/ECC trials. The data suggest that eccentric contractions do not cause hormonal changes different to the ones produced by concentric contractions, when they are performed in strength short trials with the same total workload.ResumenEl entrenamiento de fuerza de alta intensidad provoca variaciones en la concentración de esteroides. El tipo de contracción muscular, excéntrica o concéntrica, podría ser un factor que la alterase. El objetivo de este estudio fue comparar el efecto de la realización de una sesión corta de ejercicio concéntrico (CON) y otra concéntrica/excéntrica (CON/EXC), con la misma carga de trabajo total, sobre el perfil esteroideo urinario. 18 hombres realizaron dos sesiones de ejercicio de corta duración utilizando una máquina isocinética (BIODEX III) en días diferentes y trabajando los músculos cuádriceps de ambas piernas. La sesión de ejercicio 1 (CON) fue un 4×10 rep de extensión concéntrica de rodilla más relajación en el movimiento de flexión, a una velocidad de 60°/segundo y con una recuperación de 90 seg. entre cada serie y 4 minutos entre cada una de las piernas. La sesión de ejercicio 2 (CON/EXC) fue un 4×5 rep. de extensión concéntrica de rodilla más flexión excéntrica de rodilla, con las mismas condiciones de velocidad y recuperación. Muestras de orina fueron se tomaron antes del ejercicio y una hora después de finalizarlo. Los niveles urinarios (fracción libre, glucoconjugada y sulfoconjugada) de Androsterona, Etiocolanolona, DHEA, Androstenodiona, Testosterona, Epitestosterona, Dehidrotestosterona, Estrona, β-estradiol, Tetrahidrocortisona, Tetrahidrocortisol, Cortisona y Cortisol, se determinaron usando técnicas de cromatografía de gases-espectrometría de masas. No se encontraron diferencias significativas en los valores de Trabajo Total y de Pico Torque Medio, aunque los valores de Pico Torque Máximo fueron más alto en el CON/EXC ejercicio que en el CON. Tampoco se observó ningún cambio en el perfil esteroideo urinario entre antes y después de las sesiones de ejercicio, o comparando las sesiones CON/EXC con la CON. Por tanto, los datos sugieren que las contracciones excéntricas no producen alteraciones hormonales diferentes a las producidas por las contracciones concéntricas, cuando se trata de sesiones de ejercicio de fuerza de corta duración con similar carga de trabajo total.

Does a land-based compensatory strength-training programme influences the rotator cuff balance of young competitive swimmers?

Abstract During the repeated execution of the swimming strokes, the shoulder adductor and internal rotator muscles have a tendency to become proportionally stronger when compared to their antagonist group. This can lead to muscle imbalances. The aim of this study was to examine the effects of a compensatory training programme on the strength and balance of shoulder rotator muscles in young swimmers. A randomized controlled trial design was used. Forty male swimmers took part in the study and were randomly divided into two groups: an experimental group (n = 20) and a training group (n = 20). A control group (n = 16) of young sedentary male students was also evaluated. The experimental group subjects participated in a 16-week shoulder-strength programme with Thera-Band® elastic bands; the training group was restricted to aquatic training. Peak torque of shoulder internal rotator and external rotator (ER) was measured at baseline and after 16 weeks. Concentric action at 1.04 rad s−1 (3 reps) and 3.14 rad s−1 (20 reps) was measured using an isokinetic dynamometer. The strength-training programme led to an improvement of the ER strength and shoulder rotator balance in the experimental group (data from both shoulders at 1.04 rad s−1). Moreover, concentric action at 3.14 rad s−1 presented significant differences only for the dominant shoulder. Findings suggest that the prescribed shoulder-strengthening exercises could be a useful training option for young competitive swimmers. They can produce an increase in absolute strength values and greater muscle balance in shoulder rotators.

Efectos del entrenamiento acuático y posterior desentrenamiento sobre la percepción e intensidad del dolor y el número de puntos sensibles de mujeres con fibromialgia

Introduction and objectives: The most frequent and characteristic symptom of fibromyalgia is generalized and diffuse pain. The purpose of this study was to evaluate the effects of 12 weeks of physical training in warm water and subsequent detraining on the perception and intensity of pain and the number tender points in women with fibromyalgia. Methods: Thirty-five women with fibromyalgia were randomly assigned to 2 groups: an experimental group (n = 18), who exercised for 60 min in warm water 3 times a week, and a control group (n = 17), who did not receive the additional training. Pain was assessed using the dimensions of pain of the Fibromyalgia Impact Questionnaire and the Short Form-36. The number of tender points was also assessed. Results: After the 12-week training program significant improvements were observed in the perception and intensity of pain in the experimental group compared with the control group. However, after the detraining period, only the improvement in the “body pain” dimension of the Short Form-36 was maintained. The number of tender points showed no significant change in either group during the 24week program. Conclusions: Addition of the physical training program to conventional care was effective in decreasing pain in women with fibromyalgia. After the detraining period, the improvements in pain were partially maintained. However, the physical training program had no effect on the number of tender points.

Urinary endogenous steroids and their relationships with BMD and body composition in healthy young males

Some studies have stated that steroid hormones have associations with the values of strength, bone mass density (BMD), and body composition shown by people [1]. In this way, steroid hormonal changes have been directly or indirectly associated with changes in body composition, fat distribution, lean mass, muscle weakness, osteoporosis, as well as depression [2]. Regarding to this topic, most studies have been carried out using blood samples. However, some research has tried to analyze the correlation among urinary steroid hormones and body mass index, fat mass, or BMD [3, 4]. Urinary samples are easy to obtain in sufficient quantities without the need for invasive techniques. Therefore, in this study, we tested the hypothesis that the values of bone mineral density and body composition are related to the values of urinary endogenous steroid excretion (androgens, estrogens, and corticosteroids).