Rodrigo Sudatti Delevatti

Moderators of response in exercise treatment for depression: A systematic review

INTRODUCTION Exercise have antidepressant effects in people with Major Depressive Disorder (MDD). However, about to half of patients do not respond to exercise. The identification of factors that moderates the antidepressant effects of exercise in people with MDD may help researchers and health professionals to identify sub-groups of patients that would benefit more from exercise. METHODS A systematic review was carried out using Medline(PubMed), EMBASE and psycINFO up to April 2015. Individual and composite moderators were summarized and the strength of the evidence was assessed. RESULTS Eleven studies were included for review resulting in the identification of potential individual (two biological, three clinical, two psychological and two social individual) and two potential composite moderators (the interaction between BDNF and Body Mass Index (BMI) and between family history of mental illness and gender). Only the two biological features and the BDNF x BMI interaction provided confirmatory evidence. LIMITATIONS Due the different statistical approaches used in the studies, it was not possible to perform meta-analyses. The small number of studies and the exploratory nature of the evidence limits a wider generalization of the findings. CONCLUSION Potential clinical, psychological, social or biological moderators were identified. However, the small number of studies and the limited strength of the evidence requires further studies before drawn definitive results. Further trials should consider the inclusion of moderators analysis using an a-priori, theoretical/evidence based hypothesis in order to provide high quality evidence for the use of personalized medicine in exercise for depression.

Effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults

This study aimed to investigate the effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults. Thirty-four older adults men were placed into two groups: deep water endurance training (ET; n = 16; 66 ± 4 years) and deep water strength prior to endurance training (concurrent training: CT; n = 18; 64 ± 4 years). The training period lasted 12 weeks, with three sessions a week. The resting heart rate and the oxygen uptake at peak (VO2peak) and at the second ventilatory threshold (VO2VT2) were evaluated during a maximal incremental test on a cycle ergometer before and after training. In addition, maximal dynamic strength (one repetition maximum test--1RM) and local muscular resistance (maximum repetitions at 60% 1RM) of the knee extensors and flexors were evaluated. After the training period, the heart rate at rest decreased significantly, while the VO2peak and VO2VT2 showed significant increases in both groups (p<0.05). Only the VO2VT2 resulted in significantly greater values for the ET compared to the CT group after the training (p<0.05). In addition, after training, there was a significant increase in the maximal dynamic strength of the knee extensors and the local muscular endurance of the knee extensors and flexors, with no difference between the groups (p > 0.05). In summary, the two training programs were effective at producing significant improvements in cardiorespiratory and muscular strength responses in older adult men. However, deep water endurance training at high intensities provides increased cardiorespiratory responses compared to CT and results in similar muscular strength responses.

Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial

OBJECTIVES To compare the effects of two aerobic training methods in water and on dry-land on glycemic, lipid, inflammatory, hormonal, cardiorespiratory, and functional outcomes in patients with type 2 diabetes. DESIGN Randomized clinical trial. METHODS Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training interventions had duration of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. RESULTS Patients were 56.7±7.9 years old. Decreases in glycated hemoglobin were observed in both groups (AT: -0.42±0.28%, DLT: -0.35±1.8%). Total cholesterol, high density lipoprotein, low density lipoprotein levels, plasma renin activity, angiotensin II concentrations, C-reactive protein, systolic blood pressure, resting heart rate, and timed up and go test performed at the usual speed also decreased in both groups in response to both interventions (p<0.05), without between-group differences. Both groups increased the ratio between oxygen uptake at the anaerobic threshold and oxygen uptake of peak (p=0.01). CONCLUSIONS Aerobic training in an aquatic environment provides effects similar to aerobic training in a dry-land environment in patients with type 2 diabetes.

Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis

OBJECTIVE To assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese. DATA SEARCHES MEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS. STUDY SELECTION Randomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight. DATA EXTRACTION AND ANALYSIS Two independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model. RESULTS Of 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (-3.37μU/ml; CI 95%, -5.16μU/ml to -1.57μU/ml; I2, 54%, p=0.003) and HOMA (-0.61; CI 95%, -1.19 to -0.02; I2, 49%, p=0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (-4.52μU/ml; CI 95%, -7.40 to -1.65; I2, 65%, p=0.002) and in HOMA (-1.33; 95% confidence interval, -2.47 to -0.18; I2, 73%, p=0.005). CONCLUSIONS Exercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.

Effects of aquatic exercise on muscle strength in young and elderly adults: a systematic review and meta-analysis of randomized trials.

The effects of training in an aquatic environment on muscular strength are still contradictory in the literature. The aim was to conduct a systematic review and meta-analysis of randomized studies about muscle strength responses after a program of aquatic exercise. A systematic review followed the Cochrane and PRISmA recommendations. The search was performed between December 2015 and January 2016. There were no language restrictions and PUBmED, SCOPUS, Scielo, Cochrane and PEDro databases were consulted. An analysis of eligibility of the studies was done by two independent authors. The data extraction followed standard criteria, and an evaluation of methodological quality was performed. The statistical analysis was conducted in Review Manager 5.1 software. The statistical heterogeneity was assessed by means of Cochrans Q test and by the inconsistency test (I). The search found 2563 manuscripts, 27 were included, totaling a total n of 1006 participants. The analysis of the risk of bias demonstrated a lack of clarity of the randomization process, allocation concealment, blinding assessment, intention to treat analysis and calculation of the sample in 70% or more of the studies analyzed. Meta-analysis demonstrated a significant increase in handgrip strength, in isometric peak torque of knee unilateral extension and flexion and isokinetic peak torque (60°.s) of knee unilateral extension. Sensitivity analyses demonstrated that the positive effects of training in an aquatic environment may be dependent on factors such as age, velocity of movement and use of device. Land-based and aquatic exercises seem to lead to similar muscle strength gains. Aquatic exercise should be recommended as a strategy to improve muscle strength, but new studies with better methodological quality should be conducted.

Low- and High-Volume Water-Based Resistance Training Induces Similar Strength and Functional Capacity Improvements in Older Women: A Randomized Study

BACKGROUND Water-based resistance training (WRT) has been indicated to promote strength gains in elderly population. However, no study has compared different training strategies to identify the most efficient one. The aim of this study was to compare the effects of 3 WRT strategies on the strength and functional capacity of older women. METHODS In total, 36 women were randomly allocated to training groups: simple set of 30 seconds [1 × 30s; 66.41 (1.36) y; n = 12], multiple sets of 10 seconds [3 × 10s; 66.50 (1.43) y; n = 11], and simple set of 10 seconds [1 × 10s; 65.23 (1.09) y; n = 13]. Training lasted for 12 weeks. The maximal dynamic strength (in kilograms) and muscular endurance (number of repetitions) of knee extension, knee flexion, elbow flexion, and bench press, as well as functional capacity (number of repetitions), were evaluated. RESULTS All types of training promoted similar gains in maximal dynamic strength of knee extension and flexion as well as elbow flexion. Only the 1 × 30s and 1 × 10s groups presented increments in bench press maximal strength. All 3 groups showed increases in muscular endurance in all exercises and functional capacity. CONCLUSIONS WRT using long- or short-duration simple sets promotes the same gains in strength and functional capacity in older women as does WRT using multiple sets.

Acute exercise and periodized training in different environments affect histone deacetylase activity and interleukin-10 levels in peripheral blood of patients with type 2 diabetes

AIMS Our purpose was to investigate the effects of aerobic periodized training in aquatic and land environments on plasma histone deacetylase (HDAC) activity and cytokines levels in peripheral blood of diabetes mellitus type 2 (T2DM) patients. METHODS The patients underwent 12 weeks of periodized training programs that including walking or running in a swimming pool (aquatic group) or in a track (dry land group). Blood samples were collected immediately before and after both first and last sessions. Plasma cytokine levels and HDAC activity in peripheral blood mononuclear cell (PBMC) was measured. RESULTS The exercise performed in both environments similarly modulated the evaluated acetylation mark, global HDAC activity. However, a differential profile depending on the evaluated time point was detected, since exercise increased acutely HDAC activity in sedentary and after 12 weeks of training period, while a reduced HDAC activity was observed following periodized training (samples collected before the last session). Additionally, the 12 weeks of periodized exercise in both environments increased IL-10 levels. CONCLUSIONS Our data support the hypothesis that the modulation of HDAC activity and inflammatory status might be at least partially related to exercise effects on T2DM. The periodized training performed in both aquatic and land environments impacts similarly epigenetic and inflammatory status.

Acute glycemic and pressure responses of continuous and interval aerobic exercise in patients with type 2 diabetes

ABSTRACT Background: Aerobic training has been widely indicated to patients with type 2 diabetes. However, there are still few studies comparing acute glycemic and blood pressure effects of different methods of aerobic training. The aim is to compare glycemic and pressure acute responses of continuous aerobic exercise to interval aerobic exercise in patients with type 2 diabetes. Materials and Methods: This study is a randomized, crossover clinical trial. Fourteen patients with type 2 diabetes performed two sessions of aerobic training with different methods (continuous and interval). Continuous session had duration of 35 minutes with intensity of 85–90% of heart rate corresponding to anaerobic threshold (HRAT), while interval session had 45 minutes, with stimulus in intensity of 85–90% of HRAT with recovery in intensity under 85% of HRAT. Capillary glycemia, systolic and diastolic blood pressure were analyzed before and after the sessions. Results: Patients were 63.5 ± 9.8 years old. Glycemia was reduced in both sessions (p < 0.001). Only glycemia measured at 25 minutes after continuous session was not lower than pre-session values. Systolic blood pressure was also reduced in both sessions (p = 0.010) with similar behavior between them. In the diastolic blood pressure, there were differences only between the values measured immediately after exercise and the values measured 20 minutes (p = 0.002) and 30 minutes after exercise (p = 0.008). Conclusion: Both continuous and interval aerobic exercise, in a same intensity, are effective for glycemic and pressure acute reductions in individuals with type 2 diabetes. For patients with greater risk of hypertension, we believe that the interval method is safer.

PADRÕES DE BELEZA, SAÚDE E QUALIDADE DE VIDA EM MODELOS DE PASSARELA – UMA REVISÃO DE LITERATURA

Introduction: Fashion-related areas lead a pursuit of perfection to exalt models, thus imposing a corporeal pattern to be followed. Runway models must fit into the following measurements: height of 1.74 m or above, waist circumference up to 60 cm, hip up to 90 cm, and body weight around 20 kg of the proposed value for such height (example: height of 1.80 m and body weight of 60 kg). In order to achieve a lean look, models follow their own concepts of care, which makes them more vulnerable to things like physical fitness related to health, fundamental in preventing the most prevalent diseases nowadays. Objective: To review the literature on standards of beauty and physical fitness related to health in runway models. Material and Methods: A narrative review was carried out based on searches in the databases Scielo, PubMed and Google Scholar, in Portuguese, English and Spanish. Results: The lack of studies approaching health-related physical fitness in models does not allow raising consistent statements. However, we could see a significant movement in the pursuit of health to this population group, with recent campaigns and laws that might favor special attention to models in all aspects relating to health and quality of life. Conclusion: Despite the lack of studies on this topic, we perceived a latent concern about body measurements and quality of life of runway models, but not about their physical capabilities. DESCRIPTORS Fashion.Physical Fitness.Quality of life.