Viviane Soares

Cardiac Autonomic Modulation and the Kinetics of Heart Rate Responses in the On- and Off-Transient during Exercise in Women with Metabolic Syndrome

Objective: To test whether women with metabolic syndrome (MS) have impairments in the on- and off-transients during an incremental test and to study whether any of the MS components are independently associated with the observed responses. Research Design and Methods: Thirty-six women aged 35–55 years were divided into a group with MS (MSG, n = 19) and a control group (CG, n = 17). R-R intervals (RRi) and heart rate variability (HRV) were calculated on a beat-to-beat basis and the heart rate (HR) at the on- and off-transient were analyzed during an incremental cardiopulmonary exercise test (CPET). Results: MSG showed lower aerobic capacity and lower parasympathetic cardiac modulation at rest compared with CG. HR values in on-transient phase were significantly lower in MSG compared with CG. The exponential amplitudes “amp” and the parameters “τ” [speed of heart rate recovery (HRR)] were lower in MSG. MSG exhibited higher HR values in comparison to CG during the off-transient indicating a slower HRR. In MSG, there was an inverse and significant correlation between fasting plasma vs. ΔF and glucose vs. exponential “τ” of HRR dynamics. Conclusion: MS is associated with poor heart rate kinetics. The altered HR kinetics seems to be related to alterations in cardiac parasympathetic modulation, and glucose metabolism seems to be the major determinant.

Body composition of chronic renal patients: anthropometry and bioimpedance vector analysis

OBJECTIVE to compare the body composition of patients undergoing hemodialysis with that of healthy individuals using different methods. METHOD cross-sectional study assessing male individuals using anthropometric markers, electrical bioimpedance and vector analysis. RESULTS the healthy individuals presented larger triceps skinfold and arm circumference (p<0.001). The bioimpedance variables also presented significant higher values in this group. Significant difference was found in the confidence interval of the vector analysis performed for both the patients and healthy individuals (p<0.0001). The tolerance intervals showed that 55.20% of the patients were dehydrated, 10.30% presented visible edema, and 34.50% were within normal levels of hydration. Bioimpedance and vector analysis revealed that 52% of the patients presented decreased cell mass while 14.00% presented increased cell mass. CONCLUSIONS the differences in the body composition of patients and healthy individuals were revealed through bioimpedance and vector analysis but not through their measures of arm circumference and arm muscle area.OBJETIVO: comparar a composicao corporal de pacientes em hemodialise com sujeitos saudaveis, por diferentes metodos de avaliacao. METODOS: estudo transversal realizado com sujeitos do sexo masculino com avaliacoes antropometricas, bioimpedância eletrica e analise vetorial. RESULTADOS: a prega cutânea tricipital e a circunferencia de braco foram maiores (p<0,001) nos sujeitos saudaveis. As variaveis da bioimpedância, tambem, tiveram valores maiores e significativos nesse grupo. O intervalo de confianca da analise vetorial dos pacientes e sujeitos saudaveis mostrou diferenca significativa (p<0,0001). Os intervalos de tolerância para hidratacao revelaram que 55,20% dos pacientes estavam desidratados; 10,30% com edema aparente e 34,50% com hidratacao normal. A bioimpedância e a analise vetorial determinaram que 52% dos pacientes tinham reducao e 14% aumento da massa celular. CONCLUSOES: as diferencas na composicao corporal entre pacientes e sujeitos saudaveis foram demonstradas por meio da bioimpedância e analise vetorial, mas, nao pelas medidas da circunferencia e da area muscular de braco.

Composición corporal de pacientes renales crónicos en hemodiálisis: antropometría y análisis vectorial por impedancia bioeléctrica

OBJECTIVE to compare the body composition of patients undergoing hemodialysis with that of healthy individuals using different methods. METHOD cross-sectional study assessing male individuals using anthropometric markers, electrical bioimpedance and vector analysis. RESULTS the healthy individuals presented larger triceps skinfold and arm circumference (p<0.001). The bioimpedance variables also presented significant higher values in this group. Significant difference was found in the confidence interval of the vector analysis performed for both the patients and healthy individuals (p<0.0001). The tolerance intervals showed that 55.20% of the patients were dehydrated, 10.30% presented visible edema, and 34.50% were within normal levels of hydration. Bioimpedance and vector analysis revealed that 52% of the patients presented decreased cell mass while 14.00% presented increased cell mass. CONCLUSIONS the differences in the body composition of patients and healthy individuals were revealed through bioimpedance and vector analysis but not through their measures of arm circumference and arm muscle area.OBJETIVO: comparar a composicao corporal de pacientes em hemodialise com sujeitos saudaveis, por diferentes metodos de avaliacao. METODOS: estudo transversal realizado com sujeitos do sexo masculino com avaliacoes antropometricas, bioimpedância eletrica e analise vetorial. RESULTADOS: a prega cutânea tricipital e a circunferencia de braco foram maiores (p<0,001) nos sujeitos saudaveis. As variaveis da bioimpedância, tambem, tiveram valores maiores e significativos nesse grupo. O intervalo de confianca da analise vetorial dos pacientes e sujeitos saudaveis mostrou diferenca significativa (p<0,0001). Os intervalos de tolerância para hidratacao revelaram que 55,20% dos pacientes estavam desidratados; 10,30% com edema aparente e 34,50% com hidratacao normal. A bioimpedância e a analise vetorial determinaram que 52% dos pacientes tinham reducao e 14% aumento da massa celular. CONCLUSOES: as diferencas na composicao corporal entre pacientes e sujeitos saudaveis foram demonstradas por meio da bioimpedância e analise vetorial, mas, nao pelas medidas da circunferencia e da area muscular de braco.

Effects of four days hiking on postural control.

Hiking is a demanding form of exercise that may cause delayed responses of the postural muscles and a loss of somatosensory information, particularly when repeatedly performed for several days. These effects may negatively influence the postural control of hikers. Therefore, the aim of this study was to investigate the effects of a four-day hike on postural control. Twenty-six adults of both sexes travelled 262 kilometers, stopping for lunch and resting in the early evening each day. Force platforms were used to collect center of pressure (COP) data at 100 Hz for 70 seconds before hiking started and immediately after arriving at the rest station each day. The COP time course data were analyzed according to global stabilometric descriptors, spectral analysis and structural descriptors using sway density curve (SDC) and stabilometric diffusion analysis (SDA). Significant increases were found for global variables in both the anterior-posterior and medial-lateral directions (COP sway area, COP total sway path, COP mean velocity, COP root mean square value and COP range). In the spectral analysis, only the 80% power frequency (F80) in the anterior-posterior direction showed a significant increase, reflecting the increase of the sway frequencies. The SDC revealed a significant increase in the mean distance between peaks (MD) and a significant decrease in the mean peak amplitudes (MP), suggesting that a larger torque amplitude is required for stabilization and that the postural stability is reduced. The SDA revealed a decrease in the long-term slope (Hl) and increases in the short-term (Ks) and the long-term (Kl) intercepts. We considered the likelihood that the presence of local and general fatigue, pain and related neuromuscular adaptations and somatosensory deficits may have contributed to these postural responses. Together, these results demonstrated that four days of hiking increased sway frequencies and deteriorated postural control in the standing position.

Validation of a protocol to evaluate maximal expiratory pressure using a pressure transducer and a signal conditioner

The respiratory muscles can present fatigue and even chronic inability to generate force. So, reliable devices are necessary to their evaluation. The aim of this study is to evaluate the MEP (Maximal Expiratory Pressure) values of individuals between 20 and 25 years old and to validate a protocol using a pressure transducer and a signal conditioner comparing it with the digital manometer. We evaluated the MEP of 10 participants. They remained seated and made six respiratory maneuvers from Total Lung Capacity (TLC) to Residual Volume (RV). The results in the study showed no statistically significant differences when compared to values reported in the literature, and that the pressure transducer provides reliable values for MEP.

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Background: Patients undergone hemodialysis (HD) suffer with energy-protein malnutrition, uremic myopathy and protein catabolism reducing their functional capacity, tolerance to exercise and aspects related to quality of life. Objective: The aim of this study was to evaluate the effects of the two protocols of inspiratory muscle training (IMT) on muscle strength, pulmonary function and related-health quality of life on male HD patients. Methods: Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), peak expiratory flow (PEF), forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and the FEV1/FVC ratio and quality of life were evaluated pre and post six months of IMT in HD patients. IMT was performed by one group using a specific training (Power breathe) device (T-IMT, n=19) and by the other with incentive spirometry (I-IMT, n= 15). Results: Following the inspiratory training, muscle strength improved in both groups. The group that used incentive spirometry had increments in MIP larger (39.8%, p<0.001) than the group that trained with the specific training device (28.3%, p=0.001). The KDQOL-SF dimensions showed significant difference in the T-IMT group in cognitive function (p=0.03), sexual function (p=0.009) and social function dimensions (p=0.04) and in the I-IMT group in the physical function dimension (p=0.03). Conclusion: It was proved that IMT improved muscle strength and I-IMT promoted increments significantly larger in MIP. Aspects of health-related quality of life of HD male patients improved significantly with T-IMT (sexual, social and cognitive functions), while I-IMT ameliorated only physical function. Key-words: Breathing Exercises, Exercise Therapy, Quality of Life, Hemodialysis. Corresponding author: Viviane Soares, Rua Amazonas, n.294, Centro, n. 294, Centro, CEP 75024-080AnápolisGO, Phone: 0055 62 92929225. Email: ftviviane@gmail.com. 1 Teacher and researcher at Centro Universitário de Anápolis – UniEVANGELICA, Anápolis, GO, Brazil. Full list of author information is available at the end of the article. Submission date 02 August 2017; Acceptance date 26 October 2017; Publication date 27 October 2017 http://dx.doi.org/10.17784/mtprehabjournal.2017.15.506

Depression and anxiety in subjects with chronic non communicable diseases

Background: Modern society is undergoing socio-cultural and economic transformations. Such changes lead to situations in which the human being has to choose between his health or practicality, directly affecting his quality of life. Pathologies with a high degree of morbidity such as depression, anxiety and chronic diseases immerse themselves in this equation, and are taking alarming proportions in society nowadays. Objectives: To identify the levels of depression and anxiety in individuals with chronic non-communicable diseases. Method: This is a cross-sectional and quantitative study, consisting of 23 young adults with 20-40 years old, hypertensive or with type 2 diabetes mellitus. The symptoms of depression and anxiety were evaluated using the Beck Depression Inventory and Beck Anxiety Inventory. Results: In hypertensive patients, the mean scores for the Depression Inventory were 15.0 and for diabetics 15.6. For the Anxiety Inventory the mean scores obtained for hypertensive patients were 11.6 and 8.1 for diabetics. For the most part, both groups were classified as without depression (43.48%) and mild depression (43.48%); And without anxiety (47.9%) and mild anxiety (34.8%). Significant differences (p = 0.050) were found only in the mean scores for the Beck Anxiety Inventory between groups. No significant differences were found between the sexes. Conclusion: We conclude that the studied sample, both hypertensive and diabetic patients, mostly present with depression and mild anxiety. And when compared between the sexes the women showed to be more vulnerable than the men.

Body temperature and dehydration rate in adolescents undergoing the Cooper s 12-minute run test

Background: During the practice of any physical exercises is produced heat. About 30% of this heat is transformed into work and the other 70%, distributed to the body, thus increasing the body temperature of the individual. Objective: to identify changes in body temperature and hydration of adolescents classified as physically actives or inactives. Methods: This is a cross-sectional, quantitative, descriptive study with 40 students (13-17 years old) from a private school in Anápolis-GO. The tympanic and forehead body temperature and body mass were measured. The urine produced was then collected and the hydration state was estimated before and after the 12-minute run test, which was used to calculate the VO2max. After checking the normality of the data, the paired “t” test was performed to compare the pre and post-run data and a “t” test for independent samples to compare the groups denominated: active and inactive. Results: there was no significant difference in relation to the temperature pre-and post-test of the Cooper protocol in active and inactive individuals, but the active group had a higher central temperature. The active group presented a greater reduction of body mass and a worse state of dehydration, evaluated by the urine color, and also by the calculation of the rate of sweating. Finally, although both groups received the classification of “weak” regarding aerobic capacity, the active group was significantly superior to the inactive group. Conclusion: the group of actives adolescents presented higher central body temperature, with a higher rate of sweating, due to their greater physical effort (better test performance) and their better training, which can lead to a better body cooling system.

Composição corporal de pacientes renais crônicos em hemodiálise: antropometria e análise vetorial por bioimpedância

OBJECTIVE to compare the body composition of patients undergoing hemodialysis with that of healthy individuals using different methods. METHOD cross-sectional study assessing male individuals using anthropometric markers, electrical bioimpedance and vector analysis. RESULTS the healthy individuals presented larger triceps skinfold and arm circumference (p<0.001). The bioimpedance variables also presented significant higher values in this group. Significant difference was found in the confidence interval of the vector analysis performed for both the patients and healthy individuals (p<0.0001). The tolerance intervals showed that 55.20% of the patients were dehydrated, 10.30% presented visible edema, and 34.50% were within normal levels of hydration. Bioimpedance and vector analysis revealed that 52% of the patients presented decreased cell mass while 14.00% presented increased cell mass. CONCLUSIONS the differences in the body composition of patients and healthy individuals were revealed through bioimpedance and vector analysis but not through their measures of arm circumference and arm muscle area.OBJETIVO: comparar a composicao corporal de pacientes em hemodialise com sujeitos saudaveis, por diferentes metodos de avaliacao. METODOS: estudo transversal realizado com sujeitos do sexo masculino com avaliacoes antropometricas, bioimpedância eletrica e analise vetorial. RESULTADOS: a prega cutânea tricipital e a circunferencia de braco foram maiores (p<0,001) nos sujeitos saudaveis. As variaveis da bioimpedância, tambem, tiveram valores maiores e significativos nesse grupo. O intervalo de confianca da analise vetorial dos pacientes e sujeitos saudaveis mostrou diferenca significativa (p<0,0001). Os intervalos de tolerância para hidratacao revelaram que 55,20% dos pacientes estavam desidratados; 10,30% com edema aparente e 34,50% com hidratacao normal. A bioimpedância e a analise vetorial determinaram que 52% dos pacientes tinham reducao e 14% aumento da massa celular. CONCLUSOES: as diferencas na composicao corporal entre pacientes e sujeitos saudaveis foram demonstradas por meio da bioimpedância e analise vetorial, mas, nao pelas medidas da circunferencia e da area muscular de braco.

Avaliação da inicialização da marcha na gestante de baixo risco nos três trimestres gestacionais

OBJETIVOS: Descrever o processo de inicializacao da marcha de gestantes e comparar o comportamento do centro de pressao nos tres trimestres gestacionais. METODOS: Foram avaliadas 57 gestantes de baixo risco, com idades de 18 a 35 anos, em tres trimestres gestacionais, selecionadas por conveniencia. Foram dividas em tres grupos por idade gestacional - 1o trimestre (4-12 semanas), 2o trimestre (13-28 semanas) e 3o trimestre (29-42 semanas) -, sendo 19 gestantes para cada trimestre. Cada gestante foi posicionada em posicao ortostatica, com um pe em cada plataforma de forca AMTI, ficando assim ate ouvir um sinal sonoro para iniciar a marcha em um percurso de quatro metros. Os dados obtidos foram submetidos a analise estatistica com o programa SPSS. Para a comparacao dos grupos utilizou-se os teste de Kolmogorov Smirnov, teste de Tukey e o coeficiente de correlacao de Spearman. Em todas as analises considerou-se o nivel de significância de 5%. RESULTADOS: Foram encontradas diferencas significativas quando comparados os grupos 1o trimestre (GPT) e 3o trimestre (GTT), para as variaveis amplitude de oscilacao medio lateral GPT (0,4 cm) e GTT (0,2 cm) e velocidade de deslocamento medio-lateral - GPT (0,9 cm/s) e GTT (0,4 cm/s). Observou-se uma diminuicao gradativa nas variaveis de amplitude de oscilacao anteroposterior e medio-lateral, bem como, na velocidade de deslocamento do primeiro trimestre na plataforma 1 em relacao a plataforma 2. Houve diferencas significativas nas variaveis de amplitude de oscilacao medio-lateral e velocidade de deslocamento medio-lateral comparando GPT e GTT. CONCLUSAO: As variaveis analisadas apresentaram pequenas diferencas e nao constituem risco eminente para a estabilidade dinâmica da gestante.