RESUMEN
BACKGROUND: Whole-body vibration (WBV) is an exercise modality that can promote improvements in heart rate variability (HRV) with lower patient overload, and consequently reduce cardiovascular risk in renal transplant patients. The aim of this study was to evaluate the effects of a 12-week WBV training program of two weekly sessions on HRV. METHODS: A double-blind, randomized controlled clinical trial with 12 kidney transplant recipients of both genders who underwent WBV training (35â¯Hz) twice a week for 12 weeks on alternate days (WBV Group) and training with sub-therapeutic WBV (8â¯Hz) (Sham Group). Variables were evaluated in time and frequency domains of HRV through the 24-h Holter monitor, heart rate (HR), blood pressure (BP) and maximum oxygen consumption (VO2max) through an exercise stress test. RESULTS: The delta between Sham and WBV groups showed an increase in the low frequency (Δâ¯=â¯959.05â¯Hz; pâ¯=â¯0.01) and in the high frequency (Δâ¯=â¯204.42â¯Hz; pâ¯=â¯0.04) of the HRV compared to Sham group. No changes in the ergometric variables were observed for any of the groups. CONCLUSION: The present study evidenced an increase in the low and high frequency of HRV in individuals who participated in the Sham WBV group. There was no improvement in the autonomic balance in the groups, in the other HRV parameters, or the exercise test after the WBV training period.
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Trasplante de Riñón , Vibración , Sistema Nervioso Autónomo , Ejercicio Físico , Femenino , Frecuencia Cardíaca , Humanos , Masculino , Vibración/uso terapéuticoRESUMEN
BACKGROUND AND PURPOSE: Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables. METHODS: This was a cross-sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1 ], and FEV1 /FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined. RESULTS: COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat-free mass percentage (p = 0.017) and smaller fat-free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat-free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022). CONCLUSION: Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.
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Composición Corporal , Diafragma/fisiopatología , Debilidad Muscular/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Mecánica Respiratoria/fisiología , Músculos Respiratorios/fisiopatología , Anciano , Estudios Transversales , Diafragma/diagnóstico por imagen , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/fisiología , Debilidad Muscular/diagnóstico por imagen , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico por imagen , Rango del Movimiento Articular , Pruebas de Función Respiratoria , Músculos Respiratorios/diagnóstico por imagen , Índice de Severidad de la Enfermedad , Capacidad VitalRESUMEN
INTRODUCTION:: Blood flow restriction training can be used as an alternative to conventional exercise in chronic kidney disease patients with indication of arteriovenous fistula. OBJECTIVE:: Evaluating the efficacy of blood flow restriction training in the diameter and distensibility change of the cephalic vein and the diameter and flow of the radial artery, muscle strength and forearm circumference in chronic kidney disease patients with arteriovenous fistula pre-creation. METHODS:: A blind randomized clinical trial consisting of 26 chronic kidney disease patients allocated into a blood flow restriction training group (blood flow restriction; n = 12) and a group without blood flow restriction training (control group; n = 14). Blood flow restriction was performed at 50% of systolic blood pressure and using 40% of handgrip strength as load for the isometric exercises in both groups. RESULTS:: An increase in the diameter of the cephalic vein in the 2 cm (p = 0.008) and 10 cm segments (p = 0.001) was observed in the control group. The diameter of the radial artery increased in all segments in the blood flow restriction group (2, 10 and 20 cm; p = 0.005, p = 0.021 and p = 0.018, respectively) and in the 10 and 20 cm segments (p = 0.017 and p = 0.026) in the control group. Handgrip strength only increased in the control group (p = 0.003). CONCLUSION:: Physical training associated with blood flow restriction increased cephalic vein diameters in both groups and was effective in increasing the diameter of the radial artery; however, it did not demonstrate superiority over the exercise group protocol without blood flow restriction.
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Derivación Arteriovenosa Quirúrgica , Terapia por Ejercicio/métodos , Antebrazo/irrigación sanguínea , Arteria Radial/cirugía , Diálisis Renal , Insuficiencia Renal Crónica/terapia , Venas/cirugía , Anciano , Derivación Arteriovenosa Quirúrgica/efectos adversos , Velocidad del Flujo Sanguíneo , Brasil , Método Doble Ciego , Terapia por Ejercicio/efectos adversos , Femenino , Fuerza de la Mano , Humanos , Contracción Isométrica , Masculino , Persona de Mediana Edad , Arteria Radial/diagnóstico por imagen , Arteria Radial/fisiopatología , Flujo Sanguíneo Regional , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/fisiopatología , Resultado del Tratamiento , Venas/diagnóstico por imagen , Venas/fisiopatologíaRESUMEN
AIMS: To assess functional independence, balance and mobility of kidney transplant recipients, to verify transplant time, donor type, regular exercise practice, musculoskeletal complaints, as well as association among these variables METHODS: Observational study with 86 kidney transplant individuals, subjected to evaluation of the Functional Independence Measure (FIM) and Timed Up and Go test (TUG). RESULTS: The mean age of the study population was 43.98 years old, 50% of these individuals were between 5-10 years of transplantation and 50% between 10-15 years. Changes in mobility and balance (TUG) were found in 9.3% of transplant patients, while 2.3% had deficits in functional independence (FIM). The association between TUG and the FIM (χ2= 19.964, p< 0.001) was found in 25% of the 9.3% of individuals who showed changes in TUG. It was found that only 20.9% of kidney transplant between 5-10 years and 14.0% between 11 and 15 years performed regular physical exercises (χ2= 0.727, p= 0.394) and 67.4% presented prevalent complaints on lower limbs musculoskeletal. CONCLUSION: Although the level of dependence and impairments in mobility and balance found in renal transplants are low, deficits in mobility and balance may lead to changes in the ability to perform their functional activities independently.(AU)