RESUMO
BACKGROUND: Current guidelines emphasize cancer patients should increase their physical activity levels, encouraging physical exercise practice as a complementary therapy to mitigate adverse effects during treatment. Telehealth can be a feasible method to improve adherence and interventional support for breast cancer patients, of which most do not meet sufficient physical activity levels after diagnosis. The Adaptations to Breast Cancer and Exercise Using Telehealth (ABRACE: Telehealth) study aims to investigate the effects of a 12-week telehealth multicomponent training program plus a health education program (MTHE), compared to a health education program alone (HE), on physical and psychological outcomes in breast cancer patients undergoing treatment. METHODS: This study is a randomized controlled trial. Women undergoing primary treatment (during or after chemotherapy) for breast cancer (stages I-III) will be randomly assigned to MTHE (twice a week) or HE (once a week). MTHE components are mobility, aerobic, balance, resistance, and flexibility home-based exercises, supervised by video call. The primary study outcome is cancer-related fatigue. The secondary outcomes are quality of life, symptoms of depression and anxiety, physical activity level, cancer-related cognitive impairment, and functional capacity. Other outcomes are adherence to interventions and a follow-up questionnaire evaluating the individual perception in motivation, lifestyle changes, and main barriers to participation. All outcomes will be remotely assessed before and after intervention. Our analysis will follow the intention-to-treat approach and per-protocol criteria, with additional sub-group analysis. DISCUSSION: To our knowledge, this is the first randomized clinical trial in breast cancer patients using a face-to-face videoconference strategy to supervise physical exercise. Our hypothesis is of superiority for the effects of MTHE on primary and secondary outcomes compared to the effects of only the health education intervention. TRIAL REGISTRATION: Adaptations to Breast Cancer and Exercise Using Telehealth (ABRACE: Telehealth), NCT04641377. Registered on 23 November 2021, https://clinicaltrials.gov/ct2/show/NCT04641377.
Assuntos
Neoplasias da Mama , Telemedicina , Humanos , Feminino , Neoplasias da Mama/psicologia , Qualidade de Vida , Exercício Físico , Terapia por Exercício/efeitos adversos , Terapia por Exercício/métodos , Telemedicina/métodos , Educação em Saúde , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Physical properties of water cause physiological changes in the immersed human body compared with the land environment. Understanding the magnitude of cardiorespiratory alterations might ensure adequate intensity control during aquatic exercise programs. OBJECTIVE: We aimed to compare the oxygen uptake (VO2), heart rate (HR), and rating of perceived exertion (RPE) parameters during aquatic and land incremental tests. METHODS: Four databases (PubMed, LILACS, EMBASE, and SPORTDiscus) were searched in September 2020. Eligibility criteria included studies in a crossover design comparing aquatic and land incremental tests for healthy individuals with at least one of the following parameters: VO2 (maximal, VO2max; anaerobic threshold, VO2AT), HR (HRmax; HRAT), and RPE (RPEmax; RPEAT). The random-effects meta-analysis included mean difference and 95% confidence interval for VO2 and HR or standardized mean difference for RPE. The Joanna Briggs Institute Critical Appraisal tool was adapted to assess methodological quality. RESULTS: Twenty-eight studies were eligible and included in the meta-analysis. Aquatic protocols showed lower values compared with land for VO2max (- 7.07 mL.kg-1.min-1; - 8.43 to - 5.70; n = 502), VO2AT (- 6.19 mL.kg-1.min-1; - 7.66 to - 4.73; n = 145), HRmax (- 11.71 bpm; - 13.84 to - 9.58; n = 503), and HRAT (- 15.29 bpm; - 19.05 to - 11.53; n = 145). RPEmax (0.01; - 0.16 to 0.18; n = 299) and RPEAT (- 0.67; - 1.35 to 0.02; n = 55) values were similar between aquatic and land protocols. CONCLUSIONS: Our study reinforces the specificity of the environment during incremental tests for prescribing exercises based on physiological parameters as VO2 and HR parameters presented lower values in aquatic protocols than land protocols. Conversely, RPE seems an interchangeable measure of exercise intensity, with similar values during the protocols in both environments. Substantial levels of heterogeneity were present for the VO2max and HRmax meta-analyses, and as such, results should be interpreted with attention. PROTOCOL REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020212508).
Assuntos
Teste de Esforço , Esforço Físico , Exercício Físico/fisiologia , Teste de Esforço/métodos , Terapia por Exercício , Frequência Cardíaca/fisiologia , Humanos , Metanálise como Assunto , Consumo de Oxigênio/fisiologia , Esforço Físico/fisiologiaRESUMO
BACKGROUND: Although the prevalence of hypertension is high in older adults, clinical trial recruitment is a challenge. Our main aim was to describe the HAEL Study recruitment methods and yield rates. The secondary objectives were to explore the reasons for exclusion and to describe the characteristics of the enrolled participants. METHODS: This is a descriptive study within a trial. The HAEL Study was a Brazilian randomized two-center, parallel trial with an estimated sample of 184 participants. The recruitment strategy was based on four methods: electronic health records, word of mouth, print and electronic flyer, and press media. The yield rate was the ratio of the number of participants who underwent randomization to the total number of volunteers screened, calculated for overall, per recruitment method, by study center and by age group and sex. Additionally, we described the reasons for exclusion in the screening phase, as well as the demographic characteristics of those enrolled. The data are presented in absolute/relative frequencies and mean ± standard deviation. RESULTS: A total of 717 individuals were screened, and 168 were randomized over 32 months. The yield rate was higher for word of mouth (30.1%) in the overall sample. However, press media contributed the most (39.9%) to the absolute number of participants randomized in the trial. The coordinating center and participating center differed in methods with the highest yield ratios and absolute numbers of randomized participants. The main reason for exclusion in the screening phase was due to the physically active status in those intending to participate in the study (61.5%). Out of 220 participants included, 52 were excluded mainly because they did not meet the eligibility criteria (26.9%). Most of the screened volunteers were women (60.2%) age 60-69 years (59.5%), and most of the randomized participants were Caucasian/white (78.0%). CONCLUSIONS: Multiple recruitment methods constituted effective strategies. We observed that approximately one of every four individuals screened was allocated to an intervention group. Even so, there were limitations in obtaining a representative sample of older Brazilian adults with hypertension. Data show an underrepresentation of race and age groups. TRIAL REGISTRATION: This SWAT was not registered.
Assuntos
COVID-19 , Hipertensão , Idoso , Brasil , Exercício Físico , Feminino , Humanos , Hipertensão/terapia , Pessoa de Meia-Idade , SARS-CoV-2RESUMO
This study is a randomized controlled clinical trial that verified the resistance training efficacy on neuromuscular parameters, with muscle quality as primary outcome. Forty-four elderly with diabetes type 2 (69.7⯱â¯6.9â¯years; 26 men) were randomly allocated to a 12-weeks resistance training group (RTG, 3 times a week), or an active control group with stretching classes (CG, once a week). Primary and secondary outcomes were assessed at baseline and after 12â¯weeks, as follow: quadriceps muscle thickness and rectus femoris muscle quality, maximal knee extension strength, rapid strength, functional performance, visceral adipose tissue, glycemic control, lipid profile and quality of life. Generalized estimating equations were used to analyses based on intention-to-treat and per-protocol approaches, which showed the same results. Among all outcomes measured there were improvements in the knee extension strength (Pâ¯<â¯0.001) and quadriceps muscle thickness (Pâ¯<â¯0.001) for RTG. The muscle quality did not improve for both groups (Pâ¯=â¯0.98). For the secondary outcomes there were no improvements for functional performance, rapid strength, glycemic control, quality of life, visceral adipose tissue and lipid profile in both groups, with exception of triglyceride level reduction for RTG (Pâ¯=â¯0.04).The resistance training program is an efficacious strategy for improve the neuromuscular health in elderly with T2DM, considering increases in lower limb strength and muscle mass, but the same was not found for muscle quality, rapid strength, functional performance and quality of life. Furthermore, the training program did not induce significant reduction in glycated hemoglobin values of patients who already had suitable glycemic control.
Assuntos
Diabetes Mellitus Tipo 2/reabilitação , Treinamento Resistido/métodos , Idoso , Glicemia/metabolismo , Brasil , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Quadríceps/fisiologia , Qualidade de VidaRESUMO
The aim of this study was to compare the effects of low- and high-volume strength training on strength, muscle activation and muscle thickness (MT) of the lower- and upper-body, and on muscle quality (MQ) of the lower-body in older women. Twenty apparently healthy elderly women were randomly assigned into two groups: low-volume (LV, n=11) and high-volume (HV, n=9). The LV group performed one-set of each exercise, while the HV group performed three-sets of each exercise, twice weekly for 13 weeks. MQ was measured by echo intensity obtained by ultrasonography (MQEI), strength per unit of muscle mass (MQST), and strength per unit of muscle mass adjusted with an allometric scale (MQAS). Following training, there was a significant increase (p≤0.001) in knee extension 1-RM (31.8±20.5% for LV and 38.3±7.3% for HV) and in elbow flexion 1-RM (25.1±9.5% for LV and 26.6±8.9% for HV) and in isometric maximal strength of the lower-body (p≤0.05) and upper-body (p≤0.001), with no difference between groups. The maximal electromyographic activation for both groups increased significantly (p≤0.05) in the vastus medialis and biceps brachii, with no difference between groups. All MT measurements of the lower- and upper-body increased similarly in both groups (p≤0.001). Similar improvements were also observed in MQEI (p≤0.01), MQST, and MQAS (p≤0.001) for both groups. These results demonstrate that low- and high-volume strength training promote similar increases in neuromuscular adaptations of the lower- and upper-body, and in MQ of the lower-body in elderly women.
Assuntos
Envelhecimento/fisiologia , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Esforço Físico/fisiologia , Treinamento Resistido/métodos , Adaptação Fisiológica/fisiologia , Idoso , Articulação do Cotovelo/fisiologia , Eletromiografia , Feminino , Humanos , Articulação do Joelho/fisiologia , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Amplitude de Movimento Articular/fisiologia , UltrassonografiaRESUMO
The purpose of this investigation was to compare partial range-of-motion vs. full range-of-motion upper-body resistance training on strength and muscle thickness (MT) in young men. Volunteers were randomly assigned to 3 groups: (a) full range of motion (FULL; n = 15), (b) partial range of motion (PART; n = 15), or (c) control (CON; n = 10). The subjects trained 2 d · wk(-1) for 10 weeks in a periodized program. Primary outcome measures included elbow flexion maximal strength measured by 1 repetition maximum (1RM) and elbow flexors MT measured by ultrasound. The results indicated that elbow flexion 1RM significantly increased (p < 0.05) for the FULL (25.7 ± 9.6%) and PART groups (16.0 ± 6.7%) but not for the CON group (1.7 ± 5.5%). Also, FULL 1RM strength was significantly greater than the PART 1RM after the training period. Average elbow flexor MT significantly increased for both training groups (9.65 ± 4.4% for FULL and 7.83 ± 4.9 for PART). These data suggest that muscle strength and MT can be improved with both FULL and PART resistance training, but FULL may lead to greater strength gains.