O entendimento adequado da resposta cardiovascular ao exercício é fundamental para o manejo e tratamento dos pacientes com hipertensão arterial pulmonar (HAP). Entretanto, dados a respeito da adaptação da mecânica vascular pulmonar e da adaptação do ventrículo direito ao esforço são escassos na literatura. O objetivo desse estudo é caracterizar a resposta cardiovascular ao exercício nos pacientes nesse grupo de pacientes. Foram selecionados 30 pacientes com HAP (Grupo 1 de Dana Point) e 7 controles com hemodinâmica invasiva normal, entre dezembro de 2009 e novembro de 2010, que realizaram protocolo incremental de esforço em cicloergômetro limitado por sintomas. Foram avaliados o comportamento das variáveis hemodinâmicas, da mecânica vascular pulmonar e o comportamento do peptídeo natriurético tipo B durante o esforço nos pacientes e comparado sua resposta com os controles. O grupo HAP apresentou elevação da PAPm superior ao grupo controle, com elevação da Poap e FC semelhantes. A elevação do débito cardíaco no pico do esforço foi inferior nesse grupo, sem variação do volume sistólico. A complacência e resistência vascular pulmonar apresentam queda no grupo HAP, permanecendo com complacência inferior e resistência superior no pico do esforço em relação aos controles. Estas variáveis permanecem inversamente acopladas sob a função C = t / R em repouso e durante todos os passos do esforço, reforçando o poder desse acoplamento e o papel na CVP na avaliação desses pacientes. No entanto, o comportamento da resistência não é uniforme em todos os pacientes com HAP, podendo ser separada em 3 grupos distintos: elevação, manutenção e queda durante o esforço. O BNP apresenta elevação durante o esforço no grupo HAP, mas os valores de BNP basal apresentam correlação inversa superior com o DC de pico do que os valores de BNP no pico do esforço. Na avaliação por curva ROC, o BNP de pico e a variação de BNP pico basal não se mostraram superiores ao BNP basal na discriminação da resposta do DC no esforço, reforçando o papel do BNP basal na avaliação dos pacientes com HAP / The proper understanding of the cardiovascular response to exercise has a central role in the management and treatment of patients with pulmonary arterial hypertension (PAH). However, data concerning the evolution of pulmonary vascular mechanics and right ventricular adaptation to effort are scarce. The aim of this study is characterize the cardiovascular response to exercise in these patients. We selected 30 patients with PAH (Group 1 Dana Point) and 7 controls with normal invasive hemodynamics between December 2009 and November 2010 who underwent a symptom-limited exercise protocol on cycle ergometer. Were evaluated the behavior of hemodynamic parameters, pulmonary vascular mechanics and B-type natriuretic peptide during stress in patients and compared their response with controls. The PAH group showed elevation of mPAP greater than the controls, with the same elevated PCWP and HR response between the groups. Cardiac output at peak exercise was lower in the PAH patients with no change of stroke volume during effort. Compliance and pulmonary vascular resistance have decrease in PAH group, remaining with lower compliance and higher resistance at peak exercise compared to controls. These variables are inversely related at rest and during every step of the effort, strengthening the power of this relation and the role of CVP in evaluation of these patients. However, the behavior of resistance is not uniform in all PAH patients and may be separated into three distinct groups: rise, fall and maintenance during exercise. The BNP raises during exercise in PAH group, but the values of baseline BNP already has an stronger inverse correlation with peak CO, better than the correlation of peak exercise BNP with the same variable. BNP at peak exercise and the variation of BNP peak - baseline were not superior to baseline BNP in discriminating the response of the CO during exercise, when evaluated by ROC curves. These findings reinforce the role of baseline BNP in evaluating patients with PAH

Introdução: Hipertrofia de ventrículo esquerdo (HVE) detectada pelo ecocardiograma é um preditor independente de morbidade e mortalidade em indivíduos hipertensos e na população em geral. Na população adulta existe uma modesta correlação entre a medida casual da pressão arterial (PA) e HVE . A HVE pode preceder a hipertensão arterial (HA) sustentada. Existem trabalhos que demonstram que indivíduos normotensos e com resposta exagerada da PA ao esforço tem alta probabilidade de desenvolvimento de HA sustentada no futuro, assim como alta prevalência de HVE. Há divergências no que diz respeito a participação do sistema neurohumoral na HVE nesse grupo especifíco de indivíduos, sendo que alguns dados da literatura apontam a hiperatividade simpática como fator desencadeador , no entanto, parece haver uma correlação independente e significativa entre a relação aldosterona/renina e aumento da PA sistólica durante o exercício . Nosso trabalho teve como objetivo avaliar a influência neurohumoral nesses indivíduos comparando drogas que bloqueiam o sistema nervoso simpático (SNS) com drogas que atuam bloqueando o sistema renina angiotensina (SRA). Métodos e Resultados: Durante 12 meses foram avaliados 195 indivíduos normotensos, hiperreatores ao teste de esforço e com HVE que foram submetidos a tratamento com exercício físico supervisionado, rilmenidina 1 mg/dia, atenolol 50 mg/dia, enalapril 10 mg/dia ou losartan 50 mg/dia. Mudanças no índice de massa de ventrículo esquerdo (IMVE) medida através do ecocardiograma foi o desfecho primário. Mudanças na pressão sistólica de repouso e no esforço máximo também foram avaliadas. Enalapril reduziu significativamente o IMVE com relação ao basal (137,0±8,8 para 107,1±9,4 g/m2; n=36) similar ao losartan (136,0±8,7 para 107,7±10,6 g/m2; n=42); P>0,05, porém ambas foram mais eficazes de que exercício físico (136,7±10,1 para 132,8±10,4 g/m2; n=39), rilmenidina (135,7±10,2 para 129,0±9,4 g/m2;n=38) e atenolol (134,0±8,9 para 125,2±9,6 g/m2; n=40); p<0,05. Todos os tratamentos reduziram a pressão arterial sistólica no repouso e esforço máximo quando comparados ao basal, porém a redução da pressão sistólica de repouso foi mais acentuada com atenolol (135±5 para 123±6 mmHg), enalapril (134±5 para 122±7 mmHg) e losartan (133±5 para 123±6 mmHg) do que com exercício físico (132±5 para 128±7 mmHg) e rilmenidina (135±4 para 129±7 mmHg); P<0,05. Não houve diferença significativa na redução da PAS no esforço máximo entre os grupos atenolol (225±5 para 183±10 mmHg), enalapril (225±5 para 182±9 mmHg) e losartan (225±3 para 184±10 mmHg); P>0,05, sendo a redução nesses grupos superior a redução nos grupos exercício físico (225±4 para 193±11mmHg) e rilmenidina (226±6 para 191±12 mmHg); P<0,05. Conclusões: As drogas que bloqueiam o SRA foram mais eficazes na redução da HVE em pacientes hiperreatores de que exercício físico e drogas que bloqueiam o SNS e essa redução foi independente da redução dos níveis de PAS no repouso e esforço máximo / Introduction: Left ventricular hypertrophy (LVH) as detected by echocardiogram is an independent predictor of morbidity and mortality in individuals having high blood pressure and in population in general. In adult population there is a modest correlation between casual measurement of blood pressure (BP) and LVH. LVH may precede sustained arterial hypertension (AH). Some papers demonstrate that normotensive individuals with exaggerated BP response to effort are highly likely to develop sustained AH later, as well as high prevalence of LVH. There are divergences concerning the role neurohumoral system plays in LVH within this specific group of individuals, with some data in literature pointing out to sympathetic hyperactivity as a triggering factor. Nevertheless, there seems to be an independent and significant correlation between the aldosteron/renin ratio and an increase in systolic BP during exercise. Our paper aims at evaluating neurohumoral influence over these individuals by comparing drugs that block the sympathetic nervous system (SNS) to drugs that block the renin angiotensin system (RAS). Methods and Results: Over a period of 12 months, 195 individuals (normotensive, with exaggerated blood pressure response to treadmill exercise test and with LVH) were evaluated. These individuals underwent a treatment with supervised physical training, rilmenidine 1 mg/day, atenolol 50 mg/day, enalpril 10 mg/day or losartan 50 mg/day. Changes in left ventricular mass index (LVMI), measured by means of echocardiogram were the primary endpoint. Changes in systolic pressure at rest and at peak effort were also evaluated. Enalapril significantly brought LVMI down in relation to basal (137.0±8.8 to 107.1±9.4 g/m2 ; n=36) similarly to losartan (136.0±8.7 to 107.7± 10.6 g/m2; n=42); P>0.05. However, both were more efficient than physical training (136.7±10.1 to 132.8± 10.4 g/m2; n=39), rilmenidine (135.7±10.2 to 129.0± 9.4 g/m2;n=38) and atenolol (134.0± 8.9 to 125.2±9.6 g/m2; n=40); p<0.05. All treatments brought down systolic blood pressure (SBP) at rest and at peak effort when compared to basal, but systolic pressure reduction at rest was more pronounced with com atenolol (135±5 to 123±6 mmHg), enalapril (134±5 to 122±7 mmHg) and losartan (133±5 to 123±6 mmHg) than with physical training (132±5 to 128±7 mmHg) and rilmenidine (135±4 to 129±7 mmHg); P<0.05. There was no significant difference in SBP reduction at peak effort in groups with atenolol (225±5 to 183±10 mmHg), enalapril (225±5 to 182±9 mmHg) and losartan (225±3 to 184±10 mmHg); P>0.05. In such groups, reduction was greater than in groups with physical training (225±4 to 193±11mmHg) and rilmenidine (226±6 to 191±12 mmHg); P<0.05. Conclusion: Drugs that block the renin angiotensin system (RAS) were more efficient in bringing LVH down in patients having high blood pressure than physical training and drugs that block the sympathetic nervous system (SNS) and such reduction took place regardless of SBP level reduction at rest and at peak effort

O entendimento adequado da resposta cardiovascular ao exercício é fundamental para o manejo e tratamento dos pacientes com hipertensão arterial pulmonar (HAP). Entretanto, dados a respeito da adaptação da mecânica vascular pulmonar e da adaptação do ventrículo direito ao esforço são escassos na literatura. O objetivo desse estudo é caracterizar a resposta cardiovascular ao exercício nos pacientes nesse grupo de pacientes. Foram selecionados 30 pacientes com HAP (Grupo 1 de Dana Point) e 7 controles com hemodinâmica invasiva normal, entre dezembro de 2009 e novembro de 2010, que realizaram protocolo incremental de esforço em cicloergômetro limitado por sintomas. Foram avaliados o comportamento das variáveis hemodinâmicas, da mecânica vascular pulmonar e o comportamento do peptídeo natriurético tipo B durante o esforço nos pacientes e comparado sua resposta com os controles. O grupo HAP apresentou elevação da PAPm superior ao grupo controle, com elevação da Poap e FC semelhantes. A elevação do débito cardíaco no pico do esforço foi inferior nesse grupo, sem variação do volume sistólico. A complacência e resistência vascular pulmonar apresentam queda no grupo HAP, permanecendo com complacência inferior e resistência superior no pico do esforço em relação aos controles. Estas variáveis permanecem inversamente acopladas sob a função C = t / R em repouso e durante todos os passos do esforço, reforçando o poder desse acoplamento e o papel na CVP na avaliação desses pacientes. No entanto, o comportamento da resistência não é uniforme em todos os pacientes com HAP, podendo ser separada em 3 grupos distintos: elevação, manutenção e queda durante o esforço. O BNP apresenta elevação durante o esforço no grupo HAP, mas os valores de BNP basal apresentam correlação inversa superior com o DC de pico do que os valores de BNP no pico do esforço. Na avaliação por curva ROC, o BNP de pico e a variação de BNP pico basal não se mostraram superiores ao BNP basal na discriminação da resposta do DC no esforço, reforçando o papel do BNP basal na avaliação dos pacientes com HAP / The proper understanding of the cardiovascular response to exercise has a central role in the management and treatment of patients with pulmonary arterial hypertension (PAH). However, data concerning the evolution of pulmonary vascular mechanics and right ventricular adaptation to effort are scarce. The aim of this study is characterize the cardiovascular response to exercise in these patients. We selected 30 patients with PAH (Group 1 Dana Point) and 7 controls with normal invasive hemodynamics between December 2009 and November 2010 who underwent a symptom-limited exercise protocol on cycle ergometer. Were evaluated the behavior of hemodynamic parameters, pulmonary vascular mechanics and B-type natriuretic peptide during stress in patients and compared their response with controls. The PAH group showed elevation of mPAP greater than the controls, with the same elevated PCWP and HR response between the groups. Cardiac output at peak exercise was lower in the PAH patients with no change of stroke volume during effort. Compliance and pulmonary vascular resistance have decrease in PAH group, remaining with lower compliance and higher resistance at peak exercise compared to controls. These variables are inversely related at rest and during every step of the effort, strengthening the power of this relation and the role of CVP in evaluation of these patients. However, the behavior of resistance is not uniform in all PAH patients and may be separated into three distinct groups: rise, fall and maintenance during exercise. The BNP raises during exercise in PAH group, but the values of baseline BNP already has an stronger inverse correlation with peak CO, better than the correlation of peak exercise BNP with the same variable. BNP at peak exercise and the variation of BNP peak - baseline were not superior to baseline BNP in discriminating the response of the CO during exercise, when evaluated by ROC curves. These findings reinforce the role of baseline BNP in evaluating patients with PAH

O sistema visual exerce importante papel para o reconhecimento do ambiente externo e para estabelecer relações entre objetos, tempo e espaço. Além disso, ele está relacionado com o controle e o desempenho motor. O objetivo deste estudo foi verificar se a privação de luz ambiente alteraria o desempenho e as respostas fisiológicas e psicológicas durante dois modelos de exercício, um fechado e um aberto. Onze ciclistas formaram o grupo de exercício fechado (GEF) e completaram um teste de 20 km, enquanto doze indivíduos ativos formaram o grupo de exercício aberto (GEA) e executaram um teste de potência constante até a exaustão (TWC). Após teste incremental máximo, GEF e GEA realizaram exercício na presença (controle) ou privação (experimental) de luz ambiente, em ordem balanceada. Respostas de desempenho, VE, VO2, VCO2 RER, FC, eletromiografia do músculo vato lateral (EMG), percepção subjetiva de esforço (PSE) e pensamento associado ao exercício (PAE) foram obtidas durante, e no ponto final do exercício, em ambas as condições. O tempo total de exercício indicou a resposta de desempenho em GEF e GEA. As respostas das variáveis fisiológicas e psicológicas foram analisadas durante a realização, ou no ponto final do exercício. A média das respostas geradas durante os 20 km no GEF, e as respostas obtidas no mesmo tempo absoluto do TWC no GEA, pareado pelo menor tempo de exaustão atingido no teste, indicaram as respostas durante a execução do exercício. As respostas obtidas nos 5 segundos finais de cada exercício indicaram as respostas do ponto final do GEF e GEA. A taxa de incremento na PSE foi calculada em GEF e GEA, e o erro de predição da distância real percorrida no teste de 20 km foi obtido no GEF. No GEF, não houve efeito da privação de luz sobre o tempo para completar o teste de 20 km, porém a privação de luz gerou menores respostas (P< 0,01) na VE, VO2, VCO2, EMG e PAE, quando comparada ao controle. No ponto final do exercício, nenhuma diferença foi verificada entre as condições. A privação de luz não alterou a taxa de elevação da PSE ou o erro de predição da distância percorrida. No GEA a privação de luz ambiente reduziu o tempo de exaustão (P< 0,05) no TWC e aumentou a resposta do VO2 e EMG (P< 0,05). Entretanto, não foi observado efeito da privação de luz na VE, VCO2 e FC. No ponto final do exercício observou-se menor EMG com a privação de luz (P< 0,03), mas nenhuma diferença nas demais variáveis foi observada. Maior taxa de elevação na PSE foi observada em ambiente privado de luz. Os resultados do presente estudo podem ser interpretados de acordo com a existência de um \"relógio biológico interno\" que calcula a duração tolerável do exercício de acordo com a aproximação ao ponto final do exercício, sugerindo que os efeitos da privação de luz sobre o desempenho possam depender da presença de um ponto final previamente conhecido / The visual system plays an important role for the environment recognition as well as to set objects, time and space relationships. Furthermore, the visual system is related to the motor learning and performance. The aim of this study was to verify if light deprivation environment would alter performance, and physiological and psychological responses to different exercise modes, closed- and open-loop exercises. Eleven cyclists were the closed-loop exercise group (CLE) and performed a 20 km time trial, while twelve active individuals were the open-loop exercise group (OLE) and cycled to exhaustion during a constant workload exercise. After maximal incremental test CLE and OLE groups performed exercise in a control and experimental condition (i.e. under light deprivation), in a counterbalanced fashion. Performance responses and responses of VE, VO2, VCO2 RER, HR, eletromyography of the vastus lateralis muscle (EMG), ratings of perceived exertion (RPE) and associative thoughts to exercise (ATE) were obtained during exercise and at the exercise endpoint in both the conditions. Time of exercise indicated performance responses in CLE and OLE groups. Physiological and psychological responses were analyzed either during or at the exercise endpoint. Mean responses throughout the 20 km cycling time trial and responses obtained at absolute matched time of exercise, corresponding to the shortest time to exhaustion provided responses along the exercise in CLE and OLE groups, respectively. Responses obtained during the last 5 seconds of the exercises provided responses at the exercise endpoint in both CLE and OLE groups. The rate of increase in RPE was calculated in CLE and OLE groups, and the predictive error of the distance was calculated in the CLE group. In CLE group no effect of light deprivation was observed in the time to complete the 20 km, although the lower response (P< 0.01) of VE, VO2, VCO2, EMG e ATE when compared to control condition. Neither difference was observed in variables at the exercise endpoint. Light deprivation had effect in neither rate of increase in RPE or predictive error of distance. Regarding OLE group the light deprivation decreased the time to exhaustion (P< 0.05) and increased VO2 and EMG (P< 0.05) responses. However, there was no light deprivation effect in VE, VCO2 and HR. Lower EMG was observed at the exercise endpoint in light deprivation condition (P< 0.05) than in control, but no difference was observed in the others. Greater rate of increase in RPE was detected (P< 0.05) in the light deprivation condition than in control. Results of the present study were interpreted according to a \"biological internal clock\" that calculates the tolerable exercise duraton based on the exercise endpoint approximation, suggesting that light deprivation effects on performance may depend on the presence of an exercise endpoint previously known

O objetivo da presente tese foi verificar a influência do enxágue bucal com carboidrato (CHO) sobre o desempenho no exercício físico predominantemente aeróbio realizado após uma atividade cognitiva frequentemente utilizada para induzir a fadiga mental. Sete homens fisicamente ativos participaram do estudo (idade: 26 ± 5 anos; estatura: 176,0 ± 8,3 cm; massa corporal: 73,6 ± 7,4 kg e gordura corporal: 14,3 ± 3,7 %, VO2 pico: 43,9 ± 6,5 ml.kg-1.min-1, Wpico: 268 ± 23,8 W) realizaram o Stroop Incongruente para indução da Fadiga Mental (FM) ou assistiam a um documentário pelo mesmo período de tempo (controle, CON). Após a tarefa eles realizaram um exercício de carga constante (~55%Wpico) até exaustão. Em cada uma das condições FM e CON os voluntários utilizavam o enxágue bucal (10s) com CHO ou placebo (PLA). No pre-exercício, não houve diferença estatisticamente significante para glicose entre as diferentes condições. A frequência cardíaca apresentou aumento após todas as intervenções, assim como a fadiga percebida (P = 0,001, ES = 0,49), mas sem efeito de condição. O effect size foi moderado para essa variável, sugerindo que o aumento na fadiga percebida foi maior na condição FM (75%) quando comparado a condição CON (60%). A motivação não apresentou diferença entre as condições. Porém, houve uma tendência (0,07) a ser maior na condição DOC. Houve uma redução de 7,8% no tempo até exaustão na condição FM comparado ao CON, entretanto, essa diferença não foi estatisticamente significante. A frequência cardíaca, percepção subjetiva do esforço, fadiga percebida e eletromiografia do músculo vasto lateral aumentaram em função do tempo, sem diferença entre as condições. Com base nesses achados, pode-se concluir que a FM produz apenas um pequeno efeito deletério no exercício físico prologado e que o enxágue com CHO não era capaz de influenciar nessas condições experimentais. Possivelmente, isso se deve ao fato de ambas as intervenções estudadas (FM e enxágue com CHO) produzirem apenas pequenas alterações nas variáveis fisiológicas e perceptivas antes do exercício físico / The aim of this thesis was verify the influence of carbohydrate mouth rinse (CHO) on endurance performance after cognitive activity frequently used to induce mental fatigue. Seven health men (age: 26 ± 5 years; height: 176.0 ± 8.3 cm; weight: 73.6 ± 7.4 kg; and corporal fat: 14.3 ± 3.7%, VO2peak: 43.9 ± 6.5 ml.kg-1.min-1, Wpeak: 268.0 ± 23.8 W) performed an Incongruent Stroop to induce mental fatigue (FM) state or watched a documentary (control, CON) prior to endurance exercise. Following, they performed a workload exercise (~55%Wpeak) until exhaustion with CHO or placebo (PLA) mouth rinse (10s). In the pre-exercise, there was no significant difference for blood glucose between conditions. There was a main effect of distance for heart rate and perceived fatigue, but without interaction (P > 0.05) or condition (P > 0.05) effects. However, there was a moderate effect size for perceived fatigue (ES = 0,49), suggesting a possible relevant increase in perceived fatigue in the FM condition (75%) when compared to CON condition (60%). Although did not reach a significance level, the motivation tended (P = 0.07) to be greater in DOC condition. There was a reduction of 7.8% in time to exhaustion in FM condition compared to CON, however did not reach a significance level (P > 0.05). During exercise, the heart rate, rating perceived exertion, perception of fatigue and electromyography of the vastus lateralis increased over time (P < 0.05), but without interaction (P > 0.05) or condition (P > 0.05) effects. These results suggest that FM produce only a small deleterious effect in the prolonged physical exercise and that carbohydrate mouth rinse was not able to influence the endurance performance at all experimental conditions. Possibly, this is due to the fact of the experimental interventions (FM and carbohydrate mouth rinse) produced only discrete changes in the physiological and perceptual variables before endurance exercise

A interação entre a ingestão aguda de bebida alcoólica, fadiga mental e capacidade de realização de exercício físico é pouco conhecida. Seus possíveis efeitos parecem ter relação com as alterações fisiológicas que ocorrem no sistema nervoso central. Assim o objetivo deste estudo foi investigar os efeitos da ingestão aguda de cerveja, combinada a uma tarefa de alta demanda cognitiva, sobre o desempenho físico, respostas fisiológicas e psicológicas, durante uma corrida de 30 minutos, realizada como contrarrelógio. Métodos: Dezesseis homens saudáveis e fisicamente ativos, com 25,8 anos (± 5,1) em média, sem qualquer restrição física ou clínica para prática de atividade física, realizaram cinco visitas ao laboratório para realização de uma sessão preliminar para determinação do VO2PICO, seguida de duas sessões de familiarização, e duas sessões experimentais com corrida de 30 minutos. Desta forma, eles realizaram: 1) Sessão preliminar; 2) Corrida após ingestão de cerveja; 3) Corrida após ingestão de cerveja sem álcool (placebo); 4) Corrida após instalação de fadiga mental e ingestão de cerveja; 5) Corrida após instalação de fadiga mental e ingestão de placebo. Após realização da sessão preliminar, os participantes realizaram as sessões 2 e 3 (familiarização), em ordem balanceada entre elas, sendo seguidas sequencialmente das sessões 4 e 5 (experimentais), em ordem balanceada entre elas. Para as análises de comparação entre pré e pós tarefa cognitiva e medidas de desempenho utilizou-se um teste T-Student. Para as comparações múltiplas das variáveis fisiológicas e psicológicas durante a corrida, entre as condições, utilizou-se um modelo misto com correção de Bonferroni. Resultados: Os participantes apresentaram aumento significante no tempo de reação durante o teste cognitivo, e na sensação de fadiga entre os momentos antes e após teste cognitivo, para indução de fadiga mental. O desempenho físico na corrida apresentou diferença significante, e a associação da fadiga mental à ingestão de cerveja também reduziu a distância final e a velocidade média em 12 dos 16 participantes. A economia de corrida apresentou uma tendência a significância, sugerindo possível potencialização da fadiga mental após ingestão de cerveja, tornando os indivíduos menos econômicos para realização do mesmo modelo de exercício. Para as variáveis fisiológicas e psicológicas ambas apresentaram efeito do tempo. Conclusão: Os resultados indicam que a ingestão aguda de cerveja afeta o desempenho físico e altera a economia de corrida, indicando que, com baixas doses ofertadas de cerveja, na presença ou ausência de fadiga mental, ambos desempenho e economia de corrida são piorados em corrida de 30 minutos / The interaction of acute alcoholic beverage intake and exercise capacity is little known. It is possible effects appear to be related to the physiological changes that occur in the cardiovascular system, as well as in the central nervous system. Thus, the aim of this study was to investigate the effects of acute beer intake, combined with a task of high cognitive demand, on physical performance, physiological and psychological responses, during a 30-minute run, performed as a time trial. Methods: Sixteen healthy and physically active men, with a mean age of 25,8 years (± 5,1) on average, without any physical or clinical restrictions to practice physical activity, performed five visits to the laboratory for a preliminary session to determine VO2PEAK, followed of two familiarization sessions, and two experimental sessions with a 30-minute run. In this way, they performed: 1) Preliminary session; 2) Running after ingesting beer; 3) Running after drinking non-alcoholic beer (placebo); 4) Running after installation of mental fatigue and beer intake; 5) Running after installation of mental fatigue and placebo intake. After the preliminary session, the participants performed sessions 2 and 3 (familiarization), in a balanced order between them, being followed sequentially from sessions 4 and 5 (experimental), in a balanced order between them. For the comparative analyzes between pre and post cognitive task and performance measures a Student\'s T-test was used. For the multiple comparisons of the physiological and psychological variables during the race, among the conditions, a mixed model with Bonferroni correction was used. Results: Participants presented a significant increase in reaction time during the cognitive test, and in the sensation of fatigue between the moments before and after the cognitive test, to induce mental fatigue. The physical performance in the race presented a significant difference, and the association of mental fatigue with beer intake also reduced the final distance and the mean velocity in 12 of the 16 participants. The running economy presented a tendency to significance, suggesting possible potentiation of mental fatigue after beer intake, making individuals less economical to perform the same exercise model. For the physiological and psychological variables, both had an effect of time. Conclusion: These results indicate that acute beer intake affects physical performance and alters running economy, thus indicating that with low doses of beer offered in the presence or absence of mental fatigue, both performance and running economy may be impaired 30 minutes running

<p>Modern ski-treadmills allow cross-country skiers, biathletes and ski-orienteers to test their physical performance in a laboratory environment using classical and freestyle techniques on roller skis. For elite athletes the differences in performance between test occasions are quite small, thus emphasising the importance of knowing the roller skis’ rolling resistance coefficient, µ_R, in order to allow correct comparisons between the results, as well as providing the opportunity to study work economy between different athletes, test occasions and core techniques.</p><p>Thus, one of the aims of this thesis was to evaluate how roller skis’ µ_R is related to warm-up, mass, velocity and inclination of the treadmill. It was also necessary to investigate the methodological variability of the rolling resistance measurement system, RRMS, specially produced for the experiments, with a reproducibility study in order to indicate the validity and reliability of the results.</p><p>The aim was also to study physiological responses to different µ_R during roller skiing with freestyle and classical roller skis and techniques on the treadmill as a case in which all measurements were carried out in stationary and comparable conditions.</p><p>Finally, the aim was also to investigate the work economy of amateurs and female and male junior and senior cross-country skiers during treadmill roller skiing, i.e. as a function of skill, age and gender, including whether differences in body mass causes significant differences in external power per kg due to differences in the roller skis’ µ_R.</p><p>The experiments showed that during a warm-up period of 30 minutes, µ_R decreased to about 60-65% and 70-75% of its initial value for freestyle and classical roller skis respectively. For another 30 minutes of rolling no significant change was found. Simultaneous measurements of roller ski temperature and m_R showed that stabilized m_R corresponds to a certain running temperature for a given normal force on the roller ski. The study of the influence on m_R of normal force, velocity and inclination produced a significant influence of normal force on m_R, while different velocities and inclinations of the treadmill only resulted in small changes in m_R. The reproducibility study of the RRMS showed no significant differences between paired measurements with either classical or the freestyle roller skis.</p><p>The study of the effects on physiological variables of ~50% change in µ_R,showed that during submaximal steady state exercise, external power, oxygen uptake, heart rate and blood lactate were significantly changed, while there were non significant or only small changes to cycle rate, cycle length and ratings of perceived exertion. Incremental maximal tests showed that time to exhaustion was significantly changed and this occurred without a significantly changed maximal power, maximal oxygen uptake, maximal heart rate and blood lactate, and that the influence on ratings of perceived exertion was non significant or small.</p><p>The final part of the thesis, which focused on work economy, found no significant difference between the four groups of elite competitors, i.e. between the two genders and between the junior and senior elite athletes. It was only the male amateurs who significantly differed among the five studied groups. The study also showed that the external power per kg was significantly different between the two genders due to differences in body mass and m_R, i.e. the lighter female testing groups were roller skiing with a relatively heavier rolling resistance coefficient compared to the heavier testing groups of male participants.</p> / Sporttech

L'obésité pédiatrique et ses pathologies associées sont devenues un problème majeur de santé publique. La reprise des activités physiques quotidiennes et de loisirs, préconisée dans les recommandations internationales, est souvent complexe chez le jeune obèse en raison d'une image de soi dévalorisée, de difficultés d'intégration et d'une faible condition physique. L'excès pondéral, associé à la sédentarité, altère progressivement l'endurance cardiorespiratoire à l'exercice, freinant le retour à une pratique physique régulière et contribuant à la non-observance des prescriptions en activité physique. Pour répondre à un besoin croissant des professionnels de l'activité physique impliqués dans la prise en charge de ces jeunes, l'objectif de ce travail de thèse a été de valider des outils cliniques explorant l'endurance cardiorespiratoire chez l'adolescent obèse :Un test de marche/course de 12 minutes, un test de marche navette adapté sur 20 mètres (4km.h^ incrémenté de 0,5 km.HAmin-1) et un test sous-maximal sur ergocycle en 4 paliers ontpermis de déterminer des indices d'endurance cardiorespiratoire (D12, Vmax, PMA).L'analyse fréquentielle en temps variant de la variabilité de la fréquence cardiaque a permisd'estimer des intensités d'exercice sous-maximales proches des seuils ventilatoires.Le "Childhood Obesity Perceived Exertion Scale" (COPE-10) a permis de quantifier l'intensitéde l'exercice perçue au cours de l'effort.Ces outils non-invasifs et peu coûteux, utiles à l'évaluation initiale et au suivi de la condition physique du jeune obèse, peuvent être facilement utilisés pour concevoir et individualiser des programmes de réentraînement adaptés à ces jeunes. / Pédiatrie obesity and its associated diseases hâve become a major public health challenge. However, thé return to daily physical and leisure activities, recommended by most international guidelines, can be difficult for obèse youths, due to low self-esteem, difficulties in integrating groups and poor physical fitness. Overweight combined with sedentarity progressively modify cardio-respiratory exercise tolérance, rendering difficult thé return to exercise and contributing to non-compliance with prescriptions for physical activity. To meet thé growing needs of professionals in thé field of physical activity responsible for thé management of thèse subjects, thé main objective of this doctoral thesis was to validate clinical tools exploring cardiorespiratory capacity in obèse adolescent.A 12 minute walk/run test, an adapted 20m shuttle walk test (starting speed 4 km.b.-1,incréments : 0.5 km.h-1.miir1) and a submaximal exercise test by cycle ergometer with 4 stageswere proposed to calculate indices of cardiorespiratory fitness (D12, Vmax, PMA).Time-varying spectral analysis of heart rate variability was studied to estimate intensitiessubmaximal exercise near ventilatory thresholds.-The "Childhood Obesity Perceived Exertion Scale" (COPE-10) was used to quantify thé intensity of exercise as perceived by thé subjects during exercise.Thèse non-invasive tools, inexpensive, useful in thé évaluation and follow-up of cardiorespiratory fitness in obèse adolescents, can easily be used to develop and personalise adapted re-training programmes in thèse overweight teenagers.

La réalisation d’une performance sportive dans un environnement chaud est un challenge majeur que doivent surmonter les athlètes de haut niveau notamment à l’occasion des Jeux Olympiques d’été. Depuis plusieurs décennies, les scientifiques ont tenté de trouver des solutions innovantes. Parmi les réponses proposées, on distingue aujourd’hui le refroidissement corporel préalable ou consécutif à l’effort (le pré et le post-cooling, respectivement), qui permettrait de minimiser les risques d’hyperthermie et améliorerait la récupération de l’athlète. Cependant, les modalités d’utilisation de ces méthodes et leur efficacité font l’objet de conclusions pour le moins contradictoires en raison notamment des techniques de refroidissement mises en œuvre (refroidissement par immersion, vêtements thermorégulants, brumisation…), de la durée d’application, du type d’exercice réalisé et des conditions environnementales explorées. La préparation des Jeux Olympiques à Pékin, en Août 2008, a été une occasion unique de faire un état de l’art sur les méthodes existantes. Nous avons testé chez des cyclistes de haut niveau l’hypothèse selon laquelle une stratégie de refroidissement utilisant une veste garnie d’accumulateurs thermiques permettrait d’améliorer le confort thermique et la performance lors d’un exercice de type anaérobie (Wingate test) et lors d’une épreuve d’endurance de 20 minutes. L’étude menée sur le test de Wingate ne montre aucun effet significatif du pré-cooling sur le pic de puissance ni sur la puissance moyenne mais permet néanmoins d’améliorer significativement (P < 0,05) l’indice de fatigue des athlètes testés. Sur l’épreuve de 20 minutes, le pré-cooling permet une amélioration significative (P < 0,05) de la puissance moyenne développée, du confort thermique et une baisse significative des températures cutanées et rectales. Une autre étude portant sur l’influence de différents maillots sur les réponses physiologiques et perceptives de coureurs cyclistes a montré qu’un maillot constitué de larges mailles offrait un meilleur confort thermique en diminuant significativement (P < 0,05) la température cutanée, mais sans modifier la perception de l’effort. Les bénéfices observés chez les cyclistes de haut niveau nous ont orientés vers la mise en œuvre d’un protocole similaire appliqué à des personnes atteintes de pathologies affectant la thermorégulation. Ainsi, nous avons débuté un protocole de recherche clinique exploratoire visant à étudier les effets du port d’une veste thermorégulante sur les performances motrices et cognitives de patients atteints de sclérose en plaques. Ce protocole, qui a obtenu l’accord du Comité de Protection des Personnes du Grand Est –II, devrait commencer fin 2012. / Abstract: Exercising in the heat and high relative humidity is a major challenge that athletes have to overcome, especially during the summer Olympic Games. For decades, scientists investigated innovative solutions amongst which the body cooling before competing (pre-cooling) or after competing (post-cooling) seemed to be a valuable mean of minimizing hyperthermia threats and increasing the recovery of the athletes. However, contradictory results have been reported concerning body cooling protocols (cold water immersion, cooling vests, water sprays, etc.), exposure time, exercise duration, environmental conditions and their efficiency. By preparing the 2008 Beijing Olympic Games, we managed to review the existing literature on those methods. We hypothesized that a cooling vest combined with a cooling headband would increase thermal comfort of elite cyclists and their performances on an anaerobic (Wingate Test) and endurance (20 minutes time-trial) exercises. The Wingate Test study showed no significant effect of pre-cooling on peak or mean power output despite a significant increase (P < 0.05) of fatigue indexes. During the endurance study, pre-cooling maneuvers induced significant improvement (P < 0.05) of the mean power output, of the thermal comfort and a significant decrease in rectal and skin temperatures. Another study concerning the influence of wearing different cycling shirt on perceived and physiological responses of cyclists showed that a large knitted shirt provided a better thermal comfort by decreasing significantly (P < 0.05) skin temperatures, but without affecting perceived exertion. Those positive results on elite athletes lead us to apply similar cooling strategies on a population experiencing disease-related thermoregulation troubles. We decided to initiate an exploratory clinical study aiming at investigating the effects of a cooling vest on motor and cognitive skills of patients with multiple sclerosis disease. This protocol obtained the clearance of the French National Ethics Committee – East Section II, and should start on the late of 2012.

Thesis (doctoral)--Nijmegen, 1982.