Social anxiety disorder (SAD) is one of the most common anxiety disorders and understanding its symptoms and risk factors is vital for developing treatments and prevention strategies. Atypical physiological responses have been observed in anxious individuals and their consequences present a human and economic burden. This dissertation includes two studies that explore the subjective and physiological responses to an acute stress in the context of treatment and risk factors for SAD. The goal of the first study was to examine whether cognitive behavioural group therapy (CBGT) and a mindfulness-based stress reduction (MBSR) program differentially influenced the subjective and physiological response to a speech task. Participants in the treatment groups performed two speech tasks, before and after treatment, while a healthy control group completed it only once. Results indicated significant differences for the subjective, but not the physiological measures of stress. Patients with SAD reported higher subjective anxiety than the healthy control group and these scores were significantly reduced following treatment. Greater improvements were noted in the CBGT group; nonetheless, the study did indicate promising results for MBSR. The second study aimed to explore the effects of behavioural inhibition (BI), parental bonding variables and their interaction on the subjective and physiological responses to a similar speech task in healthy children. BI was related to subjective anxiety in a predictive manner, but was generally unrelated to the physiological measures. Parental bonding variables were not related to any of the stress responses and no interaction between BI and parental bonding was observed. These studies contribute to the literature by demonstrating treatment differences and their subjective and physiological consequences on stress reactions and exploring the extent to which risk factors for SAD affect the stress response in healthy children.

This study examined effectiveness of heart rate variability (HRV) biofeedback-assisted stress management training in reducing anxiety and stress in pregnant women and the effect of maternal stress management skills practice on fetal heart rate measures in real time. Participants were seven working pregnant women who volunteered in response to recruitment announcements and invitations from cooperating midwives. Reported state and trait anxiety and pregnancy specific stress were measured during five 45- to 50-minute training sessions. Training included bibliotherapy, instruction in the use of emotion-focused stress management techniques, and HRV biofeedback. Subjects used portable biofeedback units for home practice and were encouraged to practice the skills for 20 minutes a day and for short periods of time during stressful life events. At the end of training, fetal heart rate was monitored and concurrent maternal HRV measures were recorded. Repeated measures ANOVA and paired samples t-test analysis of study data revealed no statistically significant reductions in state or trait anxiety measures or in pregnancy specific stress measures. Partial eta squared (n²) and Cohen's d calculations found small to medium effect sizes on the various test scales. Friedman's analysis of variance of biofeedback measures showed a statistically significant decrease in low HRV coherence scores (X2 = 10.53, p = .03) and medium HRV coherence scores (X2 = 11.58, p = .02) and a statistically significant increase in high HRV coherence scores (X2 = 18.16, p = .001). This change is an indication of improved autonomic function. Results of concurrent maternal and fetal HRV recordings were generally inconclusive. A qualitative discussion of individual subject results is included. During follow-up interviews five subjects reported that they felt they were better able to cope with stress at the end of the study than at the beginning, that they used the stress management skills during labor, and that they continue to practice the skills in their daily lives.

Orientadores: Maria Cristina Cintra Gomes Marcondes, Dora Maria Grassi Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T12:12:43Z (GMT). No. of bitstreams: 1 Camargo_EricaAparecidaMariano_M.pdf: 3544834 bytes, checksum: d9515fe1a07bef154d0bed7c21be4a79 (MD5) Previous issue date: 2015 / Resumo: A importância da validação científica de técnicas coadjuvantes a diversos tratamentos de saúde é inquestionável. Assim a influência da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica, bem como, no sistema nervoso autonômico ainda precisa ser investigada. O objetivo deste trabalho foi avaliar o efeito da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica e na modulação autonômica da frequência cardíaca em homens e mulheres. Foram estudados 11 homens; 11 mulheres não usuárias de anticoncepcional oral e 12 mulheres usuárias de anticoncepcional oral, com 21,3 ± 2,9 anos de idade, saudáveis, sedentários e eutróficos. As amostras urinárias foram coletadas em um dia, sem intervenção terapêutica, denominado controle e em outro dia com aplicação da drenagem linfática manual. Na urina, foram analisadas osmolaridade, concentração de sódio, fluxo e concentração de glicerol. A variabilidade da frequência cardíaca foi registrada no início, durante e ao final do experimento, nos dias controle e drenagem linfática manual. Os resultados mostram que a drenagem linfática manual promoveu em homens redução dos eletrólitos urinários e aumento do fluxo e em mulheres não usuárias de anticoncepcional oral houve apenas aumento do fluxo. A técnica induziu diluição urinária em homens e mulheres não usuárias de anticoncepcional, sugerindo que os mecanismos são sexo-dependentes. Para usuárias de anticoncepcional oral, a drenagem linfática manual não diferiu do dia controle, onde houve redução dos eletrólitos e aumento do fluxo urinário. A análise da concentração de glicerol urinário mostrou que a drenagem linfática manual não altera a taxa lipolítica nos voluntários dos grupos estudados. Os resultados da modulação autonômica da frequência cardíaca indicaram que a técnica promoveu predomínio simpático no grupo de homens sem alterações nos grupos das mulheres. Conclui-se que a drenagem linfática manual foi eficaz na diluição urinária de homens e mulheres não usuárias de anticoncepcional oral, assim como, foi eficaz em promover predomínio simpático em homens. A técnica não foi eficaz em promover alterações na taxa lipolítica / Abstract: The importance of scientific validation techniques supporting the various health treatments is unquestionable. Thus, the influence of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate as well as in the autonomic nervous system has to be investigated. The objective of this study was to evaluate the effect of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate and autonomic modulation of heart rate in men and women. 11 male patients; 11 women not using oral contraceptives and 12 women used oral contraceptives, with 21.3 ± 2.9 years old, healthy, sedentary and eutrophic. The urine samples were collected in one day, without therapeutic intervention, denominated as the control and on another day with application of manual lymphatic drainage. In the urine, were analyzed osmolality, sodium concentration, flow, and the concentration of glycerol. The heart rate variability was registered at the outset, during and at the end of the experiment, in the days control and manual lymphatic drainage. The results showed that the manual lymph drainage in men promoted reduction of urinary electrolytes and increased flow and in women non-users oral contraceptives there was only increased flow. The technique induced urinary dilution in men and women non-users oral contraceptives, suggesting that the mechanisms are sex-dependent. For oral contraceptive users, manual lymphatic drainage did not differ from control day where there was a reduction of electrolytes and increased urine flow. The analysis of urinary glycerol concentration showed that manual lymphatic drainage does not change the lipolytic rate in voluntary groups studied. The results of the autonomic modulation of heart rate indicated that the technique promoted sympathetic predominance in men group and without changes in women. We conclude that manual lymphatic drainage was effective in urinary dilution of men and women non-users oral contraceptives, as well as, it was effective in promoting sympathetic predominance in men. The technique was not effective in promoting changes in lipolytic rate / Mestrado / Fisiologia / Mestra em Biologia Funcional e Molecular

O objetivo deste estudo é avaliar os efeitos da prática da ioga na freqüência cardíaca, na variabilidade da freqüência cardíaca e na freqüência respiratória. Foram estudados praticantes de ioga (IOGA, n = 8) e não praticantes controles (CT, n = 8) com idade entre 30 e 45 anos. Dois sub-grupos de quatro indivíduos cada, com atividade física regular foram também comparados (IOGAativ e CTativ). Os participantes realizaram prática de asanas (IOGA) ou simulação (CT) precedidos e sucedidos por relaxamento, sendo registrados (20 min) o eletrocardiograma e respirograma antes e após os asanas ou simulação. A freqüência cardíaca foi menor no grupo IOGA comparado ao CT (58,9 ± 6,6 e 64,3 ± 5,6 bpm) e no grupo IOGAativ comparado ao CTativ (55,0 ± 3,6 e 63,2 ± 5,5 bpm). Não foram encontradas diferenças na freqüência respiratória. O intervalo de pulso (IP) foi maior no grupo IOGA (1036,0 ± 111,2 ms) comparado ao CT (943,9 ± 85,3 ms) e IOGAativ (1101,6 ± 72,6 ms) comparado ao CTativ (957,8 ± 92,6 ms). Também o desvio padrão do IP foi maior no grupo IOGA (68,8 ± 22,8 ms) comparado ao CT (51,1 ± 21,7 ms) e grupo IOGAativ (77,8 ± 14,1 ms) comparado ao CTativ (41,5 ± 17,8 ms). A potência espectral do IP foi maior no grupo IOGAativ comparada ao CTativ na faixa de muito baixa freqüência (2157,3 ± 1159,4 vs. 876,0 ± 989,4 ms2) e maior nas faixas de baixa (1523,7 ± 964,6 vs. 494,7 ± 417,1 ms2) e alta freqüências (1684,4 ± 847,9 vs. 462,6 ± 375,1 ms2) comparando-se os valores obtidos após os asanas ou simulação. Os resultados sugerem que a combinação de exercícios físicos e ioga pode aumentar os benefícios destes à saúde. / The objective of this work is to evaluate the effects of yoga practice in heart rate (HR), HR variability and respiratory rate using spectral analysis. We compared yoga students (IOGA, n = 8) with non-practicing controls (CT, n = 8), between 30 and 45 years of age. These groups were subdivided in two subgroups (n = 4) having regular practice of physical activities besides yoga (IOGAactiv and CTactiv). The participants practiced the yoga asanas (IOGA) or physical simulation (CT) preceded and succeeded by relaxation, after which the electrocardiogram and respirogram was recorded for 20 min. Heart rate was lower in IOGA when compared to CT (58,9 ± 6,6 vs. 64,3 ± 5,6 bpm) and in IOGAactiv compared to CTactiv (55,0 ± 3,6 vs. 63,2 ± 5,5 bpm). No diferences in respiratory rate were found between groups. Pulse interval (PI) was higher in IOGA when compared to CT (1036,0 ± 111,2 vs. 943,9 ± 85,3 ms) and IOGAactiv compared to CTactiv (1101,6 ± 72,6 vs. 957,8 ± 92,6 ms). Standard deviation of pulse interval was greater in IOGA when compared to CT (68,8 ± 22,8 vs. 51,1 ± xix 21,7 ms) and IOGAactiv compared to CTactiv (77,8 ± 14,1 vs. 41,5 ± 17,8 ms). The spectral power of the PI was higher in the IOGAactiv group in relation to the CTactiv in the bands of very low (2157,3 ± 1159,4 vs. 876,0 ± 989,4 ms2) and in the band of low (1523,7 ± 964,6 vs. 494,7 ± 417,1 ms2) and high frequency (1684,4 ± 847,9 vs. 462,6 ± 375,1 ms2) after the practice of yoga asanas. These results suggest that combination of physical exercises and yoga may increase their healthy benefits.

A variabilidade da freqüência cardíaca (VFC) tem sido utilizada como um marcador fisiológico do controle autonômico do coração, enquanto a eletromiografia de superfície (EMGs) tem mostrado ser uma ferramenta útil de análise para avaliar a resposta muscular frente ao exercício físico. Assim os objetivos do presente estudo foram: avaliar o controle autonômico do coração a partir das respostas da freqüência cardíaca e de sua variabilidade nas condições de repouso, nas posições supina e sentada, e durante teste de esforço físico dinâmico contínuo do tipo rampa (TEFDC-R). Avaliar a atividade eletromiográfica durante o TEFDC-R e ainda verificar a correlação entre a atividade eletromiográfica e a variabilidade da freqüência cardíaca durante o TEFDC-R. Metodologia: estudou se 10 homens, ativos, saudáveis, jovens (23,7 ± 3,02 anos) em repouso, nas posições supina e sentada, e durante TEFDC-R, com incrementos de 20 Watts (W) por minuto. Os dados de freqüência cardíaca e dos intervalos R-R (ms) foram coletados em tempo real, batimento a batimento, durante o repouso e o exercício. A EMGs integrada foi coletada do músculo vasto lateral (VL) nos 20 segundos finais de cada minuto durante o TEFDC-R. Análise dos dados: foram calculados os valores médios da freqüência cardíaca (FC) em bpm e dos intervalos R-R (iR-R) em ms em repouso durante os 15 minutos e o índice temporal RMSSD dos iR-R (ms) e da FC (bpm) nessas condições. Durante o TEFDC-R, foi obtida a média da FC (bpm) e o RMSSD dos iR-R (ms) nos 20 s finais de cada minuto de exercício paralelamente a análise da EMGs pelo índice RMS da amplitude do sinal em microvolts. Metodologia estatística: Para a análise estatística utilizou-se os testes não paramétricos de Wilcoxon para amostras pareadas, de Friedman para medidas repetidas seguido de técnicas de comparações múltiplas com o teste de Dunn e análise de correlação de Spearman. Foram considerados níveis de significância de á=0,05. Resultados: os dados apresentam significância estatística (p<0,05) nas seguintes análises: 1) menor FC (bpm) e maior iR-R (ms) médios em supino em relação a sentado; 2) maior VFC em supino quando comparado a sentado; 3) FC (bpm) média e RMSSD dos iR-R (ms), durante o TEFDC-R, entre a potência de 4 W e os intervalos a partir de 55 e 60 W; 4) aumento do índice RMS da EMGs entre 4 W e a partir do intervalo de 57 e 60 W; 5) correlação entre RMS e RMSSD (rs=-0,64), entre FC e RMS (rs=0,61) e entre FC (bpm) e RMSSD (rs=-0,76). Conclusões: nossos dados sugerem que houve uma alteração no balanço vago-simpático com predominância vagal na posição supina quando comparada com a sentada. Mostram ainda, uma associação entre o incremento de potências durante o exercício físico com o aumento do recrutamento de fibras musculares com concomitante aumento da freqüência cardíaca e diminuição da VFC. Essa associação é atribuída tanto ao comando de controle central como dos mecanismos reflexos periféricos, ativados a partir das aferências das fibras musculares do grupo III (ergoceptores) e do grupo IV (metaboloreceptores). Sugerindo o trânsito de informações advindos do córtex motor ativando as fibras musculares e paralelamente à área cardiovascular, modulando o sistema nervoso autonômico do coração / Heart rate variability (HRV) has been used as a physiological marker of heart autonomic control, while surface electromyography (SEMG) has shown to be a useful analysis tool for evaluating muscular response to physical exercise. Therefore, the purpose of the present research was to evaluate heart autonomic control beginning from heart rate (HR) answers and its variability (HRV) in rest conditions, in supine and seating positions, and during test of dynamic physical exercise continuous of ramp type (TDPEC-R). We also intended to evaluate electromyographic activity during TDPEC-R and analyze correlation between HRV and SEMG during test of dynamic physical exercise continuous of ramp type (TDPEC-R). Methodology: Ten men; young (23,7 ± 3,02 years), healthy and with an active life style; were followed up during TDPEC-R in rest, supine and seating positions, with 20 W increments per minute. The HR and R-R intervals (R-RI) data were recorded on a beat-to-beat basis in real time during rest and exercise. Integrated SEMG was collected from vastus lateralis muscle captured during the last 20 seconds of each minute during TDPEC-R. Analysis of the data: HR average values were calculated [in beats per minute (bpm)] and R-RI, in rest condition for 15 minutes. RMSSD temporal index of R-RI and HR were calculated in both conditions. During TDPEC-R, the average HR and RMSSD of R-RI was achieved in the last 20 s of each minute of exercise in parallel with SEMG analysis by RMS index of signal width in microvolts. Statistics Methodology: Wilcoxon nonparametric tests were used for paired samples, Friedman’s for repeated measures followed by multiple comparisons techniques with Dunn test and correlation analysis of Spearman. a=0.05 was the considered level of significance. Results: the data presented statistic significance (p<0,05) in the following analyses: 1) lower HR (bpm) and R-RI (ms) average values in supine than in seating position; 2) higher HRV values in supine in comparison to seating position; 3) average HR (bpm) and xiii RMSSD of R-RI (ms) values, during TDPEC-R, between potency of 4 W and intervals starting from 55 and 60 W; 4) increase of RMS index of SEMG between 4 W and starting from interval of 57 and 60 W; 5) correlation between RMS and RMSSD (rs=-0.64), between HR and RMS (rs=0.61) and between HR (bpm) and RMSSD (rs=-0.76). Conclusions: our data suggest that there was an alteration in vagal- sympathetic balance with vagal predominance in supine position in comparison to seating position. The data also demonstrate association between power increment during physical exercise with increase of muscular fibers recruitment with simultaneous HR increase and HRV decrease. This association is attributed to central control command as well as to outlying reflexes mechanisms, activated from afferent muscular fibers of groups III (ergoreceptors) and IV (metaboreceptors). Which suggests information traffic from the motor cortex, activating muscular fibers, and parallel to cardiovascular area, modulating the autonomous nervous system of the heart

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-17T20:28:42Z No. of bitstreams: 1 Fabio Spacassassi.pdf: 735389 bytes, checksum: 05a5852fd59601a5f2553e9da68da954 (MD5) / Made available in DSpace on 2016-05-17T20:28:42Z (GMT). No. of bitstreams: 1 Fabio Spacassassi.pdf: 735389 bytes, checksum: 05a5852fd59601a5f2553e9da68da954 (MD5) Previous issue date: 2015-06-30 / A day-to-day activity as a professional firefighter leads you to a physical and psychological risk constantly. These stressful situations may cause to this professional a physiological disorder that chronically can lead to the onset of other cardiovascular diseases. Our proposal was the identification of the type of stress and its symptoms, and the hemodynamic and metabolic alterations that can effect from daily routine experiences throughout its operational career. The study compared a group of firefighters GB (n = 52), working in the operational business for over 5 years, with a control group, CO (n = 52), representing the general population. These two groups were composed by healthy volunteers who concluded a clinical evaluation before applying the tests. Data were matched by age, sex and race and calculated by weight, height, body mass index and anthropometric measurements of neck circumference, waist circumference, hip circumference and waist-hip ratio. The autonomic evaluation was performed by the frequency meter Polar device (model RS800) through the heart rate variability evaluated in time (SDNN, RMSSD and variance) and frequency (HF, LF and HF / LF) domain. The stress rate was performed by psychosocial adjustment scale Holmes-Rahe via a score that classifies the probability of potential professional illness. The hemodynamic evaluation was performed by non-invasive indirect technique with Hypertension Diagnosis Incorporation (H.D.I), with the variables systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), pulse pressure, cardiac output (CO), impedance, systemic vascular resistance (SVR) and elasticity index of large and small arteries. Commercial kits were used for biochemical data (total cholesterol, triglycerides, HDL-C, LDL-C, creatinine, uric acid, urea and glucose). It was verified that the autonomic assessment indexes SDNN (39.5 ± 3.0 ms), VARR (1734.4 ± 238.9 ms2) and RMSSD (23.5 ± 2.4 ms) were significantly lower (p<0.05) in GB than CO: SDNN (59.9 ± 5.6 ms), VARR (4108.3 ± 752.4 ms2), RMSSD (45.1 ± 7.8 ms), and higher for GB LF/HF (3.6 ± 0.4) than CO (2.3 ± 0.2). For the stress perception there was no difference between groups. The Hemodynamic data was significantly higher (p<0.05) for the GB with SBP (131.1 ± 1.8 seg/cm5), FC (81.2 ± 1.6 bpm), SVR (1234 ± 23.8 seg/cm5), impedance (125.0 ± 5.9 seg/cm5) and DC (5.7 ± 0.09 L/min ) in relation to CO which showed systolic blood pressure (125 ± 16.8 mmhg), FC (71.1 ± 1.4 bpm), SVR (1141 ± 32.5 seg/cm5), impedance (104.5 ± 3.9 seg/cm5), DC (5.0 ± 0.1 L/min) and biochemistry profile with significantly higher (p<0.05) values for the GB in CT (203 ± 4.9 mg/dL), HDL (47.6 ± 1.4 mg/dL), creatinine (1.1 ± 0.09 mg/dL) and glucose (99.0 ± 2.4 mg/dL) than CO with CT (163.5 ± 4.5 mg/dL), HDL (39.8 ± 1.5 mg/dL), creatinine (1,0 ± 0,02 mg/dL) and glucose (89,8 ± 1,1 mg/dL). Through the results it was concluded that the autonomic balance was worst in the firefighter than in control group. The results of anthropometric, hemodynamic and metabolic profile also were worst in the firefighters. It suggests a possible susceptibility for cardiovascular disease development in firefighters. / O bombeiro tem em sua rotina diária situações que o coloca em risco físico e psicológico constantemente. Essas situações são agentes estressores que fazem com que este profissional seja suscetível a alterações de ordem fisiológicas, que de forma crônica podem levar ao aparecimento de doenças como as de origem cardiovascular. A nossa proposta foi identificar se o estresse pode resultar em alterações autonômicas, hemodinâmicas e metabólicas em bombeiros. Foi feita a comparação de um grupo de bombeiros denominado GB (n=52), que trabalha na atividade operacional há mais de 5 anos, com um grupo controle, denominado CO (n=52), representando a população em geral. Os dois grupos foram voluntários sadios que passaram por uma avaliação clínica antes da aplicação de todos os testes. Os dados foram pareados pela idade, sexo e raça e realizado medida de peso, altura, índice de massa corpórea, circunferência cervical, circunferência abdominal, circunferência do quadril e relação cintura-quadril. A avaliação autonômica foi feita pelo aparelho frequencímetro Polar (modelo RS800), por meio da avaliação da variabilidade da frequência cardíaca no domínio do tempo (SDNN, RMSSD e Variância) e da frequência (HF, LF e relação HF/LF). A percepção do estresse foi realizada pela escala de reajustamento psicossocial Holmes-Rahe por um escore que classifica a probabilidade de adoecimento do profissional. A avaliação hemodinâmica foi realizada pela técnica indireta não invasiva com o Hypertension Diagnosis Incorporation (H.D.I), pelas variáveis pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), pressão arterial média (PAM), frequência cardíaca (FC), pressão de pulso, débito cardíaco (DC), impedância, resistência vascular sistêmica (RVS) e índice de elasticidade de pequenas e grandes artérias. Os dados bioquímicos para o perfil metabólico (colesterol total, triglicérides, HDL-colesterol, LDL-coleserol, creatinina, ácido úrico, ureia e glicose) foram feitos por Kits comerciais. Os índices de SDNN (39,5 ± 3,0 ms), VARR (1734,4 ± 238,9 ms2) e RMSSD (23,5 ± 2,4 ms) na avaliação autonômica foram significativamente menores (p<0,05) no GB do que o CO: SDNN (59,9 ± 5,5 ms), VARR (4108,3 ± 752,4 ms2) e RMSSD (45,1 ± 7,8 ms). O componente LF/HF foi maior no GB (3,6 ± 0,4) do que no CO (2,3 ± 0,2). Em relação a percepção do estresse não houve diferença entre os grupos. Os dados hemodinâmicos: PAS (131,1 ± 1,8 mmHg), FC (81,2 ± 1,6 bpm), RVS (1.234 ± 23,8 seg/cm5), impedância (125.0 ± 5,9 seg/cm5) e DC (5,7 ± 0,1 L/min) foram significativamente maiores (p<0,05) para o GB em relação ao CO: PAS (125 ± 16,8 mmHg), FC (71,1 ± 1,4 bpm), RVS (1.141 ± 32,5 seg/cm5), impedância (104,5 ± 3,9 seg/cm5) e DC (5,1 ± 0,1 L/min). Em relação aos dados bioquímicos, os valores de colesterol total (203 ± 4,9 mg/dL), HDL (47,6 ± 1,4 mg/dL), creatinina (1,1 ± 0,09 mg/dL) e glicose (99,1 ± 2,4 mg/dL) foram significativamente maiores (p<0,05) no GB em relação ao CO: colesterol total (163,5 ± 4,5 mg/dL), HDL (39,8 ± 1,5 mg/dL), creatinina (1,0 ± 0,02 mg/dL) e glicose (89,8 ± 1,1 mg/dL). Os dados obtidos mostram um pior balanço autonômico, sobretudo no domínio do tempo, no GB. Os dados antropométricos, hemodinâmicos e o perfil metabólico também são piores no GB do que o CO. Os resultados obtidos nesse estudo apontam para uma possibilidade de maior risco cardiovascular nos bombeiros quando comparados com o grupo controle.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-06-18T22:11:03Z No. of bitstreams: 1 Catarina Novaes Sousa Bertani.pdf: 1758532 bytes, checksum: 4dbd93d93406ca1aca9ec61fd117be81 (MD5) / Made available in DSpace on 2018-06-18T22:11:03Z (GMT). No. of bitstreams: 1 Catarina Novaes Sousa Bertani.pdf: 1758532 bytes, checksum: 4dbd93d93406ca1aca9ec61fd117be81 (MD5) Previous issue date: 2015-12-15 / Transcranial stimulation Direct Current (ETCC) in healthy subjects can modulate the autonomic nervous system (ANS), but were not found similar studies in stroke and is characteristic of this population present cardiorespiratory changes increasing the risk to new cerebrovascular events. Objective: To evaluate the immediate effect of tDCS over the left temporal cortex the (T3) and right (T4), the cardiorespiratory parameters (functional capacity and modulation ANS) in individuals who have had strokes. Methodology: clinical trial, randomized, double blind in 20 hemiparetic. Rated Heart Rate (HR), blood pressure (BP), oxygen saturation, Borg dyspnea (D) and lower limbs, distance and heart rate variability (HRV), before and after active tDCS and sham on T3, tDCS active and sham on T4. Electrode Cathode: supra-orbital contralateral to the anode, 2mA for 20 min. Sham stimulation (30 sec). Results: tDCS on T3 in patients with left injuries decreased: HR (p≤0.05), BP (p≤0.05), Borg D (p≤0.05) and increased distance traveled (p≤0.05) and on T4 decreased: HR (p≤0.05) and BP (p≤0.05). Individuals with right lesion, tDCS on T3 decreased: HR (p≤0.05), BP (p≤0.05) and increased distance (p≤0.05) in T4 BP (p≤0.05). The recovery of the 6MWT after tDCS over T3 in patients with left lesion decreased sympathovagal balance (p≤0.05) and on T4 (p≤0.05). Individuals with right post stimuli injury on T3 and T4 decreased balance (p≤0.05). Sample power was of great magnitude in individuals with injury right after tDCS over T3 (d = 1.60) compared to T4 (d = 1.41). There was no significance of HRV after active tDCS and sham on T3 and T4 at baseline. Conclusion: tDCS on T3 and T4 in the recovery of the 6MWT proved to be effective in the ANS modulation and cardiorespiratory parameters, regardless of the side of the lesion and tDCS on T3 and T4 showed no effect on basal HRV, regardless of the side of the lesion. / Estimulação Transcraniana por Corrente Contínua (ETCC) em indivíduos saudáveis pode modular o sistema nervoso autonômico (SNA), porém não foram encontrados estudos semelhantes em Acidente Vascular Encefálico (AVE), sendo característico desta população apresentarem alterações cardiorrespiratórias aumentando o risco à novos eventos cerebrovasculares. Objetivo: Avaliar o efeito imediato da ETCC sobre os córtex temporais esquerdo (T3) e direito (T4), nos parâmetros cardiorrespiratórios (capacidade funcional e modulação do SNA), em indivíduos que tiveram AVE. Metodologia: Ensaio clínico, randomizado, duplo cego em 20 hemiparéticos. Avaliadas Frequência Cardíaca (FC), Pressão Arterial (PA), saturação de oxigênio, Borg de dispneia (D) e de membros inferiores, distância percorrida e variabilidade da frequência cardíaca (VFC), antes e após ETCC ativo e placebo sobre T3, ETCC ativo e placebo sobre T4. Eletrodo catodo: supra-orbital contralateral ao anodo, 2mA, durante 20 min. Estimulação placebo (30 seg). Resultados: ETCC sobre T3 em indivíduos com lesão esquerda diminuíram: FC (p≤0,05), PA (p≤0,05), Borg D (p≤0,05) e aumentou distância percorrida (p≤0,05) e sobre T4 diminuíram: FC (p≤0,05) e PA (p≤0,05). Indivíduos com lesão direita, ETCC sobre T3 diminuíram: FC (p≤0,05), PA (p≤0,05) e aumentaram distância percorrida (p≤0,05) em T4 PA (p≤0,05). A recuperação do TC6 após ETCC sobre T3 em indivíduos com lesão esquerda diminuiu balanço simpatovagal (p≤0,05) e sobre T4 (p≤0,05). Indivíduos com lesão direita pós estímulos sobre T3 e T4 diminuíram o balanço (p≤0,05). Poder amostral foi de grande magnitude em indivíduos com lesão à direita após ETCC sobre T3 (d= 1,60) comparado ao T4 (d= 1,41). Não houve significância sobre HRV após ETCC ativo e placebo sobre T3 e T4 na condição basal. Conclusão: ETCC sobre T3 e T4 na recuperação do TC6, demonstrou ser eficaz na modulação do SNA e nos parâmetros cardiorrespiratórios, independente do lado da lesão e ETCC sobre T3 e T4 não demonstrou efeitos na VFC basal, independente do lado da lesão.

<p>Cilj ove teze bio je utvrđivanje polnih razlika<br />u mehanizmima vegetativne regulacije srčane<br />frekvencije, kao i utvrđivanje razlika u regulaciji srčane frekvencije kod žena po<br />fazama menstrualnog ciklusa. Kori&scaron;ćeni su<br />parametri varijabilnosti srčanog ritma (heart<br />rate variability) - HRV i oporavka srčane<br />frekvencije (heart rate recovery) - HRR.</p><p>Ispitivanje je obuhvatilo 90 ispitanika; 45<br />osoba mu&scaron;kog pola (20.4&plusmn;0.7 god., 184&plusmn;5.00<br />cm, 79.38&plusmn;9.42 kg, BMI 23.53&plusmn;2.83) i 45<br />osoba ženskog pola (20.5&plusmn;0.6 god., 168&plusmn;5.25<br />cm, 60.96&plusmn;6.93 kg, BMI 21.57&plusmn;2.23) -<br />studenata Univerziteta u Novom Sadu. Za<br />prikupljanje podataka kori&scaron;ćen je pulsmetar<br />(Polar, Finska). Ispitivanje je sprovedeno u<br />mirovanju, kao i u periodu oporavka posle<br />kratkotrajnog fizičkog opterećenja poznatog<br />intenziteta. U prvom modulu snimanje je<br />obavljano u miru, u sedećem poloţaju na<br />samom ergo-biciklu, stopala na platformi<br />ispred pedala, noge u fleksiji od 90&deg; u<br />kolenom zglobu, ruke na natkolenicama. U<br />drugom modulu snimanje je obavljeno u<br />priodu petominutnog oporavka posle<br />maksimalnog opteraćenja u trajanju od 30<br />sekundi (supramaksimalno opterećenje) -<br />Wingate protokol. U grupi mu&scaron;karaca<br />sprovedeno je jednokratno merenje, dok su za<br />grupu ţena isti moduli snimanja primenjeni u ri navrata: 1. U fazi menstrualnog krvarenja,<br />rana folikularna faza - najniži nivoi estrogena<br />i progesterona. 2. Kasna folikularna faza -<br />visok estrogen. 3. Srednja lutealna faza -<br />visok nivo progesterona i estrogena.<br />U miru kao i u poslednjem trominutnom<br />intervalu petominutnog oporavka određeni su<br />sledeći parametri varijabilnosti srčanog ritma:<br />srednja vrednost NN intervala - RRNN,<br />standardna devijacija NN intervala - SDNN,<br />kvadratni koren iz srednje vrednosti kvadrata<br />sukcesivnih razlika susednih NN intervala<br />(root mean square of successive differences) -<br />RMSSD, broj sucesivnih NN intervala koji<br />se razlikuju za vi&scaron;e od 50ms - NN50 i<br />procentualni udeo NN50 u ukupnom broju<br />NN intervala - pNN50. Od parametara<br />frekvencijskog domena, nakon brze Furijeove<br />transformacije analizirani su sledeći<br />parametri: snaga spektra niske frekvencije<br />(LF; 0,04-0,15Hz) i snaga spektra visoke<br />frekvencije (HF; 0,15-0,40Hz).<br />Oporavak srčane frekvencije u toku<br />petominutnog oporavka nakon<br />supramaksimalnog opterećenja na bicikl<br />ergometru procenjivan je pomoću sledećih parametara: 1. Apsolutna razlika između<br />vrednosti srčane frekvencije odmah po<br />zavr&scaron;etku opterećenja i frekvencije<br />registrovane nakon 60 sekundi oporavka -<br />HRR60. 2. Vremenska konstanta<br />kratkoročnog oporavka srčane frekvencije u<br />prvih 30 sekundi - T30. 3. Vremenska<br />konstanta opadanja srčane frekvencije u toku<br />petominutnog oporavka - T.<br />Utvrđeno je da mu&scaron;karci imaju veći pik snage<br />kao i prosečnu snagu pri supramaksimalnom<br />opterećenju u odnosu na grupu ţena bez<br />obzira na fazu menstrualnog ciklusa; dok su<br />bazalna i maksimalna srčana frekvencija bile<br />iste u obe grupe.<br />Postoje polne razlike u mehanizmima<br />vegetativne regulacije srčane frekvencije u<br />mirovanju. Najbolje su vidljive kroz<br />parametre frekvencijkog domena HRV-a (LF<br />i HF), odnosno prirodne logaritme ovih<br />vrednosti (lnLF i lnHF). Statistički značajne<br />razlike u vrednostima parametara<br />frekvencijskog domena HRV-a između grupe<br />mu&scaron;karaca i grupe ţena u sve tri faze<br />menstrualnog ciklusa potvrđene su i u fazi<br />oporavka posle supramaksimalnog opterećenja.<br />Postoje polne razlike u parasimpatičkoj<br />reaktivaciji posle supramaksimalnog<br />opterećenja koja je značajno brţa kod<br />mu&scaron;karaca. One se najbolje mogu proceniti<br />kroz matematičke modele oporavka srčane<br />frekvencije i vremensku konstantu opadanja<br />srčane frekvencije u prvih 30 sekundi<br />oporavka - T30.<br />Nisu utvrđene razlike u mehanizmima<br />vegetativne regulacije srčane frekvencije u<br />miru u grupi ţena po fazama menstrualnog<br />ciklusa; procenjeno kroz parametre<br />vremenskog i frekvencijskog domena HRVa.<br />Parametri vremenskog i frekvencijskog<br />domena HRV-a registrovani u mirovanju kao<br />i u fazi odmora posle supramaksimalnog<br />opterećenja nisu dovoljno osetljivi za<br />utvrđivanje razlika u vegetativnoj regulaciji<br />srčane frekvencije kod žena po fazama<br />menstrualnog ciklusa.<br />Nijedan od registrovanih parametara<br />oporavka srčane frekvencije (HRmax,<br />HRoporavak, HRR60, T i T30) nije se pokazao<br />dovoljno osetljivim za utvrđivanje promena u<br />parasimpetičkoj reaktivaciji kroz faze<br />menstrualnog ciklusa.</p> / <p>The aim of this study was to determine<br />gender differences in autonomic heart rate<br />control mechanisms, as well as to determine<br />heart rate control differences in women<br />during menstrual cycle. Heart rate variability<br />- HRV and heart rate recovery - HRR parameters were used.<br />The study included 90 participants; 45 males<br />(20.4&plusmn;0.7 yrs., 184&plusmn;5.00 cm, 79.38&plusmn;9.42 kg,<br />BMI 23.53&plusmn;2.83) and 45 females (20.5&plusmn;0.6<br />yrs., 168&plusmn;5.25 cm, 60.96&plusmn;6.93 kg, BMI<br />21.57&plusmn;2.23) - students of the University of<br />Novi Sad. Heart rate monitor (Polar,<br />Finland) was used for data collection.<br />Measurements were conducted while resting<br />as well as in a short recovery period after a<br />brief physical strain of known intensity. In<br />the first mode, heart rate monitoring was<br />conducted on relaxed subjects, in a sitting<br />position on an ergo-bike, feet on the<br />platform in front of the pedals, legs bent at<br />knees at 90&deg;, hands on thighs. In the second<br />mode heart rate monitoring was conducted in<br />a five-minute resting period after 30 seconds<br />of maximal exercise (supramaximal<br />exercise) - Wingate protocol. There was a<br />single monitoring in the male group, while in<br />the female group each monitoring mode was<br />conducted three times: 1. During the phase<br />of menstrual bleeding, early follicular phase<br />- the lowest levels of estrogen and<br />progesterone 2. Late follicular phase - high<br />estrogen. 3. Mid-luteal phase - high progesterone and estrogen.<br />While resting as well as in the last three<br />minutes of five-minute recovery period after<br />the exercise the following parameters of<br />heart rate variability were determined: the<br />mean value of NN intervals - RRNN, the<br />standard deviation of NN intervals - SDNN,<br />the square root of the mean of the squares of<br />the successive differences between adjacent<br />NN intervals (root mean square of<br />successive differences) - RMSSD, the<br />number of pairs of successive NN intervals<br />that differ by more than 50 ms - NN50 and<br />the proportion of NN50 divided by total<br />number of NN intervals pNN50. After the<br />fast Fourier transformation, following<br />frequency domain parameters were<br />analyzed: power spectrum of low frequency<br />(LF; 0,04-0,15Hz) and power spectrum of<br />high frequency (HF; 0,15-0,40Hz).<br />Heart rate recovery during the five-minute<br />resting period after the supramaximal<br />exercise on the ergo-bike was evaluated<br />through following parameters: 1. Absolute<br />difference between the heart rate<br />immediately after the exercise and the heart rate registered after 60 seconds of recovery -<br />HRR60. 2. Time constant of short-time heart<br />rate recovery in the first 30 seconds - T30. 3.<br />Time constant of heart rate decay<br />during the five-minute recovery period - T.<br />It was found that men had greater peak and<br />average power during supramaximal<br />exercise compared to a group of women<br />regardless of the phase of menstrual cycle;<br />while basal and maximal heart rate were the<br />same in both groups.<br />There are gender differences in autonomic<br />heart rate control mechanisms while resting.<br />These are best visible through frequency<br />domain HRV parameters (LF and HF), and<br />their natural logarithms (lnLF and lnHF).<br />Statistically significant differences in the<br />frequency domain HRV parameters between<br />the group of men and the group of women in<br />all three phases of the menstrual cycle, were<br />also found in recovery period after<br />supramaximal exercise.<br />There are gender differences in<br />parasympathetic reactivation after<br />supramaximal exercise which is significantly faster in men. These differences are best<br />assessed through mathematical models of<br />heart rate recovery and the time constant of<br />short-time heart rate recovery in the first 30<br />seconds - T30 .<br />No differences in autonomic heart rate<br />control mechanisms while resting in the<br />female group during three phases of<br />menstrual cycle were found; assessed<br />through the time and frequency domain<br />HRV parameters. The time and frequency<br />domain HRV parameters registered while<br />resting and during recovery period after<br />supramaximal еxеrcise were not sensitive<br />enough to determine differences in<br />autonomic heart rate control in women<br />through three phases of menstrual cycle.<br />None of the registered heart rate recovery<br />parameters (HRmax, HRR60, HRoporavak, T i<br />T30) were sensitive enough to determine<br />changes in parasympathetic reactivation<br />through a menstrual cycle.</p>

No description available.

Heart rate variability analysis can be used for a diagnosis of the cardiac diseases. The HRV analysis methods are divided into linear and nonlinear methods. Time-domain method is one of the simplest method and belongs to linear methods. Detrended fluctuation analysis DFA is nonlinear method made relatively recently. In this paper, it has been done the comparison of these two methods based on the changes detection in HRV caused by an ischemia.