O tempo para 1,0mm de depressão do segmento ST (T-1,0mm) adotado para caracterizar o fenômeno do aquecimento, uma expressão do precondicionamento isquêmico (PCI), em testes ergométricos sequenciais é consistente e reprodutível, porém, possui várias limitações. O objetivo deste estudo foi aplicar um escore eletrocardiográfico de isquemia miocárdica em testes ergométricos sequenciais comparando com o clássico índice T-1,0mm. Avaliamos 61 pacientes, com idade média de 62,2+7,5 anos, 86,9% homens, portadores de diabetes mellitus tipo 2 e coronariopatia multiarterial. Foram analisados 151 exames, destes 116 de pacientes completaram as duas fases de avaliação. A primeira fase compreendia dois testes ergométricos sequenciais para documentação do PCI e a segunda fase, após 1 semana, mais dois testes sob efeito de repaglinida oral. Dois observadores aplicaram o escore de forma cega. Observou-se concordância perfeita inter e intraobservador (Kendall Tau-b = 0,96, p<0,0001, Kendall Tau-b=0,98, p<0,0001, respectivamente). Os valores de sensibilidade, especificidade, valor preditivo negativo, valor preditivo positivo e acurácia, foram respectivamente de 72,41%, 89,29%, 75,8%, 87,5% e 81%. Concluímos que o escore de isquemia é um método consistente e reprodutível para documentação do fenômeno do aquecimento, representando uma alternativa factível ao índice T-1,0mm. / The time to 1.0mm ST-segment depression (T-1.0mm), adopted to document the warm-up phenomenon, an expression of the ischemic preconditioning (IPC), during sequential exercise tests is considered reliable and reproductible, although with several limitations. The main goal of this study was to apply an electrocardiographic ischemic myocardium score to sequential exercise tests, comparing with the standard T-1.0mm. We evaluated 61 patients, mean age 62,2+7,5 years-old, 86.9% male, with type 2 diabetes mellitus and multivessel coronary disease. We analyzed 151 exercise tests, being 116 tests from patients who fulfilled the two phases of the study. The first phase enrolled the patients for two sequential exercise tests to document the IPC and the second phase, after 1 week, two additional sequential exercise tests were performed under repaglinide treatment. We observed a perfect concordance inter and intraobserver (Kendall Tau-b=0.96, p<0.0001; Kendall Tau-b=0,98, p<0,0001, respectively). The sensibility, specificity, positive predictive value and negative predictive value were also determined: 72.41%, 89.29%, 75.8%, 87.5% and 81%, respectively. In conclusion, the electrocardiographic ischemic score is a consistent and reproductible tool to document the warm-up phenomenon, representing a reliable alternative to the T-1.0mm.

Introdução: Indivíduos obesos e pacientes asmáticos eutróficos apresentam, frequentemente, hiperinsuflação dinâmica (HD) e redução da capacidade de exercício. No entanto, não há estudos que tenham investigado a causa da redução da tolerância ao exercício em asmáticos obesos. Objetivo: Verificar os fatores limitantes do exercício físico em asmáticos obesos. Métodos: Esse estudo transversal incluiu mulheres asmáticas com obesidade grau II (G-Ob; IMC 35,0 - 39,9 kg/m2) e não obesas (G-NOb; IMC 18,5 - 29,9 kg/m2). Os pacientes realizaram um teste cardiopulmonar máximo para verificar a potência aeróbia (VO2 pico) e um teste submáximo para avaliar a HD. Medidas antropométricas, força e endurance muscular do quadríceps e função pulmonar também foram avaliadas. O teste qui-quadrado foi utilizado para comparar os dados categóricos e os teste-t e Mann-Whitney para comparar os dados numéricos. Uma regressão forward stepwise foi utilizada para avaliar a associação entre a tolerância ao exercício físico e os fatores limitantes do exercício. Resultados: Cinquenta e quatro pacientes completaram o estudo (G-Ob, n=36; G-NOb, n=18). A tolerância ao exercício apresentou correlação linear com endurance de quadríceps (r=0,65; p < 0, 001), pulso de oxigênio (r=0,52; p < 0,05) e HD (r=-0,46; p < 0,05). Embora o G-Ob (72,2%) tenha apresentado maior frequência de HD quando comparado ao G-NOb (38,9%; p < 0,05) e maior redução na capacidade inspiratória (respectivamente, -18,0% vs. -4,6%; p < 0,05), a regressão forward stepwise mostrou que o endurance muscular de quadríceps foi o único preditor da tolerância ao exercício nos pacientes do G-Ob (r=0,82; r2=0,67; p < 0,001). Conclusão: Apesar da hiperinsuflação dinâmica ser frequente nos asmáticos obesos, a limitação periférica foi o principal fator associado com a redução da tolerância ao exercício físico em asmáticos obesos. Uma possível implicação clínica destes achados é a necessidade de treinamento muscular de membros inferiores nos programas de reabilitação pulmonar em asmáticos obesos / Background: Obese individuals and patients with asthma can present dynamic hyperinflation (DH) and reduction of capacity exercise. However, no previous study has investigated the cause of intolerance exercise in obese asthmatics. Aim: To verify the limiting factors during exercise in obese asthmatics. Methods: This cross sectional study included asthmatic women with either obesity grade II (Ob-G; BMI 35.0 -39.9kg/m2; n=36) and non-obese (NOb-G; BMI 18.5 - 29.9kg/m2). Patients performed a cardiopulmonary test to quantify peak VO2 and a submaximal exercise test to assess DH. Anthropometric measurement, quadriceps muscle endurance and lung function were also evaluated. Chi-square test was used to compare categorical and t-test and Mann-Whitney test for numerical outcomes. A forward stepwise regression was used to evaluate the association between exercise tolerance and limiting exercise factors. Results: Fifty four patients completed the protocol (Ob-G; n=36; NOb-G; n=18). The exercise tolerance was associated with quadriceps endurance (r=0.65; p < 0.001), oxygen pulse (r=0.52; p < 0.05) and DH (r=-0.46; p < 0.05). Although Ob-G (72.2%) had showed a higher frequency of DH than NOb-G (38.9%; p < 0.05) and a greater reduction in the inspiratory capacity (-18.0% vs. -4.6%, respectively; p < 0.05), the forward stepwise regression showed that the exercise tolerance could be predicted from a linear association only for muscular endurance (r=0.82; r2=0.67; p < 0.001). Conclusion: In spite of DH to be a common condition in obese asthmatics, the peripheral limitation was the main factor associated with exercise intolerance in these patients. A possible clinical implication of these findings is the need for lower limb training in obese asthmatics

Parece ser consenso na literatura que as crianças asmáticas apresentam capacidade física reduzida, mas existem poucos estudos comparando a capacidade aeróbia de crianças asmáticas com não asmáticas. Além disto, estudos com pacientes pneumopatas crônicos têm demonstrado que eles apresentam fraqueza da musculatura periférica que parece contribuir para a redução na capacidade de exercício. Até o presente momento desconhecemos estudos que tenham avaliado força muscular periférica em crianças asmáticas. Em vista disto, o objetivo deste estudo foi avaliar a força e a resistência muscular periférica assim como a capacidade aeróbia em crianças com asma persistente leve e grave. Foram avaliadas 60 crianças com idade entre 8 e 15 anos, divididas em 3 grupos: asma persistente leve (APL), asma persistente grave (APG) e não asmáticas (controle) (n=20 cada). Estudo transversal e controlado que avaliou a força (teste de 1RM) e a resistência muscular periférica (teste com 50% de 1RM), a capacidade aeróbia máxima (VO2pico), a função pulmonar e fatores de saúde relacionados à qualidade de vida. A força e a resistência muscular foram avaliadas utilizando os exercícios de leg-press (perna), chest-press (peitorais) e remada (dorsais). Nossos resultados mostraram que os 3 grupos eram similares com relação à idade e IMC (p>0,05). As crianças com asma persistente leve e grave apresentaram menor função pulmonar quando comparadas com grupo controle (p<0,01). O grupo com asma persistente grave apresentou menor capacidade aeróbia (VO2pico) e resistência muscular de membros inferiores somente quando comparado ao grupo Controle (p<0,05). A força nos 3 grupos musculares avaliados (perna, peitoral e dorsal) foi similar. A resistência muscular da perna estava reduzida no grupo APG (p<0,05), porém não foram encontradas diferenças nos músculos peitorais e dorsais. Foi avaliada a associação da perda na resistência muscular de membros inferiores com a capacidade aeróbia e com o consumo de corticóides inalatórios e não foi verificada qualquer relação (p>0,05). Nossos resultados sugerem que crianças com asma persistente grave apresentam redução da resistência muscular de pernas e da capacidade aeróbica e que isto deve ser considerado na elaboração de um programa de condicionamento físico para estes pacientes / It has been assumed in the literature that asthmatic children have lower exercise capacity, however there are few studies comparing aerobic capacity of asthmatic children with non-asthmatic. Beside that, studies in patients with chronic pulmonary disease have showing that they present a peripheral muscle weakness and it seems to contribute to patients exercise intolerance. Until the present moment we are not aware of any study evaluating peripheral muscle strength in asthmatic children. The present study aimed to evaluate strength and endurance of peripheral muscle, as well as aerobic capacity, of children with mild and severe persistent asthma. Forty children with mild or severe persistent asthma (n=20 each) and 20 non-asthmatic (Control group) were evaluated. The present transversal controlled study evaluated muscle peripheral strength (1RM) and endurance (50%1RM), aerobic capacity (VO2peak), pulmonary function and factors related to quality of life. The muscular strength and endurance was evaluated through the exercises of leg-press (lower muscle), chest-press and row (upper muscle). Our results show that age and IMC were similar in 3 groups (p>0.05). Patients with persistent asthma (mild and severe) had lower pulmonary function than Control group (p<0.01). The severe persistent asthma group presented lower peakVO2 and leg muscle endurance only when compared with Control group (p<0.05). Upper and lower muscle strength was preserved in children either with mild or severe asthma. Muscle endurance was reduced in leg in group APG (p<0.05), but not in pectoral and dorsal muscles. At last, we observed that the lower muscle endurance weakness was not associated with either reduction in peakVO2 or corticosteroid consumption in asthmatics patients. Our results suggest that severe persistent asthmatic children have reduced leg muscle endurance and lower aerobic capacity and we understand that it must be considered in the elaboration of a program of physical conditioning for these patients

Orientador: José Dirceu Ribeiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T22:54:32Z (GMT). No. of bitstreams: 1 Pereira_FabiolaMeister_M.pdf: 3469643 bytes, checksum: b167d6d4404c4180d9e65e29ed5300dd (MD5) Previous issue date: 2011 / Resumo: OBJETIVO: avaliar pacientes com fibrose cística (FC) submetidos ao teste de caminhada de seis minutos (TC6) e compará-los a um grupo controle (GC). MÉTODO: estudo transversal e prospectivo, com indivíduos saudáveis e com FC de um centro universitário de referência. O TC6 foi aplicado de acordo com as normas da ATS e repetido após 30 minutos de repouso. Frequência respiratória (FR), frequência cardíaca (FCr), saturação periférica de oxigênio (SpO2), escala de Borg, status nutricional e valores espirométricos foram analisados. Excluíram-se pacientes em exacerbação pulmonar. O Software SAS System for Windows®, a correlação de Spearman e ANOVA para medidas repetidas foram utilizados, com p<0,05. RESULTADOS: cinquenta e cinco pacientes com FC e 185 indivíduos saudáveis participaram, com idades de 12,2±4,3 e 11,3±4,3 anos, respectivamente. O GC caminhou uma distância maior que o grupo FC em ambos os testes (610,3±53,4m vs. 547,2±80,6m e 616,2±58,0m vs. 552,2±82,1m; p<0,0001). A distância percorrida (DP) se correlacionou com idade, peso e altura. Ambos os grupos caminharam distâncias semelhantes no segundo teste, embora o grupo FC apresentou melhor desempenho no primeiro teste. A SpO2 manteve-se estável durante o teste, com aumento da FCr e da FR. CONCLUSÃO: o TC6 foi capaz de identificar comprometimento funcional em pacientes com FC sem necessidade de repetição imediata do mesmo. Estudos em longo prazo poderão confirmar a utilidade do TC6 como um método barato, eficaz e promissor para acompanhamento da capacidade cardiopulmonar e física de pacientes com FC / Abstract: OBJECTIVE: to evaluate patients with Cystic Fibrosis (CF) submitted to the six minute walk test (6MWT) and compare them to a healthy control group (CG). METHOD: transversal, prospective study comprising patients from a CF university reference centre and in healthy controls. 6MWT was applied accordingly to ATS guidelines and repeated after 30 minutes of rest. Respiratory frequency (RF), heart rate (HR), oxygen saturation (SpO2), Borg scale, nutritional status and spirometry values were analyzed. Patients on pulmonary exacerbation were excluded from the research. The SAS System for Windows® Software, Spearman's correlation and ANOVA for repeated measures were used, with p<0.05. RESULTS: fifty-five CF patients and 185 healthy individuals participated (12.2±4.3 and 11.3±4.3 years, respectively). CG walked a greater distance than the CF patients in both tests (610.3±53.4m x 547.2±80.6m and 616.2±58.0m x 552.2±82.1m; p<0.0001). Walked distance correlated with age, weight and height. Both groups achieved similar distances in the second test, although CF patients had better performance in the first test. The SpO2 maintained stable during the test, with an increase in HR and RF. CONCLUSION: the 6MWT was able to identify functional impairment in CF patients without the immediate need of test repetition. Long-term studies may confirm the use of 6MWT as an easy, cheap and promising tool to follow-up cardiopulmonary and physical capacity of CF patients / Mestrado / Saude da Criança e do Adolescente / Mestre em Ciências

Orientador: Antonio Fernando Ribeiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T03:42:04Z (GMT). No. of bitstreams: 1 Franco_CarolineBuarque_M.pdf: 1016164 bytes, checksum: d2defa35883e9f73fc3f033e2ca1c3f1 (MD5) Previous issue date: 2011 / Resumo: Objetivo: A proposta de utilizar o método Pilates teve o objetivo de desenvolver um programa de exercícios, avaliando os efeitos no início e final do acompanhamento, coletando os seguintes dados: tolerância ao esforço físico pelo teste do degrau de 3 minutos (TD3); prova de função pulmonar (PFP); avaliação força muscular respiratória (FMR) pela pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx) pela manovacuometria; qualidade de vida (QV) pelos questionários de qualidade de vida em fibrose cística (QFC); escore z de peso (kg), escore z de altura (m2) e escore z de IMC (kg/m2). Coleta dos valores em repouso e no final de cada sessão: saturação periférica de oxigênio (SpO2), frequência cardíaca (Fc), frequência respiratória (Fr), nível da dispnéia pela escala de Borg modificada. Método: estudo prospectivo descritivo analítico, casuística de 19 pacientes. A pesquisa foi realizada com os pacientes do Ambulatório de FC do Hospital de Clínicas (HC) da Universidade de Campinas (UNICAMP) e do Instituto da Criança (ICr) do HC da Faculdade de Medicina Universidade de São Paulo (FMUSP). O método foi aplicado em uma sessão semanal durante 4 meses. Resultados: A PImáx no grupo total apresentou aumento significativo (p<0,05 probabilidade do teste de Wilcoxon), a PEmáx demonstrou aumento significativo somente no grupo feminino (p=0,007). A PFP não apresentou diferenças no grupo total de pacientes (p>0,05). No TD3 pré-tratamento do grupo masculino, houve aumento significativo da frequência cardíaca (Fc) (p=0,043) e da escala de Borg (p=0,023). No pós-tratamento os sinais vitais permaneceram sem mudanças significativas. No TD3 pré-tratamento, o grupo feminino apresentou aumento significativo na Fc, frequência respiratória (Fr) e na escala de Borg (p<0,05). No pós-tratamento o TD3 deste grupo continuou com aumento significativo na Fc, Fr e na escala de Borg. Quanto as medidas de sinais vitais comparando o início e final de cada sessão, na 1ª sessão de Pilates o grupo total de pacientes,não apresentou mudanças na SpO2, Fc, Fr e na escala de Borg (p>0,05). Na 7ª sessão, no gênero masculino ocorreu aumento significativo da Fc e no grupo total de pacientes houve aumento significativo na escala de Borg. Na 16ª sessão apenas o grupo feminino apresentou aumento significativo na escala de Borg. Quanto ao escore z de peso e IMC, os pacientes não apresentaram mudanças, porém houve aumento significativo no escore z de altura apenas do grupo feminino (p=0,012). A avaliação da QV não demonstrou mudanças no QFC de crianças de 6 à 11 anos. No QFC dos pais/cuidadores de crianças de 6 à 13 anos houve aumento significativo no domínio respiratório. O QFC referente aos pacientes de 14 anos ou mais apresentou aumento significativo no domínio físico. Conclusões: O estudo evidenciou que a aplicação do Pilates foi eficaz no ganho da FMR; melhorias na tolerância física do grupo masculino pelo TD3; ganho no escore z de altura no grupo feminino. Quanto a QV do QFC dos pais/cuidadores de crianças de 6 à 13 anos, houve melhorias no domínio da condição respiratória e no QFC referente aos pacientes de 14 anos ou mais apresentou melhorias no domínio da condição física / Abstract: Objective: The proposal to use the Pilates method was to develop an exercise program, evaluating the effects at the beginning and end of follow-up by collecting the following data: the tolerance to exercise step test for 3 minutes (TD3) function test lung (PFP), respiratory muscle strength assessment (FMR) by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) by the manometer, quality of life (QOL) questionnaires for quality of life in cystic fibrosis (QFC), z-score Weight (kg), z score for height (m2) and z score of BMI (kg/m2). Collection of the values at rest and at the end of each session: peripheral oxygen saturation (SpO2), heart rate (HR), respiratory frequency (Fr), level of dyspnea by the Borg scale. Method: a prospective descriptive analytical sample of 19 patients. The survey was conducted with patients from the CF Clinic, Hospital de Clinicas (HC), Universidade de Campinas (UNICAMP) and the Instituto da Criança (Chr), HC, Faculdade de Medicina da Universidade de São Paulo (FMUSP). The method was applied to one session per week for four months. Results: MIP in the total group showed a significant increase (p<0.05 probability of the Wilcoxon test), MEP showed an increase only in the female group (p=0.007). The PFP did not show differences in the total group of patients (p>0.05). In TD3 pretreatment of the male group, there was increased heart rate (HR) (p=0.043) and Borg (p=0.023). In the post-treatment vital signs remained without significant changes. No TD3 pretreatment, the female group showed an increase in HR, respiratory frequency (Fr) and the Borg scale (p<0.05). In the post-treatment group continued TD3 this significant increase in HR, Fr and Borg scale. The measures vital signs comparing the beginning and end of each session, a session of Pilates the total group of patients showed no changes in SpO2, HR, Fr and Borg scale (p>0.05). During the 7th session, a significant increase of Fc in males and in the total group of patients showed a significant increase in Borg scale. In the 16th session only female group showed an increase in Borg scale. As for the z scores for weight and BMI, patients had no change, but there was an increase in height z scores in the female group (p=0.012). The assessment of QOL showed no changes in the QFC of children 6 to 11 years. In QFC parents/caregivers of children 6 to 13 years there was an increase in the field related respiratory and QFC in referring to patients 14 years or more, an increase in the physical realm. Conclusions: The study suggested that the use of Pilates has been effective in: gain of FMR, improvements in physical tolerance in male group, gain in height z scores in the female group. As for the QL QFC parents/caregivers of children 6 to 13 years there has been an improvement in respiratory status and QFC referring to patients 14 years or more improvements in physical condition / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Orientador: Dora Maria Grassi-Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-21T06:42:56Z (GMT). No. of bitstreams: 1 Arouca_AlineBarbedo_M.pdf: 2816326 bytes, checksum: 7245a319bb7b00c52b0d7ae0cc6d6b02 (MD5) Previous issue date: 2012 / Resumo: O ginseng é um dos suplementos herbais mais populares do mundo. Investigações revelaram que o ginseng e seus produtos relacionados reduzem o processo inflamatório, produzem atividade adaptogênica promovendo a melhora na performance em ratos e camundongos. Das diferentes espécies de ginseng, o Siberiano (Eleutherococcus senticosus) é o que apresenta menor índice de efeitos colaterais, não produzindo excitação em pacientes, exercendo efeito protetor mais intenso sobre o sistema imune, e não desenvolvendo síndrome semelhante ao estresse, conforme já observado no Panax ginseng (ginseng Coreano). Desta forma, propomos neste trabalho, avaliar a eficácia da administração crônica de Eleutherococcus senticosus (ginseng Siberiano) sobre a performance de ratos adaptados à esteira de corrida 3 x/semana (10 m/minuto, durante 10 minutos) e submetidos a treinamento de corrida (incremento de velocidade e duração do treino até a 4ª semana, e depois mantendo 25 m/minuto, durante 60 minutos/dia até a 8ª semana), aplicando três testes de performance (teste incremental de velocidade sem inclinação) ao longo de 8 semanas de tratamento. Os resultados indicaram que não houve melhora da performance dos ratos dos grupos adaptados e corrida no segundo e no terceiro teste (meio e final do tratamento, respectivamente), e a performance do grupo corrida só foi maior que a do grupo adaptado quando os ratos foram suplementados com 100 mg/kg de peso/dia de extrato padronizado de Eleutherococcus senticosus (ES). O ganho de peso foi semelhante entre os grupos adaptado e corrida, entretanto o tratamento com o ES induziu a um menor ganho de peso dos ratos quando comparados com seus respectivos controles. A ingesta alimentar, por sua vez, foi significativamente menor no grupo Corrida e o tratamento com ES não alterou este resultado. A morfometria dos adipócitos indicou menor área dos adipócitos dos ratos suplementados em relação aos seus controles, sendo significativo no panículo epididimal para o grupo Adaptado. Em relação aos biomarcadores de estresse oxidativo, no grupo Corrida Suplementado foi observado uma tendência a menor produção de espécies reativas de oxigênio analisados pela concentração de TBARS plasmático e muscular, porém não estatisticamente diferentes. Quanto aos outros biomarcadores metabólicos (lactato e glicemia plasmáticos, e glicogênio hepático e muscular), e ao perfil lipídico (triacilglicerol e colesterol total plasmáticos), não observamos alterações significativas que demonstrassem a eficácia do tratamento com ginseng no exercício proposto. Especificamente os outros biomarcadores de estresse oxidativo (catalase e superóxido dismutase) não apontaram aumento significativo na atividade antioxidante enzimática. Concluímos, portanto, que o tratamento com Eleutherococcus senticosus na forma de tratamento proposto foi eficiente em melhorar a performance no grupo treinado em esteira (Corrida Suplementado) / Abstract: Ginseng is one of the most popular herbal supplements in the world. Investigations revealed that ginseng and its related products reduce inflammation, produce adaptogenic activity promoting improvement in performance in rats and mice. Of different species of ginseng, Siberian (Eleutherococcus senticosus) is due to a lower rate of side effects, not producing arousal in patients, exerting stronger protective effect on the immune system, and not developing like syndrome to stress, as observed in Panax ginseng (Korean ginseng). Thus, we propose in this work was to evaluate the efficacy of chronic administration of Eleutherococcus senticosus (Siberian ginseng) on the performance of rats adapted to treadmill running 3 x/week (10 m/min for 10 min) and subjected to running training (increment of speed and duration of the training until the 4th week, and then maintaining 25 m/minute for 60 minutes / day to 8 weeks) by applying three performance tests (Test incremental speed without inclination) over 8 weeks treatment. The results indicated that there was no improvement of the performance of rats in groups adapted and running in the second and third test (middle and end of treatment, respectively) and running performance only group was higher than the group adapted when the rats were treated with 100 mg/kg/day of standardized extract of Eleutherococcus senticosus (ES). Weight gain was similar between groups adapted and race, however treatment with ES induced a lower weight gain of rats when compared to their respective controls. The food intake, in turn, was significantly lower in the group racing and ES treatment did not alter this result. The adipocyte morphometry showed the smallest area of adipocytes supplemented rats compared to their controls, with significant difference in panniculus epididymal isolated of Adapted group. Regarding biomarkers of oxidative stress in Race Supplemented group was observed a trend to lower production of reactive oxygen species analyzed by plasma and muscular TBARS concentration, but not statistically different. As for other metabolic biomarkers (plasma lactate and glucose, and liver and muscle glycogen), and lipid profile (total cholesterol and plasma triacylglycerol), we observed no significant changes to demonstrate the efficacy of treatment with ginseng in the proposed exercise. Specifically other biomarkers of oxidative stress (catalase and superoxide dismutase) showed no significant increase in antioxidant enzyme activity. We therefore conclude that treatment with Eleutherococcus senticosus as proposed treatment was effective in improving performance in the group trained on a treadmill (Race Supplemented) / Mestrado / Fisiologia / Mestre em Biologia Funcional e Molecular

This thesis focuses on creating an application software for monitoring and analyzing changes in body surface temperature before and after exercise test by the means of contactless thermography. Initial, theoretical part of this thesis talks about principles and possible scenarios, in which one could employ infrared thermography followed by physiology of the exercise load and concludes with an observation of the changes in body surface temperature while focusing on the actions that take place during the exercise test. Practical part of the thesis comprises of the exercise test and building of the application software for the analysis of the acquired thermographic visual output. The application software offers 2 kinds of analyses: general and under-load, while it aims to provide evaluation in both cases based on user-selected areas of interest. Last chapter of this thesis includes final output with commentary and eventual usage of the under-load experiment and application software in practical use.

At present, doctors are not consistent in the way they set the QTc interval in the recovery phase. The main goal of this study was to screen healthy subjects in the two different exercise stress tests and to compare the obtained data from both tests. We wanted to explore whether the heart rate and the QTc interval differs from each other when performed in two different body positions during the recovery phase. The main purpose was to present evidence that would prove or disprove a hypothesis that the figures differ in the different body positions. In the theoretical part we submitted the main information about the heart rate, the QT interval and the relationship between them. We compared the behaviour of the obtained data during the exercise and during the recovery phase. We described the causes of the QTc prolongation and how it is related to the cardiac arrhythmias. In the practical part we examined 20 healthy subjects. Each of them underwent two exercise stress tests on the bicycle ergometer, up to the subjective maximum level of the exercise intensity. The subjects then recovered in two different positions. The first one was a supine position. The second rest position was on the bicycle ergometer set to very low intensity. We found out that the 4-minute recovery phase, the most important for...

Laktatkonzentrationszeitkurven nach akuter körperlicher Belastung und im Stufentest haben sich ebenso wie der Dauerleistungstest in der sportwissenschaftlichen Leistungsdiagnostik etabliert. Beide Verfahren erlauben, die Leistungsfähigkeit von Sportlern einzuschätzen und die Trainingsbelastung optimal entsprechend der Sportdisziplin zu steuern. Der Unterarm-Ischämie-Test dient dazu, Muskelerkrankungen auf der Basis von Laktat- und Ammoniakkonzentration zu differenzieren. Die Laktat-Konzentrations-Zeitkurven nach akuter Belastung, im Stufentest oder im Dauerleistungstest sowie im Unterarm-Ischämietest werden vorwiegend deskriptiv durch Parameter wie die maximale Laktatkonzentration oder Leistung bei bestimmter Laktatkonzentration ausgewertet. Das Ziel der vorliegenden Untersuchung ist, pharmakokinetische Modelle für auf der Laktatkonzentration basierende Tests zu prüfen und deren praktische Relevanz zu diskutieren. Dabei können der akute Belastungstest und der Vorderarm-Ischämietest wegen eines ähnlichen Laktatprofils (Peak-Kurven), der Dauerleistungstest (kumulative Kurven) und der Stufentest (stetig monoton steigende Kurven) getrennt betrachtet werden. Die Routinelaktatprofile von 13 männlichen Freizeitsportlern (Alter: 20-35 Jahre), die sich einem 3 Minuten dauernden akuten ergometrischen Leistungstest unterzogen, wurden zur Modellbildung herangezogen. Der Unterarm-Ischämietest wurde bei acht Patienten im Alter zwischen 20 und 45 Jahren, bei denen bei Aufnahme die Verdachtsdiagnose einer Muskelerkrankung des Glukose- oder Eiweißstoffwechsels bestand, durchgeführt. Wird die Laktatkonzentrationszeitkurve, oder im Ischämietest auch der Ammoniakkonzentrationzeitkurve, als Summe eines Produktions- und Eliminationsvorgangs, dagestellt, lassen sich zusätzliche Informationen gewinnen. Blutlaktatkonzentrationen (Cb(t)) nach akuter ergometrischer Belastung wurden mittels nichtlinearer Regression an das Grundmodell Cb(t)=Co+B*(exp(-Lp*t )-exp(-Le*t)) angepasst, wobei Co der Ruhelaktatkonzentration und B einer Konstanten entsprechen. Die Laktatproduktionsrate (Lp) und Laktateliminationsrate (Le) differenzieren zwischen der Laktatproduktion einerseits und der Laktatelimination andererseits. Der Quotient Lp/P (P=erbrachte Leistung) stellt ein standardisiertes Maß für die Laktatproduktion im Muskel dar. Dagegen charakterisiert der Quotient Le/P die Elimination des Laktats aus dem Blutkompartiment. Über die Beziehung HWZp = ln2/Lp und HWZe = ln2/Le können die entsprechenden Halbwertszeiten berechnet werden. Eine reine Laktatproduktionszeitkurve (Cp(t)) lässt sich über die Beziehung Cp(t) = Cb(t) + Le*( ∫Cb(t)-Co*t) rekonstruieren und zeigt anschaulich den Verlauf der Laktatproduktion. Die Produktionszeitkurve erreicht im Verlauf der Elimination asymptotisch einen Maximalwert (Pm) und kann, identische Verteilungsvolumina des Laktats (Vdl) vorausgesetzt, über die Beziehung Ml = Vdl * Pm Informationen über die insgesamt freigesetzte Laktatmenge (Ml) geben. 19 gesunde Probanden unterzogen sich einem standardisierten Stufentest unter folgenden Bedingungen: Vor Beginn der Bergtour (Meereshöhe, SLa), nach Ankunft auf 1700 m (1700a), nach 10tägigem moderaten Training (Bergwandern zwischen 1700 und 3000m, 6 h pro Tag) auf 1700 m (1700b) sowie nach 4 Wochen (kein spezifisches Training) erneut auf Meereshöhe (SLb). Primäres Ziel der Auswertung war, mit der Potenzfunktion der allgemeinen Form Y(x) = A+ B * X^C den funktionalen Zusammenhang zwischen Laktatkonzentration und Belastung bzw. Herzfrequenz und Belastung zu beschreiben. Neben den modellabhängigen Faktoren (Ordinatenabschnitt, Steigungsfaktor, Exponent) ließen sich durch die AUC(70-280) (Area under the curve 70 bis 280 Watt Leistung) das Ausmaß der Laktatproduktion, die entsprechende mittlere Konzentration (Cm) und durch die Laktatkonzentrationen bei 70 und 280 Watt (LT-70, LT-280) der Laktatanstieg charakterisieren. Der Dauerleistungstest hat sich neben dem akuten ergometrischen Belastungstest in der sportmedizinischen Leistungsdiagnostik als Methode etabliert. Bisher konzentrierte sich die Auswertung auf die maximalen Blutlaktatkonzentrationen im steady state. Die Autoren schlagen verschiedene Modelle vor, sowohl empirische als auch mechanistische, um die Laktatkonzentrationszeitkurve im Dauerleistungstest zu beschreiben. Neben der maximalen Konzentration können nach Berechnung der Modellkurven durch nichtlineare Regression Konzentrationen zu definierten Bedingungen (z. B. LT20 = Laktat nach 20 Minuten) oder die Steigung der Kurve beurteilt werden. Darüber hinaus lässt sich die AUC (Area under the curve) als Ausmaß für die Laktatbildung während des Dauerleistungstests mit der Trapezregel bestimmen. Zusammenfassend zeigen die Untersuchungen, dass in allen Verfahren der Laktatdiagnostik, dem akuten Belastungstest, der Standardergometrie, dem Laktatischämietest und dem Dauerleistungstest, signifikante und praktikable pharmakokinetische Modelle berechnet werden können. Sie erlauben es, die Ergebnisse mittels Modellparametern zu quantifizieren und zu vergleichen. / Lactate concentration versus time curves following acute physical exercise, the standard exercise test using increasing levels of work load and the steady state exercise test have been established methods to characterise the fitness of athletes and to control training intensity. The ischemic forearm exercise test (IFET) is used to detect metabolic disorders of muscles based on lactate and ammonia concentration during exercise under ischemia. Lactate concentration curves following acute exercise, standard ergometries and steady state tests as well as IFET are generally analysed descriptively, i. e. maximum lactate concentrations or work load with regard to defined lactate concentrations are used. The primary objective of this study was to assess pharmacokinetic models for lactate in exercise tests and to discuss the relevance in sports science. For practical purpose, the models used in acute and IFET (asymmetric peak curves), the steady state exercise test (cumulative curves) and standard exercise tests (continuously increasing function) are dealt with separately. Routine lactate profiles of 13 male nonprofessional athletes (age: 20-35) years who underwent an acute ergometry lasting 3 minutes were used to assess different pharmacokinetic models. An IFET was performed in 8 patients (Age: 20-45 years) supposed to have disorders of glucose metabolism or lack of myoadenylate deaminase. Lactate concentration versus time curves were fitted by means of non-linear regression to different kinetic models. The modified basic curve Cb(t)=Co+B*(exp(-Lp*t )-exp(-Le*t)), where Cb denotes the baseline concentration, B a constant, Le denotes the lactate elimination constant and Lp the “absorption or production” constant, yielded remarkable nonlinear regression results in for both test settings. Lactate concentration versus time curves in acute exercise tests are mostly assessed descriptively by means of parameters such as maximum concentration or workload with regard to specified lactate levels. Additional diagnostic information can be obtained, if production and elimination processes of the concentration versus time curve are separated. Production rate (Lp) and elimination rate (Le) of lactate are to define the shape of the curve. The ratio Lp/P (P=performance, work load), where Lp denotes the workload of the ergometer, can be considered as a standardized criterion of lactate production in the muscle. On the contrary, the ratio Le/P characterizes the elimination process from the vascular compartment. The corresponding half-lives [Tp, Te] are obtained using the relations Tp = ln2/Lp and Te = ln2/Le. The absolute lactate production versus time curve [Cp(t)] is given by the following equation: Cp(t) = Cb(t) + Le*( ∫Cb(t)-Co*t). The production versus time curve reaches a maximum value (Pm) after termination of the elimination process. If lactate has identical volumes of distribution (Vdl), Pm characterizes the total amount of lactate production (Ml) due to the relation Ml = Vdl*Pm. Nineteen healthy volunteers were exposed to a standardized exercise test at sea level (SLa), at an altitude of 1700 m before (1700a) and after a moderate 10 day mountain training (1700b), with a final control four weeks later at sea level (SLb). Vital signs, blood lactate and arterial oxygen saturation were determined prior, during or after the exercise test. The primary aim of the study was to fit the power function Y(X) = A+ B * X^C as a model for lactate versus workload and heart rate versus workload data. Apart from model characteristics (intercept, slope, exponent) the extent of lactate production could be estimated by the model independent characteristic AUC(70-280) (Area under the curve between 70 and 280 Watt) and the corresponding average concentration (Cm). The degree of lactate increase was characterized by means of the lactate concentration at 70 and 280 Watt (LT-70, LT-280), respectively. Apart from the standard and acute exercise test the steady state exercise test has gained increasing relevance in practice of sports medicine. So far, lactate curves of steady state tests were characterised by means of maximum. The author suggests several models, both empirical and mechanistic models, in order to fit lactate concentration versus time curves of the steady state ergometry. In addition to the maximum lactate concentration fitted nonlinear regression curves allow to assess the concentrations at defined conditions (e.g. LT20=lactate after 20 minutes of steady state workload, EC50 of the Emax model) or the slope of the curve. Moreover, the AUC(0-tx) – a measure for the extent of lactate production – can be calculated using the trapezoidal rule. In conclusion, in all lactate based tests, acute and standard ergometry, ischemic forearm test and steady state exercise test, concentration versus time data were fitted suitable pharmacokinetic models which allow to quantify and compare the results.

The purpose of this study was to evaluate the use of nonexercise (N-EX) data, specifically, the Perceived Functional Ability (PFA) and Physical Activity Rating (PA-R) questionnaires, with the treadmill walk-jog-run protocol to estimate VO2max in 12 to 17 year old boys and girls. Ninety-one participants (49 males and 42 females) took part in this study. Data were collected via PFA and PA-R questionnaires, a walk-jog-run submaximal treadmill test, and a maximal graded exercise test (GXT). Data collected included gender, age, height, weight, PFA and PA-R scores, heart rate (HR), treadmill speed, maximal treadmill grade, respiratory exchange ratio (RER), rating of perceived exertion (RPE), and VO2max. Regression analysis resulted in the development of two valid and reliable models to predict VO2max. Nonexercise and submaximal exercise test data were used to build the following model: VO2max (mL∙kg-¹∙min-¹) = 11.201 + (6.877 x Gender; 0 = female; 1 = male) + (3.573 x treadmill speed; mph) – (0.174 x kg) + (0.405 x PFA score) + (0.653 x PA-R score) + (1.019 x age). The model resulted in an R2 = 0.69 and a SEE = 5.16 mL∙kg-¹∙min-¹. Maximal exercise test data were used to build the following model: VO2max (mL∙kg-¹∙min-¹) = -3.264 + (3.359 x Gender; 0 = female; 1 = male) – (0.082 x kg) + (7.351 x treadmill speed; mph) + (1.750 x maximal treadmill grade). The model resulted in an R2 = 0.88 and a SEE = 3.16 mL∙ kg-¹∙min-¹. The cross-validation PRESS statistics for both models demonstrated minimal shrinkage in the accuracy of the regression model. The results of this study demonstrate, for the first time, that N-EX data can be used to accurately predict VO2max in youth. The submaximal and maximal exercise tests validated in this study can be used to assess cardiorespiratory fitness of youth having a wide range on interests and fitness levels. In addition, the use of PFA and PA-R questionnaires enforces initiatives to increase physical activity among youth. Both exercise tests use a self-selected treadmill speed that elicits a steady-state HR of 70% of the participants age-predicted maximal HR. The use of a self-selected walking, jogging, or running speed accommodates youth with different levels of physical fitness, motivation, and interests. The exercise test protocol presented in this study is practical for use in schools, athletic facilities, and community fitness centers. The equipment required to administer the exercise test presented in this study is limited to a treadmill and a HR monitor. Together with the use of PFA and PA-R questionnaires, the submaximal and maximal exercise tests are efficacious to coaches, fitness professionals, and physical educators in a variety of settings.