This study evaluated oxygen uptake (VO2), heart rate (HR), and lactate [HLa] responses between the treadmill (TM) and the CardiosquatTM 1650 LETM inclined stepper by StairMasterTM (SM) during constant-load exercise. The slow component of VO2 (SC) was a central variable assessed during exercise. Twenty-two healthy college-aged (18-30) subjects completed an incremental TM and SM exercise test to establish a workload equivalent to 70% VO2peak. Following each incremental test, a 20-minute constant-load exercise bout was performed . Incremental and instant-load exercise bouts were separated by at least 48 hours. The order of the tests were randomized. VO2, HR, and [HLa] were evaluated at 5, 10, 15, and 20-minutes of exercise. Expired gases were analyzed using a Med Graphics CPX/D metabolic cart. Blood samples were analyzed immediately for lactate concentration with an automated lactate analyzer (Yellow Springs Instrument Model 1500 Sport ). A two-way ANOVA with repeated measures was performed on the rate of change between the treadmill and stepper for VO2, HR, and [HLa]. No significant differences were found for any of the response variables (P>0.05). These results suggest at that the same relative workload, the SM does not elicit a more pronounced SC than the TM. Based on these findings, the SM appears to be an appropriate modality of exercise for various clinical populations. / Master of Science

The present study examined the hemodynamic response to recreational hockey (n= 22) in middle-aged men (53±6 yrs). Study participants were equipped with ambulatory blood pressure and heart rate monitoring equipment prior to a weekly hockey games. Participants were monitored throughout the duration of their hockey game for “On-Ice” responses and during seated bench time (“Bench”), and for a brief period afterwards. On-Ice HR’s and blood pressures were significantly higher than values obtained during maximal cycle exercise (HR 174±8.9 vs. 163±11.0 bpm) (SBP 17%; DBP 15%) (p<0.05), Blood pressures decreased throughout the duration of the game while HR increased significantly. The On-Ice endocardial viability ratio (EVR), an index of myocardial oxygen supply and demand, did not change from early (1.56±0.05) to late (1.44± 0.06) in the game. In conclusion, recreational hockey is an extremely vigorous form of interval exercise that produces cardiovascular responses exceeding intensities commonly recommended for continuous training.

The present study examined the hemodynamic response to recreational hockey (n= 22) in middle-aged men (53±6 yrs). Study participants were equipped with ambulatory blood pressure and heart rate monitoring equipment prior to a weekly hockey games. Participants were monitored throughout the duration of their hockey game for “On-Ice” responses and during seated bench time (“Bench”), and for a brief period afterwards. On-Ice HR’s and blood pressures were significantly higher than values obtained during maximal cycle exercise (HR 174±8.9 vs. 163±11.0 bpm) (SBP 17%; DBP 15%) (p<0.05), Blood pressures decreased throughout the duration of the game while HR increased significantly. The On-Ice endocardial viability ratio (EVR), an index of myocardial oxygen supply and demand, did not change from early (1.56±0.05) to late (1.44± 0.06) in the game. In conclusion, recreational hockey is an extremely vigorous form of interval exercise that produces cardiovascular responses exceeding intensities commonly recommended for continuous training.

The purpose of this study was to compare power output and ventilatory measurements between the steep ramp test (SR) and both the 30-second Wingate anaerobic (WAT) and standard cardiopulmonary exercise tests (CPET) in chronic obstructive pulmonary disease (COPD). 11 patients (7 males and 4 females) underwent spirometry, a CPET, WAT and SR test. Repeated measures ANOVA was used to compare the differences between the peak work rate of the CPET (CPET_peak), SR (SR_peak), and the average power of the WAT (W_avg). The W_avg was higher than the SR_peak, which was higher than the CPET (231.2 ± 113.4, 156.8 ± 67.9, 65.9 ± 35.9, p>0.05 respectively). There were no differences found between the tests at end-exercise for inspiratory reserve volume (IRV), ventilation (V_E), and end-expiratory lung volume (EELV). Tidal volume (V_T) was also compared between the tests as a percentage of the inspiratory capacity (IC) remaining at end-exercise and no differences were found. The similarity between the ventilatory measures indicates a similar level of constraint, despite the large difference in work rates achieved, in all 3 tests. This shows that a standard CPET underestimates leg power in COPD patients, and the WAT and SR may be better indicators of leg muscle power and anaerobic type exercise.

The purpose of this study was to compare power output and ventilatory measurements between the steep ramp test (SR) and both the 30-second Wingate anaerobic (WAT) and standard cardiopulmonary exercise tests (CPET) in chronic obstructive pulmonary disease (COPD). 11 patients (7 males and 4 females) underwent spirometry, a CPET, WAT and SR test. Repeated measures ANOVA was used to compare the differences between the peak work rate of the CPET (CPET_peak), SR (SR_peak), and the average power of the WAT (W_avg). The W_avg was higher than the SR_peak, which was higher than the CPET (231.2 ± 113.4, 156.8 ± 67.9, 65.9 ± 35.9, p>0.05 respectively). There were no differences found between the tests at end-exercise for inspiratory reserve volume (IRV), ventilation (V_E), and end-expiratory lung volume (EELV). Tidal volume (V_T) was also compared between the tests as a percentage of the inspiratory capacity (IC) remaining at end-exercise and no differences were found. The similarity between the ventilatory measures indicates a similar level of constraint, despite the large difference in work rates achieved, in all 3 tests. This shows that a standard CPET underestimates leg power in COPD patients, and the WAT and SR may be better indicators of leg muscle power and anaerobic type exercise.

The aim of this thesis was to investigate the extent of peripheral and central components in the development of fatigue during maximal exercise. Fatigue during maximal and supramaximal exercise has traditionally been modelled from the peripheral context of an inadequate capacity to supply metabolic substrate to the contracting muscles to meet the increased energy demand. However, there are a number of observations that are not compatible with the peripheral fatigue model but which support a reduced central drive during exercise acting to prevent organ failure that might occur should the work be continued at the same intensity. Candidates for the role of “exercise stopper” have been identified as mechanical forces, teleoanticipation, cardiovascular capacity and dyspnoea. We explored these various possibilities in order to determine the most likely cause of exercise cessation during high intensity exercise.The development of a plateau in oxygen consumption during maximal incremental exercise has traditionally been used as evidence that an oxygen deficiency in the exercising muscles causes the termination of exercise. However, the incidence of this “plateau phenomenon” depends largely on mode of exercise, testing protocol and sampling frequency. The aim of this study was to examine whether the development of the “plateau phenomenon” is an artefact of pedalling cadence. In the first study nine healthy individuals performed in random order a maximal incremental ramp test (0.5 W.s-1) on four occasions at a fixed cadence of 60, 80 or 100 rpm and at a self-selected cadence. Oxygen consumption (VO2), CO2 production (VCO2), minute ventilation (VE) and heart rate were measured throughout each trial and averaged over 30 s. Cadence was recorded every second. Neither VO2max nor peak power output were different between trials. Submaximum VO2, VCO2 and VE were not influenced by cadence. A plateau in oxygen consumption was observed in 14% of the trials. Cadence declined significantly towards the end of the self-selected cadence trial (p < 0.05). This ramp protocol produces a low incidence of the “plateau phenomenon” and the measured physiological variables are unaffected by cadence. Furthermore, only one subject displayed this phenomenon on more than one occasion. This confirms that the “plateau phenomenon” is an artefact of the testing protocol. The significant fall in cadence in anticipation of exercise termination during the self-selected cadence trial indicates the presence of a neural regulation, which would lead to a “plateau phenomenon” in those cycle tests in which the work rate is cadence-dependent.The purpose of the second study was to assess whether pacing strategies are adopted during supramaximal exercise bouts lasting longer than 30 s. Eight healthy males performed six Wingate Anaerobic Tests (WAnT). Subjects were informed that they were performing four 30 s WAnT and a 33 s and 36 s WAnT. However, they actually completed two trials of 30, 33 and 36 s each. Temporal feedback in the deception trials was manipulated so that subjects were unaware of the time discrepancy. Power output (PO) was determined from the angular displacement of the flywheel and averaged over 3 s. The peak power (PPI), mean power (MPI) and fatigue (FI) indices were calculated for each trial. Power output was similar for all trials up to 30 s. However, at 36 s the PO was significantly lower in the 36 s deception trial compared to the 36 s informed trial (392 ± 32 W vs 470 ± 88 W) (p < 0.001). The MPI was significantly lower in the 36 s trials (714 ± 76 W and 713 ± 78 W) compared to the 30 s trials (745 ± 65 W and 764 ± 82 W) although they were not different at 30 s (764 ± 83 W and 755 ± 79 W). The significant reduction in FI was greatest in the 36 s deception trial. In conclusion, the significant reduction in PO in the last six seconds of the 36 second deception trial, but not in the 36 second informed trial, indicates the presence of a pre-programmed 30 second “end point” based on the anticipated exercise duration from previous experience. Furthermore the similarity in pacing strategy in all informed trials suggests that the pacing strategy is centrally regulated and is independent of the total work to be performed.Athletes adopt a pacing strategy to delay fatigue and optimise athletic performance. However, many current theories of the regulation of muscle function during exercise do not adequately explain all observed features of such pacing strategies. We studied power output, oxygen consumption and muscle recruitment strategies during successive 4km cycling time trials to determine whether alterations in muscle recruitment by the central nervous system could explain the observed pacing strategies. Seven, highly trained cyclists performed three consecutive 4 km time trial intervals, each separated by 17 minutes. Subjects were instructed to perform each trial in the fastest time possible, but were given no feedback other than distance covered. Integrated electromyographic (iEMG) readings were measured at peak power output and for 90 s before the end of each trial. Subjects reach a VO2max in each interval. Time taken to complete the first and third intervals was similar. Peak power output was highest in the first interval but average power output, oxygen consumption, heart rate and postexercise plasma lactate concentrations were not different between intervals. Power output and iEMG activity rose similarly during the final 60 s in all intervals but were not different between trials. The similar pacing strategies in successive intervals and the parallel increase in iEMG and power output towards the end of each interval suggests that these pacing strategies could not have been controlled by peripheral mechanisms. Rather, these findings are compatible with the action of a centrally regulated that are recruited and de-recruited during exercise. The extent to which peripheral feedback influences recruitment patterns could not be determined from these experiments.The fourth study examined whether the supplementation of inspired air with a hyperoxic mixture results in a dose-dependent increase in peak work rate and maximal oxygen consumption (VO2max) during a ramp test to volitional exhaustion. To avoid the methodological disadvantages associated with breathing the gas mixtures from mixing bags, the trials were performed in a sealed chamber in which the oxygen fraction (FIO2) in the ambient air was altered and subjects were able to inhale directly from the environment. The three oxygen fractions in which the subjects exercised were 21% (room air), 35 or 60%. Arterial blood sampling occurred at rest and every 3 min during the trial. The blood was analysed for the partial pressure of oxygen (pO2), and carbon dioxide (pCO2); pH; oxygen saturation (sO2); haemoglobin saturation (O2Hb); and lactate concentrations. Expired gas and heart rate were measured continuously. Arterial sO2 and O2Hb were elevated in both hyperoxic conditions and did not fall throughout either trial. However in the normoxic trial sO2 and O2Hb declined over the duration of the trial. Lactate concentrations and pH were similar between all trials. VO2max was significantly higher with an FIO2 of 35 and 60% but was not different between hyperoxic conditions. Maximal ventilation (VEmax), carbon dioxide production (VCO2max) and heart rate were similar for all trials. Peak power output was increased in the trained athletes in the 60% FIO2 trial. Since the plateau phenomenon occurred infrequently in all trial (~9%) and the effect of hyperoxia on performance was less than the changes in blood oxygen carrying capacity, we conclude that hyperoxia improved exercise performance not solely by increasing oxygen delivery to the exercising muscles.In order to be able to directly compare the results from studies using different equipment it is important to know the interchangeability of the results from the machines. The fifth study tested the reliability and interchangeability of the two automated metabolic gas analyser systems that would be used in this series of studies at a range of submaximal workloads. Eight highly trained cyclists performed two incremental submaximal cycle ergometer tests. For each session either a Schiller CS-200 or a Vmax Series 229 automated gas analyser was used for expired gas analysis. Data for oxygen consumption (VO2), CO2 production (VCO2), minute ventilation (VE) and respiratory exchange ration (RER) were averaged for each of the five stages (200, 250, 275, 300 and 325 W). The VO2, VE and RER were similar between trials at all workloads. However, VCO2 was significantly lower in the Schiller trial at workloads above 200 W (p < 0.05). Although there was a significant correlation between the two automated systems for the measured parameters (VO2 = 0.78; VCO2 = 0.80; VE = 0.82; RER = 0.72) (p < 0.05), a Bland-Altman plot revealed that the limits of agreement between the two systems were unacceptably large (VO2 = 0.53 to 1.30 L.min-1; VCO2 = 0.55 to 0.64 L.min-1; VE = -22.3 to 30.3 L.min-1; RER = - 0.03 to 0.13). The co-efficient of variation within the analysers was insignificant for both systems. Both the systems provide reliable measures of expired gas parameters. However, care should be taken in directly comparing studies that have used the two different systems due to the poor agreement between the systems.The factors causing the termination of maximal exercise at sea level are unknown. A widely held view is that skeletal muscle anaerobiosis consequent to an inadequate oxygen delivery to the exercising muscles limits exercise. However, there is also evidence that respiratory muscle fatigue at the high ventilatory volumes achieved during maximal exercise delivery and respiratory muscle work on maximal exercise performance, we exercised 8 highly trained cyclists in a pressure-sealed chamber in which O2 concentrations were manipulated and helium (He) was substituted for nitrogen in the ambient air in order to reduce the work of breathing during exercise. This system ensured that external inspiratory and expiratory resistance was minimised and identical in all experimental conditions and approximated conditions present during usual exercise. During trials with O2 enriched ambient air the peak work rate increased (451 ± 58 W vs. 429 ± 59 W). Neither maximum nor submaximal oxygen consumption was altered in FIO2 of 35% (5.0 ± 0.6 l.min-1) compared to 21% (4.9 ± 0.7 l.min- 1). Substituting helium for nitrogen had no additional effect on work (453 ± 56 W) or VO2max (4.9 ± 0.7 l.min-1) beyond those observed for the hyperoxic conditions. Although submaximum VE was reduced with helium, VEmax was unchanged. Since exercise was terminated at the same peak work rate (± 5 W) in the two hyperoxic conditions we postulate that the actual work rate may be the sensed variable that determines maximal exercise performance. The findings from these studies suggest that the maintenance of physiological homeostasis and the avoidance of organ and cellular damage are of fundamental importance during maximal exercise. This is achieved through central regulation of work output based, possibly, on afferent information from the mechanoreceptors in the exercising skeletal muscles or alternatively, the extent of motor unit recruitment during maximal exercise may be hardwired in the central nervous system in a system of feed-forward control.

Objetivos: O exercício físico regular em pacientes com fibrose cística (FC) auxilia no condicionamento aeróbico e diminui a progressão da doença, proporcionando melhor qualidade de vida. O objetivo desse estudo foi avaliar os efeitos de um programa de exercício físico aeróbico baseado na orientação verbal e instrumental na capacidade funcional e na qualidade de vida. Métodos: O Estudo constituiu-se de um ensaio clínico, randomizado, de orientações para o exercício físico realizado em um centro de FC. Os pacientes foram alocados em dois grupos, intervenção e controle, sendo 17 pacientes no grupo intervenção (G1) e 17 para o grupo controle (G2). A coleta de dados ocorreu durante o período de outubro de 2010 a outubro de 2011, e a população em estudo consistiu em crianças e adolescentes com FC e idade entre sete e 20 anos.A intervenção foi um manual de orientações com exercícios físicos aeróbicos e reforço das orientações por meio de contato telefônico a cada duas semanas. Resultados: Foram estudados 34 pacientes com FC, sendo que 20 pacientes (58,8)% eram do sexo masculino. Os grupos eram semelhantes no momento basal, sendo que no G1 seis pacientes (35,2%) referiram praticar exercício físico regularmente, a média de idade foi de 13,40±2,81 anos, do percentual do previsto do volume expiratório forçado no primeiro segundo (VEF1%) foi de 95,53±17,94 % e do consumo de oxigênio de pico relativo a massa corporal (VO2pico) foi de 34,93±9,09 ml/kg-1.min-1 . No G2, quatro pacientes (23,5%) referiram praticar exercício físico regularmente, a média de idade foi de 12,76±3,37 anos, do VEF1 foi de 100,13±21,27 % e do VO2pico foi de 33,21±8,26 ml/kg-1.min. Houve aumento significativo do G1 na prática de exercício físico relatada pelos pacientes após os três meses de intervenção comparado ao G2 (p=0,013). Nas demais variáveis não foram observadas diferenças estatisticamente significativas. Conclusão: Esse estudo demonstrou que a orientação verbal e instrumental para o exercício aeróbico, acoplado com supervisão telefônica teve impacto positivo no relato das crianças e adolescentes quanto a prática do exercício físico regular. Porém, não foram observados melhora nos parâmetros fisiológicos, nem nos domínios do questionário de qualidade de vida. / Objectives: Regular physical activity in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, which results in better quality of life. This study evaluated the effect on functional capacity and quality of life of an aerobic physical activity program based on verbal and written guidelines. Methods: This randomized clinical trial used guidelines for physical exercise in a CF center. Patients were assigned to two groups: intervention (G1), with 17 patients; and control (G2), also with 17 patients. Data were collected from October 2010 to October 2011, and the study population comprised children and adolescents with CF aged 7 to 20 years. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in contacts by phone every two weeks. Results: Thirty-four patients were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In G1, 6 patients (35.2%) reported practicing physical exercises regularly; mean age was 13.40±2.81 years, mean percent predicted forced expiratory flow at one second (FEV1%) was 95.53±17.94% and mean peak oxygen uptake (VO2peak) relative to body mass was 34.93±9.09 ml/kg-1.min-1. In G2, four patients (23.5%) reported practicing physical exercises regularly. Mean age was 12.76±3.37 years, mean FEV1 was 100.13±21.27% and mean VO2peak was 33.21±8.26 ml/kg-1.min. In G1, there was a significant increase of physical exercise practice as reported by patients after three months of intervention when compared with G2 (p=0.013). No statistically significant differences were found for the other variables. Conclusion: Verbal and written guidelines for aerobic exercise, together with supervision over the phone, had a positive impact on the report of regular physical exercise practice by children and adolescents. However, no improvement was found in physiological parameters or domains of the quality of life questionnaire.

Objetivos: O exercício físico regular em pacientes com fibrose cística (FC) auxilia no condicionamento aeróbico e diminui a progressão da doença, proporcionando melhor qualidade de vida. O objetivo desse estudo foi avaliar os efeitos de um programa de exercício físico aeróbico baseado na orientação verbal e instrumental na capacidade funcional e na qualidade de vida. Métodos: O Estudo constituiu-se de um ensaio clínico, randomizado, de orientações para o exercício físico realizado em um centro de FC. Os pacientes foram alocados em dois grupos, intervenção e controle, sendo 17 pacientes no grupo intervenção (G1) e 17 para o grupo controle (G2). A coleta de dados ocorreu durante o período de outubro de 2010 a outubro de 2011, e a população em estudo consistiu em crianças e adolescentes com FC e idade entre sete e 20 anos.A intervenção foi um manual de orientações com exercícios físicos aeróbicos e reforço das orientações por meio de contato telefônico a cada duas semanas. Resultados: Foram estudados 34 pacientes com FC, sendo que 20 pacientes (58,8)% eram do sexo masculino. Os grupos eram semelhantes no momento basal, sendo que no G1 seis pacientes (35,2%) referiram praticar exercício físico regularmente, a média de idade foi de 13,40±2,81 anos, do percentual do previsto do volume expiratório forçado no primeiro segundo (VEF1%) foi de 95,53±17,94 % e do consumo de oxigênio de pico relativo a massa corporal (VO2pico) foi de 34,93±9,09 ml/kg-1.min-1 . No G2, quatro pacientes (23,5%) referiram praticar exercício físico regularmente, a média de idade foi de 12,76±3,37 anos, do VEF1 foi de 100,13±21,27 % e do VO2pico foi de 33,21±8,26 ml/kg-1.min. Houve aumento significativo do G1 na prática de exercício físico relatada pelos pacientes após os três meses de intervenção comparado ao G2 (p=0,013). Nas demais variáveis não foram observadas diferenças estatisticamente significativas. Conclusão: Esse estudo demonstrou que a orientação verbal e instrumental para o exercício aeróbico, acoplado com supervisão telefônica teve impacto positivo no relato das crianças e adolescentes quanto a prática do exercício físico regular. Porém, não foram observados melhora nos parâmetros fisiológicos, nem nos domínios do questionário de qualidade de vida. / Objectives: Regular physical activity in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, which results in better quality of life. This study evaluated the effect on functional capacity and quality of life of an aerobic physical activity program based on verbal and written guidelines. Methods: This randomized clinical trial used guidelines for physical exercise in a CF center. Patients were assigned to two groups: intervention (G1), with 17 patients; and control (G2), also with 17 patients. Data were collected from October 2010 to October 2011, and the study population comprised children and adolescents with CF aged 7 to 20 years. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in contacts by phone every two weeks. Results: Thirty-four patients were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In G1, 6 patients (35.2%) reported practicing physical exercises regularly; mean age was 13.40±2.81 years, mean percent predicted forced expiratory flow at one second (FEV1%) was 95.53±17.94% and mean peak oxygen uptake (VO2peak) relative to body mass was 34.93±9.09 ml/kg-1.min-1. In G2, four patients (23.5%) reported practicing physical exercises regularly. Mean age was 12.76±3.37 years, mean FEV1 was 100.13±21.27% and mean VO2peak was 33.21±8.26 ml/kg-1.min. In G1, there was a significant increase of physical exercise practice as reported by patients after three months of intervention when compared with G2 (p=0.013). No statistically significant differences were found for the other variables. Conclusion: Verbal and written guidelines for aerobic exercise, together with supervision over the phone, had a positive impact on the report of regular physical exercise practice by children and adolescents. However, no improvement was found in physiological parameters or domains of the quality of life questionnaire.

Objetivos: O exercício físico regular em pacientes com fibrose cística (FC) auxilia no condicionamento aeróbico e diminui a progressão da doença, proporcionando melhor qualidade de vida. O objetivo desse estudo foi avaliar os efeitos de um programa de exercício físico aeróbico baseado na orientação verbal e instrumental na capacidade funcional e na qualidade de vida. Métodos: O Estudo constituiu-se de um ensaio clínico, randomizado, de orientações para o exercício físico realizado em um centro de FC. Os pacientes foram alocados em dois grupos, intervenção e controle, sendo 17 pacientes no grupo intervenção (G1) e 17 para o grupo controle (G2). A coleta de dados ocorreu durante o período de outubro de 2010 a outubro de 2011, e a população em estudo consistiu em crianças e adolescentes com FC e idade entre sete e 20 anos.A intervenção foi um manual de orientações com exercícios físicos aeróbicos e reforço das orientações por meio de contato telefônico a cada duas semanas. Resultados: Foram estudados 34 pacientes com FC, sendo que 20 pacientes (58,8)% eram do sexo masculino. Os grupos eram semelhantes no momento basal, sendo que no G1 seis pacientes (35,2%) referiram praticar exercício físico regularmente, a média de idade foi de 13,40±2,81 anos, do percentual do previsto do volume expiratório forçado no primeiro segundo (VEF1%) foi de 95,53±17,94 % e do consumo de oxigênio de pico relativo a massa corporal (VO2pico) foi de 34,93±9,09 ml/kg-1.min-1 . No G2, quatro pacientes (23,5%) referiram praticar exercício físico regularmente, a média de idade foi de 12,76±3,37 anos, do VEF1 foi de 100,13±21,27 % e do VO2pico foi de 33,21±8,26 ml/kg-1.min. Houve aumento significativo do G1 na prática de exercício físico relatada pelos pacientes após os três meses de intervenção comparado ao G2 (p=0,013). Nas demais variáveis não foram observadas diferenças estatisticamente significativas. Conclusão: Esse estudo demonstrou que a orientação verbal e instrumental para o exercício aeróbico, acoplado com supervisão telefônica teve impacto positivo no relato das crianças e adolescentes quanto a prática do exercício físico regular. Porém, não foram observados melhora nos parâmetros fisiológicos, nem nos domínios do questionário de qualidade de vida. / Objectives: Regular physical activity in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, which results in better quality of life. This study evaluated the effect on functional capacity and quality of life of an aerobic physical activity program based on verbal and written guidelines. Methods: This randomized clinical trial used guidelines for physical exercise in a CF center. Patients were assigned to two groups: intervention (G1), with 17 patients; and control (G2), also with 17 patients. Data were collected from October 2010 to October 2011, and the study population comprised children and adolescents with CF aged 7 to 20 years. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in contacts by phone every two weeks. Results: Thirty-four patients were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In G1, 6 patients (35.2%) reported practicing physical exercises regularly; mean age was 13.40±2.81 years, mean percent predicted forced expiratory flow at one second (FEV1%) was 95.53±17.94% and mean peak oxygen uptake (VO2peak) relative to body mass was 34.93±9.09 ml/kg-1.min-1. In G2, four patients (23.5%) reported practicing physical exercises regularly. Mean age was 12.76±3.37 years, mean FEV1 was 100.13±21.27% and mean VO2peak was 33.21±8.26 ml/kg-1.min. In G1, there was a significant increase of physical exercise practice as reported by patients after three months of intervention when compared with G2 (p=0.013). No statistically significant differences were found for the other variables. Conclusion: Verbal and written guidelines for aerobic exercise, together with supervision over the phone, had a positive impact on the report of regular physical exercise practice by children and adolescents. However, no improvement was found in physiological parameters or domains of the quality of life questionnaire.

Made available in DSpace on 2015-07-22T20:49:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-01-26 / Objetivo: O objetivo do presente estudo foi avaliar o perfil da densidade do transportador dopaminérgico utilizando SPECT em pacientes com Movimento Periódico das Pernas (MPP) e a influência do exercício físico agudo na concentração do DAT após um teste de esforço máximo (TEM). Métodos: Para isso 16 pacientes (8 grupo CTRL e 8 grupo Experimental) realizaram uma polissonografia (PSG) basal para a avaliação do padrão de sono e do índice do MPP. Após a PSG basal foi realizado o SPECT basal. Posteriormente os voluntários realizaram um TEM no período da manhã, após 2 horas, um novo exame de SPECT, e na mesma noite uma PSG para avaliar o efeito do exercício físico agudo no DAT e no padrão do sono. Resultados: Os resultados encontrados demonstraram que o grupo experimental apresentou valores menores no perfil da densidade do DAT no momento basal na região do estriado (p=0,03), foi demonstrado também uma redução do índice de MPP no grupo experimental (p=0,01) e um aumento da porcentagem do estagio 1 do sono NREM em ambos os grupos após o TEM (p=0,02). O estagio 2 do sono (p=0,02) e sono de ondas lentas (p=0,01) apresentaram diferenças entre os grupos no momento basal. Conclusão: Nossos resultados mostram que pacientes com MPP apresentaram uma menor densidade de DAT na região do putâmen esquerdo comparado ao grupo CTRL e uma sessão de exercício físico agudo (TEM) não alterou este perfil. Esses achados sugerem que alterações na densidade do DAT, talvez estejam relacionados a prática de exercício físico crônico. / Restless legs syndrome and periodic leg movement are sleep-related movement disorders and studies have shown changes in striatal dopaminergic activity in patients with these disorders. Physical exercise has been shown to improve the symptoms of restless legs syndrome and periodic leg movement, as has treatment with dopamine agonists. However, the mechanism by which physical exercise acts as a nonpharmacological treatment in improving symptoms of restless legs syndrome and periodic leg movement remains unknown. We evaluated dopamine transporter density profiles in 16 sedentary patients (control and experimental - with periodic leg movement, groups) and the influence of acute physical exercise on its concentration after a maximal exercise test. Each patient underwent baseline polysomnography to evaluate sleep patterns and periodic leg movement index values. After obtaining the polysomnography baseline, the single photon emission computer tomography baseline was determined. Subsequently, the volunteers performed a maximal exercise test in the morning, followed by a single photon emission computer tomography two hours later and polysomnography that night, to assess the effect of acute physical exercise on dopamine transporter and sleep patterns. The results showed significant lower dopamine transporter baseline densities in the striatum region for the experimental group. The results also showed a significant reduction in the periodic leg movement rate in the experimental group and a significant increased percentage of stage-1 non-REM sleep in both groups after maximal exercise test. Significant differences between the groups were only observed for Stage 2 sleep and slow wave sleep. Our results show that patients with periodic leg movement had a lower dopamine transporter density in the left putamen region compared to the control group and an acute physical exercise (maximal exercise test) did not alter this profile, providing evidence that this improvement is the result of chronic physical exercise. / TEDE / BV UNIFESP: Teses e dissertações