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This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (ß = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (ß = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.

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INTRODUCTION: Although evidence suggests that physical exercise reduces systemic inflammation, at the plasma level, there are still contradictions in chronic obstructive pulmonary disease (COPD). In this sense, analysis of intracellular cytokines could clear off the effect of physical exercise on the inflammatory profile of these subjects. AIM: The aim was to evaluate the effect of physical training on cytokine expression in CD4+ T lymphocytes from subjects with COPD. METHODS: This is a randomized controlled trial. Subjects with stable COPD were grouped into two groups, exercise and control. In total, 23 subjects with stable COPD were evaluated, of which 15 underwent aerobic strength training [physical exercise group (PEG)] and 8 underwent breathing exercises [respiratory physiotherapy group (RPG)]. Intracellular cytokines [interleukin (IL)-8, IL-13, IL-17, IL-6, IL-2, IL-10, and tumor necrosis factor alpha (TNF-α)] from CD4+ T lymphocytes were analyzed from peripheral blood through flow cytometry, before and after 8 weeks of intervention. RESULTS: The PEG and RPG groups had a mean age of 68 ± 5.96 and 72.25 ± 6.86 years and predicted forced expiratory volume in the first second (FEV1) of 58.6 ± 15.99% and 39.75 ± 10.39%, respectively. It was possible to detect a significant reduction in IL-8 (p = 0.0125) and an increase in IL-13 (p = 0.0014) and an increase in TNF-α (p < 0.001) in both groups. CONCLUSION: Eight weeks of physical training, both peripheral and respiratory, were able to reduce concentrations of IL-8 and to increase IL-13, and TNF-α in CD4+ T lymphocytes in subjects with stable COPD. The findings reinforce the benefits of interventions in subjects with COPD, revealing data not previously investigated.

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OBJECTIVE: The purpose of this study was to investigate the effectiveness of elastic resistance training on improving muscle strength, functional exercise capacity, health-related quality of life (HRQoL), and dyspnea in people with stable chronic obstructive pulmonary disease (COPD). METHODS: For this systematic review, PubMed, The Cochrane Library, Embase (OVID), PEDro, SciELO, and CINAHL were searched from inception to November 2019. Included studies were randomized clinical trials in which people with stable COPD were allocated to (1) an experimental group that received lower-limb resistance training, upper-limb resistance training, or both using elastic resistance; or (2) a control group that received no or sham resistance training or conventional resistance training using weight machines. Data extraction was performed by 3 review authors. The methodological quality of the studies was assessed using the PEDro scale. Eight studies on 332 participants were included. RESULTS: Knee extensor strength was higher in the experimental group (standardized mean difference = 0.52, 95% CI = 0.09-0.95) compared with the non-exercise control group. Compared with the conventional exercise control, the experimental group presented similar effects for muscle strength, functional exercise capacity, HRQoL, and dyspnea (95% CI overlapped the line of no effect for all). CONCLUSIONS: Elastic resistance training improves muscle strength in people with COPD. The current review suggests elastic resistance as a potential alternative to conventional resistance training using weight machines, as they show similar effects on muscle strength, functional exercise capacity, HRQoL, and dyspnea. IMPACT: Due to its beneficial effects, including reduced risk of exacerbation-related hospitalizations, exercise training is viewed as the cornerstone of pulmonary rehabilitation in people with COPD. This study shows that elastic resistance training can be an effective, portable, practical, and low-cost alternative to conventional weight resistance training. LAY SUMMARY: Training with elastic resistance tubes or bands-which are easy to carry, easy to use, and relatively low cost-can be an effective way to improve strength for people with COPD and promote similar benefits to those achieved with weight machines.

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INTRODUCTION: People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength. METHODS: This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster. RESULTS: One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p < 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes. CONCLUSIONS: Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients.

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BACKGROUND: Sarcopenic elderly present low muscle mass and strength, however, it is not clear if the inflammatory and metabolic profile is more related to low lean mass or high fat mass in sarcopenic and non-sarcopenic overfat elderly. AIM: To verify the difference in inflammatory and metabolic responses in sarcopenic and non-sarcopenic overfat elderly and the relationship between these markers, body composition, and strength in this population. METHODS: Fifty-seven elderly were divided into two groups: sarcopenic (n = 30) and non-sarcopenic (n = 27). Body composition was evaluated with octopolar bioimpedance. Total cholesterol, high-density lipoprotein cholesterol, triacylglycerol, glucose, cortisol, leptin, adiponectin, Plasminogen activator inhibitor-1 (PAI-1), TNF-α, IL-6, IL-8, and IL-10 were assessed. The handgrip test was used to evaluate strength. RESULTS: When comparing the inflammatory profile, sarcopenic individuals showed greater adiponectin concentration (p = 0.019), adiponectin/fat mass ratio (p < 0.001), adiponectin/visceral fat (p < 0.001), and higher PAI-1 (p = 0.019) than non-sarcopenic overfat elderly. After adjusting the inflammatory profile by skeletal muscle mass the significant differences between groups were maintained (p < 0.05) but no significant differences between groups were observed when adjusting by fat mass, despite a tendency to a significant difference for adiponectin concentration (p = 0.06). In addition, after adjusting leptin by fat mass there was a statistically significant lower concentration in the sarcopenic compared to non-sarcopenic overfat elderly. CONCLUSION: Non-sarcopenic overfat elderly presented lower anti-inflammatory and anti-atherogenic responses than sarcopenic elderly. Furthermore, fat mass but not skeletal muscle mass seem to change these responses.

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Background: Low-grade inflammation can be present in chronic obstructive pulmonary disease (COPD), which may affect the regulation of muscle protein and body metabolism. Regular exercise show improvement in muscle strength and dyspnea in patients with COPD, however, the response to training on inflammatory and metabolic disorders is unclear. In this study, we compared the effects of resistance training using weight machines and elastic resistance (bands and tubes) on the inflammatory and metabolic responses in patients with COPD. Methods: Patients with COPD were randomized into three groups: elastic band group (EBG), elastic tube group (ETG), and weight machines equipment group (MG). EBG and ETG were analyzed together [elastic group (EG)]. The participants were evaluated for pulmonary function (spirometry), peripheral muscle strength (digital dynamometry), IL-6, TNF-α, IL-10, IL-15 (Immunoassay), glucose, triacylglycerol, total cholesterol, HDL-c, and albumin levels (Enzymatic colorimetric). Blood samples were collected to assess the acute and chronic exercise responses after 12 weeks of training protocol. Results: The patient's mean age was 71.53 ± 6.97 years old. FEV1 (percent predicted) was 50.69 ± 16.67 and 45.40 ± 15.15% for EG and MG, respectively (p = 0.28). All groups increased muscle strength (p < 0.05) with no differences between groups. The acute response to exercise after 12 weeks of training showed improvement of inflammation when compared to baseline. Regarding the chronic effects, it was observed a decrease of all cytokines, except IL-10 (p < 0.05). After 12 weeks of training, the analysis of the metabolic profile presented a reduction in glucose concentration (p < 0.01), with no differences between groups (p = 0.30) and a decrease in triacylglycerol for the EG (p > 0.01). Conclusions: Training with elastic resistances or conventional weight machines showed improvement of inflammation response after 12 weeks of training. Chronically, both training groups showed anti-inflammatory effects, with the EG showing a strong tendency to improve IL-10/TNF-α ratio and IL-10 levels. TRIAL REGISTRATION: RBR-6V9SJJ.

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The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p < 0.05 for both), functional exercise capacity (ETG Δ4 ± 4% and CTG Δ6±8%; p < 0.05 for both). Improvement on "pain" domain of HRQOL could only be observed in the CTG (Δ21 ± 26% p = 0.037). CG showed no statistical improvement in any of the variables investigated. Resistance training using elastic tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults.

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BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

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BACKGROUND: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. OBJECTIVES: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. METHODS: Nineteen men with COPD (72±7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. RESULTS: At the beginning of the FVC maneuver, HR decreased (p<0.001) and then increased gradually until the end of the test (p<0.001). After the end of maneuver, HR continued to increase until it reached a peak (p<0.001), and then it fell quickly to below at-rest values (p<0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. CONCLUSION: The FVC test influences the behavior of COPD patient HR without changing autonomic control or BP.

CONTEXTUALIZAÇÃO: O teste de capacidade vital forçada (CVF) é rotineiramente realizado na avaliação da função pulmonar de pacientes com doença pulmonar obstrutiva crônica (DPOC). Entretanto, permanece pouco compreendida a influência do teste de CVF sobre o sistema cardiovascular de pacientes com DPOC. OBJETIVOS: Analisar o comportamento da frequência cardíaca (FC), pressão arterial (PA) e variabilidade da frequência cardíaca (VFC) no teste de CVF na DPOC. MÉTODOS: Dezenove homens com DPOC (72 ± 7 anos, no estágio de gravidade GOLD I=3, II=5, III=7 e IV=4 pacientes) realizaram a manobra de CVF e tiveram sua FC monitorada durante todo o exame, e a VFC analisada nos domínios do tempo (rMSSD) e da frequência (BF, AF e BF/AF) durante o repouso, antes e após a melhor manobra de CVF. A PA foi analisada no repouso, imediatamente ao final da manobra de CVF e 10 minutos após o término de todos os testes. RESULTADOS: Ao início da manobra de CVF, a FC reduziu (p<0,001) e, em seguida, aumentou progressivamente até o final do teste (p<0,001). Após término da manobra, a FC continuou a aumentar até atingir um pico (p<0,001) e depois caiu rapidamente a valores inferiores aos de repouso (p<0,001) e retornou ao seu valor basal. A PA e os índices da VFC não sofreram alterações nos períodos analisados. CONCLUSÃO: O teste de CVF influencia o comportamento da FC, sem alterar o seu controle autonômico, bem como a PA em pacientes com DPOC nos períodos analisados.

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