RESUMO
We aimed to investigate sex-related glycemic and cardiovascular responses after intensity- (moderate) and duration- (30 minutes) matched interval aerobic exercise (IAE) and continuous (CAE) aerobic exercise sessions in patients with type 1 diabetes mellitus (T1DM). A total of 19 volunteers (10 women) participated in 2 randomized and crossover sessions (1:1). Heart rate, systolic and diastolic blood pressure, double product, and blood glucose (BG) levels were measured before (PRE), immediately after (POST-0), and 20 minutes after (POST-20) each session. The rates of perceived exertion (RPE) and enjoyment levels (ELs) were assessed after each session. Generalized estimating equations were used to analyze the data (condition × time × sex). Regarding sex-related changes, men showed BG reductions at POST-0 and POST-20 after CAE (∆: -3.7 and -3.7 mmol/L, respectively) and only at POST-0 after IAE (∆: -1.6 mmol/L), with 1 episode of hypoglycemia occurring in the latter group. In contrast, women showed reduced BG values only after CAE at both time points (∆: -1.4 and -1.7 mmol/L) compared with PRE values. The decrease in BG levels at both time points was higher for men after CAE than IAE. Cardiovascular responses, RPEs, and ELs were similar between exercise sessions, except for blood pressure, which showed higher values in men. In conclusion, lower BG levels were observed after CAE, with greater reductions in men. Similar cardiovascular, RPE, and EL responses were found across sexes and sessions. Consideration of sex-specific recommendations may be warranted when prescribing aerobic exercise, particularly, for men with irregular physical activity levels.
Assuntos
Glicemia , Pressão Sanguínea , Estudos Cross-Over , Diabetes Mellitus Tipo 1 , Exercício Físico , Frequência Cardíaca , Humanos , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/fisiopatologia , Masculino , Feminino , Glicemia/metabolismo , Adulto , Frequência Cardíaca/fisiologia , Pressão Sanguínea/fisiologia , Exercício Físico/fisiologia , Fatores Sexuais , Adulto JovemRESUMO
Neurocritical patients (NCPs) in the intensive care unit (ICU) rapidly progress to respiratory and peripheral muscle dysfunctions, which significantly impact morbidity and death. Early mobilization in NCPs to decrease the incidence of ICU-acquired weakness has been showing rapid growth, although pertinent literature is still scarce. With this review, we summarize and discuss current concepts in early mobilization of critically ill patients within the context of neurologic pathology in NCPs. A narrative synthesis of literature was undertaken trying to answer the following questions: How do the respiratory and musculoskeletal systems in NCPs behave? Which metabolic biomarkers influence physiological responses in NCPs? Which considerations should be taken when prescribing exercises in neurocritically ill patients? The present review detected safety, feasibility, and beneficial response for early mobilization in NCPs, given successes in other critically ill populations and many smaller intervention trials in neurocritical care. However, precautions should be taken to elect the patient for early care, as well as monitoring signs that indicate interruption for intervention, as worse outcomes were associated with very early mobilization in acute stroke trials.
Assuntos
Estado Terminal , Deambulação Precoce , Humanos , Cuidados Críticos , Doenças do Sistema Nervoso/terapia , Unidades de Terapia IntensivaRESUMO
Background: Active videogames (AVGs) have been primarily studied in healthy individuals. To use the technology in type 1 diabetes mellitus (T1DM) patients, cardiovascular and enjoyment responses should be studied and compared with traditional exercises. Objective: To compare the effects of AVG and running exercises on cardiovascular and enjoyment responses in T1DM patients. Methods: Cardiovascular (heart rate, HR; blood pressure, BP; double product, DP; vessel diameter, VD; % endothelial function, %EF) and enjoyment levels were recorded during 3 weeks and twice per week. On the first day, patients completed baseline assessments, familiarization, and a 30-minute control session. On the second day and after 24 hours, the measurements were repeated. Patients repeated the same protocol in the second and third weeks and performed randomized active sessions. Results: T1DM patients had similar cardiovascular responses during active exercises without significant postexercise hypotension to HR, BP, and DP over time. However, VD and %EF values were higher in AVG, followed by running and rest, 30 minutes and after 24 hours (VD-AVG: 39.6 ± 9.5, 48.8 ± 12.3 and 56.6 ± 13.9 mm; VD-running: 41.5 ± 9.9, 47.4 ± 10.1 and 46.4 ± 12.4 mm; %EF-AVG: 9.6 ± 8.5, 29.6 ± 17.1 and 45.4 ± 25.9%; %EF-running: 7.3 ± 9.4, 14.8 ± 14.1 and 26.8 ± 18.9%, p < 0.05). Enjoyment was also higher in AVG compared with the running session (9.4 ± 0.7 vs. 7.7 ± 1.6; p < 0.05). Conclusions: AVG presented similar cardiovascular responses to running with higher endothelial and enjoyment levels.