Publications by authors named "Paulo Farinatti"

114 Publications

Muscle metaboreflex adaptations to exercise training in health and disease.

Eur J Appl Physiol 2021 Jun 29. Epub 2021 Jun 29.

Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rua São Francisco Xavier, 524, sala 8133F, Maracanã, Rio de Janeiro, RJ, CEP, 20550-013, Brazil.

Abnormalities in the muscle metaboreflex concur to exercise intolerance and greater cardiovascular risk. Exercise training benefits neurocardiovascular function at rest and during exercise, but its role in favoring muscle metaboreflex in health and disease remains controversial. While some authors demonstrated that exercise training enhanced the sensitization of muscle metabolically afferents and improved neurocardiovascular responses to muscle metaboreflex activation, others reported unaltered responses. This narrative review aimed to: (a) highlight the current evidence on the effects of exercise training upon cardiovascular and autonomic responses to muscle metaboreflex activation; (b) analyze the role of training components and indicate potential mechanisms of metaboreflex adaptations; and (c) address key methodological features for future research. Though limited, accumulated evidence suggests that muscle metaboreflex adaptations depend on the individual clinical status, exercise modality, and training duration. In healthy populations, most trials negated the hypothesis of metaboreflex improvement due to chronic exercise, irrespective of the training duration. Favorable changes in patients with impaired metaboreflex, particularly chronic heart failure, mostly resulted from long-term interventions (> 16 weeks) including aerobic exercise of moderate to high intensity, performed in isolation or within multimodal training. Potential mechanisms of metaboreflex improvements include enhanced sensitivity of channels and receptors, greater antioxidant capacity, lower metabolite accumulation, increased functional sympatholysis, and muscle perfusion. Future research should investigate: (1) the dose-response relationship of training components within different exercise modalities to elicit improvements in individuals showing intact or impaired muscle metaboreflex; and (2) potential and specific underlying mechanisms of metaboreflex improvements in individuals with different medical conditions.
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http://dx.doi.org/10.1007/s00421-021-04756-8DOI Listing
June 2021

Postexercise hypotension due to resistance exercise is not mediated by autonomic control: A systematic review and meta-analysis.

Auton Neurosci 2021 Sep 27;234:102825. Epub 2021 May 27.

Department of Kinesiology, University of Connecticut, Storrs, CT, USA.

Changes in autonomic control have been suggested to mediate postexercise hypotension (PEH). We investigated through meta-analysis the after-effects of acute resistance exercise (RE) on blood pressure (BP) and autonomic activity in individuals with normal and elevated BP. Electronic databases were searched for trials including: adults; exclusive RE interventions; and BP and autonomic outcomes measured pre- and postintervention for at least 30 min. Analyses incorporated random-effects assumptions. Thirty trials yielded 62 interventions (N = 480). Subjects were young (33.6 ± 15.6 yr), with systolic BP (SBP)/diastolic BP (DBP) of 124.2 ± 8.9/71.5 ± 6.6 mm Hg. Overall, RE moderately reduced SBP (normal BP: ~1 to 4 mm Hg, p < 0.01; elevated BP: ~1 to 12 mm Hg, p < 0.01) and DBP (normal BP: ~1 to 4 mm Hg, p < 0.03; elevated BP: ~0.5 to 7 mm Hg, p < 0.01), which was in general parallel to sympathetic increase (normal BP: g = 0.49 to 0.51, p < 0.01; elevated BP: g = 0.41 to 0.63, p < 0.01) and parasympathetic decrease (normal BP: g = -0.52 to -0.53, p < 0.01; elevated BP: g = -0.46 to -0.71, p < 0.01). The meta-regression showed inverse associations between the effect sizes of BP vs. sympathetic (SBP: slope - 0.19 to -3.45, p < 0.01; DBP: slope - 0.30 to -1.60, p < 0.01), and direct associations vs. parasympathetic outcomes (SBP: slope 0.17 to 2.59, p < 0.01; DBP: slope 0.21 to 1.38, p < 0.01). In conclusion, changes in BP were concomitant to sympathetic increase and parasympathetic decrease, which questions the role of autonomic fluctuations as potential mechanisms of PEH after RE.
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http://dx.doi.org/10.1016/j.autneu.2021.102825DOI Listing
September 2021

Does Resistance Training with Blood Flow Restriction Affect Blood Pressure and Cardiac Autonomic Modulation in Older Adults?

Int J Exerc Sci 2021 1;14(3):410-422. Epub 2021 Apr 1.

Graduate Program in Clinical and Experimental Physiopathology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.

Resistance training (RT) with blood flow restriction (BFR) appears to accelerate muscle hypertrophy and strength gains in older populations. However, the training-related effects of RT with BFR upon blood pressure (BP) and cardiac autonomic modulation in the elderly remains unclear. The objective of this study is to compare the chronic effects of low-intensity RT performed with soft BFR (BFR) . high-intensity (HI) and low-intensity RT (CON) without BFR on BP and heart rate variability (HRV) indices in older adults. Thirty-two physically inactive participants (72 ± 7 yrs) performed RT for upper and lower limbs (50-min sessions, 3 times/week) for 12 weeks, being assigned into three groups: a) BFR; 30% of 1 repetition maximum (RM) with BFR corresponding to 50% of arterial occlusion pressure; b) HI; 70% of 1RM without BFR; c) CON; 30% of 1 RM without BFR. Resting BP and HRV were assessed at rest in the supine position, before and after exercise interventions. Systolic BP (Δ = -7.9 ± 8.0 mmHg; = 0.002; effect size = 0.62), diastolic BP (Δ = trace length by the duration of the test 5.0 ± 6.0 mmHg; = 0.007; effect size = 0.67) and mean arterial pressure (Δ = -6.3 ± 6.5 mmHg; = 0.003/effect size = 0.77) reduced after BFR, remaining unaltered in HI and CON. HRV indices of sympathetic and vagal modulation did not change in all groups ( ≥ 0.07 for all comparisons). 12-wk RT with low intensity and relatively soft BFR substantially reduced BP at rest in older adults . traditional RT performed with either low or high intensity. Those reductions were not parallel to changes in autonomic modulation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136558PMC
April 2021

Moderators of strength gains and hypertrophy in resistance training: A systematic review and meta-analysis.

J Sports Sci 2021 May 12:1-10. Epub 2021 May 12.

Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

This meta-analysis investigated the role of resistance training (RT) moderators on strength and muscle mass gains in untrained young (YG) and older (OG) adults. Electronic databases were searched for randomised controlled trials simultaneously assessing muscle strength and mass. Effect sizes (ES) reflecting improvements in strength and muscle mass were found for all moderators in YG and OG (ES 0.25- to 1.72; < 0.05), excepting muscle mass in YG after RT was performed with <3 sets/exercise. Strength gains ( < 0.001) were greater in non-periodised . periodised RT in YG (ES 1.72 . 1.05) and OG (1.40 . 0.74). ES in OG was greater ( < 0.04) when RT included non-failure . failure repetitions (1.35 . 0.96), 3 . >3 sets/exercise (1.30 . 0.90), ≥3 . <3 days/week (1.70 . 0.78), and ≥12 . <12 weeks (1.48 . 0.92). Amoderating effect of RT factors on muscle mass was not detected in YG, while greater ES was found in OG for RT with ≥3 . <3 days/week (0.50 vs. 0.25). Concluding, different combinations of RT factors improved strength and muscle mass in YG and OG. In OG, this was favoured by greater frequency and duration, although hampered by excessive volume.
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http://dx.doi.org/10.1080/02640414.2021.1924978DOI Listing
May 2021

Acute effects of physical exercise with different levels of blood flow restriction on vascular reactivity and biomarkers of muscle hypertrophy, endothelial function and oxidative stress in young and elderly subjects - A randomized controlled protocol.

Contemp Clin Trials Commun 2021 Jun 25;22:100740. Epub 2021 Mar 25.

Graduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Background: Gains in muscle mass and strength have been documented in exercise training with blood flow restriction (BFR). However, the impact of retrograde blood flow during BFR training on vascular health remains unclear. The present study designed a protocol to evaluate the acute effects of exercise performed with different levels of BFR on vascular reactivity and biomarkers of endothelial function, oxidative stress, and muscle hypertrophy in young and older individuals.

Methods And Study Design: Sixty-eight physically inactive eutrophic men [34 young (18-25-yrs old) and 34 elderly (≥65-yrs old)] will be included in the study. Subjects will undergo three experimental protocols: a) control (ExCON) - handgrip exercise with intensity of 30% of the maximum voluntary contraction (MVC); b) blood flow restriction (ExBFR) - handgrip exercise with a resistance of 30% of the MVC with low level of BFR [80% of arterial occlusion pressure at rest (rAOP)]; and c) arterial occlusion pressure (ExAOP) - handgrip exercise with a resistance of 30% of the MVC with high level of BFR (120% of rAOP). Primary outcomes will be: a) vascular reactivity assessed by venous occlusion plethysmography; b) endothelial function (nitric oxide and apoptotic endothelial micro particles; c) oxidative stress (thiobarbituric acid reactive substances). Growth hormone and lactate concentration will be measured as secondary outcomes reflecting the hypertrophic drive and metabolic stress, respectively.

Discussion: The findings of the present study may help to elucidate the age-related impacts of BFR training on the vascular health.
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http://dx.doi.org/10.1016/j.conctc.2021.100740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076709PMC
June 2021

Daily physical activity, cardiorespiratory fitness, nutritional status, endothelial function, and autonomic modulation in school-age adolescents: A principal component analysis.

Obes Res Clin Pract 2021 May-Jun;15(3):205-211. Epub 2021 Apr 24.

Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, RJ, Brazil; Endocrinology Care Teaching Unit, Department of Internal Medicine, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil. Electronic address:

Purpose: This study evaluated the association between cardiorespiratory fitness, abdominal obesity, blood pressure, endothelial function, and autonomic modulation in school-age adolescents exhibiting different levels of habitual physical activity and nutritional status, through a multivariate statistical approach.

Methods: 101 adolescents aged 15-18 years (54 females) underwent assessments of daily physical activity, body mass index, cardiorespiratory fitness, reactive hyperemia, and heart rate variability. Based on BMI adjusted for age and sex (z-BMI), 21 adolescents were classified as 'overweight' (9 girls), and 9 as 'obese' (4 girls). The common variation between those variables was assessed through Principal Component Analysis (PCA).

Results: Main axis of common variation of outcomes analyzed defined four principal components (PCs) accounting for 69.7% of overall variance, related to 'abdominal obesity and blood pressure' (PC1; eigenvalue=2.76), 'cardiorespiratory fitness, endothelial function, and autonomic modulation' (PC2, eigenvalue=1.98), 'cardiorespiratory fitness' (PC3, eigenvalue=1.21), and 'sedentary behavior' (PC4, eigenvalue=1.02). Girls reported longer screen time and sedentary behavior than boys. Notwithstanding, in both sexes poorer cardiorespiratory fitness corresponded to lower reactive hyperemia and vagal modulation, irrespective of the nutritional status. Overall, adolescents classified as 'obese' and 'sedentary' exhibited poorer CRF concomitantly to autonomic and endothelial dysfunctions.

Conclusion: In school-age adolescents, endothelial and autonomic dysfunctions related to poor cardiorespiratory fitness, irrespective of the nutritional status and physical activity level. However, endothelial and autonomic dysfunctions were more prevalent among adolescents combining poor cardiorespiratory fitness, reduced levels of daily physical activity, and overweight/obesity.
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http://dx.doi.org/10.1016/j.orcp.2021.04.004DOI Listing
April 2021

Is a verification phase useful for confirming maximal oxygen uptake in apparently healthy adults? A systematic review and meta-analysis.

PLoS One 2021 17;16(2):e0247057. Epub 2021 Feb 17.

Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

Background: The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET).

Objective: To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained.

Methods: MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol.

Results: Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias.

Conclusions: The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances.

Prospero Registration Id: CRD42019123540.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247057PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888616PMC
February 2021

Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre- to established hypertension.

Clinics (Sao Paulo) 2021 20;76:e1971. Epub 2021 Jan 20.

Programa de Graduacao em Ciencias da Atividade Fisica, Universidade Salgado de Oliveira, Niteroi, RJ, BR.

Objectives: Few studies have investigated whether post-exercise hypotension (PEH) after concurrent exercise (CEX) is related to changes in cardiac output (Q) and systemic vascular resistance (SVR) in older individuals. We tested whether PEH after a single bout of CEX circuits performed in open-access facilities at the Third Age Academies (TAA) in Rio de Janeiro City (Brazil) would be concomitant with decreased Q and SVR in individuals aged ≥60 years with prehypertension. Moreover, we assessed autonomic modulation as a potential mechanism underlying PEH.

Methods: Fourteen individuals (age, 65.8±0.9 y; systolic/diastolic blood pressure [SBP/DBP], 132.4±12.1/72.8±10.8 mmHg; with half of the patients taking antihypertensive medications) had their blood pressure (BP), heart rate (HR), Q, SVR, HR variability (HRV), and spontaneous baroreflex sensitivity (BRS) recorded before and 50 min after CEX (40-min circuit, including seven stations of alternate aerobic/resistance exercises at 60-70% HR reserve) and non-exercise control (CONT) sessions. The study protocol was registered in a World Health Organization-accredited office (Trial registration RBR-7BWVPJ).

Results: SBP (Δ=-14.2±13.1 mmHg, p=0.0001), DBP (Δ=-5.2±8.2 mmHg, p= 0.04), Q (Δ=-2.2±1.5 L/min, p=0.0001), and BRS (Δ=-3.5±2.6 ms/mmHg; p=0.05) decreased after CEX as compared with the CONT session. By contrast, the HR increased (Δ=9.4±7.2 bpm, p<0.0001), and SVR remained stable throughout the postexercise period as compared with the CONT session (Δ=0.10±0.22 AU, p=0.14). We found no significant difference between the CEX and CONT with respect to the HRV indexes reflecting autonomic modulation.

Conclusion: CEX induced PEH in the older individuals with prehypertension status. At least in the first 50 min, PEH occurred parallel to the decreased Q and increased HR, while SVR was not different. The changes in autonomic outflow appeared to be unrelated to the acute cardiac and hemodynamic responses.
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http://dx.doi.org/10.6061/clinics/2021/e1971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798120PMC
April 2021

Effects of cycling bouts performed with different intensities and amounts of energy expended on central pressure and pulse wave reflection in normotensive and hypertensive men.

Blood Press Monit 2021 Jun;26(3):183-190

Postgraduate Program in Medical Sciences, Faculty of Medical Sciences.

Objective: This study investigated pulse wave analysis in normotensive and hypertensive men after cycling bouts with different intensities and amounts of energy expended.

Methods: Twenty-four men were assigned into normotensive (n = 14; age: 40.7 ± 2.8 years; 24-h ambulatory SBP/DBP:121 ± 2/74 ± 1 mmHg) and hypertensive (n = 10; age: 39.2 ± 2.3 years; 24-h ambulatory SBP/DBP:139 ± 3/86 ± 2 mmHg) groups. Participants undertook a maximal cardiopulmonary exercise test, a nonexercise control session (CTL) and three cycling bouts [two prolonged bouts expending 300 kcal at 50% (i.e. P-MOD) and 70% (i.e. P-VIG) oxygen uptake reserve (VO2R) and one short bout expending 150 kcal at 50% VO2R (i.e. S-MOD)] performed in a randomized order. Central SBP (cSBP), pulse pressure (cPP), augmentation pressure, augmentation index (AIx), heart rate (HR) and AIx adjusted for HR ([email protected]) were determined 10 min before, and 30- and 70-min postintervention.

Results: Compared to CTL, only the P-VIG changed the cSBP [70-min (Δ -11.7 mmHg)], cPP [70-min (Δ:-7.4 mmHg)], augmentation pressure [30-min (Δ:-5.7 mmHg); 70-min (Δ:-7.3 mmHg)], AIx [30-min (Δ:-15.3 %); 70-min (Δ:-16.4 %)], [email protected] [30-min (Δ:-12.8 %); 70-min (Δ:-13.9 %)] and HR [70-min (Δ: 9.9 bpm)] in the hypertensive group. However, all exercise bouts mitigated the increased cSBP responses post-CTL in the hypertensive group.

Conclusion: The present study provides evidence that vigorous-intensity aerobic exercise reduces acute central pressure and pulse wave reflection in hypertensive men.
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http://dx.doi.org/10.1097/MBP.0000000000000508DOI Listing
June 2021

Effects of aerobic, resistance and concurrent exercise on pulse wave reflection and autonomic modulation in men with elevated blood pressure.

Sci Rep 2021 01 12;11(1):760. Epub 2021 Jan 12.

Clinic of Hypertension and Associated Metabolic Diseases, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

The acute effects of exercise modes on pulse wave reflection (PWR) and their relationship with autonomic control remain undefined, particularly in individuals with elevated blood pressure (BP). We compared PWR and autonomic modulation after acute aerobic (AE), resistance (RE), and concurrent exercise (CE) in 15 men with stage-1 hypertension (mean ± SE: 34.7 ± 2.5 years, 28.4 ± 0.6 kg/m, 133 ± 1/82 ± 2 mmHg). Participants underwent AE, RE, and CE on different days in counterbalanced order. Applanation tonometry and heart rate variability assessments were performed before and 30-min postexercise. Aortic pressure decreased after AE (- 2.4 ± 0.7 mmHg; P = 0.01), RE (- 2.2 ± 0.6 mmHg; P = 0.03), and CE (- 3.1 ± 0.5 mmHg; P = 0.003). Augmentation index remained stable after RE, but lowered after AE (- 5.1 ± 1.7%; P = 0.03) and CE (- 7.6 ± 2.4% P = 0.002). Systolic BP reduction occurred after CE (- 5.3 ± 1.9 mmHg). RR-intervals and parasympathetic modulation lowered after all conditions (~ 30-40%; P < 0.05), while the sympathovagal balance increased after RE (1.2 ± 0.3-1.3 ± 0.3 n.u., P < 0.05). Changes in PWR correlated inversely with sympathetic and directly with vagal modulation in CE. In conclusion, AE, RE, and CE lowered central aortic pressure, but only AE and CE reduced PWR. Overall, those reductions related to decreased parasympathetic and increased sympathetic outflows. Autonomic fluctuations seemed to represent more a consequence than a cause of reduced PWR.
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http://dx.doi.org/10.1038/s41598-020-80800-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804273PMC
January 2021

Physical Activity Level, Sedentary Time, and Weight Regain After Bariatric Surgery in Patients Without Regular Medical Follow-up: a Cross-Sectional Study.

Obes Surg 2021 04 6;31(4):1705-1713. Epub 2021 Jan 6.

Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Purpose: The impact of regular exercises or physical activity (PA) on weight of bariatric patients need to be elucidated. We investigated PA levels, sedentary time (ST), and weight regain on these patients who were without regular medical follow-up before recruitment. Moreover, we investigated correlation and concordance between self-reported and objective measures in moderate-to-vigorous PA (MVPA) and ST.

Materials And Methods: We invited 132 patients previously subjected to a bariatric procedure to a medical appointment in our unit and proposed them to be volunteers. Ninety patients, aged 42 ± 8 years and BMI 32.9 ± 6.6 kg/m, entered the study and were allocated into groups according to time since surgery < or ≥5 years (G5- or G5+, respectively). They were further assigned into low or high rates of weight regain (RWR; cutoff 20%). PA and ST were measured by International PA Questionnaire (IPAQ) and ActiGraph GT3X+ accelerometer.

Results: In G5- group, PA and ST were similar between low and high RWR. In G5+ group, MVPA time, number of steps/day, percent of patients somewhat active, and 30-60 min/day of MVPA were statistically higher in those with low RWR. Of note, measures of MVPA < 30 min/day occurred more frequently in those with high RWR. MVPA and ST self-reported vs. objective measures were correlated (P < 0.001). Nevertheless, there was no concordance between these measures (P > 0.05).

Conclusions: Low level of PA and longer ST occurred more frequently in those with high RWR and longer time since surgery. Although well-correlated, any concordance between IPAQ and accelerometer measures was noted.
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http://dx.doi.org/10.1007/s11695-020-05184-xDOI Listing
April 2021

Blood Pressure Response to Muscle Metaboreflex Activation is Impaired in Men Living with HIV.

Int J Sports Med 2021 Mar 14;42(3):246-252. Epub 2020 Oct 14.

Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

We investigated the muscle metaboreflex contribution to blood pressure response during dynamic handgrip exercise in men living with HIV (MLHIV) vs. without HIV (Controls). Pressor and heart rate responses were evaluated during metaboreflex activation through post-exercise muscle ischemia (PEMI) method and control exercise session (CER) in 17 MLHIV and 21 Controls. Protocols were performed randomly on the same day, being both sessions composed of 12 min, as follows: a) 3 min at rest, b) 3 min of dynamic handgrip exercise at 30% of maximal voluntary contraction, c) 3 min of recovery post-exercise with vascular occlusion (occlusion only in PEMI), and d) 3 min of recovery post-exercise without vascular occlusion. To assess metaboreflex response, differences between PEMI and CER in recovery post-exercise were calculated for blood pressure and heart rate. Systolic and mean blood pressure (P<0.01) were superior in the last 2 min of recovery with vascular occlusion at PEMI in relation to CER for both groups. No difference was found between groups for blood pressure and heart rate (P>0.05). However, metaboreflex response for systolic blood pressure was lower in MLHIV vs. Controls (4.05±4.63 vs. 7.61±3.99 mmHg; P=0.01). In conclusion, pressor response during metaboreceptor stimulation was attenuated in men living with HIV, which may suggest loss of muscle metaboreflex sensibility.
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http://dx.doi.org/10.1055/a-1263-1124DOI Listing
March 2021

Physical activity among women of low socioeconomic status living with HIV in two major cities of Brazil and Mozambique: A cross-sectional comparative study.

Clinics (Sao Paulo) 2020 26;75:e1771. Epub 2020 Aug 26.

Laboratorio de Atividade Fisica e Promocao da Saude (LABSAU), Instituto de Educacao Fisica e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR.

Objectives: Physical activity (PA) may reduce cardiovascular risk and preserve functional capacity of people living with human immunodeficiency virus (HIV). However, only limited research objectively measured PA in patients with low socioeconomic status (SES) in low-income countries, particularly in South America and sub-Saharan Africa. This study compared the PA assessed by accelerometers in women of low SES living with HIV under common antiretroviral therapy (cART) from two major cities in Brazil (Rio de Janeiro, n=33; 40.1±6.1 years) and Mozambique (Maputo, n=50; 38.8±8.7 years).

Methods: Eligible women wore triaxial accelerometers during seven consecutive days, to estimate their habitual PA and daily energy expenditure.

Results: The proportion of participants with overweight/obesity was greater in Rio than Maputo (57% vs. 30%; p=0.021), as well as those classified as sedentary based on steps/day (45% vs. 22%; p=0.02). Sedentary time was prevalent (Median±IQD: Rio-1236±142 vs. Maputo-1192±135 min/day; p=0.15). Time spent in PA was short, but Brazilians exhibited lower amount of light (111±56 vs. 145±51 min/day; p<0.001) and moderate-to-vigorous PA (88±3 vs. 64±36 min/day; p=0.001) vs. Mozambicans. The proportion of patients performing 60 min/day of moderate-to-vigorous PA were 58% (Rio) and 82% (Maputo), respectively. Despite of this, estimated daily energy expenditure was equivalent in both groups (1976±579 vs. 1933±492 kcal; p=0.731).

Conclusions: Women with low SES living with HIV in Maputo were more active vs. patients from Rio de Janeiro. Albeit sedentary behavior was prevalent, the proportion of patients complying with the minimum recommended PA for health was higher than values usually reported in developed countries.
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http://dx.doi.org/10.6061/clinics/2020/e1771DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442379PMC
November 2020

Physical Activity Measured by Accelerometry in Mozambican Older Adult Women Attending a Regular Exercise Program.

J Aging Phys Act 2020 07 28;29(1):116-120. Epub 2020 Jul 28.

Time spent in different Physical Activity (PA) Intensities of 72 Mozambican older adult women (67 ± 7 years old) was assessed by means of triaxial accelerometers for 7 consecutive days, and participants were stratified based on their body mass index, as being normal weight (NW, n = 23); overweight (n = 16); or obese (OB, n = 33). Overall, most daily time was spent in sedentary activities (614 ± 111 min or 69.1%) and light PA (181 ± 56 min or 20.2%). On average, moderate to vigorous PA (MVPA) was performed during 10.6% of the day (93 ± 44 min). Time spent in MVPA was significantly higher in the NW compared to OB category (112.8 ± 51.5 vs. 81.0 ± 36.3; p = .021). The overweight group did not differ in time spent in MVPA when compared to NW and OB group. Overall, 75% of the participants spent more than 60 min a day in MVPA (NW: 83%; overweight: 81%; OB: 67%). Pearson's correlation between body mass index and total MVPA controlling for age was -.39 (p < .001). It was concluded that Mozambican older adult women living in urban and rural areas of Maputo province engaged in relatively high Physical Activity Intensities compared with individuals of similar ages in high-income countries, regardless of their nutritional status.
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http://dx.doi.org/10.1123/japa.2019-0182DOI Listing
July 2020

Effectiveness of Multicomponent Exercise Interventions in Older Adults With Dementia: A Meta-Analysis.

Gerontologist 2020 Jul 11. Epub 2020 Jul 11.

CIAFEL - Research Centre in Physical Activity, Health and Leisure, Porto, Portugal.

Background And Objectives: Multicomponent training (MT) combines aerobic, strength, postural, and balance exercises, and may be a promising intervention strategy for dementia. This meta-analysis study aims to systematize evidence concerning the effectiveness of MT in physical fitness, cognition, and functionality on activities of daily living (ADL) in older adults with dementia, and to identify moderation patterns regarding training variables.

Research Design And Methods: Four databases were systematically searched to locate potential trials through March 2019. A total of 2.312 records were identified and a final set of 17 manuscripts reviewed; of these, 6 satisfied all eligibility criteria.

Results: Samples sizes ranged from 27 to 170 participants; MT programs lasted between 4 weeks up to 12 months, took place from a daily basis to twice a week, and sessions ranged from 30-60 min. The TESTEX scale was used to analyze the methodological quality, and the funnel plots to assess risk of bias. This meta-analysis revealed that MT interventions benefit older adults with dementia regarding ADL's performance (ES= 0.313 [0.16 to 0.46]; p<0.01), but the evidence was not sufficiently robust to determine the effectiveness of MT on cognitive function and physical fitness, particularly, on agility.

Discussion And Implications: MT may be an important non-pharmacological strategy to enhance ADL's functionality on older adults with dementia. Findings suggest that long-term interventions are more prevailing than high frequency and longer duration exercise sessions. Further evidence is needed for acknowledging its benefits in specific cognitive abilities and physical fitness. This meta-analysis is registered in PROSPERO (no. CRD42020141545).
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http://dx.doi.org/10.1093/geront/gnaa091DOI Listing
July 2020

Effects of judo training upon body composition, autonomic function, and cardiorespiratory fitness in overweight or obese children aged 8- to 13 years.

J Sports Sci 2020 Nov 10;38(21):2508-2516. Epub 2020 Jul 10.

Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.

Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO (~5-10%), and VO (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.
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http://dx.doi.org/10.1080/02640414.2020.1792189DOI Listing
November 2020

Postexercise hypotension and related hemodynamic responses to cycling under heat stress in untrained men with elevated blood pressure.

Eur J Appl Physiol 2020 May 18;120(5):1001-1013. Epub 2020 Mar 18.

Department of Sport and Physical Activity, Edge Hill University, Ormskirk, L39 4QP, Lancashire, UK.

Purpose: To investigate the effect of heat stress on postexercise hypotension.

Methods: Seven untrained men, aged 21-33 years, performed two cycling bouts at 60% of oxygen uptake reserve expending 300 kcal in environmental temperatures of 21 °C (TEMP) and 35 °C (HOT) in a randomized, counter-balanced order. Physiological responses were monitored for 10-min before and 60-min after each exercise bout, and after a non-exercise control session (CON). Blood pressure (BP) also was measured during the subsequent 21-h recovery period.

Results: Compared to CON, systolic, and diastolic BPs were significantly reduced in HOT (Δ = - 8.3 ± 1.6 and - 9.7 ± 1.4 mmHg, P < 0.01) and TEMP (Δ = - 4.9 ± 2.1 and - 4.5 ± 0.9 mmHg, P < 0.05) during the first 60 min of postexercise recovery. Compared to TEMP, rectal temperature was 0.6 °C higher (P = 0.001), mean skin temperature was 1.8 °C higher (P = 0.013), and plasma volume (PV) was 2.6 percentage points lower (P = 0.005) in HOT. During the subsequent 21-h recovery period systolic BP was 4.2 mmHg lower in HOT compared to CON (P = 0.016) and 2.5 mmHg lower in HOT compared to TEMP (P = 0.039).

Conclusion: Exercise in the heat increases the hypotensive effects of exercise for at least 22 h in untrained men with elevated blood pressure. Our findings indicate that augmented core and skin temperatures and decreased PV are the main hemodynamic mechanisms underlying a reduction in BP after exercise performed under heat stress.
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http://dx.doi.org/10.1007/s00421-020-04340-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181414PMC
May 2020

Does Recreational Soccer Change Metabolic Syndrome Status in Obese Adolescents? A Pilot Study.

Res Q Exerc Sport 2021 Mar 21;92(1):91-99. Epub 2020 Feb 21.

University of Rio de Janeiro State.

: To evaluate whether a soccer program (RSP) might lower risk factors related to metabolic syndrome (MetS) in obese adolescents. : A 12-week randomized controlled trial [RSP: n = 6 (2 girls), age = 13.9 ± 1.6 yr, body mass index = 30.5 ± 2.1 kg/m; Control: n = 7 (2 girls); age = 14.7 ± 2.3 yr, body mass index: 30.8 ± 3.1 kg/m] was conducted. Participants underwent anthropometric, body fractioning, blood pressure, lipid profile, and glucose tolerance assessments at baseline and post-intervention. MetS status was determined based on waist circumference and at least two additional criteria: high blood pressure, hypertriglyceridemia, dyslipidemia, and hyperglycemia. RSP included eutrophic and overweight adolescents and consisted of small-sided games (85 ± 4% maximal heart rate) performed three times/week. : High-density lipoprotein increased [(HDL) ∆15.5 ± 5.2 mg·dL; = .01] and triglycerides lowered [(TG) ∆-34.7 ± 7.1 mg·dL; = .02] after RSP intervention. Between-group differences were also detected for changes in HDL (∆13.0 ± 6.1 mg·dL; = .04) and TG (∆-47.1 ± 7.7 mg·dL; = .05). The presence of MetS lowered in RSP (5 in 6 participants; = .02), but not Control (1 in 7 participants; = .32). : A 12-week RSP was effective to reduce MetS risk factors and status in obese adolescents.
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http://dx.doi.org/10.1080/02701367.2019.1711007DOI Listing
March 2021

Effects of moderate and high intensity isocaloric aerobic training upon microvascular reactivity and myocardial oxidative stress in rats.

PLoS One 2020 7;15(2):e0218228. Epub 2020 Feb 7.

University of Rio de Janeiro State, Rio de Janeiro, Laboratory of Physical Activity and Health Promotion, Rio de Janeiro, Brazil.

Systemic and central cardiovascular adaptations may vary in response to chronic exercise performed with different intensities and volumes. This study compared the effects of aerobic training with different intensities but equivalent volume upon microvascular reactivity in cremaster muscle and myocardial biomarkers of oxidative stress in Wistar rats. After peak oxygen uptake (VO2peak) assessment, rats (n = 24) were assigned into three groups: moderate-intensity exercise training (MI); high-intensity exercise training (HI); sedentary control (SC). Treadmill training occurred during 4 weeks, with exercise bouts matched by the energy expenditure (3.0-3.5 Kcal). Microvascular reactivity was assessed in vivo by intravital microscopy in cremaster muscle arterioles, while biomarkers of oxidative stress and eNOS expression were quantified at left ventricle and at aorta, respectively. Similar increasing vs. sedentary control group (SC) occurred in moderate intensity training group (MI) and high-intensity training group (HI) for endothelium-dependent vasodilation (10-4M: MI: 168.7%, HI: 164.6% vs. SC: 146.6%, P = 0.0004). Superoxide dismutase (SOD) (HI: 0.13 U/mg vs. MI: 0.09 U/mg and SC: 0.06 U/mg; P = 0.02), glutathione peroxidase (GPX) (HI: 0.00038 U/mg vs. MI: 0.00034 U/mg and SC: 0.00024 U/mg; P = 0.04), and carbonyl protein content (HI: 0.04 U/mg vs. MI: 0.03 U/mg and SC: 0.01 U/mg; P = 0.003) increased only in HI. No difference across groups was detected for catalase (CAT) (P = 0.12), Thiobarbituric acid reactive substances (TBARS) (P = 0.38) or eNOS expression in aorta (P = 0.44). In conclusion, higher exercise intensity induced greater improvements in myocardium antioxidant defenses, while gains in microvascular reactivity appeared to rely more on exercise volume than intensity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218228PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006926PMC
April 2020

Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial.

BMC Public Health 2019 Dec 27;19(1):1738. Epub 2019 Dec 27.

Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Rua Marechal Deodoro 217, Bloco C (Anexo), 2° Andar, Centro, Niteroi, RJ, 24030-060, Brazil.

Background: Public health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the 'Family Health Strategy' in low-income communities at Rio de Janeiro City, Brazil (known as 'favelas').

Methods: Patients were matched for age and assigned into three groups: a) FA (supervised training, n = 53; 60.5 ± 7.7 yrs); b) DA (self-reported, n = 43; 57.0 ± 11.2 yrs); c) PI (n = 48; 57.0 ± 10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications.

Results: At baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P > 0.05). However, diabetes prevalence was 10-15% lower in DA vs. FA and PI (P < 0.05). Intention-to-treat analysis showed significant reductions after intervention (P < 0.05) in FA for total cholesterol (~ 10%), LDL-C (~ 15%), triglycerides (~ 10%), systolic blood pressure (~ 8%), and diastolic blood pressure (~ 9%). In DA, only LDL-C decreased (~ 10%, P < 0.05). Significant increases were found in PI (P < 0.05) for total cholesterol (~ 15%), LDL-C (~ 12%), triglycerides (~ 15%), and systolic blood pressure (~ 5%). FRS lowered 35% in FA (intention-to-treat, P < 0.05), remained stable in DA (P > 0.05), and increased by 20% in PI (P < 0.05).

Conclusions: A supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources.

Trial Registration: TCTR20181221002 (retrospectively registered). Registered December 21, 2018.
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http://dx.doi.org/10.1186/s12889-019-7716-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935198PMC
December 2019

Four-second dynamic exercise testing (T4S) for the assessment of cardiac vagal modulation in obese adolescents.

Physiol Meas 2019 12 2;40(11):115003. Epub 2019 Dec 2.

Physical Education School, Petropolis Catholic University, Petrópolis, Brazil.

Background: Reduced vagal activity is often present in obese adolescents. Simple and practical strategies for the assessment of isolate parasympathetic outflow in this population are therefore useful.

Objectives: To compare the methods derived from heart rate variability (HRV) analysis at rest and 4 s exercise testing (T4S) for the assessment of cardiac parasympathetic modulation in adolescents classified as obese (OB) or with normal weight (NW). Additionally, associations between total and trunk fat versus autonomic modulation determined by the two methods were calculated.

Approach: A cross-sectional study was conducted with 50 adolescents (26 OB and 24 NW, 14.7  ±  1.5 years), comparing autonomic indices provided by HRV and T4S. Body fractioning was determined employing dual-energy x-ray absorptiometry (DXA).

Main Results: The cardiac vagal index (CVI) obtained from T4S and standard time- and frequency-domain HRV measures were lower in OB versus NW (P  ⩽  0.05). Correlations between CVI and HRV indices of cardiac vagal modulation were as follows: CVI versus RMSSD (r  =  0.44; P  =  0.003); CVI versus pNN50 (r  =  0.32; P  =  0.04); CVI versus HF (r  =  0.35; P  =  0.02). Associations between body fat, android/gynoid ratio, and percent trunk fat versus CVI were of similar magnitude and direction than versus HRV indices.

Significance: The T4S proved to be adequate to detect cardiac parasympathetic impairment in obese adolescents. Moreover, vagal modulation assessed by HRV and T4S inversely correlated with visceral adipose tissue. These findings along with the simplicity and safety of the T4S should encourage its use in the assessment of cardiac parasympathetic modulation in obese pediatric populations.
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http://dx.doi.org/10.1088/1361-6579/ab4f1dDOI Listing
December 2019

Strength training with blood flow restriction - a novel therapeutic approach for older adults with sarcopenia? A case report.

Clin Interv Aging 2019 14;14:1461-1469. Epub 2019 Aug 14.

Graduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, Rio de Janeiro State University , Rio de Janeiro, Brazil.

Introduction: A 91-year-old sedentary man presenting exhaustion, lower-limb weakness, hypertension, and history of multiple falls was diagnosed with sarcopenia - appendicular skeletal muscle mass index (ASM) of 7.10 kg/m.

Purpose: To investigate the effects of strength training performed with low intensity in isolation (LI) or with blood flow restriction (LI-BFR) on strength, muscle mass, IGF-1, endothelial function, microcirculation, inflammatory biomarkers, and oxidative stress.

Methods: In the first 3 months, LI was performed with intensity corresponding to 30% of 1 repetition maximum, followed by 1 month of inactivity, and another 3 months of LI-BFR (similar load than LI concomitant to BFR equivalent to 50% of resting systolic blood pressure).

Results: LI-BFR, but not LI improved muscle mass, ASM, handgrip strength, isokinetic peak torque, IL-6, and IGF-1. Endothelial function, red blood cell velocity, and concentrations of C-reactive protein, and soluble intercellular adhesion molecules-1 improved after both LI and LI-BFR. Endothelin-1 and oxidative stress increased after LI-BFR, and lowered after LI.

Conclusion: LI-BFR, but not LI improved strength, muscle mass, IGF-1, endothelial function, and selected inflammatory markers in a nonagenarian sarcopenic patient. These results are promising and suggest that LI-BFR should be considered as an alternative to prevent muscle loss and improve functional fitness in frail older populations.
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http://dx.doi.org/10.2147/CIA.S206522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698614PMC
December 2019

Postexercise blood pressure and autonomic responses after aerobic exercise following anodal tDCS applied over the medial prefrontal cortex.

Neurosci Lett 2019 10 21;711:134444. Epub 2019 Aug 21.

Physical Activity and Health Promotion Laboratory (LABSAU), Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil; Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, RJ, Brazil. Electronic address:

Transcranial direct current stimulation (tDCS) is acknowledged to modulate autonomic cardiac activity and hemodynamic responses at rest and during exercise. However, its potential to optimize postexercise hypotension (PEH) has not been investigated. This study investigated the effects of anodal tDCS applied over the medial prefrontal cortex (mPFC) upon blood pressure (BP) and heart rate variability (HRV) throughout 60 min following acute aerobic exercise. Fifteen young men (27.5 ± 5.2 yrs; 72.9 ± 8 kg; 170 ± 0.1 cm; 124.1 ± 1.9/67.7 ± 2.1 mmHg) underwent three counterbalanced experimental sessions: a) anodal tDCS + exercise (tDCS); b) sham stimulation + exercise (SHAM); c) non-exercise control (CONT). Exercise consisted in 50-min cycling at 65-70% heart rate reserve. BP and HRV were assessed during 60-min postexercise. Mean reduction in systolic BP occurred after tDCS vs. SHAM (-4.1 mmHg; P=0.03) and CONT (-5.8 mmHg; P=0.003), and in MAP vs. CONT (-3.0 mmHg, P=0.03). Parasympathetic activity lowered after tDCS and SHAM vs. CONT, as respectively reflected by R-R intervals (-328.1% and -396.4%; P = 0.001), SDNN (-155.7% and -193.4%; P = 0.006), and pNN50 (-272.3% and -259.1%; P = 0.021). There was a clear tendency of increased sympatho-vagal balance vs. CONT (P = 0.387) after SHAM (+246.3%), but not tDCS (+25.9%). In conclusion, an aerobic exercise bout preceded by tDCS applied over mPFC induced PEH in normotensive men. Parasympathetic activity lowered, while sympatho-vagal balance increased after both tDCS and SHAM vs. CONT. However, these responses seemed to be tempered by anodal stimulation, which might help explaining the occurrence of PEH after tDCS and not SHAM. These findings warrant further research on the role of tDCS within exercise programs aiming at BP management.
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http://dx.doi.org/10.1016/j.neulet.2019.134444DOI Listing
October 2019

Acute Effect of a Single Session of Pilates on Blood Pressure and Cardiac Autonomic Control in Middle-Aged Adults With Hypertension.

J Strength Cond Res 2020 Jan;34(1):114-123

Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil.

Rocha, J, Cunha, FA, Cordeiro, R, Monteiro, W, Pescatello, LS, and Farinatti, P. Acute effect of a single session of Pilates on blood pressure and cardiac autonomic control in middle-aged adults with hypertension. J Strength Cond Res 34(1): 114-123, 2020-We investigated the blood pressure (BP) and heart rate variability (HRV) responses to a single session of Pilates among adults with hypertension. Thirteen participants (7 women), aged 44-66 years, underwent Pilates and nonexercise control sessions separated by 48-72 hours in a randomized counterbalanced order. Blood pressure and HRV indices were simultaneously assessed 10 minutes before and 60 minutes after all sessions in the supine position: root mean square of successive differences (rMSSD), percentage of successive normal sinus RR intervals >50 ms (pNN50), SD of all normal sinus RR intervals over 24 hours (SDNN), and low-frequency (LF) and high-frequency (HF) bands. After an acute session of Pilates, the mean values for area under the curve for systolic BP (p = 0.004, corresponding to -7.4 ± 8.2 mm Hg) and mean arterial pressure (p = 0.023, corresponding to -5.3 ± 5.4 mm Hg) were significantly lower compared to the control session. No significant difference was detected for diastolic BP (-4.2 ± 4.7 mm Hg, p = 0.106). Concomitant to BP reduction, significant lowering of parasympathetic HRV indices occurred: RR intervals (-64.1 ± 69.9 ms·min, p = 0.043), rMSSD (-8.3 ± 15.4 ms·min, p = 0.013), pNN50 (-3.6 ± 13%·min, p = 0.028), and total power (-3,089.4 ± 5,938 m·min, p = 0.037). No difference was found for sympathetic markers: SDNN (-17.7 ± 34.6 ms·min, p = 0.100), LF (-5.2 ± 21,6 n.u.·min, p = 0.417), and LF:HF ratio (-0.3 ± 5.2 ratio·min, p = 0.422). In conclusion, a single session of Pilates reduced BP by ∼5-8 mm Hg in adults with hypertension during the first 60 minutes of post-exercise recovery. Acute BP reduction was concomitant to lowered cardiac parasympathetic activity. Our findings are promising for the use of Pilates as an alternative exercise modality to lower BP.
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http://dx.doi.org/10.1519/JSC.0000000000003060DOI Listing
January 2020

FURIN variant associations with postexercise hypotension are intensity and race dependent.

Physiol Rep 2019 02;7(3):e13952

Department of Kinesiology, University of Connecticut, Storrs, Connecticut.

FURIN is a proprotein convertase subtilisin/kexin enzyme important in pro-renin receptor processing, and FURIN (furin, paired basic amino acid cleaving enzyme) variants are involved in multiple aspects of blood pressure (BP) regulation. Therefore, we examined associations among FURIN variants and the immediate blood pressure (BP) response to bouts of aerobic exercise, termed postexercise hypotension (PEH). Obese (30.9 ± 3.6 kg m ) Black- (n = 14) and White- (n = 9) adults 42.0 ± 9.8 year with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous (VIGOROUS) and moderate (MODERATE) intensity cycling and control. Subjects were then attached to an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. FURIN genotypes were coded as the number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing corrected P-values under time-adjusted linear models for 19 hourly BP measurements. After VIGOROUS over 19 h, as FURIN #MA increased in rs12917264 (P = 2.4E-04) and rs75493298 (P = 6.4E-04), systolic BP (SBP) decreased 30.4-33.7 mmHg; and in rs12917264 (P = 1.6E-03) and rs75493298 (P = 9.7E-05), diastolic BP (DBP) decreased 17.6-20.3 mmHg among Blacks only. In addition, after MODERATE over 19 h in FURIN rs74037507 (P = 8.0E-04), as #MA increased, SBP increased 20.8 mmHg among Blacks only. Whereas, after MODERATE over the awake hours in FURIN rs1573644 (P = 6.2E-04), as #MA increased, DBP decreased 12.5 mmHg among Whites only. FURIN appears to exhibit intensity and race-dependent associations with PEH that merit further exploration among a larger, ethnically diverse sample of adults with hypertension.
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http://dx.doi.org/10.14814/phy2.13952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356167PMC
February 2019

Institutional Guidelines for Resistance Exercise Training in Cardiovascular Disease: A Systematic Review.

Sports Med 2019 Mar;49(3):463-475

Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Bloco A, Rua Marechal Deodoro, 217, bloco A, Centro, Niterói, RJ, CEP 24030-060, Brazil.

Background: Institutional position stands are useful for practitioners when designing exercise routines for specific populations. Resistance training has been included in programs for patients with cardiovascular disease.

Objective: The objective of this systematic review was to analyze institutional guidelines providing recommendations for resistance training applied to cardiovascular disease.

Methods: PubMed, Web of Science, and Scopus databases were searched from inception until 30 April, 2018.

Results: Of 994 articles initially found, 13 position stands were retained. Consensual indications occurred only for number of sets (one to three sets) and training frequency (two to three sessions/week). Recommendations concerning other major training variables were discordant regarding workload (none or loads ranging from < 30% up to 80% 1 repetition maximum) and exercise order (none or vaguely indicating alternation of muscle groups or circuit format), or insufficient regarding intervals between sets and exercises or number and type of exercises. Overall, guidelines lack recommendations of specific procedures for each type of disease at different severity levels, cardiovascular risk during exercise, or criteria for training progression.

Conclusions: Recommendations provided by institutional guidelines appear to be insufficient to support adequate resistance training prescription in the context of cardiovascular disease.
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http://dx.doi.org/10.1007/s40279-019-01059-zDOI Listing
March 2019

Blood Flow Restriction Training Reduces Blood Pressure During Exercise Without Affecting Metaboreflex Activity.

Front Physiol 2018 4;9:1736. Epub 2018 Dec 4.

Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

Blood flow restriction training (BFRT) has been proposed to induce muscle hypertrophy, but its safety remains controversial as it may increase mean arterial pressure (MAP) due to muscle metaboreflex activation. However, BFR training also causes metabolite accumulation that may desensitize type III and IV nerve endings, which trigger muscle metaboreflex. Then, we hypothesized that a period of BFR training would result in blunted hemodynamic activation during muscle metaboreflex. 17 young healthy males aged 18-25 yrs enrolled in this study. Hemodynamic responses during muscle metaboreflex were assessed by means of postexercise muscle ischemia (PEMI) at baseline (T0) and after 1 month (T1) of dynamic BFRT. BFRT consisted of 3-min rhythmic handgrip exercise applied 3 days/week (30 contractions per minute at 30% of maximum voluntary contraction) in the dominant arm. On the first week, the occlusion was set at 75% of resting systolic blood pressure (always obtained after 3 min of resting) and increased 25% every week, until reaching 150% of resting systolic pressure at week four. Hemodynamic measurements were assessed by means of impedance cardiography. BFRT reduced MAP during handgrip exercise (T1: 96.3 ± 8.3 mmHg vs. T0: 102.0 ± 9.53 mmHg, = 0.012). However, no significant time effect was detected for MAP during the metaboreflex activation ( > 0.05). Additionally, none of the observed hemodynamic outcomes, including systemic vascular resistance (SVR), showed significant difference between T0 and T1 during the metaboreflex activation ( > 0.05). BFRT reduced blood pressure during handgrip exercise, thereby suggesting a potential hypotensive effect of this modality of training. However, MAP reduction during handgrip seemed not to be provoked by lowered metaboreflex activity.
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http://dx.doi.org/10.3389/fphys.2018.01736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299290PMC
December 2018

Influence of Physical Exercise on Advanced Glycation End Products Levels in Patients Living With the Human Immunodeficiency Virus.

Front Physiol 2018 6;9:1641. Epub 2018 Dec 6.

Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

Combined antiretroviral therapy (cART) used to treat acquired immunodeficiency virus (HIV) induces a number of adverse effects, such as insulin resistance and dyslipidemia, which ultimately increases the cardiovascular risk. Advanced glycation end products (AGEs) have been implicated in the etiology of cardiovascular diseases, diabetes and other chronic diseases. It is known that physical exercise improves the lipid profile, insulin resistance and reduces the risk of cardiovascular diseases. However, the impact of physical exercise on AGE levels in HIV-infected patients has not been so far investigated. Therefore, this study compared AGEs levels in people with and without HIV and verified the effect of physical training on serum AGE levels. Participants were initially assigned into three groups: healthy control (CTL, = 35), physically inactive HIV-infected (In-HIV, = 33) and physically active HIV-infected (Ac-HIV, = 19). The In-HIV group underwent physical training for 3 months, consisting of 60-min sessions of multimodal supervised exercise (aerobic, resistance and flexibility) with moderate intensity (50-80% heart rate reserve), performed 3 times/week. AGEs were measured in serum by fluorescence spectrometry. At baseline, serum AGEs fluorescence level was significantly higher in inactive HIV-patients when compared to controls or active HIV-patients (In-HIV: 0.93 ± 0.08 vs. controls: 0.68 ± 0.13 and Ac-HIV: 0.59 ± 0.04 A.U.; < 0.001). Triglycerides were also higher in In-HIV than CTL (182.8 ± 102 vs. 132.8 ± 52.3 mg/dL; < 0.05). Waist circumference was lower in Ac-HIV, compared to In-HIV and controls (83.9 ± 10.4 vs. 92.9 ± 13.5 and 98.3 ± 12.4, respectively; < 0.05). Body mass, fasting blood glucose, LDL, HDL, and total cholesterol were similar between groups. After training, AGE levels decreased (Baseline: 0.93 ± 0.08 vs. 3 months follow-up: 0.59 ± 0.04 AU; < 0.001), no further difference being detected vs. CTL or Ac-HIV. Conclusion: HIV-infected patients under cART exhibited elevated AGEs levels compared to healthy individuals and physically active patients. Short-term aerobic training of moderate intensity counteracted this condition.
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http://dx.doi.org/10.3389/fphys.2018.01641DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291474PMC
December 2018

Increased vascular function and superoxide dismutase activity in physically active vs inactive adults living with HIV.

Scand J Med Sci Sports 2019 Jan 17;29(1):25-33. Epub 2018 Oct 17.

Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

This study compared macro- and microvascular endothelial function and redox status in active vs inactive HIV-infected patients (HIVP) under antiretroviral therapy. Using a cross-sectional design, macro- and microvascular reactivity, systemic microvascular density, and oxidative stress were compared between 19 HIVP (53.1 ± 6.1 year) enrolled in a multimodal training program (aerobic, strength and flexibility exercises) for at least 12 months (60-minutes sessions performed 3 times/wk with moderate intensity) vs 25 sedentary HIVP (51.2 ± 6.3 year). Forearm blood flow during reactive hyperemia (521.7 ± 241.9 vs 361.4% ± 125.0%; P = 0.04) and systemic microvascular density (120.8 ± 21.1 vs 105.6 ± 25.0 capillaries/mm ; P = 0.03) was greater in active than inactive patients. No significant difference between groups was detected for endothelium-dependent and independent skin microvascular vasodilation (P > 0.05). As for redox status, carbonyl groups (P = 0.22), lipid peroxidation (P = 0.86), catalase activity (P = 0.99), and nitric oxide levels (P = 0.72) were similar across groups. However, superoxide dismutase activity was greater in active vs inactive HIVP (0.118 ± 0.013 vs 0.111 ± 0.007 U/mL; P = 0.05). Immune function reflected by total T CD4 and T CD8 counts (cell/mm ) did not differ between active and inactive groups (P > 0.82). In conclusion, physically active HIVP exhibited similar immune function, but greater macrovascular reactivity, systemic microvascular density, and superoxide dismutase activity than inactive patients of similar age.
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http://dx.doi.org/10.1111/sms.13312DOI Listing
January 2019

Influence of Acute Concurrent Exercise Performed in Public Fitness Facilities on Ambulatory Blood Pressure Among Older Adults in Rio de Janeiro City.

J Strength Cond Res 2018 Oct;32(10):2962-2970

Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niteroi, Brazil.

Cordeiro, R, Monteiro, W, Cunha, F, Pescatello, LS, and Farinatti, P. Influence of acute concurrent exercise performed in public fitness facilities on ambulatory blood pressure among older adults in Rio de Janeiro city. J Strength Cond Res 32(10): 2962-2970, 2018-The project "Third-Age Academies'" (TAAs) is a public policy providing supervised physical activities to over 40,000 seniors at open-access facilities (squares etc.) in Rio de Janeiro, Brazil. We investigated whether TAA concurrent exercise circuit induced postexercise hypotension (PEH) in individuals older than 60 years. Blood pressure (BP) was measured by 24-hour ambulatory BP monitoring (ABPM) after counterbalanced CEX and nonexercise (CONT) sessions (n = 16; 66.8 ± 1.4 years; systolic/diastolic BP (SBP/DBP): 132.5 ± 4.3/78.0 ± 2.8 mm Hg). For statistical analyses purposes, groups were divided as exhibiting normal SBP (≤120 mm Hg) or high SBP (>120 mm Hg), based on 24-hour ABPM after CONT. The CEX included 2 aerobic and 9 resistance exercises performed alternately in circuit order (40 minutes at 60-70% heart rate reserve using body mass or fixed loads). 24-hour ambulatory BP monitoring lowered in individuals with high BP (n = 11; medicated = 5) (SBP: -6.5 ± 1.9 mm Hg; mean arterial pressure [MAP]: -4.3 ± 1.5 mm Hg; p < 0.015), particularly within the first 5-6 hours after exercise (SBP: -13.5 ± 2.6 mm Hg; DBP: -9.4 ± 2.2 mm Hg; and MAP: -11.4 ± 1.6 mm Hg, p < 0.05). Significant BP lowering was not detected among participants with normal BP (n = 5; medicated = 4). In conclusion, CEX provoked PEH in older adults with prehypertension to established hypertension. Because of the potential of TAAs to reach large numbers of older adults, our findings are encouraging and should be confirmed in subsequent studies.
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October 2018
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