Study objectives:In patients with moderate-to-severe COPD, an encouraged 6-min walking test (6MWT) is a high-intensity submaximal exercise protocol that shows an oxygen uptake (V O 2 ) plateau after the third minute of the test. This last feature prompted the hypothesis that self-paced walking speed is set to achieve "maximal" sustainable V O 2 , namely "critical power" or "critical speed. Key words: COPD; critical power; exercise testing; exercise tolerance; 6-min walking test; sustainable submaximal exerciseAbbreviations: ANOVA ϭ analysis of variance; 6MWT ϭ 6-min walking test; 6MWT-10 ϭ 6-min walking test carried out in a 10-m course; 6MWT-90 ϭ 6-min walking test carried out in a 90-m course; CWS ϭ critical walking speed; GOLD ϭ Global Initiative for Chronic Obstructive Lung Disease; HR ϭ heart rate; L 1 ϭ 90% of the peak walking speed; L 2 ϭ 95% of the peak walking speed; L 3 ϭ 100% of the peak walking speed; L 4 ϭ 105% of the peak walking speed; RER ϭ respiratory exchange ratio; V co 2 ϭ carbon dioxide output; V e ϭ minute ventilation; V o 2 ϭ oxygen uptake; V o 2 peak ϭ peak oxygen uptake

Osteoporotic vertebral fractures generally result in an increased kyphotic angle, which in turn may lead to disturbances in pulmonary function. The objective of the present study was to evaluate pulmonary function and quality of life in a group of osteoporotic patients. Fifteen women with osteoporosis and thoracic vertebral fractures (group 1), 20 women with osteoporosis without vertebral fracture (group 2) and 20 control women (group 3) were submitted to spirometry using a Vitatrace-130 SL spirometer and to an SF-36 quality of life questionnaire. Women with osteoporosis and vertebral fractures showed an increased kyphotic angle (median=60 degrees) and decreased forced vital capacity (group 1 vs. group 2, P =0.020; group 1 vs. group 3, P =0.039) and forced expiratory volume in 1 s (group 1 vs. group 2, P =0.008; group 1 vs. group 3, P =0.014) when compared with women without vertebral fractures or osteoporosis. A negative correlation was observed between thoracic kyphosis and the predicted value of expiratory forced volume in 1 s ( r =-0.713, P =0.003). No differences in the quality of life were detected between the three groups studied. We conclude that women with thoracic vertebral fractures have an increased kyphotic angle and present a decrease in lung volume.

The Brazilian Portuguese version of the LCADL scale is a reliable, reproducible, and valid instrument for evaluating dyspnea during activities of daily living in patients with severe COPD.

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OBJETIVO:Avaliar o nível de atividade física em estudantes universitários e sua associação com hábito de fumar. MÉTODOS:Estudo transversal com amostragem estratifi cada proporcional por conglomerados realizado em Gurupi, TO, em 2005. A amostra estudada incluiu 871 universitários. Para avaliar o nível de atividade física foi aplicado o questionário International Physical Activity Questionnaire-8. O consumo tabagístico foi avaliado por questionário modifi cado da Organização Mundial de Saúde e o grau de dependência nicotínica dos fumantes pela escala de Fagerström. As freqüências, prevalências e razões de prevalência de tabagismo e sedentarismo foram determinadas aplicando-se o teste qui-quadrado pelo método de Yates ou o teste exato de Fisher, segundo grupo geral e estratifi cadas por área, curso, turno e sexo, ao nível de signifi cância de 5%. RESULTADOS:A média de idade foi 25 (dp±8) anos e a média da idade da primeira experiência tabagística foi 17 (dp±4) anos. A prevalência de sedentarismo foi de 29,9% e de tabagismo 7,2%. A prevalência geral de sedentários fumantes foi de 8,5% e a de não-fumantes 91,5%; mas sem diferença na proporção de sedentários entre fumantes e não-fumantes. Tabagismo e sedentarismo foram mais prevalentes em indivíduos acima de 25 anos (48,6%, p<0,05). O grau de dependência nicotínica muito baixo foi o mais prevalente (68,2%, p<0,05). O consumo tabagístico foi mais prevalente no sexo masculino (10,8%, p<0,05) e a prevalência de sedentarismo não foi diferente entre os sexos (p>0,05). CONCLUSÕES:Sedentarismo ocorreu em fumantes e não-fumantes na mesma proporção, não indicando associação entre esses dois fatores. As baixas prevalências de sedentarismo e tabagismo encontradas podem estar associadas à atuação de programas nacionais, pela aplicação de medidas preventivas e educativas contínuas, sendo necessário que sejam mantidos em longo prazo. DESCRITORES: Estudantes. Exercício. Tabagismo. Estilo de Vida. Estudos Transversais.

Background: A physiological increase in muscle glutathione after training is not seen in patients with chronic obstructive pulmonary disease (COPD), indicating abnormal peripheral muscle adaptations to exercise. Objective: We hypothesized that oxidative stress is primarily associated with low body mass index (BMI). Methods: Eleven patients with preserved BMI (BMI_N: 28.2 ± 1.2 kg·m^–2), 9 patients with low BMI (BMI_L: 19.7 ± 0.60 kg·m^–2) and 5 age-matched controls (26.5 ± 0.9 kg·m^–2) were studied before and after 8 weeks of high-intensity endurance training. Reduced glutathione (GSH) and γ-glutamyl cysteine synthase heavy-subunit chain mRNA expression (γGCS-HS mRNA) were measured in the vastus lateralis. Results: After training, exercise capacity increased (ΔVO₂PEAK, 13 ± 5.2%; 10 ± 5.6% and 15 ± 4.3% in BMI_L, BMI_N and controls, respectively; p < 0.05 each). GSH levels decreased in BMI_L (from 5.2 ± 0.7 to 3.7 ± 0.8 nmol/mg protein, ΔGSH –1.5 ± 0.7 nmol/mg protein, p < 0.05); no changes were seen in BMI_N (from 5.4 ± 0.7 to 6.7 ± 0.9 nmol/mg protein, ΔGSH 1.3 ± 0.9 nmol/mg protein), whereas GSH markedly increased in controls (from 4.6 ± 1 to 8.7 ± 0.4 nmol/mg protein, ΔGSH 4.1 ± 1 nmol/mg protein, p < 0.01). ΔGSH in BMI_L was different from ΔGSH in BMI_N and controls (p < 0.05, each). Consistent changes were observed in γGCS-HS mRNA expression. Conclusions: GSH depletion after training in BMI_L may suggest that oxidative stress plays a key role in muscle wasting in COPD patients.

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The mMRC should be adopted as the classification criterion for symptom assessment in the GOLD ABCD system when focusing on PADL.