BACKGROUND:The modified Medical Research Council (mMRC) and COPD Assessment Test (CAT) are assessment instruments associated with level of physical activity of daily living (PADL) in patients with COPD. This study aimed to identify mMRC and CAT cutoff points to discriminate sedentary behavior and PADL level of subjects with COPD and verify whether these cutoff points differentiate pulmonary function, health-related quality of life (HRQOL), functional status, and mortality index in subjects with COPD. METHODS: Subjects (N 5 131, FEV 1 : 36.7 6 16.1% predicted) were assessed for lung function, mMRC, CAT, HRQOL, functional status, and mortality index. PADL was monitored using a triaxial accelerometer, and subjects were classified as sedentary/nonsedentary (cutoff point of 8.5 h/d in PADL < 1.5 metabolic equivalent of task [MET]), physically active/inactive (cutoff point of 80 min/d in PADL 6 3 METs), and with/without severe physical inactivity (cutoff point of 4,580 steps/d), according to variables provided by accelerometer. RESULTS: ROC curve indicated mMRC cutoff point of 6 2 (P < .05) for physical inactivity (sensitivity 5 66%, specificity 5 56%, AUC 5 0.62), severe physical inactivity (sensitivity 5 81%, specificity 5 66%, AUC 5 0.76), and sedentary behavior (sensitivity 5 61%, specificity 5 70%, AUC 5 0.65). The identified CAT cutoff points were 6 16 and 6 20, considering severe physical inactivity (sensitivity 5 76%, specificity 5 54%, AUC 5 0.69, P < .001) and sedentary behavior (sensitivity 5 51%, specificity 5 90%, AUC 5 0.71, P 5 .001), respectively. Subjects who had mMRC 6 2 and CAT 6 16 or 6 20 presented worse pulmonary function, HRQOL, functional status, and mortality index compared with those who scored mMRC < 2 and CAT <16 or < 20. CONCLUSIONS: mMRC cutoff point of 6 2 is recommended to discriminate PADL level and sedentary behavior, whereas CAT cutoff points of 6 16 and 6 20 discriminated severe physical inactivity and sedentary behavior, respectively. These cutoff points differentiated subjects with COPD regarding all the outcomes assessed in this study.
Introduction: Considering the osteopatic reasoning, and possible to establish a two-way interaction of direct contact or indirect of the respiratory diaphragm Several abdominal and thoracic viscera, as well as, of your skeletal inserts relations. Objective: This study aimed to investigate how anatomical and physiological relations of the diaphragm in both painful processes of the spine, in bodies Associates. Method: This study was a literature review, with searching online data PubMed, the published articles in the last ten years as associating keywords this study. Results: Ten articles contemplated the criteria for inclusion and exclusion this research and related disorders such as diaphragmatic as possible causes of low back and neck pain, and gastroesophageal reflux disease, as well as, stressed its importance as respiratory-venous-lymphatic pump. Conclusion: The respiratory diaphragm is no link anatomical and physiological interaction between the various body systems, and therefore, may be involved in dysfunctional chains que manifest signs and symptoms and local said. It is involved in several causes of pain on which to observe biomechanical changes in functional or column viscera next or correlated.
Physical exercise has been shown to be an important modulator of the antioxidant system and neuroprotective in several diseases and treatments that affect the central nervous system. In this sense, the present study aimed to evaluate the effect of physical exercise in dynamic balance, motor coordination, exploratory locomotor activity and in the oxidative and immunological balance of rats treated with vincristine (VCR). For that, 40 adult rats were divided into two groups: exercise group (6 weeks of swimming, 1h/day, 5 days/week, with overload of 5% of body weight) and sedentary group. After training, rats were treated with 0.5 mg/kg of vincristine sulfate for two weeks or with the same dose of 0.9% NaCl. The behavioral tests were conducted 1 and 7 days after each dose of VCR. On day 15 we carried out the biochemical analyzes of the cerebellum. The physical exercise was able to protect against the loss of dynamic balance and motor coordination and, had effect per se in the exploratory locomotor activity, and neutralize oxidative stress, damage DNA and immune damage caused by VCR up to 15 days after the end of the training protocol. In conclusion, we observed that previous physical training protects of the damage motor induced by vincristine.Key-words: exercise, oxidative stress, neuroprotection, cerebellum.
Objective: The objective of this study was to analyze the effects of a muscle training program with neuromuscular electrical stimulation (NMES) for lower limbs (LL) and active resisted exercises for upper limbs (UL) for patients with severe Chronic Obstructive Pulmonary Disease. Methods: With a sample of 5 subjects (65.2 ± 6.09 years), the initial and final evaluations were: One-RepetitionMaximum testing; Sit-to-stand test; perimetry of the thigh; 6-minute walk test; Saint George’s Respiratory Questionnaire; Medical Research Council scale for dyspnea and the BODE index. The intervention was performed three times a week and was composed of 18 sessions of 30-minute NMES followed by 30 minutes of exercise for the UL based on the diagonal Kabat method. The NMES parameters were: 50Hz of frequency, 6s on and 8s off, increase slope of 2s and decrease slope of 2s, pulse width of 400µs, and intensity defined as patient tolerance and increased from 1 to 5mA each day. Results: The results have shown an increase in muscle strength (p = 0.01) and of muscle resistance (p = 0.01). There was an improvement tendency in the quality of life (p = 0.16) and in the cardiorespiratory fitness (p = 0.11). Conclusion: The association of physical exercises with diagonals and NMES can be a beneficial resource for the treatment of patients with severe COPD. It is suggested, however, the need for new researches with a wider sample size for assuring these benefits
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