This study demonstrated that HRV indexes at rest may become a predictive tool for aerobic capacity in COPD patients after the development of more consistent methods.

PurposePhysical exercises are employed as part of the treatment of patients with chronic obstructive pulmonary disease (COPD); however information regarding cardiac autonomic modulation after an acute session of resistance exercise (RE) is unknown. The aim of this study was to evaluate the cardiac autonomic modulation, via heart rate variability after an acute session of RE applied at different intensities in COPD patients.Patients and methodsTwelve COPD patients underwent an acute session of RE with an intensity of 60% and another of 90% of the one repetition maximum test. For analysis of autonomic modulation, heart rate was recorded beat-by-beat for 20 minutes at rest and after the training session. Heart rate variability indexes were obtained in the time and frequency domains for the assessment of autonomic modulation.ResultsRegardless of exercise intensity, RE acute sessions influenced the autonomic modulation when the recovery period was compared with the baseline. An increase in standard deviation of normal to normal RR intervals was observed throughout recovery time after the RE, as compared to baseline in both protocols: 60% and 90% of the one repetition maximum test. The spectral component of low frequency index (ms) was higher throughout recovery when compared to baseline in both protocols. The same was also observed in the spectral component of high frequency index (ms) for the protocols of 60% and 90%.ConclusionRE sessions impact on the autonomic modulation of COPD patients by promoting differences in the recovery period compared to baseline, regardless of the intensity of the exercise performed.

IntroductionPatients with chronic obstructive pulmonary disease (COPD) exhibit aerobic function, autonomic nervous system, and mucociliary clearance alterations. These parameters can be attenuated by aerobic training, which can be applied with continuous or interval efforts. However, the possible effects of aerobic training, using progressively both continuous and interval sessions (ie, linear periodization), require further investigation.AimTo analyze the effects of 12-week aerobic training using continuous and interval sessions on autonomic modulation, mucociliary clearance, and aerobic function in patients with COPD.MethodsSixteen patients with COPD were divided into an aerobic (continuous and interval) training group (AT) (n=10) and a control group (CG) (n=6). An incremental test (initial speed of 2.0 km·h−1, constant slope of 3%, and increments of 0.5 km·h−1 every 2 minutes) was performed. The training group underwent training for 4 weeks at 60% of the peak velocity reached in the incremental test (vVO2peak) (50 minutes of continuous effort), followed by 4 weeks of sessions at 75% of vVO2peak (30 minutes of continuous effort), and 4 weeks of interval training (5×3-minute effort at vVO2peak, separated by 1 minute of passive recovery). Intensities were adjusted through an incremental test performed at the end of each period.ResultsThe AT presented an increase in the high frequency index (ms2) (P=0.04), peak oxygen uptake (VO2peak) (P=0.01), vVO2peak (P=0.04), and anaerobic threshold (P=0.02). No significant changes were observed in the CG (P>0.21) group. Neither of the groups presented changes in mucociliary clearance after 12 weeks (AT: P=0.94 and CG: P=0.69).ConclusionTwelve weeks of aerobic training (continuous and interval sessions) positively influenced the autonomic modulation and aerobic parameters in patients with COPD. However, mucociliary clearance was not affected by aerobic training.

BACKGROUND: There are still gaps in the knowledge regarding the damage to mucociliary and autonomous systems from passive exposure to cigarette smoke. Also, the influence of the frequency and duration of exposure on these systems is still unclear. The objective of this work was to verify the effects of passive smoking on mucociliary clearance and adult autonomic nervous systems and investigate the influence of frequency and time of passive exposure on these systems. METHODS: 44 smokers (smoking group), 38 passive smokers (passive smoking group), and 38 healthy individuals (control group) were evaluated. Evaluation of lung function was performed. To analyze the autonomic nervous system, heart rate variability data were collected. Hemodynamic parameters were collected. Mucociliary clearance was evaluated using the saccharin transit time test. RESULTS: The passive smoking group presented reduced lung function (P ‫؍‬ .02). Systolic blood pressure was significantly greater in the passive smoking group when compared with the smoking group (P ‫؍‬ .02). The passive smoking group presented significantly slower transportability time than the control group. No differences were observed between the groups for the heart rate variability data. There was a significant correlation (P < .05) between the frequency of exposure and diastolic blood pressure, oxygen saturation, and FEF 25-75% . Correlation analyses also demonstrated a reduction of global autonomic activity according to exposure load, in addition to a reduction in vagal activity and an increase in sympathetic activity according to exposure frequency. CONCLU-SIONS: Passive smokers presented worse mucociliary clearance, and there was a correlation between passive exposure load and damage to the hemodynamic response, pulmonary function and autonomic nervous system.

BACKGROUND: Among the types of physical exercise, resistance exercises have been gaining significant attention in the COPD population. The aim of this study was to compare effects of conventional resistance training and of training by using elastic tubes on muscle strength, exercise capacity, and creatine kinase clearance in subjects with COPD. METHODS: Twenty-eight subjects with COPD were randomized into the following: resistance training with the elastic tubing group and resistance training with the weight-machine training group (conventional resistance group), performed 3 times a week for 12 weeks. The subjects were submitted to spirometry, functional exercise capacity (the 6-min walk test), muscle strength (dynamometry), and the repetition maximum test. Differences between the initial and final evaluations (⌬) and the (final -initial evaluations)/initial evaluations ؋100 (⌬%) of each group were expressed as mean [95% CI]. RESULTS: Nineteen subjects (FEV 1 % predicted, 52 ؎ 18; years, 65 ؎ 8) completed the training program. Similar improvements were observed in both modalities on muscle strength (knee extension, ⌬%18 [6 to 29]; knee flexion, ⌬%35 [17 to 54]; elbow flexion, ⌬%28 [9 to 48]; shoulder abduction, ⌬%41 [25 to 58] and shoulder flexion, ⌬%31 [11 to 51] in the weight-machine training group (conventional resistance group); knee extension, ⌬%15 [8 to 21]; knee flexion, ⌬%28 [15 to 41]; elbow flexion, ⌬%36 [22 to 51]; and shoulder abduction, ⌬%43 [32 to 55] and shoulder flexion, ⌬%43 [25 to 61] in the elastic tubing group, P < .05 for intra-group analysis and P > .05 for between groups analysis), 6-min walk test (baseline 493 ؎ 67m vs 12 weeks 526 ؎ 78 in the weight-machine training group (P ‫؍‬ .10); baseline 493 ؎ 71 vs 12 weeks 524 ؎ 68 in the elastic tubing group (P < .01), P ‫؍‬ .88 between groups). The elastic tubing group had lower accumulated creatine kinase levels between 24 and 72 h ((⌬%؊24 [؊31 to 16] than subjects in the weight-machine training group ⌬%3 [؊21 to 28], P ‫؍‬ .042 between the groups. CONCLUSIONS: Training with elastic resistance provided similar changes in muscle strength and exercise capacity to conventional resistance group in the subjects with COPD. The elastic tubing group had faster creatine kinase clearance after a training session than the weight-machine training group (conventional resistance group). The ease of its application associated with similar training benefits to conventional training supported its application in clinical routine.

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OBJECTIVE Describe the main work risks for sugarcane cutters and their effects on workers’ health.METHODS Critical review of articles, with bibliographic research carried out in the PubMed, SciELO Medline, and Lilacs databases. The following keywords were used: sugarcane workers, sugarcane cutters, sugarcane harvesting, cortadores de cana-de-açú car , and colheita de cana -de-açúcar . The inclusion criteria were articles published between January 1997 and June 2017, which evaluated working conditions and health effects on sugarcane cutters. Those that did not deal with the work impact of cutting burned and unburnt sugarcane in the cutter’s health were excluded. The final group of manuscripts was selected by the lead author of this study and reviewed by a co-author. Disagreements were resolved by consensus using the predefined inclusion and exclusion criteria and, where necessary, the final decision was made by consulting a third co-author.RESULTS From the 89 articles found, 52 met the selection criteria and were evaluated. Studies have shown that cutters work under conditions of physical and mental overload, thermal overload, exposure to pollutants, and are subject to accidents. The main effects observed were respiratory, cardiovascular, renal, musculoskeletal, heat stress, dehydration, genotoxic, and those due to accidents.CONCLUSIONS Work on the manual cutting of sugarcane, especially of burned sugarcane, exposes workers to various risks, with different health impacts. Risk reduction for exposure to pollution and thermal and physical overload is required as a measure to preserve the health of the worker.

After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.