Search

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)., Resistance training has been shown to acutely increase arterial stiffness (AS), while endurance training appears to decrease AS. However, the findings are from studies in apparently healthy subjects and have limited applicability to patients at low and high cardiovascular risk, for whom combined exercise is recommended. We compared the time course of changes in local and regional indices of AS in response to high-volume combined endurance training (CET) and high-volume combined resistance training (CRT) in patients with coronary artery disease (CAD) and heart failure (HF). We studied 20 men with CAD and HF (10 each) aged 68.3 ± 9.6 years. AS was measured by pulse wave velocity (PWV), and brachial and central blood pressure (BP) were determined after 15 min of rest and 5 and 15 min after the exercise session. All patients completed two sessions on nonconsecutive days. A protocol by time interaction effect was observed for carotid (η2 = 0.21, p = 0.02), aortic (η2 = 0.60, p < 0.001), and femoral (η2 = 0.46, p = 0.01) PWV after CET and CRT, suggesting that PWV decreased after CET and increased after CRT. Decreases in the brachial and central variables of BP across time points were observed in both protocols. CET decreased whereas CRT increased carotid, aortic, and femoral PWV at 15 min after exercise in patients with CAD and HF.

Background: Cognitive impairment and cerebrovascular pathology are both frequent with ageing. Cognitive impairment due to vascular pathology of the brain, termed vascular cognitive impairment (VCI), is one of the most frequent causes of cognitive impairment in elderly subjects. Thus far, VCI has no specific pharmacological treatment. Recent observational studies have suggested a protective effect of physical activity in cognition, but adequate randomised controlled trials (RCT) are lacking. Methods: AFIVASC is a multi-centre randomised controlled trial, with a 6-month intervention treatment and an additional follow-up of 6 months, that aims to estimate the impact of 6 months of moderate intensity physical activity on cognition (the primary outcome) at 6 and 12 months in subjects with VCI. Participants are community dwellers with criteria for VCI without dementia or who have had previous stroke or transient ischaemic attack (TIA). Patients may be self-referred or referred from a medical appointment. After confirming the inclusion criteria, a run-in period of 1 month is conducted to access adherence; only after that are subjects randomly assigned (using a computerised program blinded to clinical details) to two groups (intervention group and best practice usual care group). The intervention consists of three physical activity sessions of 60 min each (two supervised and one unsupervised) per week. The primary outcome is measured by the presence or absence of decline in cognitive status. Secondary outcomes include changes in neuro-cognitive measures, quality of life, and functional and motor status. Primary and secondary outcomes are evaluated at 6 and 12 months by investigators blinded to both intervention and randomisation. A required sample size of 280 subjects was estimated. Statistical analyses will include regression analysis with repeated measures. The study was approved by the Ethics Committee for Health of Centro Hospitalar de Lisboa Norte (ref. no. 1063/13) and by the Ethics Committee for Health of Centro Hospitalar do Porto CHP (ref. no. 2016.055(049-DEFI/048-CES)). Discussion: We aim to show whether or not moderate physical activity has a beneficial impact on cognition, quality of life, motor, and functional status in people with vascular cognitive impairment, and to generate new insights on the applicability of implementing physical activity in this specific population. Trial Registration: ClinicalTrials.gov, NCT03578614 July 6, 2018. publishersversion published

SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 124 kb)

Cardiac rehabilitation (CR) is a multidisciplinary process for patients recovering after an acute cardiac event or with chronic cardiovascular disease that reduces mortality and morbidity and improves quality of life. It is considered a cost-effective intervention and is expressly indicated in the guidelines of the major medical societies. In Portugal, only 8% of patients discharged from hospital after myocardial infarction are included in CR programs. In Europe overall, the percentage admitted to CR programs is 30%, while in the USA it is 20-30%. In view of the underuse of CR in Portugal, we call the attention of the health authorities to the need to increase the number and national coverage of CR programs, while maintaining high quality standards. The aim is for all patients resident in Portugal who are eligible for CR programs to have the same opportunities for access and attendance. In order to preserve the benefits and safety of this intervention, CR needs to be performed according to international guidelines. The fact that various initiatives in this field have been developed by different professional groups, some of them non-medical, that do not follow the European guidelines, has prompted us to prepare a series of norms defining mandatory criteria for CR, based on current knowledge and evidence. In this way we aim to ensure that the required increase in the number of CR programs, linked in a national network of CR centers, does not detract from the need to maintain their efficacy and quality. These criteria should serve as the basis for the future accreditation of CR centers in Portugal. publishersversion published

Este trabalho foi financiado pelo Concurso Anual para Projetos de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) 2016 do Instituto Politécnico de Lisboa. Código de referência: IPL/2016/SFQ2017_ESTeSL Introduction: Loss of muscle mass and function is a common occurrence in liver transplant Familial Amyloidotic Polyneuropathy (FAP) patients. Sarcopenia is associated with morbidity and mortality before and after liver transplantation. However, the ability of skeletal muscle mass to recover after transplant remains questionable and thus the importance of clinical exercise prescription. Methods: Participants were 39 FAP patients aged 23-59 years, who had been submitted to a liver transplant (Tx) (22 men) between 2 and 4 months post-tx. Sarcopenia was defined according to the International Working Group on Sarcopenia and Society of Sarcopenia, Cachexia, and Wasting Disorders. Whole-body dual x-ray absorptiometry was used to measure body fat and lean-soft tissue. Skeletal Muscle Index (SMI) was calculated adjusting the value of appendicular skeletal mass to the squared height. Functional aerobic capacity was assessed using the 6 min walk test (6MWT), and handgrip strength were measured on the dominant hand using a hand dynamometer. Results: The prevalence of sarcopenia using SMI was 45.5% in men and 41.2% in women. A fat mass higher than 16% for men and 26% for women was found in 54.5% of men and 52.9% of women. Also, 27.3% of men and 17.6% of the women could be classified as having sarcopenia with low mobility (distance < 400 m). Discussion and Conclusions: Sarcopenia is common in FAP patients and a liver transplant seems to increase the prevalence, also because an aggressive medication with impact on muscle metabolism should be made longtime. More data are needed on the long-term effects of sarcopenia after transplant, especially in light of the high rate of metabolic syndrome. A clinical exercise prescription seems to be necessary for these patients but more studies are needed (e.g. longitudinal studies). info:eu-repo/semantics/publishedVersion