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Mixed circuit training acutely reduces arterial stiffness in patients with chronic stroke: a crossover randomized controlled trial. Eur J Appl Physiol 2023; 123:121-134. [PMID: 36205814 DOI: 10.1007/s00421-022-05061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/30/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Investigate whether a single bout of mixed circuit training (MCT) can elicit changes in arterial stiffness in patients with chronic stroke. Second, to assess the between-day reproducibility of post-MCT arterial stiffness measurements. METHODS Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and two bouts of MCT on separate days in a randomized counterbalanced order. The MCT involved 3 sets of 15 repetition maximum for 10 exercises, with each set separated by 45-s of walking. Brachial-radial pulse wave velocity (br-PWV), radial artery compliance (AC) and reflection index (RI1,2) were assessed 10 min before and 60 min after CTL and MCT. Ambulatory arterial stiffness index (AASI) was calculated from 24-h recovery ambulatory blood pressure monitoring. RESULTS Compared to CTL, after 60 min of recovery from the 1st and 2nd bouts of MCT, lower values were observed for br-PWV (mean diff = - 3.9 and - 3.7 m/s, respectively, P < 0.01; ICC2,1 = 0.75) and RI1,2 (mean diff = - 16.1 and - 16.0%, respectively, P < 0.05; ICC2,1 = 0.83) concomitant with higher AC (mean diff = 1.2 and 1.0 × 10-6 cm5/dyna, respectively, P < 0.01; ICC2,1 = 0.40). The 24-h AASI was reduced after bouts of MCT vs. CTL (1st and 2nd bouts of MCT vs. CTL: mean diff = - 0.32 and - 0.29 units, respectively, P < 0.001; ICC2,1 = 0.64). CONCLUSION A single bout of MCT reduces arterial stiffness during laboratory (60 min) and ambulatory (24 h) recovery phases in patients with chronic stroke with moderate-to-high reproducibility. TRIAL REGISTRATION Ensaiosclinicos.gov.br identifier RBR-5dn5zd.
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Michalski ADC, Ferreira ADS, Kasuki L, Gadelha MR, Lopes AJ, Guimarães FS. Clinical and functional variables can predict general fatigue in patients with acromegaly: an explanatory model approach. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:235-240. [PMID: 31038594 PMCID: PMC10522193 DOI: 10.20945/2359-3997000000127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 01/14/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate whether hormonal profile, arterial function, and physical capacity are predictors of fatigue in patients with acromegaly. Subjects and methods: This is a cross-sectional study including 23 patients. The subjects underwent a Modified Fatigue Impact Scale (MFIS) assessment; serum growth hormones (GH) and IGF-1 measurements; pulse wave analysis comprising pulse wave velocity (PWV), arterial compliance (AC), and the reflection index (IR1,2); dominant upper limb dynamometry (DYN); and the six-minute walking distance test (6MWT). Multiple linear regression models were used to identify predictors for MFIS. The coefficient of determination R2 was used to assess the quality of the models' fit. The best model was further analyzed using a calibration plot and a limits of agreement (LOA) plot. RESULTS The mean ± SD values for the participants' age, MFIS, PWV, AC, IR1,2, DYN, and the distance in the 6MWT were 49.4 ± 11.2 years, 31.2 ± 18.9 score, 10.19 ± 2.34 m/s, 1.08 ± 0.46 x106 cm5/din, 85.3 ± 29.7%, 33.9 ± 9.3 kgf, and 603.0 ± 106.1 m, respectively. The best predictive model (R2 = 0.378, R2 adjusted = 0.280, standard error = 16.1, and P = 0.026) comprised the following regression equation: MFIS = 48.85 - (7.913 × IGF-I) + (1.483 × AC) - (23.281 × DYN). CONCLUSION Hormonal, vascular, and functional variables can predict general fatigue in patients with acromegaly.
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Affiliation(s)
- André da Cunha Michalski
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Arthur de Sá Ferreira
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Leandro Kasuki
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaHospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Centro de Pesquisa em Neuroendocrinologia, Serviço de Endocrinologia, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Instituto Estadual do Cérebro Paulo NiemeyerSecretaria Estadual de Saúde do Rio de JaneiroRio de JaneiroRJBrasil Divisão de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Monica R. Gadelha
- Universidade Federal do Rio de JaneiroFaculdade de MedicinaHospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Centro de Pesquisa em Neuroendocrinologia, Serviço de Endocrinologia, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Instituto Estadual do Cérebro Paulo NiemeyerSecretaria Estadual de Saúde do Rio de JaneiroRio de JaneiroRJBrasil Divisão de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Agnaldo José Lopes
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - Fernando Silva Guimarães
- Centro Universitário Augusto MottaPrograma de Pós-Graduação em Ciências da ReabilitaçãoCentro Universitário Augusto MottaRio de JaneiroRJBrasilPrograma de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de JaneiroDepartamento de FisioterapiaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Fisioterapia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
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Moura NGR, Cordovil I, Ferreira ADS. Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:100-13. [PMID: 26988431 DOI: 10.1016/s2095-4964(16)60233-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Pulse wave analysis (PWA) quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine. OBJECTIVE This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This observational, cross-sectional study enrolled 45 patients (26 men, (55.2 ± 10.3) years, systolic blood pressure (155 ± 28) mmHg, diastolic blood pressure (93 ± 17) mmHg) for assessment of clinical and laboratorial data. MAIN OUTCOME MEASURES Primary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the 'simultaneous pressing' method for identification of factors such as strength (strong/weak), depth (superficial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system. RESULTS Significant multivariate main effects were observed for depth (λ=0.648, F5,29 =3.149, P=0.022, η(2) =0.352), strength (λ=0.608, F5,29 =3.736, P=0.010, η(2) =0.392), and speed (λ=0.535, F5,29 =5.302, P=0.002, η(2) =0.465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s. CONCLUSION Associations were explained by LaPlace's law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.
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Affiliation(s)
- Nathalia Gomes Ribeiro Moura
- Postgraduate Program of Rehabilitation Science, Augusto Motta University Center, 21041-010, Rio de Janeiro, RJ, Brazil
| | - Ivan Cordovil
- Division of Arterial Hypertension, National Institute of Cardiology, 22240-002, Rio de Janeiro, RJ, Brazil
| | - Arthur de Sá Ferreira
- Postgraduate Program of Rehabilitation Science, Augusto Motta University Center, 21041-010, Rio de Janeiro, RJ, Brazil
- Department of Physical Therapy, Salgado de Oliveira University, 24030-060, Niterói, RJ, Brazil
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Gomes Ribeiro Moura N, Sá Ferreira A. Pulse Waveform Analysis of Chinese Pulse Images and Its Association with Disability in Hypertension. J Acupunct Meridian Stud 2016; 9:93-8. [DOI: 10.1016/j.jams.2015.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022] Open
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de Sá Ferreira A. Plasma Homocysteine and Arterial Stiffness: Risk Factors or Risk Markers for Cardiovascular Diseases? J Clin Hypertens (Greenwich) 2015; 17:601-2. [PMID: 25894299 DOI: 10.1111/jch.12549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Arthur de Sá Ferreira
- Programa de Pós-graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro, RJ, Brazil
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Ferreira ADS, Moura NGRD. Asserted and neglected issues linking evidence-based and Chinese medicines for cardiac rehabilitation. World J Cardiol 2014; 6:295-303. [PMID: 24944759 PMCID: PMC4062128 DOI: 10.4330/wjc.v6.i5.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 03/28/2014] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
High blood pressure is among the most prevalent chronic disease in adults that impacts on the quality of life of patients, which are often subjected to physical rehabilitation. Chinese medicine intervention in patients with hypertension presents promising albeit inconclusive results, mostly due to methodological issues. This paper discusses asserted and neglected issues linking evidence-based and Chinese medicines as related to systemic arterial hypertension, as well as their impact on the physical rehabilitation of those patients. On the one hand, natural history of hypertension, pulse palpation, and herbal therapy are among the asserted issues because of the scientific evidence collected about them, either in favor or against its integration to the current medical practice. On the other hand, anatomical variations of vessels and comparative physiology are among the most commonly neglected issues because previous researches on integrative medicine ignored the possible effects of these issues as related to the study’s outcome. The asserted issues highlighted in this paper stimulate the increasing use of Chinese medicine for health care and the continuity of research on integrative medicine in the cardiovascular field for rehabilitation. The neglected issues poses additional challenges that must not be overlooked in future research on this topic so that the integration of both traditional and current knowledge may be of benefit to the population with cardiovascular disease.
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de Sá Ferreira A, Lopes AJ. Pulse waveform analysis as a bridge between pulse examination in Chinese medicine and cardiology. Chin J Integr Med 2013; 19:307-14. [PMID: 23546634 DOI: 10.1007/s11655-013-1412-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Indexed: 02/04/2023]
Abstract
Pulse examination was probably the earliest attempt to distinguish between health and illnesses. Starting at the pre-Hippocratic era, Chinese medicine practitioners developed techniques for pulse examination and defined pulse images based on their perceptions of pulse waveforms at the radial artery. Pulse images were described using basic variables (frequency, rhythm, wideness, length, deepness, and qualities) developed under philosophical trends such as Taoism and Confucianism. Recent advances in biomedical instrumentation applied to cardiology opened possibilities to research on pulse examination based on ancient Chinese medical theories: the pulse wave analysis. Although strongly influenced by philosophy, some characteristics used to describe a pulse image are interpretable as parameters obtained by pulse waveform analysis such as pulse wave velocity and augmentation index. Those clinical parameters reflect concepts unique to Chinese medicine - such as yinyang - while are based on wave reflection and resonance theories of fluids mechanics. Major limitations for integration of Chinese and Western pulse examination are related to quantitative description of pulse images and pattern differentiation based on pulse examination. Recent evidence suggests that wave reflection and resonance phenomena may bridge Chinese medicine and cardiology to provide a more evidence-based medical practice.
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Affiliation(s)
- Arthur de Sá Ferreira
- Postgraduation Program of Rehabilitation Science, Augusto Motta University Center, Rio de Janeiro, RJ, Brazil.
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Noninvasive pressure pulse waveform analysis of flow-mediated vasodilation evoked by post-occlusive reactive hyperemia maneuver. Biomed Signal Process Control 2012. [DOI: 10.1016/j.bspc.2012.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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WU QUANYU, MA ZUCHANG, SUN YINING. NONINVASIVE POWER SPECTRUM ANALYSIS OF RADIAL PRESSURE WAVEFORM FOR ASSESSMENT OF VASCULAR SYSTEM. J MECH MED BIOL 2012. [DOI: 10.1142/s0219519411004782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Wrist pulse diagnosis has been used in traditional Chinese medicine (TCM) for thousands of years, because pulse pressure signal contains a large number of physiological and pathological information of people. In this research, a systematic approach was proposed to analyze the computerized radial pressure waveform, with the focus placed on the power spectrum. We gained the power spectrum by using a modified fast Fourier transform, and the power-spectral characteristics were analyzed and compared. The analyzing program calculated the first peak frequency (F1) and the second peak (F2) automatically, and gained the time of phase shift between two frequencies. They could provide a simple noninvasive means for studying changes in the elastic properties of the vascular system depending on the age and the disease. Namely, the frequency analysis of radial pressure waveform gives new insight into the dynamics of cardiovascular system.
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Affiliation(s)
- QUAN-YU WU
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei 230031, China
- Department of Automation, University of Science and Technology of China, Hefei 230027, China
- Department of Mechanical and Electronic Engineering, West Anhui University, Liu-an 237012, China
| | - ZU-CHANG MA
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei 230031, China
| | - YI-NING SUN
- Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei 230031, China
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Ferreira ADS, Oliveira JFD, Cordovil I, Barbosa Filho J. Quadriceps short-term resistance exercise in subjects with resistant hypertension. FISIOTERAPIA EM MOVIMENTO 2011. [DOI: 10.1590/s0103-51502011000400006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Resistant arterial hypertension may lead to muscle disuse and reduced functional capacity due to arterial and target-organs lesions. The main objective of this work is to evaluate the quadriceps strength and fatigue tolerance after a program of resistance exercise in subjects with resistant primary hypertension. METHODS: Six patients under pharmacological treatment were submitted to a four-week resistance exercise training program for the quadriceps (8-14 repetitions, 3 sets, 3 days per week). Strength was evaluated by isometric dynamometry, as the percentage change in maximum voluntary contraction over the four week program. Fatigue was analyzed by surface electromyography, as the change in both root mean square value and intercept of median frequency slope of vastus medialis and vastus lateralis. RESULTS: Significant increase in the maximum voluntary contraction was observed (p = 0.04). Fatigue tolerance was not improved as seen by root mean square as well as in the intercept of median frequency (p > 0.05). Additionally, no significant changes were observed in resting arterial blood pressure and heart rate throughout the training period. CONCLUSION: The prescribed protocol seemed to successfully increase localized muscle strength without negatively affecting the monitored cardiovascular variables in patients with resistant hypertension under pharmacological treatment.
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Ferreira ADS, Filho JB, Souza MND. Model for post-occlusive reactive hyperemia as measured noninvasively with pressure pulse waveform. Biomed Signal Process Control 2011. [DOI: 10.1016/j.bspc.2010.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Zangfu zheng (patterns) are associated with clinical manifestations of zang shang (target-organ damage) in arterial hypertension. Chin Med 2011; 6:23. [PMID: 21682890 PMCID: PMC3155491 DOI: 10.1186/1749-8546-6-23] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 06/17/2011] [Indexed: 12/22/2022] Open
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Benchimol-Barbosa PR, Barbosa-Filho J. Natural reflection site and arterial pulse wave velocity estimations based on brachial pulse wave morphology analyses. Int J Cardiol 2010; 143:443-6. [DOI: 10.1016/j.ijcard.2008.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 12/04/2008] [Indexed: 11/16/2022]
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de Sá Ferreira A, Filho JB, Cordovil I, de Souza MN. Three-section transmission-line arterial model for noninvasive assessment of vascular remodeling in primary hypertension. Biomed Signal Process Control 2009. [DOI: 10.1016/j.bspc.2008.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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