Background: Cardiac rehabilitation with aerobic exercises is the first strategy for nonpharmacological treatment in the postoperative period of individuals undergoing coronary artery bypass grafting (CABG) to improve functional capacity and vascular health. However, other exercise modalities remain uncertain regarding the same benefits. Objectives: Evaluation of the effect of different modalities of exercise, such as early cardiac rehabilitation on subjects submitted to CABG in the six-minute walk test (6-MWT) and on the percentage of flow-mediated dilatation (FMD) of the brachial artery. Methods: A randomized clinical trial in which 15 patients (62.7 ± 6.7 years) who underwent CABG were randomly assigned to the following groups: isometric (IG, Handgrip Jamar^®), ventilatory muscle training (VG, PowerBreathe^®) and control (CG, conventional respiratory and motor physiotherapy). All patients were attended to physically twice a day (20 min/session) for a consecutive week after the CABG (hospital admission). Functional capacity was assessed by 6-MWT and endothelial function was assessed through the technique of FMD, before and after (~7 days) admission to CABG. The doppler ultrasound videos were analyzed by Cardiovascular Suite^® software (Quipu, Pisa, Italy) to measure %FMD. Statistics: Generalized estimation equation, followed by Bonferroni post hoc (p < 0.05). Results: Systolic, diastolic and mean arterial pressure (SBP/DBP/MAP, respectively) were 133, 76 and 95 mmHg. The groups presented walking meters (m) distance before and after intervention of: IG_basal 357.80 ± 47.15 m vs. IG_post 306.20 ± 61.63 m, p = 0.401 (+51 m); VG_basal 261.50 ± 19.91 m vs. VG_post 300.75 ± 26.29 m, p = 0.052 (+39 m); CG _basal 487.83 ± 83.23 m vs. CG_post 318.00 ± 31.08, p = 0.006 (−169 m). %FMD before and after intervention was IG_basal 10.4 ± 4.8% vs. IG_post 2.8 ± 2.5%, p = 0.152; VG_basal 9.8 ± 5.1% vs. VG_post 11.0 ± 6.1%, p = 0.825; CG_basal 9.2 ± 15.8% vs. CG_post 2.7 ± 2.6%, p = 0.710 and resting mean basal blood flow was IG_basal 162.0 ± 55.0 mL/min vs. IG_post 129.9 ± 63.7 mL/min, p = 0.662; VG_basal 83.74 ± 12.4 mL/min vs. VG_post 58.7 ± 17.1 mL/min, p = 0.041; CG_basal 375.6 ± 183.7 mL/min vs. CG_post 192.8 ± 115.0 mL/min, p = 0.459. Conclusions: Ventilatory muscle training for early cardiac rehabilitation improved acute functional capacity and modulated mean flow of individuals undergoing CABG.

Isometric exercise can be an alternative approach to lowering blood pressure in individuals with hypertension. However, it is uncertain whether the muscle mass involved can influence Post-Exercise Hypotension (PEH). Thus, the authors evaluate the acute effect of an isometric exercise session with a Small Muscle Mass (SMM) and a Large Muscle Mass (LMM) on Systolic (SBP) and Diastolic (DBP) blood pressure in individuals with hypertension. Randomized clinical trial with 36 volunteers aged 40‒70y with hypertension allocated into (n = 12/group): control group (no exercise), SMM group (bilateral isometric handgrip contractions using a hydraulic handheld dynamometer), and LMM group (bilateral isometric full knee extension on a leg extension machine). Both exercise interventions consisted of 4 × 2 min of bilateral contraction at 30 % of the individual's maximum capacity. The authors used 24-hour Ambulatory Blood Pressure Monitoring (ABPM) after the interventions. One-way ANOVA or Generalized Estimation Equations (GEE) were used to test for potential differences (p < 0.05). The authors found no increase in SBP/DBP immediately after the interventions. However, 24 h ABPM revealed lower SBP post-intervention in the SMM group (Δ-4.1 mmHg; p = 0.044) and the LMM group (Δ-5.6 mmHg; p = 0.040) compared to the control group, with no difference between these groups. DBP did not change over a period of 24 h ABPM. In conclusion, isometric exercise-induced PEH assessed by 24 h ABPM regardless of the muscle mass involved. This study shows that both interventions may contribute to lowering blood pressure in individuals with hypertension. www. gov; ID NCT03982758.

Objetivo: verificar a associação entre a capacidade funcional e a força muscular em pacientes com insuficiência renal crônica. Método: estudo do tipo quantitativo, descritivo transversal. Foi avaliada a distância percorrida no Teste de Caminhada de Seis Minutos, o número de repetições no Teste Sentar e Levantar em trinta segundos, a força muscular respiratória e a força de preensão palmar. Resultados: a distância percorrida no teste de caminhada de 6 minutos não apresentou diferença dos valores previstos e associou-se com o número de repetições no teste de sentar e levantar. As medidas de força de preensão palmar, pressão inspiratória e expiratória máximas apresentaram redução em relação aos valores de referência. Foram identificadas associações da força de preensão palmar dos membros com e sem a fístula arteriovenosa com as pressões respiratórias máximas. Conclusão: pacientes com insuficiência renal crônica sofrem impacto na função física com comprometimento predominante na força muscular ventilatória e periférica.

Introdução: pacientes recuperados de COVID-19 podem apresentar sintomas que persistem ou se desenvolvem semanas após a contaminação inicial. Objetivo: avaliar a relação entre os sintomas de dispneia e fadiga e a qualidade de vida em pacientes recuperados de COVID-19. Métodos: estudo transversal com pacientes de ambos os sexos, maiores de 18 anos, com histórico autorreferido de contaminação por COVID-19 e com sintomas persistentes. A qualidade de vida foi avaliada pelo questionário SF-36 e a intensidade dos sintomas (dispneia e fadiga) pela escala de Borg modificada. Resultados: 42 pacientes (57,8% homens; 53,6 ± 11,8 anos) com 5 (2,5 – 8) meses de diagnóstico foram avaliados. A prevalência de fadiga foi de 88,9% e associou-se com a Capacidade Funcional (r=-,483; p=0,010), Dor (r=-,311; p=0,045) e Estado Geral de Saúde (r=-,355; p=0,021). A prevalência de dispneia foi de 77,1% e associou-se com a Capacidade Funcional (r=-, 558; p=0,010), Saúde Geral (r=-,346; p=0,025), Vitalidade (r=-,359; p=0,020), Papel Emocional (r=-,361; p=0,019) e Saúde Mental (r =-,380; p=0,013). Foram identificadas diferenças nos escores de Capacidade Funcional (p<0,001), Saúde Geral (p<0,027), Vitalidade (p<0,022), Aspectos Emocionais (p<0,021) e Saúde Mental (p<0,015) entre pacientes com maior e menor intensidade da dispneia e diferenças nos escores de Capacidade Funcional (p<0,002), Dor (p<0,046) e Estado Geral de Saúde (p<0,023) entre pacientes com maior e menor intensidade de fadiga. A intensidade dos sintomas foi capaz de predizer escores dos domínios do questionário de qualidade de vida. Conclusão: pacientes recuperados da COVID-19 podem apresentar sintomas meses após a contaminação aguda e esses sintomas afetarem a percepção de saúde.