Vol 2-2 Mini Review

Low Level Laser Therapy as an adjuvant therapy for Duchenne muscular dystrophy

Lidiane Begalli de Souza1, Mariana Cruz Lazzarin1, Flavia de Oliveira1*

1Departamento de Biociências, Universidade Federal de São Paulo, Campus Baixada Santista, SP, Brazil

Duchenne muscular dystrophy (DMD) is a rare disease caused by mutations or rearrangements in the dystrophin gene, leading to progressive muscle lesion. There is no curative treatment for DMD, however, there is evidence that treatment with LLLT acts to decrease inflammation, oxidative stress, pain and stimulate muscle repair. The aim of this review was to discuss the effects of LLLT as a helpful alternative therapy to be associated with other treatments for DMD. To this end, a systematic research in PubMed database was conducted including the following terms: “Duchenne muscular dystrophy” and “low level laser therapy” or “mdx mice” and “low level laser therapy”. After prospecting scientific articles, 5 were selected. As a result, it was found that there is a lack of information about the use of LLLT on DMD patients because all of the studies were preclinical. The selected articles showed that mdx mice were chosen as the experimental model and although they describe the positive effects of LLLT, the studies were performed with different mice ages, parameters of irradiation, treatment duration and muscle chosen. In conclusion, according to this review both preclinical animal experiments and human clinical studies with LLLT use should be expanded to the benefits of patients in this translational research answer.

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Vol 2-2 Research Article

The effects of ninety minutes per week of moderate intensity aerobic exercise on metabolic health in individuals with Type 2 Diabetes: A pilot study

Vagner R. R. Silva1#, Felipe L. Belozo1#, Rodrigo M. Pereira1, Carlos K. Katashima1, Andre V. Cordeiro1, Jean F. Alves2, Jose R. Pauli1, Adelino Silva3,4, Eduardo R. Ropelle1, Leandro P. De Moura1*

1Department of Sport Sciences, School of Applied Science, University of Campinas (UNICAMP), Limeira, Sao Paulo, Brazil

2Department of Biochemistry, Faculty of Biology, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil

3Postgraduate Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, USP, Ribeirao Preto, SP, Brazil

4School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil

5School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo (USP), Ribeirao Preto, SP, Brazil

Sedentary lifestyle is one of the main factors that contribute to the development of diabetes. The amount recommended, in order to achieve an improved overall metabolic health, is at least 150 minutes of moderate-intensity exercise weekly. However, due to the high volume prescribed, the adherence to this practice is not as good as expected, thereby increasing the incidence of sedentary lifestyle and diabetes. Here, we show the impact of reducing the recommended amount of exercise by 40% (90 minutes/week) on cholesterolemia and glycemia among diabetic individuals. 13 diabetics (men and women), divided into two groups: untrained (n=6) and trained (n=7) (mean age 45.3±3.9). The trained group was submitted to the practice of aerobic exercise on a treadmill, three times a week (70–80% MHR), for 30 min/day, for 8 weeks. Subsequently, were analysed glucose levels, glycated hemoglobin A1C (HbA1c), total cholesterol and its fraction (LDL-c, VLDL-c, HDL-c) and total triglycerides (TG). Ninety minutes per week of moderate-intensity exercise was effective in controlling blood cholesterol by reducing the total cholesterol and LDL-c fraction. Furthermore, it was observed that this amount of exercise promoted a reduction in hyperglycemia from the first session until the end of the experiment. Fasting glycemia was reduced after the fourth week of training, even without changes in the adiposity. In conclusion, 90 minutes of moderate intensity exercise a week, spread over 3 nonconsecutive days of 30 minutes of exercise, can improve the lipid profile and glucose homeostasis in diabetic patients, even without a reduction of adiposity.

This study was registered under ClinicalTrials.gov with the identifier code number: RBR-8mwkyq

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Vol 2-2 Research Article

Functional mobility in older practitioners of Liang Gong exercise

Felipe L. Belozo1, Naely Pivetta2, Victor A. R. Fernandes1,3, Rebeca S.M.N. Belozo1, Tatiane C. de Paula1, Carlos K. Katashima5, Andre K. Yamada4, Carlos Roberto Bueno Jr.4, Vagner R. R. Silva5*

1College of Physical Education - Network Faculty, Nova Odessa, SP, Brazil

2State University of Campinas (UNICAMP), Campinas, SP, Brazil

3Laboratory of Tissue Morphology. Jundiai Medical School. Jundiaí, SP, Brazil

4School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeiro Preto, Brazil

5Postgraduate Program in Nutrition and Sport Sciences and Metabolism. School of Applied Sciences, University of Campinas (UNICAMP), Limeira, SP, Brazil

Background: Falls can lead to several comorbidities and are considered a major cause of mortality in the elderly.

Objective: Herein, we evaluated functional mobility in older practitioners of Liang Gong exercise as a strategy to prevent falls.

Method: We evaluated 90 subjects (10 men and 80 women) using measures of body mass index (BMI), waist circumference (WC), abdominal circumference (AC), calf circumference (CC), 5 times sit to stand test (5TSS), and 4-meter gait speed test (4GST).

Results: Against our expectations, 68.88% of the participants presented low-performance in the 5TSS and 71.11% in the 4GST. In addition, we associated CC (considered a marker of sarcopenia) with the 5TSS using Pearson's correlation analysis but no statistical differences were found between the low-performance group and the high-performance group.

Conclusion: Our results showed that the majority of the older adults who have been practicing Liang Gong exercise for more than 6-months presented unsatisfactory results in the indices of functional mobility and we believe that a combination of resistance, functional and aerobics trainings would be more effective to improve it.

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Vol 2-2 Research Article

Rehabilitation of balance control with the rotatory chair protocol depends on rehabilitation onset and postural task difficulty in unilateral vestibular hypofunction patients

Michel Lacour1,4*, Laurent Tardivet2, Alain Thiry3

1Neurosciences Department, Aix-Marseille University/CNRS, Marseille, France

2Otorhinolaryngology Department, CHU Nice, 30 Voie Romaine, 06000 Nice, France

3Physiotherapist, 29 Bd Dubouchage, 06000 Nice, France

421 Impasse des Vertus - 13710 Fuveau (France)

Purpose: Postural instability is a disabling symptom in patients with acute unilateral vestibular hypofunction (UVH). Vestibular rehabilitation (VR) with the unidirectional rotation paradigm has been shown recently to improve gaze stabilization in UVH patients, particularly when performed early after onset of the vestibular pathology, but its role on posture recovery remains unknown until today.

Methods: Effects on posture and balance recovery of early versus delayed VR with the rotatory chair protocol were analyzed under static and dynamic postural tasks performed in different visual conditions (eye open: EO, eyes closed: EC, optokinetic stimulation). Posture control was investigated through non-linear analyses of the stabilogram in three groups of patients submitted to the same VR program performed at different time periods after onset of the acute vertigo attack (early VR: first two weeks; late 1 VR: third and fourth weeks; late 2 VR: one month and more). The Dizziness Handicap Inventory (DHI) score was evaluated before and after VR.

Results: All the postural parameters (Postural Instability Index: PII, Spectral Power Density: SPD, Critical Point amplitude: CP amp, and Hausdorff Frequency: HF) were significantly modified in the UVH patients tested before VR compared to the controls. Greater instability (increased PII) associated with higher energy to control posture (enhanced SPD), higher CoP displacements without feedback corrections (increased CP amp), and lower time of automatic control of posture (decreased HF) was the typical pattern of the UVH patients. After rehabilitation and in static posturography conditions, all the postural parameters were improved in the three groups of patients, whatever the visual condition, without significant differences between the groups. By contrast, recovery of balance in the dynamic postural conditions was better only when rehabilitation was performed early. A lower percentage of fallers was observed in the early and late 1 group in the most challenging conditions with EC and optokinetic stimulation. In addition, the early group was the only one to show significant improvement of the postural parameters (PII, SPD, CP amp and HF), and the late 2 group the only one to show no significant changes. The late 1 group exhibited an intermediate recovery pattern. The DHI scores were significantly reduced in the early and late 1 groups only.

Conclusions: Posture control is strongly impaired in the UVH patients who display greater instability, higher body sway without feedback correction, and spend much more energy to keep balance. Postural recovery after VR does not depend on the time period between onset of pathology and beginning of VR when patients were tested in the easy postural tasks on a stable support. However, in the most challenging conditions on unstable support, without vision or moving visual environment, earlier the rehabilitation with the rotatory chair protocol, better the recovery. This latter result suggests a critical period to recover optimally the dynamic vestibulo-spinal function, similar to the early opportunity time window we have highlighted for the recovery of the dynamic vestibulo-ocular reflex.

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Vol 2-2 Research Article

Peyronie’s disease and the role of therapeutic ultrasound: A randomized controlled trial

Joanne E. Milios*, Timothy R. Ackland, Daniel J. Green

School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, 6009

Peyronie’s Disease (PD) is a connective tissue disorder of the penis affecting 1 in 10 men, resulting in penile deformity and psychological distress in 50% of afflicted men. Therapeutic Ultrasound (TUS) is a non-invasive treatment that uses high frequency sound waves to stimulate tissue repair via thermal effects to increase blood flow, reduce pain and promote a proinflammatory response. TUS has been shown to be effective in case study series however no RCTs currently exist.

Methods & Materials: Forty-six men with PD were recruited into a randomised controlled study that assessed the effectiveness of TUS (n= 23 intervention, n= 20 control).

12 TUS sessions were provided over 4 weeks utilising 1.5-2.5 W/cm2, 3 MHz x 10mins/session before and after which all outcome measures were re-assessed. The control group had a 4 -week delayed entry into the intervention. Participants underwent Penile Duplex Doppler Ultrasound (PDDU) to confirm PD. as well as completing the Peyronie’s Disease Questionnaire (PDQ) and IIEF-5.

Results: Forty-three participants (59 y ± 11y, BMI=26.3, duration PD 17 months) completed the trial. PDDU outcomes indicated a Group x Time interaction (F= 4.702, p=0.036) and showed a significant main effect. Average reduction in penile curvature angle was , or 38% of total and ANOVA results show a significant main effect for time and curvature reduction (F=16.762; p < 0.001). For the IIEF-5 outcomes, results show a significant main effect for the Group x Time interaction (F=4.752, p=0.035).

Conclusions: TUS offered an effective first line, non-invasive approach to treatment for PD. Previous studies utilizing TUS on PD have relied on case study reports and this is the first RCT to be undertaken in this field.

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Vol 2-2 Mini Review

Exercise activates AMPK signaling: Impact on glucose uptake in the skeletal muscle in aging

Renan Fudoli Lins Vieira1, Rafael Lima Junqueira1, Rafael C. Gaspar1, Vitor R. Munoz1, Jose R. Pauli1,2*

1Department of Health Sciences, Laboratory of Molecular Biology of Exercise, School of Applied Sciences, University of Campinas, Sao Paulo, Brazil

2CEPECE-Center of Research in Sport Sciences, School of Applied Sciences, University of Campinas (UNICAMP), Limeira, Sao Paulo, Brazil

Aging is characterized by a decline in metabolism and functional capacities. On the other hand, physical exercise is a well-known strategy that provides metabolic and functional benefits. Since elderly subjects have insulin resistance and issues with carbohydrate metabolism, physical exercise can contribute to glucose homeostasis through its participation in skeletal muscle glucose uptake via insulin-dependent/insulin-independent mechanisms. Therefore, it is important to understand the effects of physical exercise on 5' AMP-activated protein kinase (AMPK) signaling in skeletal muscle and on positive metabolic adaptations and the prevention of age-related diseases. In this mini-review, we will discuss the participation of AMPK in controlling skeletal muscle glucose uptake in response to physical exercise and aging.

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