Abstract Aims: Muscular strength (MS) and jump power (JP) tests are used to assess athletic ability and measure the effectiveness of training programs. However, their use in various sport modalities needs to be investigated further. This study aimed to explore the changes in MS and JP during three different moments of a macrocycle training session and verify the validity of the tests used to predict the effectiveness of basketball training programs. Methods: During macrocycle training (three different moments), sixteen basketball players were evaluated for MS (measured using isokinetic dynamometry at the speed of 60°/s) during concentric contraction of knee flexor and extensor muscles and JP, using countermovement vertical jump (CMVJ) on a force platform. Results: Peak torque and maximal work values for knee extension and flexion showed no differences, during the three moments analyzed. Additionally, no changes were observed for CMVJ. Conclusions: Our results suggest that the effectiveness of basketball training programs does not seem to be related to the performance achieved by athletes on the tests used. Moreover, the lack of changes in MS and JP values during the macrocycle could be related to the training structure used; volume, intensity, density and workload specificity.

OBJECTIVES: To assess functional capacity in the preoperative phase of pulmonary surgery by comparing predicted and obtained values for the six-minute walk test (6MWT) in patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated using the 6MWT, followed by monitoring of the postoperative evolution of each participant who underwent the routine treatment. Participants were then divided into two groups: the group with PPC and the group without PPC. The results were also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by the group without PPC was 80% of the predicted value, whereas the group with PPC averaged less than 70% (p=0.03), with more appropriate predicted values for the reference equations CONCLUSIONS: The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation in pulmonary surgery and may indicate patients with a higher chance of developing PPC.

BACKGROUND: The effects of physical therapy on heart rate variability (HRV), especially in children, are still inconclusive. OBJECTIVE: We investigated the effects of conventional physical therapy (CPT) for airway clearance and nasotracheal suction on the HRV of pediatric patients with acute bronchiolitis. METHOD: 24 children were divided into two groups: control group (CG, n=12) without respiratory diseases and acute bronchiolitis group (BG, n=12). The heart rate was recorded in the BG at four different moments: basal recording (30 minutes), 5 minutes after the CPT (10 minutes), 5 minutes after nasotracheal suction (10 minutes), and 40 minutes after nasotracheal suction (30 minutes). The CG was subjected to the same protocol, except for nasotracheal suction. To assess the HRV, we used spectrum analysis, which decomposes the heart rate oscillations into frequency bands: low frequency (LF=0.04-0.15Hz), which corresponds mainly to sympathetic modulation; and high frequency (HF=0.15-1.2Hz), corresponding to vagal modulation. RESULTS: Under baseline conditions, the BG showed higher values in LF oscillations, lower values in HF oscillations, and increased LF/HF ratio when compared to the CG. After CPT, the values for HRV in the BG were similar to those observed in the CG during basal recording. Five minutes after nasotracheal suction, the BG showed a decrease in LF and HF oscillations; however, after 40 minutes, the values were similar to those observed after application of CPT. CONCLUSIONS: The CPT and nasotracheal suction, both used for airway clearance, promote improvement in autonomic modulation of HRV in children with acute bronchiolitis.

CONTEXTUALIZAÇÃO: Pico de fluxo expiratório (PFE) é uma das medidas de função pulmonar definida como o maior fluxo obtido em uma expiração forçada a partir de uma inspiração completa ao nível da capacidade pulmonar total (CPT). Essa medida é dependente do esforço, da força dos músculos expiratórios, do calibre das vias aéreas e do volume pulmonar. OBJETIVO: Comparar os resultados de PFE em homens e mulheres saudáveis, obtidos na posição sentada, com decúbito dorsal (DD), decúbito lateral direito (DLD) e esquerdo (DLE). MÉTODO: Participaram 30 indivíduos, com média de idade de 22,7 anos, saudáveis e não fumantes, sendo 15 do sexo masculino. Todos realizaram espirometria e responderam ao questionário IPAQ para caracterizar a normalidade da função pulmonar e o nível de atividade física. As medidas de PFE foram realizadas nas quatro posições, sendo realizadas três medidas em cada posição, em ordem aleatória. Para análise estatística, foi utilizado o teste t de Student, com nível de significância estabelecido em 5%. RESULTADOS: Houve diferença entre os valores obtidos na posição sentada (481±117, 1 L/min) com o DD (453,2±116,3 L/min) e DLD (454±112,9 L/min) (p<0,05), porém, não encontramos diferença significativa entre as posições sentada e DLE (469±83 L/min). CONCLUSÕES: A posição corporal afeta os valores de PFE, com diminuição dos valores em DD e DLD. O DLE pode ser uma alternativa para otimizar o fluxo expiratório em situações de restrição à posição sentada.

BACKGROUND: One of the measures of the pulmonary function is the peak expiratory flow (PEF) that can be defined as the major flow obtained in an expiratory pressure after a complete inspiration to the level of the total lung capacity. This measure depends on the effort and strength of expiratory muscles, the airway diameter and the lung volume. OBJECTIVE: To compare the results of the peak expiratory flow in healthy male and female obtained in a seated position and dorsal decubitus (DD), right lateral decubitus (RLD) and left lateral decubitus (LLD). METHOD: Thirty young subjects with mean age 22.7 years, healthy and non-smokers were included at the study, 15 of male sex. They did spirometry and IPAQ questionnaire to check the normal pulmonary function and physical activity level. The measures of PEF were performed in four positions, being performed 3 measures in which position, in a random order. Statistical analysis was performed according to Student's t test, with significance level set at 5%. RESULTS: There was a difference between the values obtained in sitting position(481±117.1 L/min) with DD(453.2±116.3 L/min) and RLD (454±112.9 L/min) (p<0.05), however, did not find a significant difference between the sitting position and LLD (469±83 L/min). CONCLUSIONS: Body position affects the values of PEF, with decreasing values in DD and RLD. The LLD can be an alternative to optimize the expiratory flow in situations of constraint to the sitting position.

CONTEXTUALIZAÇÃO: O índice de respiração rápida e superficial (IRRS) tem sido o mais utilizado dentro das unidades de terapia intensiva (UTIs) como preditor do resultado do desmame, porém diferenças no método de obtenção têm gerado dúvidas quanto a seu valor preditivo. OBJETIVO: Verificar a influência de baixos níveis de pressão de suporte (PS) no valor do IRRS em pacientes graves. MÉTODO: Estudo prospectivo, incluindo 30 pacientes sob ventilação mecânica (VM) por 72 horas ou mais, prontos para extubação. Anteriormente à extubação, o IRRS foi obtido com o paciente conectado ao ventilador Evita-XL da DragerTM recebendo pressão de suporte ventilatório (PSV) e PEEP=5 cmH2O (IRRS_MIN) e, logo após, desconectado da VM e conectado a um ventilômetro de WrightTM, onde sua frequência respiratória e o volume corrente exalado eram registrados durante 1 minuto (IRRS_ESP). Os pacientes foram divididos de acordo com o desfecho em grupo sucesso extubação (GS) e grupo insucesso extubação (GI). RESULTADOS: Dos 30 pacientes, 11 (37%) falharam no processo de extubação. Na comparação intragrupos (IRRS_MIN x IRRS_ESP), os valores foram menores para o IRRS_MIN em ambos os grupos: GS (34,79±4,67 e 60,95±24,64) e GI (38,64±12,31 e 80,09±20,71) (p<0,05). Na comparação intergrupos não houve diferença entre IRRS_MIN (34,79±14,67 e 38,64±12,31), por outro lado, IRRS_ESP foi maior nos pacientes com falha na extubação: GS (60,95±24,64) e GI (80,09±20,71) (p<0,05). CONCLUSÃO: Em pacientes graves e sob VM acima de 72 horas, níveis mínimos de PS superestimam o IRRS, sendo necessária sua obtenção com o paciente respirando de forma espontânea sem o auxílio de PS.

BACKGROUND: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. OBJECTIVE: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. METHOD: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (DragerTM Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH2O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). RESULTS: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79±4.67 and 60.95±24.64) and FG (38.64±12.31 and 80.09±20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79±14.67 and 38.64±12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95±24.64) and FG (80.09±20.71; p<0.05). CONCLUSIONS: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.