Introduction: Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load.Methods: A comprehensive review of the Cochrane Library’s, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. Results:The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases.Conclusion:The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load.

BackgroundFibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin.Methods/DesignA randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay.DiscussionThis is the first randomized controlled trial in which the role of phototherapy, exercise training, and a combination of these interventions will be evaluated for chronic pain in patients with FM and TMD. The results will offer valuable clinical evidence for objective assessment of the potential benefits and risks of procedures.Trial registrationClinicalTrials.gov Identifier: NCT02279225. Registered 27 October 2014.

We analyzed the relationship between performance on the 6-min walk test (6MWT) and health-related quality of life (HRQoL) in older subjects. Our secondary aim was to determine the distance to be completed on the 6MWT for the subject to achieve a score of 50 on the Short Form (36) Health Survey (SF-36). Associations were tested using linear correlation and multivariate linear regression. Participants were 130 healthy older individuals. The predictive performance of the 6MWT based on an SF-36 score of 50 was assessed using a receiver operating characteristic curve and its area under curve (AUC). Associations were observed between physical functioning, role-emotional, social functioning, vitality, general health score, and 6MWT performance in women, after adjusting for confounding variables (coefficients: 0.57, 0.38, 0.40, and 0.46, respectively; p < 0.05). No association was found for men. The distance for the 6MWT to predict an SF-36 score of 50 was 481 m for men in the physical functioning (AUC: 0.79) and role-physical (AUC: 0.84) domains, and 420 m for women in role-emotional (AUC: 0.75), role-physical (AUC: 0.80), and general health (AUC: 0.80) domains. Our results indicate that superior 6MWT performance may be associated with better HRQoL in several domains in only healthy older women. No association between 6MWT performance and role-emotional, mental health, or vitality domains was found. We suggest that a score of 50 is represented by a 6MWT distance of 481 m for men and 420 m for women, at least in the role-physical domain.

Introduction: Although sodium bicarbonate (NaHCO3) supplementation has been shown to decrease fatigue and improve high-intensity exercise performance, the effects on maintenance of isometric contractions are not clear. Objective: To investigate the effect of NaHCO3 on the performance of individuals subjected to a fatigue protocol in an isometric exercise on the isokinetic dynamometer. Methods: Participants were 12 men in a randomized, double-blind, crossover, placebo-controlled trial. Sixteen minutes after the intake of 0.3 g/kg of body mass of NaHCO3 or placebo, the participants performed an isometric fatigue protocol of right knee extension exercises during eight minutes at 70% of maximum voluntary isometric contraction. The fatigue indicator was the time point at which torque was reduced to 50% of the initial value. The length of resistance was assessed by maintaining the task over 50% of the initial torque. Lactate/blood pH concentrations and rate of perceived exertion (RPE) and pain (RPP) indexes were analyzed. The RPE of the session was evaluated 30 minutes after the test. Results: Blood pH was higher in pre-protocol and in the fatigue indicator after NaHCO3 intake, as were the blood lactate concentrations in the fatigue indicator and at the end of the protocol (p<0.001). NaHCO3 supplementation increased the time to fatigue and lessened the rate of decline of isometric peak torque at the end of the protocol (p<0.001). RPE and RPP were smaller at the end of the protocol in the NaHCO3 condition, and the RPE of the session was diminished (p<0.001). Conclusion: NaHCO3 supplementation enhances steady isometric contraction performance and reduces the internal load. Level of Evidence II; Diagnostic studies - Investigation of an examination for diagnosis.

Introduction: The malocclusion can be defined as any change in the natural position of contact between the teeth and the arcades format that affects the morphofunctional architecture of the masticatory system of individuals affected by such condition. The aim of this study was to review the literature and to investigate the morphofunctional changes of the mandible and masticatory muscles as result of malocclusion. Material and Methods: This study consisted of a systematic review and the search for the theoretical composition was performed in the Lilacs, PubMed and Scielo database using as descriptors the words Malocclusion, Mandible, Masticatory Muscles and as filters the words Abstract Available, English Language, Humans, Rats. Results: This research allowed the authors to assert that the occlusal alterations are capable of causing morphological and functional modifications in the mandible and masticatory muscles. Conclusion: Given these aspects, it was possible to highlight the malocclusion as an aggravating factor at quality of life.