Background Aortic stenosis is a valvular heart disease characterised by fixed obstruction of the left ventricular outflow. It can be managed by surgical aortic valve replacement (sAVR) or transcatheter aortic valve implantation (TAVI). This review aimed to describe the evidence supporting a cardiac rehabilitation programme on functional capacity and quality of life in aortic stenosis patients after sAVR or TAVI. Methods The search was conducted on multiple databases from January to March 2016. All studies were eligible that evaluated the effects of a post-interventional cardiac rehabilitation programme in aortic stenosis patients. The methodological quality was assessed using the PEDro scale. Meta-analysis was performed separately by procedure and between procedures. The walked distance during the six-minute walk test (6MWD) and Barthel index were evaluated. The analysis was conducted in Review Manager. Results Five studies were included (292 TAVI and 570 sAVR patients). The meta-analysis showed that a cardiac rehabilitation programme was associated with a significant improvement in 6MWD (0.69 (0.47, 0.91); P < 0.001) and Barthel index (0.80 (0.29, 1.30); P = 0.002) after TAVI and 6MWD (0.79 (0.43, 1.15); P < 0.001) and Barthel index (0.93 (0.67, 1.18); P < 0.001) after sAVR. In addition, the meta-analysis showed that the cardiac rehabilitation programme promoted a similar gain in 6MWD (4.28% (-12.73, 21.29); P = 0.62) and Barthel index (-1.52 points (-4.81, 1.76); P = 0.36) after sAVR or TAVI. Conclusions The cardiac rehabilitation programme improved the functional capacity and quality of life in aortic stenosis patients. Patients who underwent TAVI benefitted with a cardiac rehabilitation programme similar to sAVR patients.

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With short-term recordings, selection methods may interfere with the non-linear heart rate variability analysis. The confidence interval, the replacement by the average of previous data and the selection of 256 of the highest stability points of the signal seem to be the most adequate procedures to treat the data with prior to analysis.

Background:The talk test (TT) evaluates the exercise intensity by measuring speech comfort level during aerobic exercise. There are several application protocols available to assess individuals with cardiopulmonary diseases. However, the measurement properties of the TT were not systematically reviewed yet. Methods: A systematic review was developed, registered (CRD420181068930), and reported according to PRISMA Statement. Randomized clinical trials, cross-sectional studies, or series cases were identified through multiple databases and were selected if they presented concomitant speech provocation and an exercise test. Included studies were evaluated based on methodological quality (adapted New Castle-Ottawa Scale), descriptive quality (STROBE Statement), and risk of bias (COSMIN bias risk scale). Results: Ten studies were included. Seven studies presented moderate to high quality and the majority presented good scores according to the STROBE statement. Four hundred and fourteen subjects performed the TT, the majority being patients with coronary artery disease. The test validity was supported by the included studies. Talk Test reliability was considered satisfactory, although only one study presented an adequate reliability analysis. The studies found a correlation between the last positive stage of the TT with the first ventilatory threshold. Workload, oxygen uptake, and heart rate in the last positive stage of the TT were not different from the same parameters related to the first ventilatory threshold. Conclusions: The evidence indicates that the TT is suitable as an alternative tool for the assessment and prescription of exercise in individuals with cardiovascular diseases. The stage when the individual is still able to speak comfortably is suggested as the intensity for aerobic exercise prescription. As there is still no well-defined and fully explored TT protocol, caution is required when interpreting the TT results.

ResumoMuitas atribuições são dadas ao alongamento, contudo nem todas possuem comprovação científica. O objetivo deste estudo foi analisar os efeitos do alongamento durante o treinamento de força visando à hipertrofia muscular. A amostra do estudo foi composta por um individuo que treinou durante 16 semanas exercícios de força para M.S. e M.I. de modo unilateral, alongando os membros sinistros antes e após a sessão de treino. O resultado obtido foi um aumento na circunferência nos membros não-alongados e uma diminuição da espessura da prega cutânea no M.I. alongado, o M.S. alongado não apresentou diferença significativa com o não-alongado. Contudo mais estudos devem ser feitos para verificar os verdadeiros efeitos do alongamento no treinamento de força visando à hipertrofia. Palavras-ChaveFisiologia; Flexibilidade; Treinamento de Força. THE STRETCHING AS INTERVINIENTE FACTOR IN MUSCLE HYPERTROPHY: A PRELIMINARY STUDY Gustavo dos Santos RibeiroAbstract A lot of attributions are given to the prolongation, however nor all possess scientific proof. The objective of this study was to analyze the effects of the prolongation during the training of force seeking to the muscular hypertrophy. The sample of the study was composed by an individual that for 16 weeks exercises of force for M.S. and M.I. in an unilateral way, prolongateing the sinister members before and after the training session. The obtained result was an increase in the circumference in the no-prolonged members and a decrease of the thickness of the cutaneous pleat in M.I. prolonged, M.S. prolonged it didn't present significant difference with the no-prolonged. However more studies should be made to verify the true effects of the prolongation in the training of force seeking to the hypertrophy.