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Gómez-Bruton A, Irún P, Matute-Llorente A, Lozano-Berges G, Moradell A, Ara-Gimeno S, Subias-Perie J, Sánchez-Luengo M, Hijos-Mallada G, García-Mateo S, Arechavaleta S, Palacios Fanlo MJ, Lanas A, Casajús JA. Effects of whole-body vibration on body composition, microbiota, cardiometabolic markers, physical fitness, and quality of life after bariatric surgery: protocol for a randomized controlled trial. Trials 2024; 25:413. [PMID: 38926901 PMCID: PMC11210142 DOI: 10.1186/s13063-024-08221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Morbid obesity is a complex chronic condition characterized by a body mass index of 40 kg/m2 or higher. The incidence of the condition is on the rise in developed countries, and bariatric surgery has been proposed as a potential solution to address this trend. Nonetheless, bariatric surgery may also result in adverse effects, including a reduction in bone mineral density (BMD) and muscle mass, as well as an increased risk of fractures. The present study aims to elucidate the effects of bariatric surgery and whole-body vibration (WBV) training on body composition, microbiota, physical fitness, quality of life, and cardiometabolic markers. METHODS Twenty-eight participants (14 females), aged 18 to 50 years, will undergo sleeve gastrectomy surgery. They will be randomly allocated into a control group or a WBV training group. The WBV group will train three times per week with increasing intensities and duration ranging from 30 to 45 min over the 4-month training period. Measurements of body composition (dual-energy X-ray absorptiometry and peripheral quantitative computed tomography), physical fitness (muscular strength, agility, cardiorespiratory fitness, and balance), gait biomechanics, cardiometabolic markers, gut microbiota, quality of life, and physical activity levels will be collected at four different time points: (1) prior to the surgery, (2) 45 days post-surgery, (3) 6 months post-surgery, and (4) 18 months post-surgery. DISCUSSION Both groups are expected to experience improvements in most of the aforementioned variables. Nonetheless, we expect the WBV group to show larger improvements proving that the training is effective and safe. TRIAL REGISTRATION Clinicaltrials.gov NCT05695599. Registered on January 25, 2023.
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Affiliation(s)
- Alejandro Gómez-Bruton
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain.
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de La Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
| | - Pilar Irún
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Angel Matute-Llorente
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de La Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Gabriel Lozano-Berges
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de La Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Moradell
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de La Salud y del Deporte, Universidad de Zaragoza, Huesca, Spain
| | - Susana Ara-Gimeno
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
| | - Jorge Subias-Perie
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
- Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Marta Sánchez-Luengo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Service of Digestive Diseases, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Gonzalo Hijos-Mallada
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Service of Digestive Diseases, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Sandra García-Mateo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Service of Digestive Diseases, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Samantha Arechavaleta
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - María José Palacios Fanlo
- Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Angel Lanas
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Service of Digestive Diseases, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Departamento de Medicina, Psiquiatría y Dermatología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Jose A Casajús
- EXER-GENUD (EXERCISE-Growth, Exercise, NUtrition and Development) Grupo de Investigación, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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Yiu EML, Cheng LKH, Wang F. Frequency Transmission of Oscillation from External Whole-Body Vibration Platform to the Larynx. J Voice 2024:S0892-1997(24)00093-6. [PMID: 38614894 DOI: 10.1016/j.jvoice.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE This study investigates (1) the presence of frequency transmission of oscillation from an external whole-body vibration (WBV) platform to the larynx; and (2) the factors that influence this frequency transmission. METHODS Thirty participants (mean age=22.3years) with normal voice were exposed to four frequency-intensity levels of WBV (10 Hz-10%, 10 Hz-20%, 20 Hz-10%, 20 Hz-20%) and were instructed to produce the natural vowel /a/ three times during each WBV setting. The frequency was extracted from the middle 1-second of each electroglottographic (EGG) signal after passing through a Hann band filter with a range of 6-24 Hz. Linear mixed-effects models were applied to determine the factors that influenced the absolute deviation of the frequency transmission. RESULTS All participants exhibit an extracted EGG frequency that aligns with the external WBV frequency, deviating by - 0.6 to 1.2 Hz. The absolute deviation of WBV frequency transmission is consistent for both sexes across various WBV settings, except the 10 Hz-10% setting where men tend to exhibit significantly higher deviations (P = 0.018). CONCLUSION Oscillations at a specific frequency are transmitted from an external WBV platform to the larynx. This study proposes the use of a "spring" system to investigate the effect of WBV on the larynx, and recommends further research to explore the potential of WBV in managing voice disorders.
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Affiliation(s)
- E M-L Yiu
- Voice Research Laboratory, The University of Hong Kong, Pokfulam, Hong Kong
| | - L K H Cheng
- Voice Research Laboratory, The University of Hong Kong, Pokfulam, Hong Kong
| | - F Wang
- School of Humanities, Shanghai Normal University, Shanghai, China.
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Nantakool S, Punturee K, Konghakote S, Sitthichoke C, Phirom K, Chuatrakoon B. Immediate Effects of Aerobic Exercise and Whole-Body Vibration on Fat Oxidation, Lipid Mobilization, and Cardiovascular Response in Individuals with Obesity. J Clin Med 2023; 13:44. [PMID: 38202051 PMCID: PMC10779615 DOI: 10.3390/jcm13010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Among obesity, cumulative fat and poor physical activity are risk factors for cardiovascular disease. Due to the limit in performing aerobic exercise (AER), whole-body vibration (WBV) as a passive form of exercise is an alternative therapeutic strategy. Herein, this study aimed to compare the immediate effects of AER and WBV on metabolic and cardiovascular responses, and dyspnea level in obesity. Forty-nine eligible obesities performed both AER and WBV, with a random order assignment (age = 28.94 ± 11.39 years). Fat oxidation, cardiovascular parameters (i.e., heart rate (HR) and blood pressure (BP)), and dyspnea level (i.e., rating perceived exertion (RPE)) were measured during exercise, while lipid mobilization (i.e., triglycerides) was collected pre- and post-exercise. Fat oxidation rate in AER was significantly higher than in WBV. Significantly increased fat oxidation rates were shown in both groups (within-group analyses) (also shown in females aged 20-45). Triglyceride levels between AER and WBV were similar. A significant decrease in triglyceride levels was only observed in WBV (within-group change). HR and RPE in AER were significantly higher than in WBV (p < 0.05). HR and RPE were significantly increased throughout both AER and WBV, while systolic blood pressure was only significantly elevated in AER (whining-group analyses). WBV may facilitate fat oxidation (particularly in females aged below 45), induce lipid mobilization, and reduce interference on cardiovascular parameters in obesity.
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Affiliation(s)
- Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
| | - Khanittha Punturee
- Center Research Unit of Associated Medical Sciences (AMS-CRU), Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Supatcha Konghakote
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
| | - Cattaleeya Sitthichoke
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
| | - Kochaphan Phirom
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
| | - Busaba Chuatrakoon
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
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Lecce E, Nuccio S, Del Vecchio A, Conti A, Nicolò A, Sacchetti M, Felici F, Bazzucchi I. Sensorimotor integration is affected by acute whole-body vibration: a coherence study. Front Physiol 2023; 14:1266085. [PMID: 37772061 PMCID: PMC10523146 DOI: 10.3389/fphys.2023.1266085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction: Several whole-body vibration (WBV) effects on performance have been related to potential changes in the neural drive, motor unit firing rate, and sensorimotor integration. In the present paper, motor unit coherence analysis was performed to detect the source of neural modulation based on the frequency domain. Methods: Thirteen men [25 ± 2.1 years; Body Mass Index (BMI) = 23.9 ± 1.3 kg m2; maximal voluntary force (MVF): 324.36 ± 41.26 N] performed sustained contractions of the Tibialis Anterior (TA) at 10%MVF before and after acute WBV. The vibrating stimulus was applied barefoot through a platform to target the TA. High-Density surface Electromyography (HDsEMG) was used to record the myoelectrical activity of TA to evaluate coherence from motor unit cumulative spike-trains (CSTs). Results: Mean coherence showed a significant decrease in the alpha and low-beta bandwidths (alpha: from 0.143 ± 0.129 to 0.132 ± 0.129, p = 0.035; low-beta: from 0.117 ± 0.039 to 0.086 ± 0.03, p = 0.0001), whereas no significant changes were found in the other ones (p > 0.05). The discharge rate (DR) and the Force Covariance (CovF%) were not significantly affected by acute WBV exposure (p > 0.05). Discussion: According to the significant effects found in alpha and low-beta bandwidths, which reflect sensorimotor integration parameters, accompanied by no differences in the DR and CovF%, the present results underlined that possible neural mechanisms at the base of the previously reported performance enhancements following acute WBV are likely based on sensorimotor integration rather than direct neural drive modulation.
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Affiliation(s)
- E. Lecce
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - S. Nuccio
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - A. Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Faculty of Engineering, Zentralinstitut für Medizintechnik (ZIMT), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - A. Conti
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - A. Nicolò
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - M. Sacchetti
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - F. Felici
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
| | - I. Bazzucchi
- Department of Movement, Human, and Health Sciences, Laboratory of Exercise Physiology, University of Rome “Foro Italico”, Rome, Italy
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Niewiadomski W, Gąsiorowska A, Żyliński M, Karbowniczek A, Cebrat J, Stępniewska A. Exaggerated pressor response to static squats in Parkinson's disease (PD) and healthy subjects is likely an individual trait, not influenced by whole body vibration (WBV). NeuroRehabilitation 2023; 52:289-298. [PMID: 36641689 PMCID: PMC9986697 DOI: 10.3233/nre-220234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Reduced muscle strength is one symptom of Parkinson's disease (PD). Strength can be increased by strength training, which may cause exaggerated blood pressure (BP) rise. It is believed that exercises performed on vibrating platform can strengthen leg muscles without excessive BP increase. OBJECTIVE To measure the pressor response to static exercises performed during whole body vibration in PD patients. METHODS Twenty-four aged PD patients and twelve healthy young volunteers participated in the study. PD subjects performed six repetitions of deep-, semi-squat, and calves at vibration frequency of 30 Hz. Each 30 s exercise was followed by 30 s rest. The young volunteers performed two sessions of above-mentioned exercises with and without vibration. BP was measured continuously. RESULTS In PD patients, the highest BP values were observed during deep squat; systolic blood pressure rose 10 mmHg in 'weak responders', and 50 mmHg in 'strong responders'. This difference correlated with the rise in pulse pressure suggesting indirectly the role of stoke volume in individual response. In healthy subjects pressor response was also individually differentiated and not influenced by vibration. CONCLUSION Deep and semi squat can evoke a strong cardiovascular response in some PD and healthy subjects. Low-magnitude vibrations likely did not affect pressor response.
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Affiliation(s)
- Wiktor Niewiadomski
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Gąsiorowska
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Marek Żyliński
- Institute of Metrology and Biomedical Engineering, Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | | | - Justyna Cebrat
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Stępniewska
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
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Reis-Silva A, Coelho-Oliveira AC, Martins-Anjos E, Moura-Fernandes MC, Mulder A, Xavier VL, Mendonça VA, Lacerda ACR, Paineiras-Domingos LL, Taiar R, Sartorio A, Bernardo-Filho M, Sá-Caputo DC. Impact of Two Whole-Body Vibration Exercise Protocols on Body Composition of Patients with Metabolic Syndrome: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010436. [PMID: 36612756 PMCID: PMC9819771 DOI: 10.3390/ijerph20010436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 05/14/2023]
Abstract
(1) Background: This study investigated the effects of two 6-week whole-body vibration exercise (WBVE) protocols on body composition in patients with metabolic syndrome (MSy). Thirty-three patients were allocated to either the Fixed Frequency WBVE Group (FFG-WBVE) or the Variable Frequency WBVE Group (VFG-WBVE). (2) Methods: A side-alternating vibration platform was used and the patients remained in the semi-squat position on this platform. In the FFG-WBVE (n = 12; median age = 50.50 years) and (body mass index BMI = 31.95 kg/m2), patients were exposed to 10 s of mechanical vibration at a fixed frequency of 5 Hz, followed by 50 s without vibration. In the VFG-WBVE (n = 10; median age = 57.50 years) and (BMI = 32.50 kg/m2), the patients performed 60 s of mechanical vibration at different frequencies from 5 to 16 Hz). Body composition evaluated through (bioelectrical impedance analysis and anthropometric measurements) were was evaluated before and after the all the interventions in each group. (3) Results: The VFG-WBVE decreased waist circumference, p = 0.01 and segmental fat mass [left arm, p = 0.01; right arm, p = 0.02 and trunk, p = 0.03]. Bone content increased, p = 0.01. No significant changes were observed in the FFG- WBVE. (4) Conclusions: In conclusion, this study demonstrated that 6 weeks of WBVE with a protocol with variable frequency can positively modify the body composition of MSY patients. These findings might contribute to improvements in the metabolic health of these patients.
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Affiliation(s)
- Aline Reis-Silva
- Medicina Laboratorial e Tecnologia Forense, Programa de Pós-Graduação Profissional em Saúde, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-013, RJ, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcântara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil
- Correspondence: ; Tel.: +55-21-981-304-162
| | - Ana C. Coelho-Oliveira
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, RJ, Brazil
| | - Elzi Martins-Anjos
- Medicina Laboratorial e Tecnologia Forense, Programa de Pós-Graduação Profissional em Saúde, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-013, RJ, Brazil
| | - Márcia Cristina Moura-Fernandes
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, RJ, Brazil
| | - Alessandra Mulder
- Departamento de Nutrição Aplicada, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, RJ, Brazil
| | - Vinicius Layter Xavier
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-000, RJ, Brazil
| | - Vanessa A. Mendonça
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, MG, Brazil
| | - Ana C. R. Lacerda
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, MG, Brazil
| | - Laisa Liane Paineiras-Domingos
- Departamento de Fisioterapia, Instituto Multidisciplinar de Reabilitação e Saúde, Universidade Federal da Bahia, Salvador 40210-905, BA, Brazil
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims, F-51100 Reims, France
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 20145 Milan, Italy
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcântara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, RJ, Brazil
| | - Danúbia C. Sá-Caputo
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, RJ, Brazil
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