array:24 [
  "pii" => "S2173511510700749"
  "issn" => "21735115"
  "doi" => "10.1016/S2173-5115(10)70074-9"
  "estado" => "S300"
  "fechaPublicacion" => "2010-09-01"
  "aid" => "70074"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2010;16:717-36"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3442
    "formatos" => array:3 [
      "EPUB" => 235
      "HTML" => 2071
      "PDF" => 1136
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173511510700750"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(10)70075-0"
    "estado" => "S300"
    "fechaPublicacion" => "2010-09-01"
    "aid" => "70075"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2010;16:737-57"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3313
      "formatos" => array:3 [
        "EPUB" => 197
        "HTML" => 1996
        "PDF" => 1120
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Impact of combined exercise on chronic obstructive pulmonary patients’ state of health"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "737"
          "paginaFinal" => "757"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Impacto do eercício físico combinado na percepção do estado de saúde da pessoa com doença pulmonar obstrutiva crónica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ângela Maria Pereira, Helena Santa-Clara, Ernesto Pereira, Sérgio Simões, Índia Remédios, João Cardoso, José Brito, Jan Cabri, Bo Fernhall"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Ângela"
              "apellidos" => "Maria Pereira"
            ]
            1 => array:2 [
              "nombre" => "Helena"
              "apellidos" => "Santa-Clara"
            ]
            2 => array:2 [
              "nombre" => "Ernesto"
              "apellidos" => "Pereira"
            ]
            3 => array:2 [
              "nombre" => "Sérgio"
              "apellidos" => "Simões"
            ]
            4 => array:2 [
              "nombre" => "Índia"
              "apellidos" => "Remédios"
            ]
            5 => array:2 [
              "nombre" => "João"
              "apellidos" => "Cardoso"
            ]
            6 => array:2 [
              "nombre" => "José"
              "apellidos" => "Brito"
            ]
            7 => array:2 [
              "nombre" => "Jan"
              "apellidos" => "Cabri"
            ]
            8 => array:2 [
              "nombre" => "Bo"
              "apellidos" => "Fernhall"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511510700750?idApp=UINPBA00004E"
    "url" => "/21735115/0000001600000005/v1_201305151534/S2173511510700750/v1_201305151534/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173511510700737"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(10)70073-7"
    "estado" => "S300"
    "fechaPublicacion" => "2010-09-01"
    "aid" => "70073"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "edi"
    "cita" => "Rev Port Pneumol. 2010;16:709-15"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2519
      "formatos" => array:3 [
        "EPUB" => 219
        "HTML" => 1327
        "PDF" => 973
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "titulo" => "Role of extra-pulmonary factors–depression, muscle weakness, health-related quality of life–in DPOC evolution"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "709"
          "paginaFinal" => "715"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Importância de factores extrapulmonares–depressão, fraqueza muscular, qualidade de vida–na evolução da DPOC"
        ]
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Fátima Rodrigues"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Fátima"
              "apellidos" => "Rodrigues"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511510700737?idApp=UINPBA00004E"
    "url" => "/21735115/0000001600000005/v1_201305151534/S2173511510700737/v1_201305151534/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "titulo" => "Isokinetic muscle evaluation of quadriceps in patients with chronic obstructive pulmonary disease"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "717"
        "paginaFinal" => "736"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Luciana Vieira, Martim Bottaro, Rodrigo Celes, Carlos Alberto de Assis Viegas, César Augusto Melo e Silva"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "Luciana"
            "apellidos" => "Vieira"
            "email" => array:1 [
              0 => "lutavernard@yahoo.com.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Martim"
            "apellidos" => "Bottaro"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Rodrigo"
            "apellidos" => "Celes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Alberto de Assis Viegas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "C&#233;sar"
            "apellidos" => "Augusto Melo e Silva"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Fisioterapeuta&#44; Centro de Fisioterapia&#44; Hospital Universit&#225;rio de Bras&#237;lia&#47;Physiotherapist&#44; Physiotherapy Unit&#44; Hospital Universit&#225;rio de Bras&#237;lia"
            "etiqueta" => "<span class="elsevierStyleSup">1</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Educador f&#237;sico&#44; Programa de Gradua&#231;&#227;o em Educa&#231;&#227;o F&#237;sica&#44; Universidade de Bras&#237;lia&#47;Physical Educator&#44; Graduate Programme in Physical Education&#44; Universidade de Bras&#237;lia"
            "etiqueta" => "<span class="elsevierStyleSup">2</span>"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "M&#233;dico&#44; Servi&#231;o de Pneumologia&#44; Hospital Universit&#225;rio de Bras&#237;lia&#47;Physician&#44; Pulmonology Unit&#44; Hospital Universit&#225;rio de Bras&#237;lia"
            "etiqueta" => "<span class="elsevierStyleSup">3</span>"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Correspondence to</span>&#47;Correspond&#234;ncia&#58; SQS 402 Bloco R Apartamento 301 Asa Sul CEP&#58; 70236-180 &#8211; Bras&#237;lia&#47;DF &#8211; Brasil Telefone&#58; 55-61-35327956"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Avalia&#231;&#227;o muscular isocin&#233;tica do quadr&#237;ceps em indiv&#237;duos com doen&#231;a pulmonar obstrutiva cr&#243;nica"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2010-06-02"
    "fechaAceptado" => "2010-06-08"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec161006"
          "palabras" => array:4 [
            0 => "Chronic obstructive pulmonary disease"
            1 => "muscle strength"
            2 => "isokinetic test"
            3 => "reference standards"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras chave"
          "identificador" => "xpalclavsec161007"
          "palabras" => array:4 [
            0 => "Doen&#231;a pulmonar obstrutiva cr&#243;nica"
            1 => "for&#231;a muscular"
            2 => "teste isocin&#233;tico"
            3 => "padr&#245;es de refer&#234;ncia"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Rationale</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Muscle debility has a significant impact on health-related quality of life in subjects with chronic obstructive pulmonary disease &#40;COPD&#41;&#44; and is correlated to exacerbation and even mortality&#46; Assessing muscle strength is extremely relevant&#46; Lack of standardisation in numbers of sets and rest interval in isokinetic test protocol can lead to distinct results&#44; making com prehension and comparisons among studies difficult&#46;</p> <span class="elsevierStyleSectionTitle">Aim</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To analyse the effect of two sets and three different rest intervals on isokinetic strength measurement of quadriceps tests&#44; in order to define the adequate test protocol&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Subjects with severe or very severe COPD underwent three isokinetic tests to evaluate knee extensor muscle strength&#44; at an angular velocity of 60&#176;&#183;s<span class="elsevierStyleSup">-1</span>&#44; with rest intervals of 30&#44; 60 and 120 seconds&#46; Each test consisted of two sets of five repetitions&#44; during which peak torque&#44; total work and fatigue index were measured&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">In 20 studied subjects &#40;66&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;4 years&#44; 70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;8kg&#44; 167&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;2cm&#44; FEV1 36&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;1&#37;&#41;&#44; there were no significant differences in peak torque&#44; total work and fatigue index&#44; independent of number of sets or rest interval between sets&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">In subjects with severe or very severe COPD&#44; quadriceps muscle strength can be evaluated by an isokinetic protocol with one set of five repetitions&#46; If two sets are performed&#44; a rest interval of 30 seconds is enough to ensure muscle recovery between sets&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle">Contexto</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A debilidade muscular tem impacto significativo na qualidade de vida do indiv&#237;duo com doenca pulmonar obstrutiva cronica &#40;DPOC&#41;&#44; correlacio nando-se com o numero de exacerbacoes e a mortalidade&#46; Medir a forca muscular torna-se&#44; portanto&#44; de extrema importancia&#46; A ausencia de padronizacao quanto ao numero de series e intervalo de recuperacao no protocolo de avaliacao isocinetica pode gerar resultados dispares&#44; dificultando a compreensao e a comparacao a entre os estudos&#46;</p> <span class="elsevierStyleSectionTitle">Objectivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analise do efeito de duas series e tres intervalos de repouso na medida de forca isocinetica do quadriceps&#44; a fim de identificar o protocolo adequado para a realizacao do teste&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Individuos com DPOC grave ou muito grave realizaram tres testes isocineticos para avaliacao da musculatura extensora do joelho&#44; a velocidade angular de 60&#176;&#183;s<span class="elsevierStyleSup">-1</span>&#44; com intervalos de recuperacao de 30&#44; 60 ou 120 segundos&#46; Cada teste consistiu em duas series de cinco repeticoes&#44; nas quais foram mensurados pico de torque&#44; trabalho total e indice de fadiga&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nos 20 individuos estudados &#40;66&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;4 anos&#44; 70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;8 kg&#44; 167&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span> 6&#44;2<span class="elsevierStyleHsp" style=""></span>cm&#44; VEF1 36&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;1&#37; do predito&#41; nao houve diferenca significativa nos valores de pico de torque&#44; trabalho total e indice de fadiga&#44; independente do numero de series ou da duracao do intervalo de recuperacao entre elas&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Em individuos com DPOC grave ou muito grave&#44; a forca muscular do quadriceps pode ser avaliada por meio de protocolo isocinetico composto por uma serie de contraccoes com cinco repeticoes&#59; se forem realizadas duas series&#44; 30 segundos de intervalo entre elas e suficiente para garantir a recuperacao muscular&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography&#47;Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:57 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic manifestations and comorbidities of COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;J&#46; Barnes"
                            1 => "B&#46;R&#46; Celli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00128008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "1165"
                        "paginaFinal" => "1185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19407051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global initiative for chronic obstructive lung disease&#46; Global strategy for the diagnosis&#44; management&#44; and prevention of chronic obstructive pulmonary disease &#8211; updated 2008&#46; National Heart&#44; Lung and Blood Institute&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.goldcopd.org/">http&#58;&#47;&#47;www&#46;goldcopd&#46;org&#46;</a>"
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscles in chronic obstructive pulmonary disease&#58; deconditioning&#44; or myopathy&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;D&#46; Wagner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-1843.2006.00939.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2006"
                        "volumen" => "11"
                        "paginaInicial" => "681"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17052294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral muscle wasting in chronic obstructive pulmonary disease &#8211; Clinical relevance and mechanisms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Debigar&#233;"
                            1 => "C&#46;H&#46; C&#244;te"
                            2 => "F&#46; Maltais"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.9.2104035"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "1712"
                        "paginaFinal" => "1717"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11719314"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle dysfunction in chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "ATS&#44;ERS"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "159"
                        "paginaInicial" => "510"
                        "paginaFinal" => "540"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;C&#46; Kim"
                            1 => "M&#46; Mofarrahi"
                            2 => "S&#46;N&#46; Hussain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "International Journal of COPD"
                        "fecha" => "2008"
                        "volumen" => "3"
                        "paginaInicial" => "637"
                        "paginaFinal" => "658"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19281080"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muscle wasting and changes in muscle protein metabolism in chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;T&#46; Jagoe"
                            1 => "M&#46;P&#46; Engelen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "52s"
                        "paginaFinal" => "63s"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral muscle weakness contributes to exercise limitation in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Gosselink"
                            1 => "T&#46; Troosters"
                            2 => "M&#46; Decramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.153.3.8630582"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1996"
                        "volumen" => "153"
                        "paginaInicial" => "976"
                        "paginaFinal" => "980"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8630582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physical activity and hospitalization for exacerbation of COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Pitta"
                            1 => "T&#46; Troosters"
                            2 => "V&#46;S&#46; Probst"
                            3 => "M&#46;A&#46; Spruit"
                            4 => "M&#46; Decramer"
                            5 => "R&#46; Gosselink"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.129.3.536"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "129"
                        "paginaInicial" => "536"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16537849"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muscle weakness is related to utilization of health care resources in COPD patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Decramer"
                            1 => "R&#46; Gosselink"
                            2 => "T&#46; Troosters"
                            3 => "M&#46; Verschueren"
                            4 => "G&#46; Evers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1997"
                        "volumen" => "10"
                        "paginaInicial" => "417"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9042643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "K&#46; Marquis"
                            1 => "R&#46; Debigar&#233;"
                            2 => "Y&#46; Lacasse"
                            3 => "P&#46; LeBlanc"
                            4 => "J&#46; Jobin"
                            5 => "G&#46; Carrier"
                            6 => "F&#46; Maltais"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.2107031"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2002"
                        "volumen" => "166"
                        "paginaInicial" => "809"
                        "paginaFinal" => "813"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12231489"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fraqueza muscular esquel&#233;tica e intoler&#226;ncia ao exerc&#237;cio em pacientes com doen&#231;a pulmonar obstrutiva cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;R&#46; Silva"
                            1 => "K&#46;T&#46; Marrara"
                            2 => "D&#46;M&#46; Marino"
                            3 => "V&#46;A&#46; DiLorenzo"
                            4 => "M&#46; Jamami"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Fisioter"
                        "fecha" => "2008"
                        "volumen" => "12"
                        "paginaInicial" => "169"
                        "paginaFinal" => "175"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle function in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Casaburi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "71s"
                        "paginaFinal" => "267s"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10841638"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manifesta&#231;&#245;es sist&#234;micas na doen&#231;a pulmonar obstrutiva cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46;Z&#46; Dourado"
                            1 => "S&#46;E&#46; Tanni"
                            2 => "S&#46;A&#46; Vale"
                            3 => "M&#46;M&#46; Faganello"
                            4 => "F&#46;F&#46; Sanchez"
                            5 => "I&#46; Godoy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bras Pneumol"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "161"
                        "paginaFinal" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17273586"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure&#58; underlying mechanisms and therapy perspectives"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;R&#46; Gosker"
                            1 => "E&#46;F&#46; Wounters"
                            2 => "G&#46;J&#46; van der Vusse"
                            3 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Clin Nut"
                        "fecha" => "2000"
                        "volumen" => "71"
                        "paginaInicial" => "1033"
                        "paginaFinal" => "1047"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on the mechanisms of muscle dysfunction in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Gea"
                            1 => "E&#46; Barreiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2008"
                        "volumen" => "44"
                        "paginaInicial" => "328"
                        "paginaFinal" => "337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18559223"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of sarcopenia on the development of physical disability&#58; the cardiovascular health study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; Janssen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1532-5415.2005.00540.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "56"
                        "paginaFinal" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16420198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of rest interval on quadriceps torque during an isokinetic testing protocol in elderly"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Bottaro"
                            1 => "A&#46; Russo"
                            2 => "R&#46;J&#46; Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Sports Sci Med"
                        "fecha" => "2005"
                        "volumen" => "4"
                        "paginaInicial" => "285"
                        "paginaFinal" => "290"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral muscle weakness contributes to exercise limitation in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Gosselink"
                            1 => "T&#46; Troosters"
                            2 => "M&#46; Decramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.153.3.8630582"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1996"
                        "volumen" => "153"
                        "paginaInicial" => "976"
                        "paginaFinal" => "980"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8630582"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle structure and function in response to electrical stimulation in moderately impaired COPD patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:12 [
                            0 => "S&#46; Dal Corso"
                            1 => "L&#46; N&#225;polis"
                            2 => "C&#46; Malaguti"
                            3 => "A&#46;C&#46; Gimenes"
                            4 => "A&#46; Albuquerque"
                            5 => "C&#46;R&#46; Nogueira"
                            6 => "M&#46;B&#46; De Fuccio"
                            7 => "R&#46;D&#46; Pereira"
                            8 => "A&#46; Bulle"
                            9 => "N&#46; McFarlane"
                            10 => "L&#46;E&#46; Nery"
                            11 => "J&#46;A&#46; Neder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2006.10.023"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiratory Medicine"
                        "fecha" => "2007"
                        "volumen" => "101"
                        "paginaInicial" => "1236"
                        "paginaFinal" => "1243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17174082"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scaling skeletal muscle function to mass in patients with moderate-to-sever COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "C&#46; Malaguti"
                            1 => "L&#46;E&#46; Nery"
                            2 => "S&#46; Dal Corso"
                            3 => "L&#46; N&#225;polis"
                            4 => "M&#46;B&#46; De Fuccio"
                            5 => "M&#46; Castro"
                            6 => "J&#46;A&#46; Neder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00421-006-0292-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Appl Physiol"
                        "fecha" => "2006"
                        "volumen" => "98"
                        "paginaInicial" => "482"
                        "paginaFinal" => "488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17021786"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized controlled trial of transcutaneous electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Bourjeily-Habr"
                            1 => "C&#46;L&#46; Rochester"
                            2 => "F&#46; Palermo"
                            3 => "P&#46; Snyder"
                            4 => "V&#46; Mohsenin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "1045"
                        "paginaFinal" => "1049"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12454299"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic impairment in relation to disease burden in patients with mode rate COPD eligible for a lifestyle program Findings from the INTERCOM trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;R&#46; van Wetering"
                            1 => "F&#46;E&#46; van Nooten"
                            2 => "S&#46;J&#46; Mol"
                            3 => "M&#46; Hoogendoorn"
                            4 => "M&#46;P&#46; M&#246;lken"
                            5 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "International Journal of COPD"
                        "fecha" => "2008"
                        "volumen" => "3"
                        "paginaInicial" => "443"
                        "paginaFinal" => "451"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18990973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Neder"
                            1 => "D&#46; Sword"
                            2 => "S&#46;A&#46; Ward"
                            3 => "E&#46; Mackay"
                            4 => "L&#46;M&#46; Cochrane"
                            5 => "C&#46;J&#46; Clark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "333"
                        "paginaFinal" => "337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11923552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non-invasive ventilation improves peripheral oxygen saturation and reduces fatigability of quadriceps in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Borghi-Silva"
                            1 => "L&#46; Thommazo"
                            2 => "C&#46;B&#46; Pantoni"
                            3 => "R&#46;G&#46; Mendes"
                            4 => "T&#46;F&#46; Salvini"
                            5 => "D&#46; Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-1843.2009.01515.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2009"
                        "volumen" => "14"
                        "paginaInicial" => "537"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19386071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Myopathological features in skeletal muscle of patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;R&#46; Gosker"
                            1 => "B&#46; Kubat"
                            2 => "G&#46; Schaart"
                            3 => "G&#46;J&#46; van der Vusse"
                            4 => "E&#46;F&#46; Wouters"
                            5 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "280"
                        "paginaFinal" => "285"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12952261"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limb muscle dysfunction in COPD&#58; effects of muscle wasting and exercise training"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46;M&#46; Franssen"
                            1 => "R&#46; Broekhuizen"
                            2 => "P&#46;P&#46; Janssen"
                            3 => "E&#46;F&#46; Wouters"
                            4 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Sci Sports Exerc"
                        "fecha" => "2005"
                        "volumen" => "37"
                        "paginaInicial" => "2"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15632660"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46;M&#46; Franssen"
                            1 => "R&#46; Broekhuizen"
                            2 => "P&#46;P&#46; Janssen"
                            3 => "E&#46;F&#46; Wouters"
                            4 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2004"
                        "volumen" => "125"
                        "paginaInicial" => "2021"
                        "paginaFinal" => "2028"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15189917"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thigh muscle strength and endurance in patients with COPD compared with healthy controls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Janaudis-Ferreira"
                            1 => "K&#46; Wadell"
                            2 => "G&#46; Sundelin"
                            3 => "B&#46; Lindstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2005.11.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiratory Medicine"
                        "fecha" => "2006"
                        "volumen" => "100"
                        "paginaInicial" => "1451"
                        "paginaFinal" => "1457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16337114"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;A&#46; Maffiuletti"
                            1 => "M&#46; Bizzini"
                            2 => "K&#46; Desbrosses"
                            3 => "N&#46; Babault"
                            4 => "U&#46; Munzinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1475-097X.2007.00758.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Physiol Funct Imaging"
                        "fecha" => "2007"
                        "volumen" => "27"
                        "paginaInicial" => "346"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17944656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ASEP Procedures recommendation I&#58; Accurate assessment of muscular strength and power"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;E&#46; Brown"
                            1 => "J&#46;P&#46; Weir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Exerc Physiol"
                        "fecha" => "2001"
                        "volumen" => "4"
                        "paginaInicial" => "1"
                        "paginaFinal" => "21"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The utility of isokinetic dinamometry in the assessment of human muscle function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;P&#46; Gleeson"
                            1 => "T&#46;H&#46; Mercer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Sports Med"
                        "fecha" => "1996"
                        "volumen" => "21"
                        "paginaInicial" => "18"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8771283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A brief review&#58; factors affecting the length of the rest interval between resistance exercise sets"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46; Willardson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1519/R-17995.1"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Strength Cond Res"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "978"
                        "paginaFinal" => "984"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17194236"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Minimum rest period for strength recovery during a common isokinetic testing protocol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;C&#46; Parcell"
                            1 => "R&#46;D&#46; Sawyer"
                            2 => "V&#46;A&#46; Tricoli"
                            3 => "T&#46;D&#46; Chinever"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Sci Sports Exerc"
                        "fecha" => "2002"
                        "volumen" => "34"
                        "paginaInicial" => "1018"
                        "paginaFinal" => "1022"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12048331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Caron MA&#44; Debigar&#233; R&#44; Dekhuijzen R&#44; Maltais F&#46; Comparative assessment of the quadriceps and the diaphragm in patients with COPD&#46; Article in press&#46; J Appl Physiol&#46;&#40;April 9&#44; 2009&#41;&#46;"
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relevance of assessing quadriceps endurance in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Coronell"
                            1 => "M&#46; Orozco-Levi"
                            2 => "R&#46; M&#233;ndez"
                            3 => "A&#46; Ramirez-Sarmiento"
                            4 => "J&#46;B&#46; G&#225;ldiz"
                            5 => "J&#46; Gea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "129"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15293615"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "From muscle disuse to myopathy in COPD&#58; potential contribution of oxidative stress"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Couillard"
                            1 => "C&#46; Prefaut"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.05.00139904"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "703"
                        "paginaFinal" => "719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16204604"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral muscle composition and health status in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "M&#46; Montes de Oca"
                            1 => "S&#46;H&#46; Torres"
                            2 => "Y&#46; Gonzalez"
                            3 => "E&#46; Romero"
                            4 => "N&#46; Hernandez"
                            5 => "A&#46; Mata"
                            6 => "C&#46; Talamo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2006.01.020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2006"
                        "volumen" => "100"
                        "paginaInicial" => "1800"
                        "paginaFinal" => "1806"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16545558"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle fiber-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "H&#46;R&#46; Gosker"
                            1 => "H&#46; van Mameren"
                            2 => "P&#46;J&#46; van Dijk"
                            3 => "M&#46;P&#46; Engelen"
                            4 => "G&#46;J&#46; van der Vusse"
                            5 => "E&#46;F&#46; Wouters"
                            6 => "A&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "617"
                        "paginaFinal" => "625"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11998989"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Hartman"
                            1 => "R&#46; Knols"
                            2 => "K&#46; Murer"
                            3 => "E&#46;D&#46; de Bruin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000172832"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gerontology"
                        "fecha" => "2009"
                        "volumen" => "55"
                        "paginaInicial" => "259"
                        "paginaFinal" => "268"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18997454"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of different rest intervals on isokinetic muscle performance among older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Ernesto"
                            1 => "M&#46; Bottaro"
                            2 => "F&#46;M&#46; Silva"
                            3 => "M&#46;P&#46; Sales"
                            4 => "R&#46;S&#46; Celes"
                            5 => "R&#46;J&#46; Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Bras Fisioter"
                        "fecha" => "2009"
                        "volumen" => "13"
                        "paginaInicial" => "65"
                        "paginaFinal" => "72"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of hand-grip stabilization on isokinetic torque at the knee"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;A&#46; Stumbo"
                            1 => "S&#46; Merriam"
                            2 => "K&#46; Nies"
                            3 => "A&#46; Smith"
                            4 => "D&#46; Spurgeon"
                            5 => "J&#46;P&#46; Weir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Strength Cond Res"
                        "fecha" => "2001"
                        "volumen" => "15"
                        "paginaInicial" => "372"
                        "paginaFinal" => "377"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11710668"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Learning effect of isokinetic measurements in healthy subjects&#44; and reliability and comparability of Biodex and Lido dynamo meters"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "H&#46; Lund"
                            1 => "K&#46; S&#248;ndergaard"
                            2 => "T&#46; Zachariassen"
                            3 => "R&#46; Christensen"
                            4 => "P&#46; B&#252;low"
                            5 => "M&#46; Henriksen"
                            6 => "E&#46;M&#46; Bartels"
                            7 => "B&#46; Danneskiold-Sams&#248;e"
                            8 => "H&#46; Bliddal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1475-097X.2004.00593.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Physiol Funct Imaging"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "75"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15725305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isokinetic dynamometry of knee flexors and extensors&#58; comparative study among non-athletes&#44; jumpers athletes and runner athletes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;M&#46; Siqueira"
                            1 => "F&#46;R&#46; Pellegrini"
                            2 => "M&#46;F&#46; Fontana"
                            3 => "J&#46;M&#46; Greve"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Hosp Clin Fac Med S&#227;o Paulo"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "19"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12170345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "a influ&#234;ncia da contra&#231;&#227;o muscular pr&#233;via no desempenho da for&#231;a r&#225;pida"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;A&#46; Batista"
                            1 => "J&#46;P&#46; Coutinho"
                            2 => "R&#46; Barroso"
                            3 => "V&#46; Tricoli"
                            4 => "Potencializa&#231;&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "R Bras Ci e Mov"
                        "fecha" => "2003"
                        "volumen" => "11"
                        "paginaInicial" => "7"
                        "paginaFinal" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postactivation potentiation&#58; Role in human performance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;G&#46; Sale"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Exerc Sport Sci Rev"
                        "fecha" => "2002"
                        "volumen" => "30"
                        "paginaInicial" => "138"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12150573"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postactivation potentiation&#58; Role in performance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;G&#46; Sale"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bjsm.2002.003392"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Sports Med"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "386"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15273166"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skeletal muscle fatigue&#58; cellular mechanisms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;G&#46; Allen"
                            1 => "G&#46;D&#46; Lamb"
                            2 => "H&#46; Westerblad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/physrev.00015.2007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Physiol Rev"
                        "fecha" => "2008"
                        "volumen" => "88"
                        "paginaInicial" => "287"
                        "paginaFinal" => "332"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18195089"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fatigue during high-intensity intermittent exercise&#58; application to bodybuilding"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;P&#46; Lambert"
                            1 => "M&#46;G&#46; Flynn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Sports Med"
                        "fecha" => "2002"
                        "volumen" => "32"
                        "paginaInicial" => "511"
                        "paginaFinal" => "522"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12076177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anaerobic energy release in working muscle during 30s to 3 min of exhausting bicycling"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;I&#46; Medbo"
                            1 => "I&#46; Tabata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1993"
                        "volumen" => "75"
                        "paginaInicial" => "1654"
                        "paginaFinal" => "1660"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8282617"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prolonged exercise to fatigue in humans impairs skeletal muscle Na&#43;-K&#43;-ATPase activity&#44; sarcoplasmic reticulum Ca2&#43; release&#44; Ca2&#43; uptake"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Leppik"
                            1 => "R&#46;J&#46; Aughey"
                            2 => "I&#46; Medved"
                            3 => "I&#46; Fairweather"
                            4 => "M&#46;F&#46; Carey"
                            5 => "M&#46;J&#46; McKenna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/japplphysiol.00964.2003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "2004"
                        "volumen" => "97"
                        "paginaInicial" => "1414"
                        "paginaFinal" => "1423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15155714"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Particularidades fisiopatol&#243;gicas de las alteraciones musculares en el paciente con EPOC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Gea"
                            1 => "M&#46; Orozco-Levi"
                            2 => "E&#46; Barreiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Nutr Hosp"
                        "fecha" => "2006"
                        "volumen" => "21"
                        "numero" => "Supl 3"
                        "paginaInicial" => "62"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16768032"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral muscle alterations in non-COPD smokers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Montes de Oca"
                            1 => "E&#46; Loeb"
                            2 => "S&#46;H&#46; Torres"
                            3 => "J&#46; De Sanctis"
                            4 => "N&#46; Hernandez"
                            5 => "C&#46; Talamo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.07-1592"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2008"
                        "volumen" => "133"
                        "paginaInicial" => "13"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18187741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "E&#46;B&#46; Swallow"
                            1 => "D&#46; Reyes"
                            2 => "N&#46;S&#46; Hopkinson"
                            3 => "W&#46; Man"
                            4 => "R&#46; Porcher"
                            5 => "E&#46;J&#46; Cetti"
                            6 => "A&#46;J&#46; Moore"
                            7 => "J&#46; Moxham"
                            8 => "M&#46;I&#46; Polkey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2006.062026"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2007"
                        "volumen" => "62"
                        "paginaInicial" => "115"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17090575"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Voluntary activation during knee extensions in severely deconditioned patients with chronic obstructive pulmonary disease&#58; benefit of endurance training"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Vivodtzev"
                            1 => "P&#46; Flore"
                            2 => "P&#46; L&#233;vy"
                            3 => "B&#46; Wuyam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/mus.20867"
                      "Revista" => array:6 [
                        "tituloSerie" => "Muscle Nerve"
                        "fecha" => "2008"
                        "volumen" => "37"
                        "paginaInicial" => "27"
                        "paginaFinal" => "35"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17912747"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isokinetic muscle function in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Haccoun"
                            1 => "A&#46;A&#46; Smountas"
                            2 => "W&#46;J&#46; Gibbons"
                            3 => "J&#46; Bourbeau"
                            4 => "L&#46;C&#46; Lands"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2002"
                        "volumen" => "121"
                        "paginaInicial" => "1079"
                        "paginaFinal" => "1084"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11948035"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physical activity in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Watz"
                            1 => "B&#46; Waschki"
                            2 => "T&#46; Meyer"
                            3 => "H&#46; Magnussen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00024608"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "262"
                        "paginaFinal" => "272"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19010994"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735115/0000001600000005/v1_201305151534/S2173511510700749/v1_201305151534/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9552"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Article&#47;Artigo Original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001600000005/v1_201305151534/S2173511510700749/v1_201305151534/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511510700749?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 16. Issue 5.
Pages 717-736 (September - October 2010)
Share
Share
Download PDF
More article options
Vol. 16. Issue 5.
Pages 717-736 (September - October 2010)
Full text access
Isokinetic muscle evaluation of quadriceps in patients with chronic obstructive pulmonary disease
Avaliação muscular isocinética do quadríceps em indivíduos com doença pulmonar obstrutiva crónica
Visits
991
Luciana Vieira1,
Corresponding author
lutavernard@yahoo.com.br

Correspondence to/Correspondência: SQS 402 Bloco R Apartamento 301 Asa Sul CEP: 70236-180 – Brasília/DF – Brasil Telefone: 55-61-35327956
, Martim Bottaro2, Rodrigo Celes2, Carlos Alberto de Assis Viegas3, César Augusto Melo e Silva1
1 Fisioterapeuta, Centro de Fisioterapia, Hospital Universitário de Brasília/Physiotherapist, Physiotherapy Unit, Hospital Universitário de Brasília
2 Educador físico, Programa de Graduação em Educação Física, Universidade de Brasília/Physical Educator, Graduate Programme in Physical Education, Universidade de Brasília
3 Médico, Serviço de Pneumologia, Hospital Universitário de Brasília/Physician, Pulmonology Unit, Hospital Universitário de Brasília
This item has received
Article information
Abstract
Rationale

Muscle debility has a significant impact on health-related quality of life in subjects with chronic obstructive pulmonary disease (COPD), and is correlated to exacerbation and even mortality. Assessing muscle strength is extremely relevant. Lack of standardisation in numbers of sets and rest interval in isokinetic test protocol can lead to distinct results, making com prehension and comparisons among studies difficult.

Aim

To analyse the effect of two sets and three different rest intervals on isokinetic strength measurement of quadriceps tests, in order to define the adequate test protocol.

Methods

Subjects with severe or very severe COPD underwent three isokinetic tests to evaluate knee extensor muscle strength, at an angular velocity of 60°·s-1, with rest intervals of 30, 60 and 120 seconds. Each test consisted of two sets of five repetitions, during which peak torque, total work and fatigue index were measured.

Results

In 20 studied subjects (66.1±7.4 years, 70±10.8kg, 167.4±6.2cm, FEV1 36.5±10.1%), there were no significant differences in peak torque, total work and fatigue index, independent of number of sets or rest interval between sets.

Conclusion

In subjects with severe or very severe COPD, quadriceps muscle strength can be evaluated by an isokinetic protocol with one set of five repetitions. If two sets are performed, a rest interval of 30 seconds is enough to ensure muscle recovery between sets.

Key words:
Chronic obstructive pulmonary disease
muscle strength
isokinetic test
reference standards
Resumo
Contexto

A debilidade muscular tem impacto significativo na qualidade de vida do indivíduo com doenca pulmonar obstrutiva cronica (DPOC), correlacio nando-se com o numero de exacerbacoes e a mortalidade. Medir a forca muscular torna-se, portanto, de extrema importancia. A ausencia de padronizacao quanto ao numero de series e intervalo de recuperacao no protocolo de avaliacao isocinetica pode gerar resultados dispares, dificultando a compreensao e a comparacao a entre os estudos.

Objectivo

Analise do efeito de duas series e tres intervalos de repouso na medida de forca isocinetica do quadriceps, a fim de identificar o protocolo adequado para a realizacao do teste.

Métodos

Individuos com DPOC grave ou muito grave realizaram tres testes isocineticos para avaliacao da musculatura extensora do joelho, a velocidade angular de 60°·s-1, com intervalos de recuperacao de 30, 60 ou 120 segundos. Cada teste consistiu em duas series de cinco repeticoes, nas quais foram mensurados pico de torque, trabalho total e indice de fadiga.

Resultados

Nos 20 individuos estudados (66,1±7,4 anos, 70±10,8 kg, 167,4± 6,2cm, VEF1 36,5±10,1% do predito) nao houve diferenca significativa nos valores de pico de torque, trabalho total e indice de fadiga, independente do numero de series ou da duracao do intervalo de recuperacao entre elas.

Conclusão

Em individuos com DPOC grave ou muito grave, a forca muscular do quadriceps pode ser avaliada por meio de protocolo isocinetico composto por uma serie de contraccoes com cinco repeticoes; se forem realizadas duas series, 30 segundos de intervalo entre elas e suficiente para garantir a recuperacao muscular.

Palavras chave:
Doença pulmonar obstrutiva crónica
força muscular
teste isocinético
padrões de referência
Full text is only aviable in PDF
Bibliography/Bibliografia
[1.]
P.J. Barnes, B.R. Celli.
Systemic manifestations and comorbidities of COPD.
Eur Respir J, 33 (2009), pp. 1165-1185
[2.]
Global initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease – updated 2008. National Heart, Lung and Blood Institute. Available from: http://www.goldcopd.org.
[3.]
P.D. Wagner.
Skeletal muscles in chronic obstructive pulmonary disease: deconditioning, or myopathy?.
Respirology, 11 (2006), pp. 681-686
[4.]
R. Debigaré, C.H. Côte, F. Maltais.
Peripheral muscle wasting in chronic obstructive pulmonary disease – Clinical relevance and mechanisms.
Am J Respir Crit Care Med, 164 (2001), pp. 1712-1717
[5.]
ATS,ERS.
Skeletal muscle dysfunction in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 159 (1999), pp. 510-540
[6.]
H.C. Kim, M. Mofarrahi, S.N. Hussain.
Skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease.
International Journal of COPD, 3 (2008), pp. 637-658
[7.]
R.T. Jagoe, M.P. Engelen.
Muscle wasting and changes in muscle protein metabolism in chronic obstructive pulmonary disease.
Eur Respir J, 22 (2003), pp. 52s-63s
[8.]
R. Gosselink, T. Troosters, M. Decramer.
Peripheral muscle weakness contributes to exercise limitation in COPD.
Am J Respir Crit Care Med, 153 (1996), pp. 976-980
[9.]
F. Pitta, T. Troosters, V.S. Probst, M.A. Spruit, M. Decramer, R. Gosselink.
Physical activity and hospitalization for exacerbation of COPD.
Chest, 129 (2006), pp. 536-544
[10.]
M. Decramer, R. Gosselink, T. Troosters, M. Verschueren, G. Evers.
Muscle weakness is related to utilization of health care resources in COPD patients.
Eur Respir J, 10 (1997), pp. 417-423
[11.]
K. Marquis, R. Debigaré, Y. Lacasse, P. LeBlanc, J. Jobin, G. Carrier, F. Maltais.
Midthigh muscle cross-sectional area is a better predictor of mortality than body mass index in patients with COPD.
Am J Respir Crit Care Med, 166 (2002), pp. 809-813
[12.]
K.R. Silva, K.T. Marrara, D.M. Marino, V.A. DiLorenzo, M. Jamami.
Fraqueza muscular esquelética e intolerância ao exercício em pacientes com doença pulmonar obstrutiva crónica.
Rev Bras Fisioter, 12 (2008), pp. 169-175
[13.]
R. Casaburi.
Skeletal muscle function in COPD.
Chest, 117 (2000), pp. 71s-267s
[14.]
V.Z. Dourado, S.E. Tanni, S.A. Vale, M.M. Faganello, F.F. Sanchez, I. Godoy.
Manifestações sistêmicas na doença pulmonar obstrutiva crónica.
J Bras Pneumol, 32 (2006), pp. 161-171
[15.]
H.R. Gosker, E.F. Wounters, G.J. van der Vusse, A.M. Schols.
Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure: underlying mechanisms and therapy perspectives.
Am J Clin Nut, 71 (2000), pp. 1033-1047
[16.]
J. Gea, E. Barreiro.
Update on the mechanisms of muscle dysfunction in COPD.
Arch Bronconeumol, 44 (2008), pp. 328-337
[17.]
I. Janssen.
Influence of sarcopenia on the development of physical disability: the cardiovascular health study.
J Am Geriatr Soc, 54 (2006), pp. 56-62
[18.]
M. Bottaro, A. Russo, R.J. Oliveira.
The effects of rest interval on quadriceps torque during an isokinetic testing protocol in elderly.
J Sports Sci Med, 4 (2005), pp. 285-290
[19.]
R. Gosselink, T. Troosters, M. Decramer.
Peripheral muscle weakness contributes to exercise limitation in COPD.
Am J Respir Crit Care Med, 153 (1996), pp. 976-980
[20.]
S. Dal Corso, L. Nápolis, C. Malaguti, A.C. Gimenes, A. Albuquerque, C.R. Nogueira, M.B. De Fuccio, R.D. Pereira, A. Bulle, N. McFarlane, L.E. Nery, J.A. Neder.
Skeletal muscle structure and function in response to electrical stimulation in moderately impaired COPD patients.
Respiratory Medicine, 101 (2007), pp. 1236-1243
[21.]
C. Malaguti, L.E. Nery, S. Dal Corso, L. Nápolis, M.B. De Fuccio, M. Castro, J.A. Neder.
Scaling skeletal muscle function to mass in patients with moderate-to-sever COPD.
Eur J Appl Physiol, 98 (2006), pp. 482-488
[22.]
G. Bourjeily-Habr, C.L. Rochester, F. Palermo, P. Snyder, V. Mohsenin.
Randomized controlled trial of transcutaneous electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease.
Thorax, 57 (2002), pp. 1045-1049
[23.]
C.R. van Wetering, F.E. van Nooten, S.J. Mol, M. Hoogendoorn, M.P. Mölken, A.M. Schols.
Systemic impairment in relation to disease burden in patients with mode rate COPD eligible for a lifestyle program Findings from the INTERCOM trial.
International Journal of COPD, 3 (2008), pp. 443-451
[24.]
J.A. Neder, D. Sword, S.A. Ward, E. Mackay, L.M. Cochrane, C.J. Clark.
Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease.
Thorax, 57 (2002), pp. 333-337
[25.]
A. Borghi-Silva, L. Thommazo, C.B. Pantoni, R.G. Mendes, T.F. Salvini, D. Costa.
Non-invasive ventilation improves peripheral oxygen saturation and reduces fatigability of quadriceps in patients with COPD.
Respirology, 14 (2009), pp. 537-544
[26.]
H.R. Gosker, B. Kubat, G. Schaart, G.J. van der Vusse, E.F. Wouters, A.M. Schols.
Myopathological features in skeletal muscle of patients with chronic obstructive pulmonary disease.
Eur Respir J, 22 (2003), pp. 280-285
[27.]
F.M. Franssen, R. Broekhuizen, P.P. Janssen, E.F. Wouters, A.M. Schols.
Limb muscle dysfunction in COPD: effects of muscle wasting and exercise training.
Med Sci Sports Exerc, 37 (2005), pp. 2-9
[28.]
F.M. Franssen, R. Broekhuizen, P.P. Janssen, E.F. Wouters, A.M. Schols.
Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD.
Chest, 125 (2004), pp. 2021-2028
[29.]
T. Janaudis-Ferreira, K. Wadell, G. Sundelin, B. Lindström.
Thigh muscle strength and endurance in patients with COPD compared with healthy controls.
Respiratory Medicine, 100 (2006), pp. 1451-1457
[30.]
N.A. Maffiuletti, M. Bizzini, K. Desbrosses, N. Babault, U. Munzinger.
Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer.
Clin Physiol Funct Imaging, 27 (2007), pp. 346-353
[31.]
L.E. Brown, J.P. Weir.
ASEP Procedures recommendation I: Accurate assessment of muscular strength and power.
J Exerc Physiol, 4 (2001), pp. 1-21
[32.]
N.P. Gleeson, T.H. Mercer.
The utility of isokinetic dinamometry in the assessment of human muscle function.
Sports Med, 21 (1996), pp. 18-34
[33.]
J.M. Willardson.
A brief review: factors affecting the length of the rest interval between resistance exercise sets.
J Strength Cond Res, 20 (2006), pp. 978-984
[34.]
A.C. Parcell, R.D. Sawyer, V.A. Tricoli, T.D. Chinever.
Minimum rest period for strength recovery during a common isokinetic testing protocol.
Med Sci Sports Exerc, 34 (2002), pp. 1018-1022
[35.]
Caron MA, Debigaré R, Dekhuijzen R, Maltais F. Comparative assessment of the quadriceps and the diaphragm in patients with COPD. Article in press. J Appl Physiol.(April 9, 2009).
[36.]
C. Coronell, M. Orozco-Levi, R. Méndez, A. Ramirez-Sarmiento, J.B. Gáldiz, J. Gea.
Relevance of assessing quadriceps endurance in patients with COPD.
Eur Respir J, 24 (2004), pp. 129-136
[37.]
A. Couillard, C. Prefaut.
From muscle disuse to myopathy in COPD: potential contribution of oxidative stress.
Eur Respir J, 26 (2005), pp. 703-719
[38.]
M. Montes de Oca, S.H. Torres, Y. Gonzalez, E. Romero, N. Hernandez, A. Mata, C. Talamo.
Peripheral muscle composition and health status in patients with COPD.
Respir Med, 100 (2006), pp. 1800-1806
[39.]
H.R. Gosker, H. van Mameren, P.J. van Dijk, M.P. Engelen, G.J. van der Vusse, E.F. Wouters, A.M. Schols.
Skeletal muscle fiber-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease.
Eur Respir J, 19 (2002), pp. 617-625
[40.]
A. Hartman, R. Knols, K. Murer, E.D. de Bruin.
Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults.
Gerontology, 55 (2009), pp. 259-268
[41.]
C. Ernesto, M. Bottaro, F.M. Silva, M.P. Sales, R.S. Celes, R.J. Oliveira.
Effects of different rest intervals on isokinetic muscle performance among older adults.
Rev Bras Fisioter, 13 (2009), pp. 65-72
[42.]
T.A. Stumbo, S. Merriam, K. Nies, A. Smith, D. Spurgeon, J.P. Weir.
The effect of hand-grip stabilization on isokinetic torque at the knee.
J Strength Cond Res, 15 (2001), pp. 372-377
[43.]
H. Lund, K. Søndergaard, T. Zachariassen, R. Christensen, P. Bülow, M. Henriksen, E.M. Bartels, B. Danneskiold-Samsøe, H. Bliddal.
Learning effect of isokinetic measurements in healthy subjects, and reliability and comparability of Biodex and Lido dynamo meters.
Clin Physiol Funct Imaging, 25 (2005), pp. 75-82
[44.]
C.M. Siqueira, F.R. Pellegrini, M.F. Fontana, J.M. Greve.
Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumpers athletes and runner athletes.
Rev Hosp Clin Fac Med São Paulo, 57 (2002), pp. 19-24
[45.]
M.A. Batista, J.P. Coutinho, R. Barroso, V. Tricoli, Potencialização.
a influência da contração muscular prévia no desempenho da força rápida.
R Bras Ci e Mov, 11 (2003), pp. 7-12
[46.]
D.G. Sale.
Postactivation potentiation: Role in human performance.
Exerc Sport Sci Rev, 30 (2002), pp. 138-143
[47.]
D.G. Sale.
Postactivation potentiation: Role in performance.
Br J Sports Med, 38 (2004), pp. 386-387
[48.]
D.G. Allen, G.D. Lamb, H. Westerblad.
Skeletal muscle fatigue: cellular mechanisms.
Physiol Rev, 88 (2008), pp. 287-332
[49.]
C.P. Lambert, M.G. Flynn.
Fatigue during high-intensity intermittent exercise: application to bodybuilding.
Sports Med, 32 (2002), pp. 511-522
[50.]
J.I. Medbo, I. Tabata.
Anaerobic energy release in working muscle during 30s to 3 min of exhausting bicycling.
J Appl Physiol, 75 (1993), pp. 1654-1660
[51.]
J.A. Leppik, R.J. Aughey, I. Medved, I. Fairweather, M.F. Carey, M.J. McKenna.
Prolonged exercise to fatigue in humans impairs skeletal muscle Na+-K+-ATPase activity, sarcoplasmic reticulum Ca2+ release, Ca2+ uptake.
J Appl Physiol, 97 (2004), pp. 1414-1423
[52.]
J. Gea, M. Orozco-Levi, E. Barreiro.
Particularidades fisiopatológicas de las alteraciones musculares en el paciente con EPOC.
Nutr Hosp, 21 (2006), pp. 62-68
[53.]
M. Montes de Oca, E. Loeb, S.H. Torres, J. De Sanctis, N. Hernandez, C. Talamo.
Peripheral muscle alterations in non-COPD smokers.
Chest, 133 (2008), pp. 13-18
[54.]
E.B. Swallow, D. Reyes, N.S. Hopkinson, W. Man, R. Porcher, E.J. Cetti, A.J. Moore, J. Moxham, M.I. Polkey.
Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease.
Thorax, 62 (2007), pp. 115-120
[55.]
I. Vivodtzev, P. Flore, P. Lévy, B. Wuyam.
Voluntary activation during knee extensions in severely deconditioned patients with chronic obstructive pulmonary disease: benefit of endurance training.
Muscle Nerve, 37 (2008), pp. 27-35
[56.]
C. Haccoun, A.A. Smountas, W.J. Gibbons, J. Bourbeau, L.C. Lands.
Isokinetic muscle function in COPD.
Chest, 121 (2002), pp. 1079-1084
[57.]
H. Watz, B. Waschki, T. Meyer, H. Magnussen.
Physical activity in patients with COPD.
Eur Respir J, 33 (2009), pp. 262-272
Copyright © 2010. Sociedade Portuguesa de Pneumologia
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?