6-week Protocol Research Articles

Intense Physical Exercise Induces an Anti-inflammatory Change in IgG N-Glycosylation Profile.

Exercise is known to improve many aspects of human health, including modulation of the immune system and inflammatory status. It is generally understood that exercise reduces inflammation, but there are missing links in terms of understanding the mechanisms as well as the differences between exercise modalities. N-glycosylation of immunoglobulin G (IgG) and total plasma proteins was previously shown to reflect changes in inflammatory pathways, which could provide valuable information to further clarify exercise effects. In order to further expand the understanding of the relationship between physical activity and inflammation, we examined the effect of intense exercise, in the form of repeated sprint training (RST), on IgG and total plasma proteins N-glycosylation in combination with traditionally used inflammation markers: C-reactive protein (CRP), interleukin 6 (IL-6), and leukocyte count. Twenty-nine male physical education students were separated into treatment (RST, N = 15) and control (N = 14) groups. The RST group completed a 6-week exercise protocol while the control group was instructed to refrain from organized physical activity for the duration of the study. Three blood samples were taken at different time points: prior to start of the training program, the final week of the exercise intervention (EXC), and at the end of the 4-week recovery period (REC). Following the end of the recovery period IgG N-glycosylation profiles showed anti-inflammatory changes in RST group compared to the control group, which manifested as a decrease in agalactosylated (p = 0.0473) and an increase in digalactosylated (p = 0.0473), and monosialylated (p = 0.0339) N-glycans. Plasma protein N-glycans didn’t change significantly, while traditional inflammatory markers also didn’t show significant change in inflammatory status. Observed results demonstrate the potential of intense physical exercise to reduce levels of systemic basal inflammation as well as the potential for IgG N-glycosylation to serve as a sensitive longitudinal systemic inflammation marker.

An energy restriction-based weight loss intervention is able to reverse the effects of obesity on the expression of liver tumor-promoting genes.

The epidemiological evidence regarding the association of obesity with liver disease and possibly hepatocellular carcinoma highlights the need for investigations of whether obesity itself could induce the differential expression of genes commonly associated with the initial phase of liver tumorigenesis, and whether such phenomenon could be reversed after a weight loss intervention. In this study, obese Zucker rats were found to have dysregulated cell proliferation, antioxidative defenses, and tumor suppressor gene expression in association with liver dysfunction parameters, as well as oxidative stress and inflammation. Importantly, after a 4-week weight loss protocol of energy restriction and/or exercise, this effect on the liver carcinogenesis-related genes was reversed concomitantly with reductions in the fat mass, hepatic lipid content, oxidative stress, and inflammation. The findings indicate that the oxidative stress and inflammation associated with excess adiposity promote dysregulation of the genes involved in liver tumorigenesis. This is clinically relevant because these effects were detectable in the liver without evidence of a tumoral mass and were reversed after weight loss. Consequently, this study reveals the susceptibility of obese individuals to the initiation of a hepatocarcinogenic process, and how this can be prevented by achieving a healthy body weight.

Detailing postoperative pain and opioid utilization after periacetabular osteotomy with automated mobile messaging.

In the setting of periacetabular osteotomy (PAO), this investigation sought to (i) describe patient-reported pain scores and opioid utilization in the first 6 weeks following surgery and (ii) evaluate the effectiveness of postoperative communication using a robotic mobile messaging platform. Subjects indicated for PAO were enrolled from a young adult hip clinic. For the first 2 weeks after surgery, subjects received daily mobile messages inquiring about pain level on a 0–10 scale and the number of opioid pain medication tablets they consumed in the previous 24 h. Messaging frequency decreased to 3 per week in Weeks 3–6. Pain scores, opioid utilization and response rates with our mobile messaging platform were quantified for the 6-week postoperative period. Twenty-nine subjects underwent PAO. Twenty-one had concurrent hip arthroscopy. Average daily pain scores decreased over the first four postoperative days. Average pain scores reported were 5.9 ± 1.9, 4.1 ± 3.3 and 3.0 ± 3.5 on Day 1, Day 14 and Week 6, respectively. Reported opioid tablet utilization was 5.0 ± 3.2, 2.2 ± 2.0 and 0.0 ± 0.0 on Days 1 and 14 and at 6 weeks. Response rate for participants completing the 6-week messaging protocol was 84.1%. Patient-reported pain scores decreased over the first two postoperative weeks following PAO before plateauing in weeks 3–6. Opioid pain medication utilization increased in the first postoperative week before gradually declining to no tabs consumed at 6 weeks after PAO. Automated mobile messaging is an effective method of perioperative communication for the collection of pain scores and opioid utilization in patients undergoing PAO.

Short group psychoeducation followed by daily electronic self-monitoring in the long-term treatment of bipolar disorders: a multicenter, rater-blind, randomized controlled trial

BackgroundDespite various pharmacological and psychological treatment interventions, bipolar disorders rank among the leading causes of global disease burden. Group psychoeducation has been demonstrated an effective add-on to pharmacotherapy, but it may be difficult to implement in practice depending on the clinical setting and available human resources.MethodsMulticenter, rater-blind, randomized controlled trial to investigate the efficacy of a new intervention program consisting of an initial 6-week psychoeducation protocol plus a subsequent structured daily computer-based self-charting program (ChronoRecord) over 54 weeks in remitted patients with bipolar disorders. The control condition included non-structured group sessions followed by daily computer-based self-reports (unstructured like a diary). Both groups received treatment-as-usual.ResultsOver 2 years, 41 mood episodes occurred in the experimental group (n = 39) compared to 27 in the control group (n = 34), without reaching statistical significance. Time to recurrence did not significantly differ between the experimental and control group (25% relapsed after 112 and 273 days, respectively). There were no significant group-by-time interactions in mood symptoms, quality of life, self-efficacy expectations or perceived involvement in care.ConclusionsSix weekly psychoeducational group sessions followed by daily self-monitoring via ChronoRecord for 54 weeks may not be superior to non-structured group meetings followed by unstructured self-reporting. Other psychotherapeutic interventions may be needed to optimize the treatment of patients with bipolar disorders, especially for those at later disease stages.Trial registration Retrospectively registered at German Clinical Trials Register on May 24, 2019; DRKS00017319

Biofeedback-Assisted Resilience Training for Traumatic and Operational Stress: Preliminary Analysis of a Self-Delivered Digital Health Methodology

BackgroundPsychological resilience is critical to minimize the health effects of traumatic events. Trauma may induce a chronic state of hyperarousal, resulting in problems such as anxiety, insomnia, or posttraumatic stress disorder. Mind-body practices, such as relaxation breathing and mindfulness meditation, help to reduce arousal and may reduce the likelihood of such psychological distress. To better understand resilience-building practices, we are conducting the Biofeedback-Assisted Resilience Training (BART) study to evaluate whether the practice of slow, paced breathing with or without heart rate variability biofeedback can be effectively learned via a smartphone app to enhance psychological resilience.ObjectiveOur objective was to conduct a limited, interim review of user interactions and study data on use of the BART resilience training app and demonstrate analyses of real-time sensor-streaming data.MethodsWe developed the BART app to provide paced breathing resilience training, with or without heart rate variability biofeedback, via a self-managed 6-week protocol. The app receives streaming data from a Bluetooth-linked heart rate sensor and displays heart rate variability biofeedback to indicate movement between calmer and stressful states. To evaluate the app, a population of military personnel, veterans, and civilian first responders used the app for 6 weeks of resilience training. We analyzed app usage and heart rate variability measures during rest, cognitive stress, and paced breathing. Currently released for the BART research study, the BART app is being used to collect self-reported survey and heart rate sensor data for comparative evaluation of paced breathing relaxation training with and without heart rate variability biofeedback.ResultsTo date, we have analyzed the results of 328 participants who began using the BART app for 6 weeks of stress relaxation training via a self-managed protocol. Of these, 207 (63.1%) followed the app-directed procedures and completed the training regimen. Our review of adherence to protocol and app-calculated heart rate variability measures indicated that the BART app acquired high-quality data for evaluating self-managed stress relaxation training programs.ConclusionsThe BART app acquired high-quality data for studying changes in psychophysiological stress according to mind-body activity states, including conditions of rest, cognitive stress, and slow, paced breathing.

Group Treatment of Fecal Incontinence: A Description of an Interdisciplinary Intervention.

Approximately 5% of children in the United States have chronic fecal incontinence. Unfortunately, standard medical management of fecal incontinence fails in 20% to 60% of cases. A combined medical-behavioral model is often recommended in these cases. The purpose of this pilot study was to describe an interdisciplinary group-based treatment for fecal incontinence in school-aged children, and to present a description of changes in treatment adherence rates that affect clinical effectiveness. Poop group employed a developmentally appropriate model of care in which caregivers and children participated in separate but simultaneously held therapy groups. This interdisciplinary 6-week protocol is designed to increase appropriate stooling, decrease soiling events, and increase medication adherence pre- to post-treatment. Group sessions focus on the GI system, medication, toilet sitting posture, hydration, fiber, and behavior contracts. In addition, participant families consult with an Advanced Nurse Practitioner privately at each session discussing symptoms and making medication modifications as needed. Nineteen families completed the 6-week protocol. Appropriate stool frequency was improved (P ≤ 0.01), and soiling was reduced (P ≤ 0.00). Medication adherence was also improved (P ≤ 0.04). Treatment results were maintained at 1-month follow-up. A developmentally targeted intervention and interdisciplinary focus of treatment likely account for treatment successes. Poop group may be an effective interdisciplinary treatment option for families of children who fail traditional outpatient treatment.

Effects of a Required Large-Group Mindfulness Meditation Course on First-Year Medical Students' Mental Health and Quality of Life: a Randomized Controlled Trial.

Teaching mindfulness techniques has been used in the attempt to prevent mental health problems in medical students. Although it has already shown promising results when offered to volunteers, the use as a required strategy is still controversial. To verify the efficacy of teaching mindfulness techniques to large groups when made part of a required discipline at the beginning of medical training. Randomized controlled trial PARTICIPANTS: First-year medical students at the Federal University of Juiz de Fora, Brazil METHOD: Students were randomized into two groups: an intervention group (receiving a 6-week mindfulness protocol) and a control group (given a 6-week course containing organizational aspects of the medical school). Intervention and control groups were compared on the levels of quality of life (WHOQOL-Bref), stress, anxiety and depression (DASS 21) and the facets of mindfulness (FFMQ) at baseline and at the end of the intervention. A total of 141 students were included in the study, 70 in the intervention group and 71 in the control group. No significant differences were found between the intervention and control groups in all mental health, quality of life, and FFMQ scores (Cohen's d = 0.01 to 0.14). Likewise, no significant gains in mental health measures, quality of life, and FFMQ were identified in the intervention group when compared with the control group (Cohen's d = 0.02 to 0.33). The incorporation of a required mindfulness course for large groups in the curriculum during the first semester of medical training was not associated with an improvement on medical students' mental health and quality of life. NCT03132597.

Definition of a Yoga Breathing (Pranayama) Protocol That Improves Lung Function.

This study tests the hypothesis that yoga breathing (pranayama) improves lung function in healthy volunteers during a 6-week protocol. A randomized controlled pilot study demonstrated an improvement in peak expiratory flow rate and forced expiratory volume. The easy-to-learn approach can be translated to the inpatient and outpatient settings.

Spinal decompression therapy as an alternative modality for management of low back pain and radicular pain caused by lumbar disc herniation or protrusion

BackgroundRecent studies have suggested that motorized nonsurgical spinal decompression AQ5 can reduce chronic low back pain (LBP) due to lumbar disc herniation or protrusion.AimThe purpose of this study was to evaluate the efficacy of motorized nonsurgical spinal decompression by the DRX9000 device in the reduction of LBP and radicular pain caused by lumbar disc herniation or protrusion and whether it correlated with MRI changes in disc height or not.Patients and methodsThis study was carried out on 73 patients with chronic LBP attributed to disc protrusion selected from outpatients of rheumatology and rehabilitation clinics at Abdul Latif Jameel Hospital for Medical Rehabilitation, Jeddah, Saudi Arabia; these patients were divided into two groups. The first group comprised 39 patients who underwent a 6-week treatment protocol of motorized nonsurgical spinal decompression via the DRX9000, and the other group comprising 34 patients underwent a 6-week physiotherapy with deep heat modalities and ordinary traction; pain assessment using a visual analog scale with MRI was carried out before and after treatment. Paired t-test or linear regression was used, as appropriate, with P less than 0.05 considered to be statistically significant.ResultsThe main outcomes were a significant improvement in LBP in both groups using visual analog scale, but radicular pain and disc height using MRI were significantly improved in group 1 compared with group 2.ConclusionsThe study concluded that nonsurgical spinal decompression was associated with a reduction in back pain and radicular pain and with an increase in disc height and can be used as an alternative modality for discogenic LBP.

Does endurance training improve red blood cell aging and hemorheology in moderate-trained healthy individuals?

ObjectiveTo examine the impact of a 6-week endurance training on red blood cell (RBC) aging and deformability of healthy participants to detect possible improved hemorheological and performance-related adaptations. MethodsA total of 31 participants (17 females and 14 males) performed a 6-week moderate training protocol (three 1-h running sessions per week at 70% of maximal heart rate). Blood was sampled before and after the training. RBCs from each participant were fractioned according to density and age into 4 RBC subfractions. Subfractions were examined for changes of RBC properties, including aging distribution, RBC deformability, RBC microparticles, and phosphatidylserine concentrations. RBC and plasma nitrite levels were measured as indicators of nitric oxide metabolism. ResultsAerobic performance, peak oxygen consumption, ventilatory thresholds, velocity at the aerobic–anaerobic threshold, and lactate at exhaustion improved after training. The relative amount of both young RBCs and old RBCs increased, and the amount of the main RBC fraction decreased. Phosphatidylserine externalization and RBC-derived microparticles decreased. Overall deformability expressed as shear stress required to achieve half-maximum deformation to theoretical maximal elongation index at infinite shear stress improved in unfractioned RBCs (p < 0.001). Nitrite decreased in total (p = 0.001), young (p < 0.001), main (p < 0.001), and old (p = 0.020) aged RBCs and in plasma (p = 0.002), but not in very old RBCs. ConclusionThese results indicate that non-endurance-trained healthy participants benefit from a regular moderate running training program because performance-related parameters improve and a younger RBC population with improved RBC properties is induced, which might support oxygen supply in the microcirculation.

The Impact of Hippocampal Sex Hormones Receptors in Modulation of Depressive-Like Behavior Following Chronic Anabolic Androgenic Steroids and Exercise Protocols in Rats.

The aim of this study was to evaluate alterations in depressive-like behaviors in rats following chronic administration of a supraphysiological dose of anabolic androgenic steroids (AASs) as well as exposure to a prolonged exercise protocol. The role of hippocampal sex hormones receptors in the modulation of depressive-like behavior was also assessed. A total of 48 male Wistar albino rats were divided into six groups: control, exercise (1 h/day, five consecutive days), nandrolone-decanoate (ND, 20 mg/kg/week, in a single dose), exercise plus ND, testosterone-enanthate (TE, 20 mg/kg/week, in a single dose), and exercise plus TE. After the 6-week protocols were complete, the rats underwent behavioral testing in the tail suspension test (TST). Rats were sacrificed for the collection of blood samples, to determine sex hormones levels, and isolation of the hippocampus, to determine [androgen receptors (AR) and estrogen receptors α (ERα)] expression. ND and TE treatment induced significant depressive-like behavior, opposing the antidepressant effect of exercise. Chronic TE administration elevated testosterone (T) and dihydrotestosterone (DHT) serum levels, and this was augmented by exercise. In contrast, ND and exercise alone did not alter T or DHT levels. There were no changes in serum estradiol levels in any of the groups. Immunohistochemical analysis showed that exercise reduced AR immunoreactivity in all hippocampal regions and increased the ERα expression in the CA1, dentate gyrus (DG), and total hippocampal sections, but not in the CA2/3 region. AASs administration increased AR expression in all hippocampal regions, although not the total hippocampal section in the TE group and did not significantly decrease ERα. The hippocampal AR/ERα expression index was lowered while parvalbumin (PV)-immunoreactivity was enhanced by exercise. AASs administration increased the AR/ERα index and reduced PV-immunoreactivity in the hippocampus. The number of PV-immunoreactive neurons negatively correlated with the antidepressant effects and the AR/ERα ratio. Our results suggest a potential role of the numerical relationship between two sex hormones receptors (stronger correlation than for each individual receptor) in the regulation of depressive-like behavior via the hippocampal GABAergic system in rats, which allow better understanding of the hippocampal sex hormones receptors role in modulation of depressive-like behavior.

DUATHLON TRAINING MODEL ADAPTED FOR FEMALE RATS: BLOOD GLUCOSE-LACTATE CORRELATIONS

ABSTRACT Objective: To propose a duathlon model adapted for rats (associated swimming and running training) and compare it with the individual activities carried out separately, considering the glucose uptake and serum lactate production mechanism. Methods: Twenty-eight 90-day-old Wistar rats with a mean weight of 150-200 g were used. The animals were divided into four groups: control group, swimming group, running group, and swimming/running group. These animals were adapted to their respective training programs for three days and underwent the 4-week training protocol soon afterwards. Pre- and post-training blood lactate and blood glucose analyses were performed at the end of each week. Statistical difference was considered when the p value was less than 0.01 (p &lt;0.01). Results: There was a decrease in glycemic levels and an increase in lactate levels in the swimming and swimming/running groups throughout the training period, which did not occur in the running group. Conclusion: The duathlon model adapted for rats proved satisfactory in terms of the production and stabilization of blood lactate levels. Level of evidence II; Therapeutic Studies - Investigating the Results of Treatment.

Physical activity intervention program through walking routes in sedentary university students

Objective: Effect of a physical activity program on body composition and physical condition with university teacher students. Methods: 51 university students from the Faculty of Education and Sport Sciences, University of Vigo (Spain), participated in the study. Students performed a 6-week protocol, using the walking routes designed in the university's own facilities. Two cohorts, experimental group and control group were analysed, before and after the program. The 6-minute walking test, countermovement jump (CMJ), flexibility through active straight leg raise, rate of perceived exhaustion (RPE) and heart rate (HR) were evaluated, and a bioimpedance measurement was used to evaluate the basal and final metabolism. Results: On the 6-minutes walking test, CMJ, and flexibility of the right leg significant differences were found between the experimental and the control group. There were no significant differences in either group for any RPE. In the bioimpedance, there were significant differences in fat and lean mass in the left leg. Conclusion: The analysed data indicates an improvement in aerobic endurance, jumping and flexibility capacities at the end of the program. But for body composition, in general there were no significant variations.

Blenderized Tube Feedings for Adult Patients on Home Enteral Nutrition: A Pilot Study.

Despite surveys indicating a high prevalence of blenderized tube feeding (BTF) as an alternative to commercial enteral nutrition (EN), there remains a paucity of data regarding use in clinical practice. The objective of the present open-label pilot study was to assess the safety and effectiveness of BTF in adult patients being given home enteral nutrition (HEN). This is an open-label pilot study, in which all participants who had been on traditional EN formulas were changed to BTF for 6 weeks. The Mayo Clinic in Rochester, Minnesota. Twenty individuals gave their consent to participate in the study, with nine completing the 6-week BTF protocol. Weight was measured at baseline and at 6 weeks of BTF use. Participants completed a survey regarding the frequency of BTF use and adverse effects, at baseline and then weekly for 6 weeks. Nine participants with a mean age of 60.6 ± 7.8 years completed the 6-week protocol. BTF use increased from 4.85 ± 2.44 to 6.45 ± 0.82 days per week from week 1 to week 6. The percentage of participants consuming >50% of their calorie intake from BTF increased from 23.1% (3 of 13 participants) at week 1 to 44.4% (4 of 9 participants) at week 6. Six of nine participants experienced weight gain, weight was maintained by one participant, and two participants lost weight (intentionally in one and due to an intolerance of commercial formula in the other). BTF was found to be safe and effective in promoting weight gain in adult participants who required HEN for at least 6 weeks.

Standardized Aronia melanocarpa Extract as Novel Supplement against Metabolic Syndrome: A Rat Model.

The aim of our study was to examine the effects of different dietary strategies, high-fat (HFd) or standard diet (Sd) alone or in combination with standardized oral supplementation (0.45 mL/kg/day) of Aronia melanocarpa extract (SAE) in rats with metabolic syndrome (MetS). SAE is an official product of pharmaceutical company Pharmanova (Belgrade, Serbia); however, the procedure for extraction was done by EU-Chem company (Belgrade, Serbia). Rats were divided randomly into six groups: control with Sd, control with Sd and SAE, MetS with HFd, MetS with HFd and SAE, MetS with Sd and MetS with Sd and SAE during 4 weeks. At the end of the 4-week protocol, cardiac function and liver morphology were assessed, while in the blood samples glucose, insulin, iron levels and systemic redox state were determined. Our results demonstrated that SAE had the ability to lower blood pressure and exert benefits on in vivo and ex vivo heart function. Moreover, SAE improved glucose tolerance, attenuated pathological liver alterations and oxidative stress present in MetS. Obtained beneficial effects of SAE were more prominent in combination with changing dietary habits. Promising potential of SAE supplementation alone or in combination with different dietary protocols in triggering cardioprotection should be further examined in future.

PSV-16 Assessment of oxidative stress and muscle damage in exercising horses in response to level and form of vitamin E.

Vitamin E is an essential antioxidant abundant in fresh forage and is a key component to equine diets. Most notable for its role in stopping free radical chain reactions, it is thought that supplemental vitamin E may be beneficial to athletes in reducing oxidative stress. Vitamin E has multiple chemical structures of which RRR-α-tocopherol is the most readily absorbed. Supplements can be derived from natural sources (100% RRR-α-tocopherol) or manufactured as synthetic vitamin E (12.5% RRR-α-tocopherol). This study aimed to (1) determine if supplemental vitamin E above NRC recommendations is beneficial to exercising horses and (2) determine if there is a benefit of natural compared to synthetic vitamin E. After a 2-week washout, 18 horses were divided into three groups and fed a control diet plus: (1) 1000 IU synthetic α-tocopherol acetate/d (SYN-L), or (2) 4000 IU/d synthetic α-tocopherol acetate (SYN-H), or (3) 4000 IU/d micellized RRR-α-tocopherol (NAT-H). After a 7-day acclimation period, horses began a 6-week exercise protocol of increasing intensity, with standard exercise tests (SET) performed prior to and at the conclusion of the 6-week exercise protocol. Resting, pre-feeding venous blood samples were collected at day 0 and 29. Additionally, blood samples were collected pre and 2hours post each SET plus 24hours post SET2. No differences were seen between treatment groups in serum α-tocopherol concentrations (SAT) at initial and pre SET1 times. At all other time points, NAT-H horses had higher SAT (P<0.05). Plasma malondialdehyde concentrations were lower in NAT-H vs SYN-L horses 2hours post SET2 (P=0.02). Serum aspartate aminotransferase (AST) was significantly lower 2hours post SET2 in NAT-H horses vs SYN-L or SYN-H (P<0.05). In conclusion, feeding high levels of the more bioavailable natural vitamin E source did appear to have a beneficial effect on increasing SAT and potentially reducing oxidative stress and muscle damage.

Balance Training With a Dynamometric Platform Following Total Knee Replacement: A Randomized Controlled Trial.

Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training program using a dynamometric platform improved balance performance to a higher extent than a control group training without such a device. The inclusion of this instrument in the functional training protocol may be beneficial for recovering balance following TKR.

Injury Prevention Programs Based on Flywheel vs. Body Weight Resistance in Recreational Athletes.

Monajati, A, Larumbe-Zabala, E, Sampson, MG, and Naclerio, F. Injury prevention programs based on flywheel vs. body weight resistance in recreational athletes. J Strength Cond Res 35(2S): S188-S196, 2021-This study compares the effect of an isoinertial flywheel technology vs. a traditional gravity-dependent exercise protocol on modifiable factors associated with the incidence of hamstring strain (HAM) and anterior cruciate ligament (ACL) injuries. Furthermore, the effect on repeated sprint ability was also considered. Eighteen recreationally trained volleyball players completed one of the following 6-week protocols: (a) flywheel (FY) included 3 exercises using a YoYo isoinertial-squat machine and 3 exercises with a Versa-Pulley isoinertial device, and (b) gravity-dependent (GT) involved 6 similar exercises with no external resistance (participants' body weight). Both programs consisted in 2 sessions·wk-1 performing 2 sets of 8 repetitions with 2 minutes of rest. Outcomes included a 10-second tuck jump assessment (TJA), landing knee valgus score, hamstring and quadriceps concentric and eccentric isokinetic 60°·s-1 peak torque, optimal peak torque localization, conventional and functional hamstring-to-quadriceps ratio, and 30-m repeated shuttle sprint ability (RSSA) test. FY improved TJA (-2, interquartile range [IQR] = -3 to -1) and valgus (-1, IQR = -1 to 0) scores, hamstring eccentric (20.37, 95% confidence interval [CI] = 9.27-31.47 N·m) and concentric (17.87, 95% CI = 0.40-35.34 N·m) peak torque, as well as the RSSA (-0.28, 95% CI = -0.45 to -0.10 seconds), whereas GT only improved hamstring eccentric peak torque (21.41, 95% CI = 9.00-33.82 N·m). A 6-week protocol using flywheel technology seems to elicit better positive adaptations to protect athletes from HAM and ACL injuries and to enhance RSSA performance compared to exercising with no external resistance other than athletes' body weight.

Regular exercise and creatine supplementation prevent chronic mild stress-induced decrease in hippocampal neurogenesis via Wnt/GSK3β/β-catenin pathway.

[Purpose]Chronic stress can lead to mood-related psychomotor behaviors such as despair. Decreased hippocampal neurogenesis has been observed in patients with depression and in animal models of depression. Exercise enhances the population of the new born cells in the dentate gyrus (DG). A few studies have demonstrated that creatine has antidepressant effects in humans. However, the mechanism underpinning these effects is poorly understood. Therefore, we examined whether regular exercise and/or creatine was closely associated with the activity of the Wnt/GSK3β/β-catenin pathway in the hippocampal DG.[Methods]Mice were subjected to 4 weeks of chronic mild stress starting a week prior to the start of a 4-week protocol of treadmill running and creatine supplementation. Tail suspension (TST) and forced swimming tests (FST) were carried out 2 days after the final treadmill running session. Immunohistochemical and western blot analyses were conducted to evaluate hippocampal neurogenesis, GSK3β activity, and nuclear β-catenin protein levels in the DG. Furthermore, Wnt signaling antagonism in the DG using stereotaxic injection was performed.[Results]Chronic mild stress-induced increase in immobility in the TST and FST were restored by treadmill running and/or creatine supplementation. The number of Ki-67+ and doublecortin (DCX)+ cells were decreased by chronic stress, and this decline was reversed by the exercise and supplement regimen, along with the changes in GSK3β activity and nuclear β-catenin protein levels in the DG. Local antagonism of DG Wnt signaling caused an increase in immobility even 5 days after injection with C59.[Conclusion]Regular exercise combined with creatine supplementation had a greater effect on hippocampal neurogenesis via the Wnt/GSK3β/β-catenin pathway activation compared with each treatment in chronic mild stress-induced behavioral depression.

A Pilot Study of a 4-Week eHealth-Based Protocol of the Attention Training Technique Component of Metacognitive Therapy Among Patients With Anxiety Disorders.

The attention training technique (ATT) component of metacognitive therapy seeks to reduce anxiety and strengthen executive attention. ATT has the potential to expand mental health service delivery, with researchers labeling ATT as a possible form of eHealth. However, the only known published study to examine ATT in that delivery capacity was not supportive of its use. The current pilot study examined a new 4-week eHealth-based protocol of ATT among a small mixed sample of patients with anxiety disorders (N = 16). Patients attended a single in-person session to practice ATT and then practiced ATT remotely by accessing a standardized recording of ATT through the Internet for 4 weeks. There was no attrition and over 80% of patients achieved the practice benchmark. Improvements were noted across clinician-rated, patient-rated, and performance-based outcomes. Results support further examination of ATT as a possible eHealth treatment for anxiety disorders. Recommendations for future research are discussed.