Aerobic Interval Training Research Articles

Resistance exercise training augments the immunomodulatory adaptations to aerobic high-intensity interval training

ABSTRACT To compare the effectiveness of different types of high-intensity interval training (HIIT) on meta-inflammation during obesity, TLR4 pathway activities were assessed following a 10-week randomized trial. 30 young females with overweight and obesity were randomly allocated to aerobic HIIT (HIIT/AE) or resistance exercise in HIIT (HIIT/RE) and performed a 28-minute (4 × 4 min) in each session. During each interval, the HIIT/AE performed four minutes of all-extremity cycling, whereas the HIIT/RE completed four minutes of combined resistance exercises and all-extremity cycling. The TLR4 pathway gene expression was measured for the TLR4 receptor, downstream adaptors (TIR domain-containing adaptor-inducing interferon-β (TRIF) and myeloid differentiation factor (MYD) 88), transcriptional factors (nuclear factor kappa B (NF-κB), and interferon regulatory factor (IRF) 3), and its negative regulator (tumor necrosis factor (TNF) a-induced protein 3 (TNFAIP3)). The serum levels of TNFα, interferon (IFN) γ, interleukin (IL)-10, and adiponectin were measured. We found that TLR4 (HIIT/RE: 0.6 ± 0.43 vs. HIIT/AE: 1.24 ± 0.82, p = 0.02), TRIF (HIIT/RE: 0.51 ± 0.4 vs. HIIT/AE: 3.56 ± 0.52, p = 0.001), and IRF3 (HIIT/RE: 0.49 ± 0.42 vs. HIIT/AE: 0.6 ± 0.89; p = 0.04) levels were significantly downregulated in HIIT/RE compared to the HIIT/AE, with a significant reduction in serum levels of TNFα (pg/ml) (HIIT/RE: 22.5 ± 11.3 to 6.3 ± 5.3 vs. HIIT/AE: 19.16 ± 20.8 to 13.48 ± 21.7, p = 0.04) and IFNγ (pg/ml) (HIIT/RE: 43.5 ± 20.6 to 37.5 ± 4.3 vs. HIIT/AE: 37.6 ± 5.6 to 68.1 ± 22.5, p = 0.03). Adiponectin and IL-10 levels did not significantly differ between the two groups. Thus, resistance exercise training augments the immunomodulatory adaptations to HIIT and should be prescribed to people at risk of cardiometabolic disease. Highlights HIIT in combination with resistance exercise looks more effective than HIIT alone to target TLR4-mediated inflammation in individuals with overweight and obesity. HIIT/RE induces a different effect on two downstream cascades of TLR4, leading to a greater overall reduction of TRIF-dependent pathway activities compared to MYD88. Both HIIT protocols show comparable effects on the negative regulatory protein TNFAIP3 gene expression.

Experiences with physical activity, health and well-being among young adults with serious mental illness

ABSTRACT Purpose To explore how young adults with serious mental illness (SMI) experience physical activity and how these experiences influence their perceived health and well-being. Methods Nine young adults with SMI who had participated in an aerobic high-intensity interval training program were interviewed in depth. The interviews were transcribed and subjected to reflexive thematic analysis. Results The results indicated that people with SMI mainly experience physical activity as a meaningful activity that contributes to an increased sense of well-being and better health. However, to overcome various barriers, it is crucial to experience social support and encouragement. The following three main themes were identified through reflexive thematic analysis: (1) positive changes in focus and an increase in well-being occur through physical activity; (2) increased mental strength results from physical activity; and (3) a lack of support and feelings of safety prevent physical activity. Conclusions This study shows that adapted physical activity is an important resistance resource that can promote stronger self-identity, increased mental well-being and social engagement and thus contribute to an improved ability to manage stressors. Furthermore, the findings reveal that to engage in physical activity and promote sustainable life changes, it is important for individuals to choose a physical activity based on personal interest and meaning.

Feasibility of remotely delivered and supported aerobic walking exercise training for cognitive processing speed impairment in fully-ambulatory persons with multiple sclerosis.

The current pilot, single-blind, randomized controlled trial (RCT) examined the feasibility of remotely-delivered and supported aerobic walking exercise training compared with an active control condition on cognitive processing speed (CPS) in 19 fully-ambulatory persons with multiple sclerosis (pwMS) who were pre-screened for impaired CPS. Feasibility was assessed in the domains of process (e.g., recruitment), resource (e.g., monetary costs), management (e.g., time requirements), and scientific outcomes (i.e., treatment effect). Fully-ambulatory, but CPS-impaired pwMS were randomly assigned into either 16-weeks of home-based aerobic walking exercise or home-based stretching and range-of-motion activities. Both conditions involved delivery of informational newsletters and one-on-one, online video chats with a behavior coach. Participants across both conditions tracked their activity using highly accurate wearable motion sensors. Treatment-blinded assessors administered the Symbol Digit Modalities Test (SDMT) remotely before and after the 16-week study period. The study was cost-effective, accessible, and acceptable. The intervention further was safe. Adherence and compliance rates across both conditions exceeded 80%. There was an overall moderate effect for change in SDMT score between the conditions (d=0.42). The intervention was associated with a 4.8-point improvement in SDMT scores (d=0.70; 10% increase) compared with a 1-point improvement for the control condition (d=0.09; 2% increase). This remotely-delivered and supported aerobic walking exercise training intervention was safe and feasible for fully-ambulatory, CPS-impaired pwMS. The pattern of results, including the promising effects on CPS, support the design and implementation of an appropriately-powered RCT on this approach for managing CPS impairment in a large MS sample.

EXERCISE THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION: A SYSTEMATIC REVIEW WITH META-ANALYSIS

Objective: High grade evidence supports exercise as a key therapy in the prevention and management of hypertension. Yet, the lack of a meta-analysis on the effects of exercise on ambulatory blood pressure monitoring (ABPM) in patients with hypertension was identified as an important research gap in the 2022 consensus document from the European Association of Preventive Cardiology and the ESC council on Hypertension. Therefore, we performed a meta-analysis to investigate the effects of exercise on blood pressures measured by means of ABPM, in patients with arterial hypertension or high-normal blood pressure (BP). Design and method: A systematic literature search was performed in three databases from inception to October 2021. Randomized controlled trials involving exercise training of at least 4 weeks, in adults with a high-normal BP or arterial hypertension, were included. Trials had to report data on daytime, nighttime or 24-h ambulatory systolic blood pressure (SBP) and/or diastolic blood pressure (DBP). Primary outcomes were changes in 24h, daytime and nighttime ABP. Pooled effect sizes are reported as weighted mean with 95% confidence intervals (CI). Results: We included 24 trials, involving 23 aerobic training interventions and 4 resistance exercise interventions. A total of 1668 participants were included: 942 in exercise groups, 726 as controls. Table 1: Pooled effect size, 95% CI and p-value of different exercise types on 24h, daytime and nighttime BP: Only 67 participants and 35 controls were included in resistance exercise protocols. In this subpopulation, results for 24h, daytime or nighttime BP were insignificant (p>0.05). Funnel plots for 24h, daytime and nighttime BP did not show any significant publication bias. Conclusions: Exercise therapy reduces 24h BP in patients with arterial hypertension or high normal blood pressure. The effect is more pronounced on daytime than on nighttime BP. The results of this meta-analysis are mostly driven by trials examining aerobic exercise. More trials are needed on the effect of resistance exercise on ABPM.

Effects of Exercise Intensity on Cardiometabolic Parameters of Ovariectomized Obese Mice.

The aim of this study was to compare the effects of continuous-moderate vs. high-intensity interval aerobic training on cardiovascular and metabolic parameters in ovariectomized high-fat-fed mice. C57BL/6 female ovariectomized were divided into four groups (n=8): low-fat-fed sedentary (SLF); high-fat-fed sedentary (SHF); high-fat-fed moderate-intensity continuous trained (MICT-HF); and high-fat-fed high-intensity interval aerobic trained (HIIT-HF). The high-fat diet lasted 10 weeks. Ovariectomy was performed in the fourth week. The exercise training was carried out in the last four weeks of protocol. Fasting glycemia, oral glucose tolerance, arterial pressure, baroreflex sensitivity, and cardiovascular autonomic modulation were evaluated. Moderate-intensity continuous training prevented the increase in arterial pressure and promoted a reduction in HR at rest, associated with an improvement in the sympathovagal balance in MICT-HF vs. SHF. The high-intensity interval training reduced blood glucose and glucose intolerance in HIIT-HF vs. SHF and MICT-HF. In addition, it improved sympathovagal balance in HIIT-HF vs. SHF. Moderate-intensity continuous training was more effective in promoting cardiovascular benefits, while high-intensity interval training was more effective in promoting metabolic benefits.

Train Smart Study: protocol for a randomised trial investigating the role of exercise training dose on markers of brain health in sedentary middle-aged adults

IntroductionRegular aerobic exercise is associated with improved cognitive function, implicating it as a strategy to reduce dementia risk. This is reinforced by the association between greater cardiorespiratory fitness and larger...

Pre- and Postoperative Exercise Effectiveness in Mobility, Hemostatic Balance, and Prognostic Biomarkers in Hip Fracture Patients: A Study Protocol for a Randomized Controlled Trial.

Hip fractures are a major health concern, particularly for older adults, as they can reduce life quality, mobility loss, and even death. Current evidence reveals that early intervention is recommended for endurance in patients with hip fractures. To our knowledge, preoperative exercise intervention in patients with hip fractures remains poorly researched, and no study has yet applied aerobic exercise preoperatively. This study aims to investigate the short-term benefits of a supervised preoperative aerobic moderate-intensity interval training (MIIT) program and the added effect of an 8-week postoperative MIIT aerobic exercise program with a portable upper extremity cycle ergometer. The work-to-recovery ratio will be 1-to-1, consisting of 120 s for each bout and four and eight rounds for the pre- and postoperative programs, respectively. The preoperative program will be delivered twice a day. A parallel group, single-blinded, randomized controlled trial (RCT) was planned to be conducted with 58 patients each in the intervention and control groups. This study has two primary purposes. First, to study the effect of a preoperative aerobic exercise program with a portable upper extremity cycle ergometer on immediate postoperative mobility. Second, to investigate the additional effect of an 8-week postoperative aerobic exercise program with a portable upper extremity cycle ergometer on the walking distance at eight weeks after surgery. This study also has several secondary objectives, such as ameliorating surgical and keeping hemostatic balance throughout exercise. This study may expand our knowledge of preoperative exercise effectiveness in hip fracture patients and enhance the current literature about early intervention benefits.

Effect of Aerobic Exercise Training on Sleep and Core Temperature in Middle-Aged Women with Chronic Insomnia: A Randomized Controlled Trial

Exercise represents a viable non-pharmacological intervention to help treating insomnia but the interaction mechanisms between sleep and physical activity still remain poorly understood. The aim of this study was to investigate the effect of a aerobic exercise training intervention on sleep and core temperature. Twenty-four adult women suffering from insomnia participated in this study. They were randomized into an exercise group and a control group. Aerobic exercise training consisted in moderate to vigorous aerobic exercise training for 12 weeks. Outcome measures included both subjective (Insomnia Severity Index, ISI) and objective (actigraphy recordings) sleep quality assessments, and core body temperature continuously recorded for a minimum 24 h. The exercise group showed a decrease in ISI (p < 0.001) and in various objective sleep parameters. The core temperature batyphase value was lowered (p = 0.037) whereas its amplitude was larger (p = 0.002). We also found a tight correlation between the evolution of insomnia and the evolution of mean night-time core temperature and batyphase values. A moderate to vigorous aerobic exercise program appears to be an effective non-drug therapy for improving sleep in women with insomnia. In addition, exercise programs should aim to increase core body temperature during practice to induce sleep-promoting adaptations and rebound.

Improving Cognitive Function Through High-Intensity Interval Training in Breast Cancer Patients Undergoing Chemotherapy: Protocol for a Randomized Controlled Trial

More than 75% of patients with breast cancer treated with chemotherapy experience cognitive impairments (eg, memory and attention problems), commonly known as chemo-brain. Exercise, especially aerobic high-intensity interval training (HIIT), is associated with better cognitive function in healthy populations. However, clinical trials testing the impact of exercise interventions on chemotherapy-induced cognitive decline in patients with cancer are lacking, and the mechanisms through which exercise could improve cognitive function are unclear. The objective of the Improving Cognitive Function Through High-Intensity Interval Training in Breast Cancer Patients Undergoing Chemotherapy trial is to examine the effects of HIIT on cognitive function in patients with breast cancer undergoing chemotherapy. This 2-arm, single-center, pilot randomized controlled trial will randomize 50 patients with breast cancer undergoing chemotherapy to HIIT or attention control. The HIIT group will perform a supervised 16-week, thrice-weekly intervention, with each session including a 5-minute warm-up at 10% maximal power output (POmax), 10 sets of alternating 1-minute high-intensity (90% POmax) and 1-minute recovery (10% POmax) intervals, and a 5-minute cooldown (10% POmax). The attention control group will receive a stretching program with no exercise components and be asked to maintain their exercise levels for 16 weeks. The primary outcomes of the study are executive function and memory measured using the National Institutes of Health toolbox and resting-state connectivity and diffusion tensor imaging microstructure evaluated using magnetic resonance imaging. The secondary and tertiary outcomes include cardiorespiratory fitness, body composition, physical fitness, and psychosocial health. The study has been approved by the institutional review board of the Dana-Farber Cancer Institute (20-222). The trial was funded in January 2019, with recruitment started in June 2021. As of May 2022, a total of 4 patients have consented and been randomized (n=2, 50% to exercise; n=1, 25% to control; and n=1, 25% nonrandomized). Trial completion is expected in January 2024. This first-of-its-kind study incorporates a novel exercise intervention (ie, HIIT) and comprehensive cognitive measures. If positive, our findings will establish the pilot efficacy of HIIT on chemotherapy-induced cognitive function in patients with breast cancer, providing the foundation for future larger phase-II and phase-III trials to confirm the findings and potentially establish HIIT as a standard of care for women undergoing chemotherapy for breast cancer. ClinicalTrials.gov NCT04724499; https://clinicaltrials.gov/ct2/show/NCT04724499. DERR1-10.2196/39740.

Exercise Training to Improve Brain Health in Older People Living With HIV: Study Protocol for a Randomized Controlled Trial.

With the advent of antiretrovirals, people living with HIV are living near-normal lifespans. However, people living with HIV are at greater risk of experiencing cognitive impairment and reduced brain integrity despite well-controlled viremia. A robust literature supports exercise interventions as a method of improving cognition and structural brain integrity in older individuals without HIV. The effects of exercise on cardiometabolic, neurocognitive, and neural structures in middle-aged to older people living with HIV are less well known, with few prospective studies examining these measures. This prospective randomized clinical trial will examine the effects of a 6-month exercise training intervention compared to a 6-month stretching intervention (control) on cardiorespiratory fitness, physical function and strength, cognition, and neuroimaging measures of brain volumes and cerebral blood flow in people living with HIV. Sedentary middle-aged to older people living with HIV (ages≥40; n=150) with undetectable HIV viral load (<20 copies/mL) will be enrolled in the study. At the baseline and final visit, fasting plasma lipid, insulin, glucose, and brain neurotrophic factor concentrations; cardiorespiratory fitness; cognitive performance; brain volumes; and cerebral blood flow via a magnetic resonance imaging scan will be measured. Participants will be randomized in a 2:1 ratio to either the exercise or control stretching intervention. All participants will complete their assigned programs at a community fitness center 3 times a week for 6 months. A professional fitness trainer will provide personal training guidance at all sessions for individuals enrolled in both arms. Individuals randomized to the exercise intervention will perform endurance and strength training exercises, while those randomized to the control intervention will perform stretches to increase flexibility. A midpoint visit (at 3 months) will assess cognitive performance, and at the end point visit, subjects will undergo cardiorespiratory fitness and cognition testing, and a magnetic resonance imaging scan. Physical activity throughout the duration of the trial will be recorded using an actigraph. Recruitment and data collection are complete as of December 2020. Data processing, cleaning, and organization are complete as of December 2021. Data analysis began in January 2022, with the publication of study results for primary aims 1 and 2 expected by early 2023. This study will investigate the effects of a 6-month aerobic and resistance exercise training intervention to improve cardiometabolic risk factors, cognitive performance, cerebral structure, and blood flow in sedentary people living with HIV. Results will inform clinicians and patients of the potential benefits of a structured aerobic exercise training program on the cognitive, functional, and cardiometabolic health status of older people living with HIV. Assessment of compliance will inform the development and implementation of future exercise programs for people living with HIV. ClinicalTrials.gov NCT02663934; https://clinicaltrials.gov/ct2/show/NCT02663934. DERR1-10.2196/41421.

Aerobic high-intensity interval exercise training in patients with angina and no obstructive coronary artery disease: feasibility and physiological effects.

Patients with chest pain and normal coronary angiogram [angina with normal coronary arteries (ANOCA)] constitute a therapeutic problem with considerable functional limitation and reduced quality of life. The aims of the current pilot study were to (i) explore if a structured aerobic high-intensity interval training (HIT) program for 12 weeks was feasible in patients with ANOCA, and (ii) to assess mechanisms related to symptoms in this population. Sixteen patients with ANOCA underwent a 3-month aerobic HIT program with one-to-one monitored exercise sessions on treadmill in a 4 min × 4 manner, three times a week. Four patients served as controls. Coronary flow velocity reserve (CFVR) transthoracic Doppler, flow-mediated vasodilation (FMD) and VO2max was measured at baseline and after 12 weeks. The average attendance to training sessions was 82.3% ± 10.1 (56-94). CFVR in the training group increased from 2.50 ± 0.48 to 3.04 ± 0.71 (P < 0.001) whereas FMD increased from 4.19 ± 2.42% to 8.28 ± 2.85% (P < 0.001). Improvement in CFVR correlated with the relative improvement in FMD (R = 0.45, P = 0.047). This was associated with an increase in VO2max from 28.75 ± 6.51 mL/kg/min to 31.93 ± 6.46 mL/kg/min (P < 0.001). A 3-month program of monitored HIT was feasible, with high adherence resulting in improved functional capacity in patients with ANOCA. CFVR improved and this improvement was associated with improved FMD. NCT02905630.

Interventions to Improve Standing Balance in Individuals With Incomplete Spinal Cord Injury: A Systematic Review and Meta-Analysis.

Incomplete spinal cord injury (iSCI) often results in impaired balance leading to functional impairments. Recovery of standing balance ability is an important aim of rehabilitative programs. However, limited information is available on effective balance training protocols for individuals with iSCI. To assess the methodological quality and effectiveness of various rehabilitation interventions for improving standing balance in individuals with iSCI. A systematic search was performed in SCOPUS, PEDro, PubMed, and Web of Science from inception until March 2021. Two independent reviewers screened articles for inclusion, extracted data, and evaluated methodological quality of the trials. PEDro Scale was used to assess the quality of randomized controlled trials (RCT) and crossover studies while pre-post trials were assessed using the modified Downs and Black tool. A meta-analysis was performed to quantitatively describe the results. The random effects model was applied to present the pooled effect. Ten RCTs with a total of 222 participants and 15 pre-post trials with 967 participants were analyzed. The mean PEDro score and modified Downs and Black score was 7/10 and 6/9, respectively. The pooled standardized mean difference (SMD) for controlled and uncontrolled trials of body weight-supported training (BWST) interventions was -0.26 (95% CI, -0.70 to 0.18; p = .25) and 0.46 (95% CI, 0.33 to 0.59; p < .001), respectively. The pooled effect size of -0.98 (95% CI, -1.93 to -0.03; p = .04) indicated significant improvements in balance after a combination of BWST and stimulation. Pre-post studies analyzing the effect of virtual reality (VR) training interventions on Berg Balance Scale (BBS) scores in individuals with iSCI reported a mean difference (MD) of 4.22 (95% CI, 1.78 to 6.66; p = .0007). Small effect sizes were seen in pre-post studies of VR+stimulation and aerobic exercise training interventions indicating no significant improvements after training on standing balance measures. This study demonstrated weak evidence to support the use of BWST interventions for overground training for balance rehabilitation in individuals with iSCI. A combination of BWST with stimulation however showed promising results. There is a need for further RCTs in this field to generalize findings. Virtual reality-based balance training has shown significant improvement in standing balance post iSCI. However, these results are based on single group pre-post trials and lack appropriately powered RCTs involving a larger sample size to support this intervention. Given the importance of balance control underpinning all aspects of daily activities, there is a need for further well-designed and appropriately powered RCTs to evaluate specific features of training interventions to improve standing balance function in iSCI.

The effect of eight weeks of spirulina supplementation and resistance and interval aerobic training on skeletal muscle CXCL1 gene expression and liver enzymes in male rats

زمینه و هدف: کم‌تحرکی و در مقابل آن تمرین جزء عوامل مرتبط با شاخص‌های آسیب کبدی به‌شمار می‌روند. با وجود این هنوز نقش بسیاری از تمرین‌های ورزشی به‌ویژه تمرینات تناوبی و مقاومتی و مصرف برخی مکمل‌های غذایی از جمله اسپیرولینا بر عوامل ایمنی و التهابی کاملاٌ شناخته نشده است؛ بنابراین هدف از این پژوهش تعیین اثر هشت هفته مکمل‌دهی اسپیرولینا و تمرین مقاومتی و تناوبی هوازی بر فعالیت بافت کبد و بیان ژن CXCL1 در بافت عضلة موش‌های صحرایی نر بود.مواد و روش‌ها: در این پژوهش نیمه‌تجربی، 60 سر موش صحرایی نر نژاد ویستار با سن پنج هفته و میانگین وزن 6/24 ± 4/246 گرم به‌طور تصادفی به شش گروه تمرین تناوبی + مکمل اسپیرولینا، تمرین مقاومتی+ مکمل اسپیرولینا، کنترل+ مکمل اسپیرولینا، تمرین تناوبی+ سالین، تمرین مقاومتی+ سالین، کنترل+ سالین تقسیم‌ شدند. بر این اساس، مقدار مکمل اسپیرولینا در گروه‌های مصرفی مکمل اسپیرولینا 500 میلی‌گرم بر کیلوگرم وزن بدن بود. گروه تمرین تناوبی به مدت هشت هفته و هر هفته پنج جلسه تمرین کردند. همچنین گروه تمرین مقاومتی با بار فزاینده سه جلسه در هفته فعالیت را اجرا کردند. 48 ساعت پس از آخرین جلسة تمرین، حیوانات در گروه‌های مورد آزمایش با ترکیب کتامین زایلازین بی‌هوش شدند و نمونة خون از ورید تحتانی گرفته شد و به‌سرعت بافت عضلة چهارسررانی نمونه‌برداری شد. میزان بیان ژن CXCL1در عضلة چهارسررانی و آنزیم‌های کبدی به‌عنوان شاخص عملکرد کبد در سرم اندازه‌گیری شد. تجزیه‌وتحلیل داده‌های آماری با استفاده از تحلیل واریانس یکسویه انجام گرفت (05/0P£).نتایج: یافته‌ها نشان داد که پس از هشت هفته تمرین تناوبی و مقاومتی با بار فزاینده، در عضلة چهارسر رانی میزان بیان ژن CXCL1 گروه کنترل بیشتر بود، ولی تفاوت معناداری مشاهده نشد. همچنین، میزان آنزیم‌های کبدی به‌طور معناداری نسبت به گروه کنترل بیشتر بود. همچنین نتایج نشان داد که مصرف اسپیرولینا به‌همراه تمرینات هوازی تناوبی و مقاومتی می‌تواند شاخص‌های عملکرد کبدی را در مقایسه با گروه کنترل به‌طور معناداری تغییر دهد. با این همه بیان ژن CXCL1 در گروه‌های مصرف‌کنندة اسپیرولینا و تمرینات هوازی و مقاومتی در بخشی با گروه کنترل تغییر معناداری نشان نداد.نتیجه‌گیری: یافته‌های پژوهش حاضر نشان داد که مصرف اسپیرولینا و انجام تمرینات هوازی تناوبی و مقاومتی می‌تواند شاخص‌های عملکردی کبد و بیان ژن CXCL1 در بافت عضلة چهارسررانی را تا حدی تعدیل کند. این نتایج نشان می‌دهد که مصرف اسپیرولینا می‌تواند در بروز پاسخ‌های سازگاری مرتبط با آسیب‌های متابولیکی درگیر باشد.

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke.

Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors. PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs). Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings. Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL. A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.

Influence of Recovery Mode on the Maximum Number of Intervals Until Exhaustion During an Aerobic Interval Training Session.

Varela-Sanz, A, Sánchez-Otero, T, Tuimil, JL, Boullosa, D, and Iglesias-Soler, E. Influence of recovery mode on the maximum number of intervals until exhaustion during an aerobic interval training session. J Strength Cond Res 37(9): e510-e520, 2023-We analyzed work capacity, cardiometabolic, perceptual, and neuromuscular responses to an aerobic interval training (AIT) running session until exhaustion, with active (AR) vs. passive recovery (PR). Eight well-trained male endurance runners (36.88 ± 7.14 years, 58.22 ± 3.39 ml·kg -1 ·minute -1 ) randomly completed, after familiarizations and the University of Montreal Track Test (UMTT), 2 AIT track running sessions until exhaustion consisting in 2-minute bouts at 100% of maximum aerobic speed (MAS), with 2 minutes of recovery at 80% of the velocity associated to the second ventilatory threshold (vVT 2 ) (i.e., AR), or no exercise (i.e., PR). Oxygen consumption (V̇O 2 ), heart rate (HR), blood lactate [La], rating of perceived exertion (RPE), and countermovement jump (CMJ) were continuously monitored during sessions. The level of statistical significance was set at p ≤ 0.05. PR resulted in longer time to exhaustion during sessions (13.9 vs. 11.6 bouts, p = 0.045), but lower HR ( p < 0.01) when compared with AR. Time spent over 90% of maximum oxygen consumption (V̇O 2max ), blood lactate concentrations, neuromuscular performance, and RPE did not differ between AR and PR ( p > 0.05). Thus, PR allowed runners to perform more work intervals and, therefore, to accumulate a greater volume. On the other hand, when training goals are focused on reaching a higher chronotropic stress (i.e., higher HR) during the training session, athletes would obtain more benefits from AR. This study also demonstrates that the current volume recommendations for AIT are far below (54-64.5%) the maximum training capacity of well-trained runners.

Low-Volume and High-Intensity Aerobic Interval Training May Attenuate Dysfunctional Ventricular Remodeling after Myocardial Infarction: Data from the INTERFARCT Study.

Aerobic high-intensity interval training (HIIT) has demonstrated benefits for ventricular remodeling after myocardial infarction (MI) through various mechanisms. Despite this, the optimal training volume is not well known. The present study aimed to assess the effects of different (low vs. high volume) aerobic HIIT compared to an attentional control (AC) group on echocardiographic and biochemical indicators of left ventricular (LV) remodeling in adults after MI. Randomized clinical trial conducted on post-MI patients with preserved ventricular function. Participants were assigned to three study groups. Two groups performed HIIT 2 d/week, one group with low-volume HIIT (20 min, n = 28) and another with high-volume HIIT (40 min, n = 28). A third group was assigned to AC (n = 24) with recommendations for unsupervised aerobic training. Left ventricular echocardiographic parameters and cardiac biomarker levels (N-terminal pro-b-type natriuretic peptide, NT-proBNP; soluble growth stimulation expressed gene 2, ST2; troponin T; and creatine kinase) were assessed at baseline and after the intervention (16 weeks). Eighty participants (58.4 8.3 yrs, 82.5% male) were included. Both low- and high-volume HIIT showed increases (p 0.05) in left ventricular end-diastolic diameter (1.2%, 2.6%), and volume (1.1%, 1.3%), respectively. Interventricular septal and posterior walls maintained their thickness (p = 0.36) concerning the AC. Significant (p 0.05) gain in diastolic function was shown with the improvements in E (-2.1%, -3.3%), e' waves (2.2%, 5.5%), and the deceleration time (2.1%, 2.9%), and in systolic function with a reduction in global longitudinal strain (-3.2%, -4.7%), respectively. Significant (p 0.05) reductions of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (-4.8%, -11.1%) and of ST2 (-21.7%, -16.7%)were found in both HIIT groups respectively compared to the AC group. Creatine kinase elevation was shown only in high-volume HIIT (19.3%, p 0.01). Low-volume HIIT is proposed as a clinically time-efficient and safer strategy to attenuate dysfunctional remodeling by preventing wall thinning and improving LV function in post-MI patients.

Effect of Exercise on Arterial Stiffness in Healthy Young, Middle-Aged and Older Women: A Systematic Review.

Arterial stiffness, an age-dependent phenomenon, is improved with exercise, which in turn may prevent cardiovascular diseases in women. However, there is a lack of consolidated information on the impact of exercise on arterial stiffness among healthy women. The aim of this review was to (i) analyse the effect of exercise on arterial stiffness in healthy young, middle-aged, and older women, and (ii) recommend types, intensity, and frequency for each age group. Database searches on PubMed, ScienceDirect, Web of Science, and Scopus were conducted using PRISMA guidelines until September 2022. The keywords were: exercise, women/female, and arterial stiffness. The inclusion criteria were: healthy women, supervised exercise, and arterial stiffness measures. Study quality and bias were assessed using the PEDro scale. Fifty-one papers were classified into young (n = 15), middle-aged (n = 14), and older (n = 22) women. Improvements in arterial stiffness were observed among: young women (Pulse Wave Velocity, PWV: 4.9-6.6 m/s), following an 8-week high-intensity aerobic (3 days/week) or hypoxic high-intensity interval training; middle-aged women (PWV: 5.1-7.9 m/s), aerobic exercise with moderate intensity or stretching exercise at "moderate to heavy" (Borg Scale), 20-30 s per site, 10 s of rest interval for 30 min; and for older women (PWV: 7.9-15.6 m/s), resistance training at light intensity, aerobic exercise at any intensity, or a combination of the two exercises. This review shows that arterial stiffness increases with age in healthy women and has an inverse relationship with exercise intensity. Therefore, when prescribing exercise to improve arterial stiffness, age and arterial stiffness measures should be accounted for.

EXERCISE IMPROVES HEART RATE RECOVERY GREATER THAN STANDARD CARE IN TYPE 2 DIABETES

https://youtu.be/HRw1f_DoX-Q INTRODUCTION An attenuated heart rate recovery (HRR) immediately after exercise is considered an index of autonomic imbalance and is a predictor of all cause mortality in patients with type 2 diabetes (T2D). Because autonomic dysfunction in T2D patients has shown to be reversible with glycemic control, weight loss, and fitness gain, we investigated the effect of a 12 week aerobic exercise (AE) intervention compared to standard care on HRR in patients with T2D. METHODS T2D patients (n=32) were randomized to a 12-week AE intervention (n=19) or standard of care (n=13). The AE intervention consisted of supervised exercise training for 1h/day 5/wk for 12 weeks at 80% VO2peak. All subjects completed body composition analysis (DEXA), oral glucose tolerance test (OGTT), and maximal exercise testing before and after the study period. HRR was measured every minute for 10 minutes after cessation of maximal exercise testing. RESULTS Baseline HRR 1-minute values were negatively associated with ASCVD Risk (rho = 0.623; p = 0.002) and positively associated with VO2peak (rho = 0.361; p = 0.042). Body weight was unchanged in both control (p = 0.989) and AE group (p = 0.248) after the study period. Following AE training intervention, VO2peak increased by 7.4 ± 1.9% (p &amp;lt; 0.001), glucose metabolism, as measured by OGTT area under the curve (AUC), improved by 11.6 ± 6.0% (p = 0.040), and HRR 1-minute increased by 10.4 ± 6.1% (p = 0.234). The control group showed no significant changes as VO2peak increased by 0.7 ± 2.6% (p = 0.826), AUC improved by 3.1 ± 3.5% (p = 0.585), and HRR 1-minute increased 3.9 ± 9.0% (p = 0.915). Baseline HRR predicted change in HRR after the study period in the control group (rho = −0.817; p = 0.002) but not in the AE group (rho = −0.054, p = 0.860). Upon controlling for baseline HRR, AE group possessed a significantly higher post intervention HRR 1-minute value than control by 28.5% (p = 0.036). We found the AE group also had higher HRR values than control during the post-intervention 10-minute recovery resulting in a main effect of group (p &amp;lt; 0.001). CONCLUSIONS T2D patients with higher HRR, only receiving standard of care, are more susceptible to chronic detriments in HRR indicative of gradual autonomic function loss. To our knowledge these are the first data showing regular moderate-vigorous intensity exercise, which improved glycemic control and fitness gain independent of weight loss, outperforms standard of care alone for greater HRR.

Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group

ContextTranstibial Amputation (TA) predisposes to a sedentary lifestyle. ObjectivesTo evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. DesignThis was a longitudinal, prospective and controlled trial study. MethodsThirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) ‒ 17 non-athlete and untrained UTA and Group 2 (G2) ‒ 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. ResultsPatients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. ConclusionAfter eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.

Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis.

Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamper the routine application of physical activity as part of the clinical care of schizophrenia. To determine the effect of exercise on psychopathology and other clinical markers in patients with schizophrenia. We also looked at several moderators. MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, PsycINFO, and Cochrane Library databases were systematically searched from inception to October 2022. Randomized controlled trials of exercise interventions in patients 18-65years old diagnosed with schizophrenia disorder were included. A multilevel random-effects meta-analysis was conducted to pool the data. Heterogeneity at each level of the meta-analysis was estimated via Cochran's Q, I2, and R2. Pooled effect estimates from 28 included studies (1,460 patients) showed that exercise is effective to improve schizophrenia psychopathology (Hedges' g=0.28, [95% CI 0.14, 0.42]). Exercise presented stronger effects in outpatients than inpatients. We also found exercise is effective to improve muscle strength and self-reported disability. Our meta-analysis demonstrated that exercise could be an important part in the management and treatment of schizophrenia. Considering the current evidence, aerobic and high-intensity interval training exercises may provide superior benefits over other modalities. However, more studies are warranted to determine the optimal type and dose of exercise to improve clinical outcomes in people with schizophrenia.