Concurrent Exercise Training Research Articles

Circulating Extracellular Vesicle Characteristics Differ Between Men And Women Following 12-weeks Of Concurrent Exercise Training.

Circulating Extracellular Vesicle Characteristics Differ Between Men And Women Following 12-weeks Of Concurrent Exercise Training.

Feasibility and Effectiveness of a 12-Week Concurrent Exercise Training on Physical Performance, Muscular Strength, and Myokines in Frail Individuals Living in Nursing Homes: A Cluster Randomized Crossover Trial

ObjectiveTo examine the feasibility and effects of a 12-week exercise intervention on physical performance, muscular strength, and circulating myokines in frail individuals living in nursing homes. DesignA cluster randomized, 2-period, 2-intervention crossover trial. Setting and ParticipantsFrail residents of 9 nursing homes were randomly assigned to either 12 weeks of concurrent exercise training (n = 5, 29 participants) or usual care (n = 4, 17 participants). The concurrent exercise training consisted of resistance and aerobic exercises (3 days/week). The usual care consisted of everyday routine and standard care. After a 4-week washout period, participants crossed to the other intervention. MethodsThe feasibility outcomes included recruitment rate, dropout rate and reasons, harms during the trial, adherence to exercise, and implementation cost. The primary endpoint was the change in physical performance measured by the Short Physical Performance Battery (SPPB). The secondary endpoints were changes in muscular strength (eg, handgrip strength, isokinetic knee extension, and flexion strength) and serum myokines concentration (myostatin and decorin). ResultsFrom the 46 participants enrolled (aged 70–99 years, 67.4% female), 34 completed the trial (26.1% dropout rate), the median adherence was 93.75%, and no adverse events occurred during the exercise sessions. The concurrent exercise training provided significant benefits over usual care on SPPB (B = 2.18; 95% CI, 1.35–3.00; P < .001), handgrip strength (B = 2.15; 95% CI, 1.00–3.30; P < .001), myostatin concentrations (B = −7.07; 95% CI, −13.48 to −0.66; P = .031) and myostatin-decorin ratio (B = −95.54; 95% CI, −158.30 to −32.78, P = .004). No significant between-group differences were found for the remaining secondary endpoints. Conclusions and ImplicationsThis concurrent exercise training is feasible, well-tolerated, and effective in improving physical performance, handgrip strength, myostatin, and myostatin-decorin ratio concentrations in frail older adults residing in nursing homes. These data reinforce the relevance of integrating exercise interventions in long-term care settings.

Impact of Concurrent Exercise Training on Cardiac Autonomic Modulation, Metabolic Profile, Body Composition, Cardiorespiratory Fitness, and Quality of Life in Type 2 Diabetes with Cardiac Autonomic Neuropathy: A Randomized Controlled Trial.

Background: Type 2 diabetes mellitus (T2DM) often leads to cardiac autonomic neuropathy (CAN), a severe complication affecting cardiovascular health. Exercise training is a proven intervention for improving metabolic control and cardiovascular health in T2DM, but the effects of concurrent exercise training (CET), combining aerobic and resistance exercises, on CAN are not fully understood. Objective: This randomized controlled trial investigates the impact of a structured CET program on cardiac autonomic modulation, metabolic profile, body composition, cardiorespiratory fitness (CRF), and quality of life (QoL) in individuals with T2DM and CAN. Methods: A total of 96 participants, aged 35-70 years, with T2DM and CAN, were randomized into CET (n = 48) and control (n = 48) groups. The CET group engaged in combined aerobic and resistance training three times per week for 13 weeks, while the control group received standard care. Primary outcomes included heart rate variability (HRV) and heart rate recovery (HRR). Secondary outcomes were metabolic profile, body composition, CRF, and QoL, which were assessed using standardized protocols and validated questionnaires. The trial was registered with the Clinical Trials Registry-India (CTRI/2021/09/036711). Results: Significant improvements were noted in the CET group compared to controls. HRV metrics (SDNN, RMSSD, pNN50, TP, LF power, HF power, and LF/HF ratio) and HRR metrics (HRR30s, HRR1, HRR2, and HRR3) all showed significant enhancements (p < 0.01). The CET group also exhibited substantial reductions in fasting blood glucose, postprandial blood glucose, HbA1c, waist circumference, hip circumference, and percentage body fat (p < 0.01). Improvements were observed in lipid profile markers and CRF (VO2max) (p < 0.01). QoL scores improved significantly in the CET group as per the ADDQoL-19 (p < 0.01). Conclusions: CET significantly enhances cardiac autonomic modulation, metabolic profile, body composition, CRF, and QoL in individuals with T2DM and CAN. These findings support the integration of CET into standard T2DM management to improve clinical outcomes and QoL. Further research is needed to explore the long-term benefits and broader applicability of CET in diverse diabetic populations.

A three-arm randomized controlled trial of aerobic and resistance training in women with spinal cord injuries: Effects on physical fitness and pulmonary function

BackgroundThis study aimed to investigate the effects of different volumes of aerobic training (AT) and resistance training (RT) during a concurrent exercise training program on selected indicators of physical fitness and pulmonary function in women with spinal cord injury (SCI). MethodsTwenty-three inactive females with complete or incomplete SCI from T6 to L5 were divided into three groups: concurrent training with a focus on AT (CTAT; two weekly sessions of AT and one of RT), concurrent training with a focus on RT (CTRT; two weekly sessions of RT and one of AT), and control (CON). Tests were performed before and after an 8-week experimental period for indicators of pulmonary function, aerobic power, endurance performance, muscular strength and endurance, speed, and change of direction. ResultsMarkers of both aerobic and muscular fitness increased in the CTAT and CTRT groups, but not in CON. There were significant differences in aerobic power and endurance performance between the CTAT and CTRT groups, with greater changes in CTAT. Both CTAT and CTRT improved respiratory functions, with no differences between them (p > 0.05). ConclusionsCTAT and CTRT improved most of the indicators of physical fitness. However, CTAT should be used to achieve higher aerobic power and endurance without compromising muscle strength.

Circulating extracellular vesicle characteristics differ between men and women following 12 weeks of concurrent exercise training.

Concurrent resistance and endurance exercise training (CET) has well-studied benefits; however, inherent hormonal and genetic differences alter adaptive responses to exercise between sexes. Extracellular vesicles (EVs) are factors that contribute to adaptive signaling. Our purpose was to test if EV characteristics differ between men and women following CET. 18 young healthy participants underwent 12-weeks of CET. Prior to and following CET, subjects performed an acute bout of heavy resistance exercise (AHRET) consisting of 6 × 10 back squats at 75% 1RM. At rest and following AHRET, EVs were isolated from plasma and characteristics and miRNA contents were analyzed. AHRET elevated EV abundance in trained men only (+51%) and AHRET-induced changes were observed for muscle-derived EVs and microvesicles. There were considerable sex-specific effects of CET on EV miRNAs, highlighted by larger variation following the 12-week program in men compared to women at rest. Pathway analysis based on differentially expressed EV miRNAs predicted that AHRET and 12 weeks of CET in men positively regulates hypertrophy and growth pathways more so than in women. This report highlights sex-based differences in the EV response to resistance and concurrent exercise training and suggests that EVs may be important adaptive signaling factors altered by exercise training.

Concurrent exercise training potentiates the effects of angiotensin-converting enzyme inhibitor on regulatory systems of blood pressure control in ovariectomized hypertensive rats.

Enalapril has shown satisfactory potential in controlling increased and sustained blood pressure (BP). However, multiple dysregulated mechanisms that interact with each other and are involved in the pathophysiology of arterial hypertension may not be affected, contributing to the remaining cardiovascular risk. Using an exercise training protocol, we investigated whether adding both approaches to arterial hypertension management could promote higher modulation of regulatory mechanisms of BP in postmenopausal rats. Spontaneously hypertensive rats were allocated into sedentary (S) and ovariectomized groups: sedentary (OS), sedentary treated with enalapril maleate (OSE) and trained treated with enalapril maleate (OTE). Both the pharmacological and exercise training protocols lasted for 8 weeks. The BP was directly recorded. Inflammation and oxidative stress were evaluated in the cardiac tissue. Although BP reduction was similar between OSE and OTE, trained group showed lower vasopressor systems outflow after sympathetic ganglion blocking by hexamethonium (mean BP) (OTE: -53.7 ± 9.86 vs. OS: -75.7 ± 19.2 mmHg). Bradycardic and tachycardic response were increased in OTE group (-1.4 ± 0.4 and -2.6 ± 0.4 vs. OS: -0.6 ± 0.3 and -1.3 ± 0.4 bpm/mmHg, respectively), as well as BP variability. In addition, the combination of approaches induced an increase in interleukin 10, antioxidant defense (catalase and glutathione peroxidase) and nitrite levels compared with the OS group. Despite similar BP, the inclusion of exercise training in antihypertensive drug treatment exacerbates the positive adaptations induced by enalapril alone on autonomic, inflammatory and oxidative stress profiles, probably affecting end-organ damage and remaining risk.

Impact of exercise training associated with enalapril treatment on blood pressure variability and renal dysfunctions in an experimental model of arterial hypertension and postmenopause.

In this study, we aimed to investigate the effects of the concurrent exercise training (CET) associated with the enalapril maleate on blood pressure variability (BPV) and renal profile in an experimental model of arterial hypertension (AH) and postmenopause. Female ovariectomized spontaneously hypertensive rats (SHR) were distributed into 4 groups (n = 8/group): sedentary (SO), sedentary + enalapril (SOE), trained (TO) and trained + enalapril (TOE). Both enalapril (3mg/kg) and CET (3 days/week) were conducted during 8 weeks. Blood pressure (BP) was directly recorded for BPV analyses. Renal function, morphology, inflammation and oxidative stress were assessed. The SOE, TO e TOE groups presented decreased systolic BP compared with SO. Both trained groups (TO and TOE) presented lower BPV and increased baroreflex sensitivity (TO: 0.76 ± 0.20 and TOE: 1.02 ± 0.40 vs. SO: 0.40 ± 0.07 ms/mmHg) compared with SO group, with additional improvements in TOE group. Creatinine and IL-6 levels were reduced in SOE, TO and TOE compared with SO group, while IL-10 was increased only in TOE group (vs. SO). Enalapril combined with CET promote reduction in lipoperoxidation (TOE: 1.37 ± 0.26 vs. SO: 2.08 ± 0.48 and SOE: 1.84 ± 0.35 μmol/mg protein) and hydrogen peroxide (TOE: 1.89 ± 0.40 vs. SO: 3.70 ± 0.19 and SOE: 2.73 ± 0.70 μM), as well as increase in catalase activity (vs. sedentary groups). The tubulointerstitial injury was lower in interventions groups (SOE, TO and TOE vs. SO), with potentialized benefits in the trained groups. Enalapril combined with CET attenuated BPV and baroreflex dysfunctions, probably impacting on end-organ damage, as demonstrated by attenuation in the AH-induced renal inflammations, oxidative stress and morphofunctional impairments in postmenopausal rats.

Influence of Concurrent Exercise Training on Ankle Muscle Activation during Static and Proactive Postural Control on Older Adults with Sarcopenic Obesity: A Multicenter, Randomized, and Controlled Trial.

Sarcopenic obesity (SO), characterized by age-related muscle loss and excess body fat, significantly impairs postural control. However, limited research has explored the effects of concurrent exercise training on neuromuscular strategies during postural control in older adults with SO. The study enrolled 50 older adults with SO, split into an intervention group (IG, n = 25, mean age = 76.1 ± 3.5 years; mean BMI = 34.4 ± 4.0 kg/m2) and a control group (CG, n = 25, mean age = 75.9 ± 5.4 years; mean BMI = 32.9 ± 2.3 kg/m2). Participants in the IG were engaged in 60-min Total Mobility Plus Program (TMP) sessions three times a week for four months, while the CG maintained their typical daily activities. Standardized evaluations were conducted both before and after the intervention. These assessments included the Romberg and Timed Up and Go (TUG) tests, as well as the measurement of Center of Pressure (CoP) displacements parameters under various conditions. Additionally, ankle muscle activities were quantified during postural control evaluations and maximal voluntary contractions of plantar and dorsal flexors. Post-intervention results revealed a significant reduction of the standing time measured in the Romberg (-15.6%, p < 0.005) and TUG (-34.6%, p < 0.05) tests. Additionally, CoP area and velocity were notably reduced in various conditions (p < 0.05). Postural control improvements were associated with an increase of strength (p < 0.05) and decrease of ankle muscle activation (p < 0.05). These findings highlight the reversibility of neuromuscular system alterations associated with the synergistic effects of sarcopenia and obesity, emphasizing the trainability of postural control regulation within this population. By incorporating these insights into clinical practice and public health strategies, it seems possible to optimize the health and well-being of older adults with SO.

Impact of Exercise Intervention Combined with Optimal Mediterranean Diet Adherence during Pregnancy on Postpartum Body Composition: A Quasi-Experimental Study-The GESTAFIT Project.

This study aimed to investigate whether the effects of an exercise program during pregnancy on postpartum body composition are moderated by following a healthy dietary pattern (i.e., Mediterranean diet (MD)). Eighty-three pregnant women (control n = 40, exercise n = 43) were included in the present quasi-experimental study. The exercise intervention consisted of a 60 min, 3 day/week throughout pregnancy from gestational week 17, supervised concurrent (aerobic + resistance) exercise program. A food frequency questionnaire and the MD Score (min-max: 0-50) were employed to assess dietary habits and the MD adherence during pregnancy, respectively. Postpartum body composition was measured with dual-energy X-ray absorptiometry, 6 weeks postpartum. The body mass index and the gynecoid fat mass at postpartum were lower in the exercise compared to the control group (p = 0.018 and p = 0.047, respectively). There was an interaction showing that the MD adherence during pregnancy positively moderated the effects of the exercise intervention on postpartum lean mass (p = 0.024), fat mass percentage (p = 0.092), android fat mass (p = 0.076), and android-to-gynecoid fat mass (p = 0.019). The Johnson-Neyman technique revealed that the effects of exercise were enhanced at a MD score of ~31 for lean mass, ~25 for fat mass, ~23 for android fat mass and ~29 for android-to-gynecoid fat mass. Our results suggest that a concurrent-exercise training plus an optimal MD adherence during pregnancy might be a useful strategy to promote a healthier body composition at the postpartum period.

The Effects of a Short-Term Combined Exercise Program on Liver Steatosis Indices and the Lipidemic and Glycemic Profile in NAFLD Individuals: A Pilot Study.

Non-alcoholic fatty liver disease (NAFLD) is a very common liver disease associated with obesity, unhealthy diet, and lack of physical exercise. Short-term aerobic or resistance exercise has been shown to result in reduced liver fat in patients with NAFLD; however, the impact of the combination of these types of exercise has received less attention. This study investigated the effect of a short-term (7 days) concurrent exercise training program performed daily on liver steatosis indices, as well as the glycemic and lipidemic profile of overweight/obese sedentary volunteers. Twenty adult patients (age: 47.3 ± 12.3 yrs, body mass index: 32.4 ± 3.4 kg/m2) with NAFLD, detected by ultrasound and hematological indices, participated in the study. Pre- and post-exercise intervention assessment included body weight (BW), waist circumference (WC), hip/waist ratio (H/W), Homeostasis Model Assessment Insulin Resistance (HOMA-IR), blood lipids, and steatosis indices. Fatty Liver Index, Lipid Accumulation Index, WC, H/W, triglycerides, and total cholesterol were improved (p < 0.05) post-exercise, while no differences (p > 0.05) were observed in BW, HOMA-IR, HDL, LDL, Hepatic Steatosis Index, and Framingham Steatosis Index compared to pre-exercise values. It is concluded that a 7-day combined exercise program can have beneficial effects on hepatic steatosis and central adiposity indices, independently of weight loss, in patients with NAFLD.

Feasibility of delivering supervised exercise training following surgical resection and during adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PRECISE): a case series

IntroductionPancreatic ductal adenocarcinoma (PDAC) is an aggressive neoplasm, with surgical resection and adjuvant chemotherapy the only curative treatment. Treatment-related toxicities place a considerable burden on patients although exercise training has shown promise is helping to manage such adversities and facilitate rehabilitation. The feasibility and safety of exercise training as a supportive therapy during adjuvant chemotherapy remains unknown.MethodsPatients with PDAC were screened post-surgical resection and enrolled in a 16-week, progressive, concurrent exercise programme alongside their chemotherapy regimen. Feasibility was the primary objective detailing recruitment, retention and adherence rates throughout as well as the safety and fidelity of the intervention. Secondarily, the impact on functional fitness and patient-reported outcomes was captured at baseline, post-intervention and 3-month follow up.ResultsEight patients consented to participate in this trial, with five proceeding to enrol in exercise training. Concurrent exercise training is feasible and safe during adjuvant chemotherapy and prevented an expected decline in functional fitness and patient-reported outcomes during this time.DiscussionThis case series provides preliminary evidence that concurrent exercise training during adjuvant therapy is safe, feasible and well tolerated, preventing an expected decline in functional fitness, muscular strength and health-related quality of life (HRQoL). Given the adverse effects of treatment, these findings are promising and provide further evidence for the inclusion of exercise training as a standard of care for surgical rehabilitation and managing treatment-related toxicities. Future research should explore the impact of exercise training during neoadjuvant chemotherapy, with prehabilitation now standard practice for borderline resectable disease.Trial registrationClinicalTrials.gov Identifier: NCT04305067, prospectively registered 12/03/2020, https://classic.clinicaltrials.gov/ct2/show/NCT04305067.

O.1.1-7 As we were and as we should be, concurrent exercise training in adults with schizophrenia: CORTEX-SP study

Abstract Purpose People with schizophrenia (SP) in addition to presenting an unhealthy lifestyle, psychosocial determinants, such as decreased self-esteem and social stigma, and the presence of psychiatric symptoms, have a profound impact on the health-related quality of life (HRQoL). Thus, people with SP have reported greater disability than those healthy control (HC) in HRQoL, assessed by the 36-Item Short-Form Health Survey questionnaire (SF-36). Therefore, the promotion of a healthy lifestyle and interventions aiming to increase physical activity (i.e., aerobic and resistance training) should be a priority given the health benefits. It is well known that regular physical activity improves HRQoL contributing to perceived well-being, with greater improvements in interventions supervised by exercise specialists. Methods This research was carried out to analyze the HRQoL measurements in an SP population (n = 112, 20.4% women, 41.3±10.4 yr old) in comparison to an HC sample (n = 30), and to determine in the SP sample the changes in QoL following 20-week supervised concurrent exercise training program (EX) compared to a Treatment-As-Usual (TAU). The SF-36 questionnaire was used to assess HRQoL. Results At baseline, the SP population showed lower scores (P &amp;lt; 0.05) in physical function, role-physical, bodily pain, general health, vitality, social functioning, mental health, and physical and mental component summaries compared to HC. After 20-week intervention, physical functioning (↑12.9%), general health (↑15.3%), mental health (↑8.3%), and physical component summary (↑5.1%), increased (P &amp;lt; 0.05) in EX group. In contrast, no significant changes were seen in the TAU for any of the domains studied. Following the Bonferroni correction, there were between-group significant differences. Thus, the EX group showed significant (P &amp;lt; 0.05) improvements (i.e., higher values) compared with the TAU group in physical functioning (difference = 14.3; 95% CI, 5.8-22.8), general health (difference = 11.7; 95% CI, 5.0-18.5) and physical component summary (difference = 4.6; 95% CI, 1.1-8.2), and no significant between-group differences were found in any other domains. Conclusions These results highlight the important role of supervised exercise in improving physical and psychological health.

O.1.1-8 Impact on health-related quality of life after a concurrent exercise program in adults with treatment resistant depression: TRACE-RMD study

Abstract Purpose Treatment-resistant depression (TRD) is defined as those who do not remit to major depressive disorder with pharmacological treatment. TRD is associated with a worse health-related quality of life (QoL). Thus, people with TRD have reported greater disability than those healthy control (HC) in QoL, assessed by the 36-Item Short-Form Health Survey questionnaire (SF-36). Concurrent exercise training (i.e., a combination of aerobic and resistance exercise in the same session) could be an efficient non-pharmacological treatment strategy for improving QoL. Exercise is recommended as a non-pharmacological adjuvant program for patients with TRD. Therefore, this study aimed to determine the effectiveness of a concurrent exercise program on QoL in a TRD population. Methods Participants (n = 15, 73.3% women, 57.7±13.7 yr old) with TRD carried out a concurrent exercise program (2 days/week and 12 weeks of intervention). The SF-36 questionnaire was used to assess health-related QoL. At baseline, the TRD population showed lower scores (P ≤ 0.001) in physical function, role-physical, bodily pain, general health, vitality, social functioning, emotional role, mental health, and physical and mental component summaries compared to HC. Results After 12-week of intervention, general health (↑50.5%), vitality (↑41.2%), social functioning (↑76.4%), and mental component summary (↑24.9%) were increased (P &amp;lt; 0.05). However, there was not a significant (P &amp;gt; 0.05) change increase in physical functioning, role physical, bodily pain, emotional role, mental health, and physical component summary. Conclusion In conclusion, beneficial effects on QoL variables in patients with TRD after concurrent exercise should lead to considering exercise as an adjuvant program in their treatment.

Effect of acute concurrent exercise training and the mediating role of lactate on executive function: An ERP study

Both acute aerobic (AE) and resistance exercise (RE) have been acknowledged to be effective methods in enhancing executive function and brain-related P3 amplitudes. Nevertheless, the effect of acute concurrent exercise training (CET), combining both AE and RE, on executive function remains subject to speculation. Moreover, investigation of the mechanisms that underlie improvements in executive function would facilitate scientific understanding. Notably, lactate has emerged as a candidate among several potential mechanisms. Therefore, the main aim of the present study was to investigate the effect of acute CET on the cognitive flexibility dimension of executive function using behavioural and neuro-electric measures. A secondary aim was to determine the mediating effect of blood lactate in the acute exercise–executive function relationship. Seventy-eight young adults (38 women, 40 men; 22.8 ± 1.8 years) were randomly assigned to one of the following groups: CET, AE, or reading control (RC). Cognitive flexibility was evaluated using the Task-Switching Test and its derived electroencephalography (EEG) was assessed immediately prior to and following each treatment. Fingertip lactate assays were taken prior to, at the midpoint, and after each treatment. Both acute CET and AE shortened response time regardless of test conditions when compared to the RC group. Greater P3 amplitude was observed following CET in the heterogeneous condition and under AE in the switch condition. A significant mediation of blood lactate for response time emerged in both the CET and AE groups for the heterogeneous and switch conditions. The blood lactate mediation was not reflected in P3 amplitude. The present findings suggest that acute CET leads to positive behavioural and neuro-electric alterations of cognitive flexibility, and its effect is similar to AE. Additionally, blood lactate serves as a mediator of the effects of acute exercise on executive function from a behavioural, but not neuro-electric standpoint.

Mitochondrial Dysfunction and Sarcopenic Obesity: The Role of Exercise.

Sarcopenic obesity (SO) constitutes the coexistence of skeletal muscle mass loss (sarcopenia) and excess adiposity (obesity). It is mainly considered as a condition in the elderly with health-threatening impacts ranging from frailty to mortality. Mitochondrial dysfunction consists one of the basic pathophysiological mechanisms leading to the development of SO and its consequences. Indirect indicators of mitochondrial function, such as VO2max and exercise capacity, have been demonstrated to be negatively affected in individuals with SO, while the positive effect of exercise on mitochondrial function has been widely proved; thus, in this review, we aimed at investigating the effects of endurance, resistance, and concurrent exercise training on indexes of mitochondrial dysfunction in SO patients. The results of the clinical trials evaluated reveal positive effects of chronic exercise on VO2max and physical capacity, as well as mitochondrial biogenesis and activity. It has been concluded that utilizing a systematic exercise training program that includes both aerobic and strength exercises can be an effective strategy for managing SO and promoting overall health in these patients.

Concurrent exercise training induces additional benefits to hydrochlorothiazide: Evidence for an improvement of autonomic control and oxidative stress in a model of hypertension and postmenopause.

This study aimed to evaluate whether exercise training could contribute to a better modulation of the neurohumoral mechanisms linked to the pathophysiology of arterial hypertension (AH) in postmenopausal hypertensive rats treated with hydrochlorothiazide (HCTZ). Female spontaneously hypertensive rats (SHR) (150-200g, 90 days old) were distributed into 5 hypertensive groups (n = 7-8 rats/group): control (C), ovariectomized (O), ovariectomized treated with HCTZ (OH), ovariectomized submitted to exercise training (OT) and ovariectomized submitted to exercise training and treated with HCTZ (OTH). Ovarian hormone deprivation was performed through bilateral ovariectomy. HCTZ (30mg/kg/day) and concurrent exercise training (3d/wk) were conducted lasted 8 weeks. Arterial pressure (AP) was directly recorded. Cardiac effort was evaluated using the rate-pressure product (RPP = systolic AP x heart rate). Vasopressin V1 receptor antagonist, losartan and hexamethonium were sequentially injected to evaluate the vasopressor systems. Inflammation and oxidative stress were evaluated in cardiac tissue. In addition to the reduction in AP, trained groups improved RPP, AP variability, bradycardic (OT: -1.3 ± 0.4 and OTH: -1.6 ± 0.3 vs. O: -0.6 ± 0.3 bpm/mmHg) and tachycardic responses of baroreflex sensitivity (OT: -2.4 ± 0.8 and OTH: -2.4 ± 0.8 vs. O: -1.3 ± 0.5 bpm/mmHg), NADPH oxidase and IL-10/TNF-α ratio. Hexamethonium injection revealed reduced sympathetic contribution on basal AP in OTH group (OTH: -49.8 ± 12.4 vs. O: -74.6 ± 18.1 mmHg). Furthermore, cardiac sympathovagal balance (LF/HF ratio), IL-10 and antioxidant enzymes were enhanced in OTH group. AP variability and baroreflex sensitivity were correlated with systolic AP, RPP, LF/HF ratio and inflammatory and oxidative stress parameters. The combination of HCTZ plus concurrent exercise training induced additional positive adaptations in cardiovascular autonomic control, inflammation and redox balance in ovariectomized SHR. Therefore, combining exercise and medication may represent a promising strategy for managing classic and remaining cardiovascular risks in AH.

Cardiac Effects of Long-Duration Space Flight

BackgroundVentricular mass responds to changes in physical activity and loading, with cardiac hypertrophy after exercise training, and cardiac atrophy after sustained inactivity. Ventricular wall stress (ie, loading) decreases during microgravity. Cardiac atrophy does not plateau during 12 weeks of simulated microgravity but is mitigated by concurrent exercise training. ObjectivesThe goal of this study was to determine whether the current exercise countermeasures on the International Space Station (ISS) offset cardiac atrophy during prolonged space flight. MethodsWe measured left ventricular (LV) and right ventricular (RV) mass and volumes (via magnetic resonance imaging) in 13 astronauts (4 females; age 49 ± 4 years), between 75 and 60 days before and 3 days after 155 ± 31 days aboard the ISS. Furthermore, we assessed total cardiac work between 21 and 7 days before space flight and 15 days before the end of the mission. Data were compared via paired-samples t-tests. ResultsTotal cardiac work was lower during space flight (P = 0.008); however, we observed no meaningful difference in LV mass postflight (pre: 115 ± 30 g vs post: 118 ± 29 g; P = 0.053), with marginally higher LV stroke volume (P = 0.074) and ejection fraction postflight (P = 0.075). RV mass (P = 0.999), RV ejection fraction (P = 0.147), and ventricular end-diastolic (P = 0.934) and end-systolic volumes (P = 0.145) were not different postflight. There were strong positive correlations between the relative change in LV mass with the relative changes in total cardiac output (r = 0.73; P = 0.015) and total cardiac work (r = 0.53; P = 0.112). ConclusionsThe current exercise countermeasures used on the ISS appear effective in offsetting reductions in cardiac mass and volume, despite overall reductions in total cardiac work, during prolonged space flight.

Influence of a Concurrent Exercise Training Program on Health-Related Quality of Life During Advanced Pregnancy: The GESTAFIT Project.

Health-related quality of life (HRQoL) may be altered during pregnancy due to pregnancy-related changes in all domains of women's health. A supervised concurrent exercise-training program from the 17th gestational week until birth positively influences HRQoL. Randomized controlled trial. Level 1. Eighty-six pregnant women (age, 33.1 ± 4.6 years; prepregnancy body mass index, 23.5 kg/m2), divided into exercise (n = 41) and control (n = 45) groups, participated in this study (per-protocol basis). The exercise group followed a 60-min, 3 days/week, concurrent (aerobic + resistance) exercise training program. HRQoL was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores (0-100) indicate better HRQoL. After adjusting for potential confounders, the exercise group decreased 16.1 points less than the control group in the SF-36 physical functioning domain [between-group differences (B): 95% confidence interval (CI), 9.02 to 23.22; P < 0.01], and 4.5 points less in the SF-36 physical component summary than the control group (between-group differences (B): 95% CI, 0.65 to 8.28; P = 0.02). Intention-to-treat basis analyses depicted similar results, where the exercise group decreased 10.03 points less than the control group the in the SF-36 social functioning domain (between-group differences (B): 95% CI, 0.39 to 19.68; P = 0.04). A supervised concurrent exercise training program ameliorates HRQoL decreases along gestation. Although HRQoL decreased throughout pregnancy in both groups, this impact was less in the exercise group, especially in the SF-36 physical functioning, the SF-36 social functioning, and the SF-36 physical component summary. Healthcare providers may encourage pregnant women to exercise in this physiological stage for a better HRQoL throughout pregnancy. NCT02582567; Date of registration: 20/10/2015.

Influence of a concurrent exercise training program during pregnancy on the placenta mitochondrial DNA integrity and content of minerals with enzymatic relevance. The GESTAFIT project

IntroductionWe aimed i) to investigate the effects of a concurrent (aerobic plus strength) exercise intervention during pregnancy on placental mtDNA copy number, proportion of deleted mtDNA, and on the content of some trace and ultra-trace minerals with coenzymatic relevance; ii) to explore the association of such mitochondrial markers with the concentration of these minerals. MethodsFor the present study specific aims, 47 placentas were randomly selected from women that participated in the GESTAFIT project into exercise (n = 24) or control (n = 23) groups. The exercise group followed a concurrent aerobic and strength training program, three 60-min sessions/week, from the 17th gestational week until birth. Placenta tissue was collected and processed for minerals determination by the inductively coupled plasma mass spectrometry technique. RT-PCR was used to determine placentas mtDNA copy number and ND1/ND4 deletion. ResultsAfter adjusting for potential confounders, the mothers who participated in the exercise program had placentas with greater mtDNA copy number (p = 0.04) and lower mtDNA deletion (p = 0.003). Placentas from mothers in the exercise group presented higher manganese content than those from the controls (0.26 ± 0.03 mg/dL vs. 0.13 ± 0.03 mg/dL, p = 0.003). Placenta manganese content was significantly associated with lower mtDNA deletions (r = −0.382) and greater mtDNA copy number (r = 0.513). Iron content was associated with higher mtDNA copy number (r = 0.393). Selenium content was associated with lower mtDNA deletion (r = −0.377) and greater mtDNA copy number (r = 0.442). Finally, zinc and magnesium content were associated with higher mtDNA copy number (r = 0.447 and r = 0.453, respectively). DiscussionThis concurrent exercise training program induced a better placental status, which might be mediated through an improvement of mitochondrial bioenergetics and antioxidative capacity.

Effects of concurrent exercise training on blood pressure variability and values are blunted in subjects with non-dipping blood pressure nocturnal pattern

Abstract Funding Acknowledgements Type of funding sources: None. The purpose of this study was to investigate the effects of 12-weeks concurrent aerobic plus resistance exercise training (CT) on short –term blood pressure variability (BPV) and BP values in hypertensive patients with non-dippper BP nocturnal pattern and underlying coronary artery disease. The study included 72 consecutive patients who were divided into two groups according to the nocturnal BP pattern: dipping pattern (33 pts) and non-dipping (39 pts). Before starting CT and at 12 weeks patients underwent six minute walk test, ergometric test, assessment of 1-repetiton mximun (1RM), and 24/h BP monitoring (24-h ABPM). After CT exercise capacity increased in both groups in a similar fashion. Twenty-four/h systolic BPV and daytime systolic BPV decreased significantly in the dipping group while they were unchanged in the nondipping group (between groups changes: -1.0 mmHg and -1.3 mmHg; p 0.02 and p 0.006 respectively). Twenty-four/h systolic BP and daytime systolic BP decreased significantly in the dipping group while were unchanged in the non-dipping group (between groups changes: -7.1 mmHg and -7.8 mmHg; p 0.004 and p 0.0002 respectively). Nighttime systolic BP and BPV was unchanged in both groups. Twenty-four/h diastolic BP presented small not significant changes in both groups. In conclusion: the effects of CT on BPV and BP were blunted in hypertensive subjects with non.dipping BP pattern