Reliability of the first ventilatory threshold assessment in people with neuromuscular diseases: Impact on exercise prescription and evaluation.

Comparison of cardiorespiratory responses between the incremental step test and the cardiopulmonary exercise test in people with chronic obstructive pulmonary disease.

Robust empirical evidence supports the effectiveness of physical and cognitive training in preventing and delaying cognitive decline. Emerging research suggests distinct neurobiological mechanisms underpin the effects of these different training modalities. An unresolved question is whether the mechanisms through which these training modalitiesimpart their effect interact synergistically to improve cognitive outcomes, rather than exerting additive effects, differ. In addition, past research has been inconsistent in adequately controlling for or documenting the dosage of physical and/or cognitive training. Consequently, the aim of this study is to assess the relative effectiveness of physical and cognitive training conducted in isolation or concurrently, whilst rigorously controlling and documenting the treatment parameters. This study is a three-arm randomised controlled trial conducted over a 3-month period, comparing cognitive training, physical activity, and a combination of both interventions. Older cognitively healthy participants (n = 126) aged 60-75years will be recruited from the community. The physical only training will require participants to cycle on a cycle ergometer at above 60% of their age-predicted heart rate maximum for 50min with a 3-min warm-up and cool-down period. The cognitive only training will require participants to complete up to five different cognitive tasks selected from a set of eight on the BrainHQ platform during each 50-min training session. The concurrent cognitive and physical training will require participants to undertake both treatments at the same time. Primary outcomes, assessed pre- and post- intervention, will include speed of processing and episodic memory assessed with the NIH Toolbox, as well as general driving skills assessed on a driving simulator. Findings will inform the design of interventions and population health advice aimed at mitigating cognitive decline. If a substantial synergetic effect is detected, it may lead to the use of more widespread concurrent physical and cognitive training and the potential development of methods to make concurrent training practical. Findings will also provide important clarification as to the relative benefit of the two modes of training. Prospective registration with Australia and New Zealand Clinical Trial Registry (ACTRN12624001088538) on 10th September 2024 and World Health Organisation International Clinical Trials Registry (U1111-1280-3851).

Background: The purpose of this study was to examine the effects of acute dietary nitrate (NO3−) and caffeine (CAF) supplementation on end power (EP) and work performed above EP (WEP) in trained male cyclists during a 3 min all-out test (3MT) on a cycle ergometer. Methods: Fifteen healthy, trained male cyclists (28.5 ± 5.3 years, 79.2 ± 9.1 kg, VO2peak 55.2 ± 5.6 mL·kg−1·min−1) completed four exercise trials in a randomized, double-blind, placebo-controlled, crossover study design separated by 3–7 days. The four experimental conditions were placebo beverage (nitrate-depleted) + placebo capsule, nitrate-rich beetroot juice + placebo capsule (BR), placebo beverage + caffeine capsule (CAF), and nitrate-rich beetroot juice + caffeine capsule (BR + CAF). Participants consumed nitrate-rich beetroot juice (~13 mmol NO3−) or nitrate-depleted placebo three hours before exercise, and caffeine (5 mg∙kg−1) or maltodextrin placebo one hour before testing. EP and WEP were determined from the 3MT. Secondary outcomes included peak and mean power output. Data were analyzed using a repeated-measures ANOVA with repeated measures on condition. A p-value of 0.05 was used to determine statistical significance. Effect size was evaluated using partial eta squared. Results: No significant effect of condition was observed for EP (p = 0.401, ηp2 = 0.056), WEP (p = 0.580, ηp2 = 0.048), peak power (p = 0.642, ηp2 = 0.046), mean power (p = 0.212, ηp2 = 0.108), or total work (p = 0.217, ηp2 = 0.107). Conclusions: No statistically significant differences between conditions were detected under the conditions of the present study.

Continuous glucose monitoring (CGM) systems have become important technologies to improve glycaemia in people with type 1 diabetes (T1D). However, it has been shown that during rapid glucose change, sensor performance can deteriorate. Comparative data on sensor performance during high rates of glucose change, such as during exercise, between a real-time continuous glucose monitor (rtCGM) and an intermittently scanned continuous monitor (isCGM) remain limited. Twenty-two people with T1D (8 women, age 42 ± 11 years, HbA1c 59 ± 8 mmol/mol (7.6 ± 0.8%)) simultaneously used an rtCGM (Dexcom G6) and an isCGM (Freestyle Libre 1). Sixty-minute exercise sessions were performed on a cycle ergometer at moderate intensity, and glucose values from both CGM systems were compared against capillary reference blood glucose measurements (EKF S-Line; EKF Diagnostics, Germany). Data were assessed using the Median Absolute Relative Difference (MedARD) with interquartile range, as well as the Diabetes Technology Society Error Grid (DTS EG). During exercise, the MedARD was 14.6% [7.0;23.8] for rtCGM (2304 comparison points) vs. 11.6% [5.6;19.6] for isCGM (2266 comparison points) (p < 0.0001). When stratified by glycaemic range, the MedARD was 39.2% [31.8;46.8] vs. 27.0% [17.0;34.6] for time below range (<70 mg/dL) (p = 0.0001), 16.1% [8.1;24.8] vs. 12.8% [6.4;20.4] for time in range (70-180 mg/dL) (p < 0.0001) and 9.5% [4.7;16.0] vs. 8.0% [3.8;13.7] for time above range (>180 mg/dL) (p = 0.0064) for rtCGM vs. isCGM. In this head-to-head comparison of rtCGM and isCGM, isCGM demonstrated superior performance during exercise in adults with T1D.

This study aimed to clarify the effects of the following cooling garments on performance during and after vigorous, heart-rate-clamped exercise under hot and humid conditions: base layers made of cross-shaped fibers (C), sugar alcohol-printed base layers (S), and a combination of S with a fan-attached jacket (S+F). Fifteen healthy male participants wore the cooling garments and rested for 20 min in a room set to ~30°C and ~60% relative humidity. The participants then completed a 20-min cycle ergometer exercise with heart rate clamped at 65% of heart rate reserve and rated their perceived exertion (RPE). Before and after exercise, we assessed thermal, comfort, and wetness sensations and measured body temperature, vertical jump height, ground reaction force during rising from the chair, visual reaction time, and the Stroop interference. Cooler sensations were consistently reported in the order of S+F, S, and C. Despite the lowest RPE, pedaling load was highest in S+F. Sweat loss was comparable among the conditions, while garment sweat absorption and post-exercise skin temperature were lowest in S+F. These results suggest that S+F improves endurance performance under hot and humid conditions through efficient evaporative heat loss mainly facilitated by increased airflow from the fans.

Background: In patients with left ventricular hypertrophy, resting structural parameters alone may not explain exertional symptoms. Hence, we investigate whether combined Cardiopulmonary Exercise Testing- Exercise Stress Echocardiography (CPET-ESE) can provide an integrated functional characterisation of hypertrophic phenotypes. Methods: As a preliminary investigation, this prospective single-centre pilot study enrols 43 patients, categorised into: obstructive hypertrophic cardiomyopathy (n = 19), transthyretin cardiac amyloidosis (n = 15), or preserved-ejection-fraction hypertrophic phenotypes (n = 9). Patients undergo symptom-limited semi-supine CPET-ESE on an electronically braked cycle ergometer with an individualised ramp protocol. Peak effort is defined by symptom limitation and respiratory exchange ratio criteria (), while peak VO2 is defined as the highest 30 s averaged value. Results: Exercise responses differ across phenotypes. Patients with obstructive hypertrophic cardiomyopathy have higher peak VO2 than the other groups, despite their lower chronotropic reserve. The preserved-ejection-fraction hypertrophic group shows lower peripheral oxygen extraction, whereas transthyretin amyloidosis shows a mixed central and peripheral limitation pattern. Right ventricle–pulmonary artery uncoupling is observed in the latter two groups. Conclusions: The use of CPET-ESE may help describe distinct physiological exercise profiles in hypertrophic phenotypes, but these findings should be considered exploratory. The small, heterogeneous and single-centre cohort precludes definitive mechanistic or predictive conclusions and supports the need for larger validation studies.

Performance and metabolism are reported to relate more closely to the ventilatory threshold (Tvent) than to peak oxygen uptake (VO 2 peak). Normalizing exercise to a percentage of VO 2 peak at Tvent may help better interpret DNA damage and facilitate comparisons between sexes. Accordingly, the purpose of this study was to examine the effects of a 2-hour moderate-intensity endurance exercise on systemic DNA damage and repair, focusing on sex-based differences in moderately trained men and women with equivalent anaerobic thresholds. It was hypothesized that higher fitness levels would enhance DNA repair, reducing DNA damage, with similar sex-specific responses. Moderately active male and female volunteers were recruited, with 22 of them (12 men [M: age: 20.0±1.3 years], 10 women [W: age: 20.9±0.3 years]) exhibiting comparable anaerobic threshold levels, normalized to a percentage of VO 2 peak at ventilatory threshold (M: 57.7±9.7, F: 52.6±11.7), subsequently selected for the study. All volunteers carried out an incremental exercise test to volitional exhaustion to evaluate cardiorespiratory indices (ventilatory threshold [VO 2 at Tvent], respiratory compensation point [VO 2 at RCP], and VO 2 peak; all expressed in ml/kg fat-free mass/min) on an electromagnetically braked cycle ergometer. In all 22 individuals, 2-hour urinary samples were taken at three time points: before (-2–0 h), immediately after (0–2 h), and 24–26 h after 2 hours of submaximal cycling exercise at 60%VO 2 peak, followed by the quantification of urinary 8-hydroxy-2’-deoxyguanosine (8-OHdG, a potential marker of whole-body DNA oxidation [DNA damage/repair balance]) using high-performance liquid chromatography with electrochemical detection. The female participants performed the submaximal exercise protocol during the early follicular phase of their menstrual cycle (5 to 9 days following the onset of menstruation) to control for hormonal influences on exercise-induced metabolic responses. Percent changes in urinary 8-OHdG were calculated using values before (-2–0 h) and 24–26 h after exercise. Pearson’s correlation coefficients were calculated separately for men and women to examine the relationships of the percent change in urinary 8-OHdG concentration (pre vs 24–26 h post-exercise) with each of VO 2 at Tvent, VO 2 at RCP, and VO 2 peak. Fisher’s Z-transformation was applied to normalize the correlation coefficients. A Z-test was then used to compare the Z-scores between sexes. Correlation analysis demonstrated no significant associations of the percent change in urinary 8-OHdG concentration with VO 2 at Tvent (M: r=0.292, p=0.357; W: r=-0.452, p=0.190), VO 2 at RCP (M: r=0.301, p=0.342; W: r=0.102, p=0.779), or VO 2 peak (M: r=0.429, p=0.164; W: r=-0.001, p=0.997). Additionally, Fisher’s Z-transformation followed by a Z-test also revealed no significant sex-specific differences in these variables between men and women with matched anaerobic thresholds. The present study indicates that moderately prolonged exercise does not induce detectable DNA damage in moderately active men and women, likely due to enhanced antioxidant defense mechanisms. Moreover, men and women with similar anaerobic threshold levels appear to exhibit similar whole-body DNA oxidation responses, although this marker was not significantly associated with cardiorespiratory indices. This work was supported by Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (Grant No. 23500867 and 25K14756). This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

While heart rate variability (HRV) offers a non-invasive alternative for ventilatory thresholds (VTs) estimation, its conventional linear parameters (e.g., RMSSD) exhibit a "floor effect" limiting utility. DFAα1 is a promising non-linear HRV parameter, reflecting the complex pattern of autonomic regulation. This study evaluated DFAα1 for threshold estimation, intensity monitoring, and recovery assessment. 27 healthy adults underwent an incremental cycle ergometer test. VTs were determined via standard criteria, while HRV thresholds (HRVTs) were determined using multiple parameters. A subset (n = 19) then performed low to severe intensity exercise tests (E1-E4) to validate HRV sensitivity and dynamic responses. For HRVT1 vs. VT1: DFAα1-derived HRVT1 exhibited the highest ICC (> 0.60) among all parameters but with a systematic bias; for HRVT2 vs. VT2: DFAα1-derived HRVT2 exhibited moderate-to-high ICC (> 0.60) and RMSSD-derived achieved the highest ICC (0.88-0.95). During E1-E4, DFAα1 and the natural log of RMSSD (LnRMSSD) both decreased during exercise and increased during recovery. During exercise, DFAα1 in E1 and E2 exceeded in E3 and E4, while LnRMSSD was higher in E1 than in E2-E4 (all P < 0.05). During recovery in E2-E4, DFAα1 exceeded baseline, and this rebound was delayed with intensity, while LnRMSSD was lower than baseline with a downward trend. DFAα1 showed potential for estimating both VTs, retained sensitivity across intensity domains, and showed recovery dynamics proportional to prior intensity. Despite individual variability suggesting use for broad zoning rather than precise estimation, DFAα1 serves as an intensity-sensitive biomarker for individualized exercise prescription.

Prolonged sitting disrupts lower-limb endothelial and microvascular function, likely via reduced shear stress and blunted microvascular reactivity. We examined whether Tabata-style high-intensity interval training (HIIT) mitigates this sitting-induced vascular dysfunction. Twenty-two healthy young adults (age 20.3±0.8 years) were randomly assigned to a control group (n=11) or a training group (n=11); each group comprised seven men and four women. Participants completed 8weeks of HIIT (4 sessions/week) using a cycle ergometer and bodyweight exercises. Before and after the intervention, participants underwent a 3h period of sitting during which popliteal artery flow-mediated dilation (FMD) and reactive hyperaemic blood flow were assessed; plasma nitrate/nitrite and endothelin-1 were also measured at rest. Sitting reduced popliteal artery blood flow and shear rate in both groups before and after training (P<0.05). Popliteal artery FMD decreased after sitting at baseline in both groups and remained lower after sitting in the training group post-intervention. However, post-sitting FMD at week 8 was higher in the HIIT group than in controls after adjustment for pre-sitting FMD. Post-sitting blood-flow area under the curve was decreased by sitting in both groups before and after the intervention (P<0.05), and resting nitrate/nitrite and endothelin-1 did not change with training. These results indicate that 8weeks of HIIT does not prevent sitting-induced impairments in endothelial function or microvascular function. Although the HIIT maintained higher post-sitting FMD, HIIT alone was insufficient to counteract the acute endothelial and microvascular dysfunction imposed by sitting.

Purpose Maximal oxygen uptake (VO2max) is a strong, independent predictor of both all-cause and disease-specific mortality, making it a key health and performance marker for individuals with heart disease. While cardiopulmonary exercise testing is the gold standard for determining VO2max, its use in primary healthcare settings remains underexplored. This study aims to evaluate standard criteria for assessing VO2max in individuals enrolled in cardiac rehabilitation. Methods A cross-sectional study was conducted in a primary healthcare setting. Participants who referred to exercise-based cardiac rehabilitation underwent a cycle ergometer exercise test to determine VO2max. The primary validation criterion was the presence of a VO2 plateau, defined by cut-offs of ≤50 and ≤100 mL O2/min. Secondary criteria included respiratory exchange ratio, rate of perceived exertion, and maximal heart rate. Results Among 93 participants, 88% reached a VO2 plateau using the ≤100 mL cut-off. Additionally, 61% met at least two secondary criteria, indicating maximal effort. Conclusion In primary healthcare cardiac rehabilitation, a cut-off of ≤100 mL may be suitable for identifying a VO2 plateau. For those not reaching a plateau, maximal effort can be assessed using RER ≥1.15 and RPE ≥17 as criteria.

Type 1 diabetes (T1D) is associated with an increased risk of cardiovascular and autonomic complications. Although cardiopulmonary exercise testing (CPET) is a valuable tool for assessing cardiorespiratory function, data on physiological response to maximal exertion in adolescents with T1D remain limited and inconsistent. This study aimed to compare cardiovascular, respiratory, metabolic, and microvascular responses to CPET in adolescents with T1D and healthy peers. Sixteen participants aged 11-16 years (eight with T1D and eight healthy controls), matched for anthropometric characteristics, underwent CPET on a cycle ergometer. Respiratory gas exchange, heart rate, heart rate variability, blood pressure, blood glucose, lactate concentration, skin blood flow, skin temperature, and cutaneous vascular conductance were measured at predefined time points during rest, exercise, and recovery. Blood glucose, lactate concentration, and skin microvascular variables were assessed at rest and during recovery. Adolescents with T1D demonstrated a significantly lower V̇O2/power output slope and a higher ventilatory equivalent for oxygen at maximal effort, suggesting altered oxygen uptake efficiency. Maximal power output and maximal oxygen consumption did not differ between groups. Heart rate responses and heart rate variability were similar throughout testing. However, finger skin blood flow and cutaneous vascular conductance were significantly lower in the T1D group at rest and during recovery. Adolescents with T1D showed preserved cardiovascular function and comparable overall exercise capacity to healthy peers, despite subtle impairments in oxygen utilization and reduced skin microvascular function. These findings indicate that even at a young age, T1D is associated with altered metabolic, respiratory, and microvascular responses to maximal exercise. The results suggest that peripheral, rather than central mechanisms may underlie these differences, potentially involving glucose levels or synthetic insulin effects on vascular endothelium.

The aim of this study was to establish sex- and age-specific reference values for ramp cycle-ergometer and treadmill cardiopulmonary exercise testing (CPET) in patients with Tetralogy of Fallot (ToF). Despite successful surgical repair, residual pulmonary regurgitation remains common in repaired ToF (rToF), often leading to right or left ventricular dysfunction and reduced exercise capacity. CPET is a reliable tool for evaluating cardiopulmonary function. Although both treadmill and cycle ergometer protocols are used interchangeably, reference value ranges for each method in this population remain unclear. CPET data were collected from asymptomatic rToF patients who had undergone cardiac magnetic resonance imaging (CMR) and performed CPET on a treadmill or cycle ergometer between 2020 and 2024. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Among 290 patients, median age at CPET was 21.6 years (15.9-29.3), and median BMI was 22.5 kg/m2 (20.0-24.9). Nearly all participants (99%) were in NYHA class I. Physical activity was classified as sedentary in 29%, moderate in 61%, and high in 9%. Median VO₂ peak was 26.4 mL/min/kg (23.0-31.5), corresponding to 72.9% predicted (62.4-83.2). Median oxygen pulse at peak was 9.9 mL/beat (8.2-12.0), with 76.9% predicted (68.0-87.5). Median VE/VCO₂ slope at the respiratory compensation point was 29.0 (26.0-32.6), and median oxygen uptake efficiency slope (OUES) was 1,792.5 mL/min/log(L/min) (1,535.0-2,181.5). VO₂ peak and percent-predicted VO₂ were significantly higher with treadmill testing in both sexes (p < 0.05); oxygen pulse was higher only in females. VE/VCO₂ slope and OUES were unaffected by modality. When stratified by age (<18 vs. ≥18 years), treadmill-related differences in VO₂ peak and percent-predicted VO₂ remained significant in both sexes ≥18 years, and in females <18 years. Oxygen pulse was significantly higher with treadmill only in females ≥18 years. VE/VCO₂ slope and OUES remained unchanged across modalities and age groups. This study provides CPET values stratified by modality and sex in a large cohort of asymptomatic rToF patients, offering valuable reference data for clinical assessment. Future studies should validate pediatric normative CPET values through prospective, inclusive, statistically powered cohorts using standardized protocols and cross-center comparability.

Objectives: Maximal cardiorespiratory capacity in terms of maximal oxygen uptake (V˙O2max) declines with age. Submaximal exercise parameters, such as the regulation of the cardiorespiratory system (kinetics) as an indicator of cardiorespiratory fitness, seem to be less influenced by age and are preserved by sufficient physical activity. However, kinetics parameters seem to be affected by the habitual type of locomotion in daily life. Hence, kinetics parameters are compared between younger and older adults with similar levels of physical activity for treadmill and cycle ergometry. Methods: 16 younger (28±6 yrs) and 19 older (65±6 yrs) participants were tested on a cycle and treadmill ergometer, respectively. The protocols consisted of randomly changing moderate work rates. Kinetics parameters were assessed via time series analysis. Higher maxima at smaller lags indicate faster kinetics responses. Key results: Time courses for HR kinetics were similar in younger and older adults with equal levels of physical activity (p=0.763), while V˙O2 kinetics were slightly faster for older adults during treadmill but not cycling exercise for several lags (p&lt;0.05). For the older adults, V˙O2 kinetics, but not HR kinetics were faster during treadmill exercise, compared with cycling for several lags (p&lt;0.05), while for the younger adults, faster V˙O2 kinetics were noticed for cycling compared with treadmill exercise for several lags (p&lt;0.05). Conclusion: The type of ergometry seems to be relevant to assess cardiorespiratory kinetics in younger and older adults. This should be considered in clinical practice, after the findings have been evaluated in a frailer group of participants. Key Words: Cardiorespiratory Fitness, Older Adults, Treadmill Exercise, Cycling Exercise

Recent evidence suggests that moderately elevated bilirubin plasma concentrations possess protective effects against non-communicable diseases. One possible explanation for this might be that Gilbert's Syndrome (GS), a mildly hyperbilirubinaemic condition, leads to an enhanced lipid metabolism. Furthermore, there are first hints that individuals with GS may have a greater performance capacity. We hypothesize that GS participants have a greater maximal fat oxidation and performance capacity. To test this, we conducted an age- and gender-matched human case-control study. We included 40 people with GS and 40 controls, aged 18-65 years, who were all moderately physically active. 50% of the participants were over the age of 35. Participants performed a FatMax test on a bicycle ergometer. The study was performed from March 2023 to December 2023 at the University of Vienna. The group of GS participants over the age of 35 had a significantly higher FatMax (GS: median = 1.03 [maximum = 0.44; minimum = 2.42] W/kg body weight; C: median = 0.48 [minimum = 0.33; maximum = 1.61] W/kg body weight, p = 0.002) and a significantly greater oxygen consumption (GS: mean = 30.2 ± standard diviation (sd) = 8.09ml/min/ kg body weight; C: mean = 23.4 ± sd = 5.91ml/min/kg body weight, p = 0.005) at the respiratory compensation point. This is the first study to demonstrate that older GS individuals can generate more power whilst harnessing fatty acid metabolism and this may enhance their performance over prolonged periods of sub-maximal exercise.

Patellar and Achilles tendinopathy are overuse injuries associated with repetitive strain and often arise following sudden increases in exercise intensity or volume. As such, interventions that reduce tendon strain may represent effective methods for reducing overuse injury risk in this at-risk population of novice cyclists. One potential intervention is through the anterior/posterior positioning of the cycling cleat. Ten recreational athletes, who were all novice cyclists, cycled on a stationary cycle ergometer at three cleat positions (neutral, 20 mm anterior, 20 mm posterior), four power outputs (150 W, 200 W, 250 W, 300 W) and two rider positions (seated, standing) for a total of 24 conditions. Motion capture and plantar pressure data were collected, and peak Achilles and patellar tendon strains were obtained using musculoskeletal modelling. Metabolic output for each condition was also modelled using a combination of musculoskeletal modelling and a previously published metabolic model. Peak Achilles tendon strain was significantly reduced with a posterior cleat position compared to a neutral (p = 0.047) and anterior (p < 0.001) position during both standing and seated cycling. However, peak patellar tendon strain (p = 0.928) and modelled metabolic output (p = 0.778) were not influenced by cleat position. Cycling with a 20 mm posterior cleat position represents an effective intervention for reducing the risk of developing Achilles tendinopathy without concurrently increasing patellar tendon strain and sacrificing performance.

The analgesic potential of virtual reality has been demonstrated in acute and chronic pain populations, where it is often employed as a distraction tool or integrated into virtually delivered biopsychosocial pain management plans. However, the extent to which virtual reality can augment exercise-induced hypoalgesia remains underexplored. The aim of the study was to examine the effects of virtual reality on experimentally-induced pain (using cuff pressure algometry), as well as affective and perceptual responses, to moderate-intensity cycle ergometer exercise. A counterbalanced within-subjects design was employed and 19 healthy, pain-free adults completed 20-min exercise bouts at ventilatory threshold under two conditions: virtual reality and control. A one-way repeated measures ANOVA indicated a significant main effect of assessment for pressure detection threshold (p = .038), with higher pain thresholds observed immediately following each exercise bout when compared to baseline. However, there were no differences in pressure detection threshold between exercise conditions. Analyses also revealed that the virtual reality condition was associated with more positive affective valence (p = .002) and greater attentional dissociation (p = .036) when compared to control, as well as higher post-task ratings of exercise enjoyment (p < .001), remembered pleasure (p = .045), and forecasted pleasure (p = .033). Despite the lack of enhancement in experimentally-induced pain modulation, the findings support the notion that virtual reality technology can be a useful tool for promoting pleasurable exercise experiences.

It is unclear whether moderate-intensity aerobic exercise is feasible and safe for inpatients with non-hematological cancer receiving one cycle of chemotherapy. To evaluate adherence, compliance, acceptability, adverse events, and clinical stability during a short-term moderate-intensity aerobic training in non-hematological inpatients undergoing one cycle of chemotherapy. This feasibility and safety study included adults with non-hematological cancer inpatients receiving one cycle of chemotherapy. Patients participated in four consecutive days of moderate-intensity aerobic training using a cycle ergometer, during which vital signs and perceived exertion were monitored. Following the intervention, patients were assessed for the acceptability of intervention. Adherence rates, compliance, and adverse events related to the training were also recorded. Twenty patients (mean age 61 ± 15 years, mean BMI 25 ± 8 kg/m2; 75% with digestive cancers, 50% physically active) were analyzed. Adherence to the intervention was 92%, compliance was 68.6%, and acceptability was reported at 100%. Vital signs and perceived exertion remained stable throughout all training sessions (heart rate P = .99, peripheral O2 saturation P = .54, mean arterial blood pressure P = .79, sensation of dyspnea P = .97). Two patients reported adverse events during training (vomiting and extreme fatigue), while three experienced adverse effects post-training (tremor, nausea, and back pain). Short-term moderate-intensity aerobic training for inpatients with non-hematological cancer undergoing one cycle of chemotherapy is feasible and safe.

Patients with pancreatic cancer (PC) commonly present with reduced aerobic fitness, sarcopenia, and malnutrition, which may increase perioperative risk and compromise access to chemotherapy treatments. Although exercise-based prehabilitation can improve physical fitness, its implementation is often limited by short diagnostic-to-surgery intervals and treatment-related toxicity. We conducted a pilot prospective pretest-posttest feasibility study in Torino, Italy. Patients with PC undergoing neoadjuvant chemotherapy prior to surgery were offered a 4-week, partially supervised, home-based bimodal exercise prehabilitation program (single-arm design) combining remotely monitored high-intensity interval training (HIIT) on a cycle ergometer with functional and resistance exercises. The primary outcome was adherence to prescribed exercise frequency, intensity, and duration, objectively assessed via remote monitoring. Secondary outcomes included cardiorespiratory fitness (CPET), muscle function, body composition, fatigue, quality of life, and circulating inflammatory markers. From July 2022 to February 2024, 23 patients were screened; 15 were eligible and 10 enrolled. Four participants discontinued the intervention (two due to asthenia/fatigue, one due to chemotherapy-related adverse events, and one for organizational reasons), leaving six participants who completed the program. Among completers, fatigue and quality of life did not change meaningfully. Aerobic capacity and muscle function outcomes were generally stable, with few pre-post changes exceeding the minimum clinically important difference (MCID) thresholds used. Body composition markers and the assessed circulating cytokines/chemokines remained unchanged except for IL-6 levels, which decreased significantly (p < 0.05). A partially supervised, home-based HIIT-based prehabilitation program is feasible for a subset of PC patients undergoing neoadjuvant therapy, but a substantial attrition rate suggests the need for more flexible symptom-adapted prescriptions and enhanced supportive strategies.

CPAP does not modify exercise-derived autonomic responses in nonsleepy patients with coronary artery disease and obstructive sleep apnea.