Effects Of Different Exercise Modalities Research Articles

Aerobic exercise in anthracycline-induced cardiotoxicity: a systematic review of current evidence and future directions.

Cancer and cardiovascular disease are major causes of morbidity and mortality worldwide. Older cancer patients often wrestle with underlying heart disease during cancer therapy, whereas childhood cancer survivors are living long enough to face long-term unintended cardiac consequences of cancer therapies, including anthracyclines. Although effective and widely used, particularly in the pediatric population, anthracycline-related side effects including dose-dependent association with cardiac dysfunction limit their usage. Currently, there is only one United States Food and Drug Administration-approved drug, dexrazoxane, available for the prevention and mitigation of cardiotoxicity related to anthracycline therapy. While aerobic exercise has been shown to reduce cardiovascular complications in multiple diseases, its role as a therapeutic approach to mitigate cardiovascular consequences of cancer therapy is in its infancy. This systematic review aims to summarize how aerobic exercise can help to alleviate unintended cardiotoxic side effects and identify gaps in need of further research. While published work supports the benefits of aerobic exercise, additional clinical investigations are warranted to determine the effects of different exercise modalities, timing, and duration to identify optimal aerobic training regimens for reducing cardiovascular complications, particularly late cardiac effects, in cancer survivors exposed to anthracyclines.

Influence of exercise on visceral pain: an explorative study in healthy volunteers.

Background and objectivesContradictory results have been found about the effect of different exercise modalities on pain. The aim of this study was to investigate the early effects of aerobic and isometric exercise on different types of experimental pain, including visceral pain, compared to an active control condition.MethodsFifteen healthy subjects (6 women, mean [standard deviation] age 25 [6.5] years) completed 3 interventions consisting of 20 minutes of aerobic cycling, 12 minutes of isometric knee extension and a deep breathing procedure as active control. At baseline and after each intervention, psychophysical tests were performed, including electrical stimulation of the esophagus, pressure pain thresholds and the cold pressor test as a measure for conditioned pain modulation. Participants completed the Medical Outcome Study Short-Form 36 and State-Trait Anxiety Inventory prior to the experiments. Data were analyzed using two-way repeated measures analysis of variance.ResultsNo significant differences were found for the psychophysical tests after the interventions, compared to baseline pain tests and the control condition.ConclusionNo hypoalgesic effect of aerobic and isometric exercise was found. The evidence for exercise-induced hypoalgesia appears to be not as consistent as initially thought, and caution is recommended when interpreting the effects of exercise on pain.

Effects of different exercise modalities on ataxia in multiple sclerosis patients: a randomized controlled study

Purpose: To investigate the effects of different exercise protocols on ataxia in patients with multiple sclerosis (MS).Method: A total of 42 MS patients, 17 male and 25 female (Expanded Disability Status Scale (EDSS): 3–5), were enrolled in this randomized controlled study. The patients were divided into three groups: a balance training (BT) group, a lumbar stabilization (LS) group and a task-oriented training (TT) group. All groups received balance training; additionally, the LS group received lumbar stabilization exercises, and the TT group received task-oriented training. The Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), Functional Reach Test (FRT), 2-Minute Walk Test (2MWT), Sensory Organization Test (SOT), and measurement of Somatosensory Evoked Potentials (SSEPs) were performed before and at the end of the 18 training sessions.Results: The BBS, ICARS, FRT, 2MWT, and composite balance score of the SOT were improved in all groups. The ICARS kinetic function sub-score and the left limb cortical onset amplitudes of SSEPs were increased significantly in both the TT and the LS groups. The ICARS total score, composite balance score, and 2MWT were different between groups (p < 0.05). According to multiple comparison analyses of the ICARS total score and the composite balance score, the LS, and the TT group were different from the BT group (p < 0.005), while the LS and the TT groups improved similarly (p > 0.005). The 2MWT results were better for the LS group than the BT group, while the BT and the TT groups improved similarly.Conclusion: Balance training alone is not sufficient for rehabilitation of ataxic MS patients. A combination of lumbar stabilization exercises or task-oriented training increases the success of balance rehabilitation.Implications for rehabilitationMultiple sclerosis is a chronic inflammatory and autoimmune disease of central nervous system and ataxia is one of the most challenging symptoms of this disease.Different exercise modalities are commonly employed to control ataxic symptoms in MS patients.Lumbar stabilization exercises or task-oriented training should be considered as complementary approach to improve balance and coordination in ataxic multiple sclerosis patients.

Basic Body Awareness Therapy and patient education in hip osteoarthritis: a multiple case study

International guidelines recommend exercise and patient education (PE) in hip osteoarthritis. However, we need more in-depth evidence regarding the effect of different exercise modalities. The aim of this study was to examine short- and long-term outcomes of PE and Basic Body Awareness Therapy (BBAT). Seven patients (five men, two women) with moderate to severe osteoarthritis were recruited. Pain, function and quality of life were assessed at baseline and after 4 and 10 months, pain during walking being the main outcome. PE, aiming for patients’ empowerment through information and counselling, was given in a 2 h group setting. BBAT, focusing on promoting movement quality and awareness in a variety of daily movements, was given weekly in groups over 12 weeks. Five patients participated in PE and BBAT, two in PE only. After 4 months all reported improvement. Less pain during walking was found in four patients, and after 10 months in three patients (one PE, two PE and BBAT, two missing). One patient (PE) reported being unchanged and one (PE and BBAT) worse and motivated for surgery, both with 0 mm joint space. BBAT and PE may be beneficial in hip osteoarthritis, but the supplementary effect of BBAT must be further examined.

Glycemic control through physical exercise in type 2 diabetes systematic review

In Spain, nearly 14% of the population is diabetic, 95% corresponds to Type 2 Diabetes Mellitus patients. Poor glycemic control increases morbidity and mortality. There are three pillars in the treatment of type 2 diabetes: diet, medication and exercise. However, the potential for prescribing exercise training has not been fully exploited. To analyze the effect of different exercise modalities (AE, RT, Combo, HIIT) on glycemic control in patients with type 2 diabetes mellitus. The reserch was performed in 3 electronic databases (Pubmed, Scopus and Proquest), including publications from 2011 to the present, publications undertaking interventions with AE, RT, Combo or HIIT, and those that measured capillary glucose, CGMS or HbA1c. Of the 386 articles found, 14 met the inclusion criteria. These items were classified according to exercise intervention modality (AE, RT, Combo, HIIT) and whether glycemic control was measured as a result of continued training or 24-48h post-workout. EA, RT, Combo and HIIT show efficacy in glycemic control in both the continuous training and 24-48h post-training. To achieve certain benefits in glycemic control, prescribing a structured frequency, volume and intensity training is required. Combo is the modality that gets better results through continued training.

The effect of different exercise modalities on dyspnea and leg fatigue in healthy subjects

BackgroundThis study documents the impact of different exercise modalities on dyspnea and leg fatigue during equivalent cardiopulmonary stress in healthy subjects. MethodologyFollowing a familiarization, 20 subjects (age 21–44 years; 8 males) performed six 5-min exercise tests, randomized among: 2 steep slope treadmill tests (25% grade), 2 lesser slope treadmill tests (12% grade) and 2 bicycle tests on 3 separate days. Subjects reported either dyspnea or leg fatigue during each test. Oxygen consumption (V˙O2), ventilation (V˙E), respiratory rate (fR) and heart rate (HR) were measured during each test. ResultsV˙O2,V˙E, HR, dyspnea and leg fatigue were not significantly different among the three exercise conditions (p>0.05). ConclusionThese findings indicate that at equivalent levels of cardiopulmonary stress reflected by similar levels of V˙O2 and heart rate, the perceived level of exertional dyspnea is not influenced by different patterns of neuromuscular activity. Similarly, the intensity of leg fatigue primarily reflects whole body work and is independent of different patterns of neuromuscular activity.

Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials.

Background and ObjectivesPhysical activity is associated with lower cardiovascular and all-cause mortality. However, the effects of different exercise modalities on arterial stiffness are currently unclear. Our objectives were to investigate the effects of exercise modalities (aerobic, resistance or combined) on pulse wave velocity (PWV) and augmentation index (AIx), and to determine whether the effects on these indices differed according to the participants' or exercise characteristics.MethodsWe searched the Medline, Embase and Cochrane Library databases from inception until April 2014 for randomized controlled trials lasting ≥4 weeks investigating the effects of exercise modalities on PWV and AIx in adults aged ≥18 years.ResultsForty-two studies (1627 participants) were included in this analysis. Aerobic exercise improved both PWV (WMD: −0.63 m/s, 95% CI: −0.90, −0.35) and AIx (WMD:−2.63%, 95% CI: −5.25 to −0.02) significantly. Aerobic exercise training showed significantly greater reduction in brachial-ankle (WMD: −1.01 m/s, 95% CI: −1.57, −0.44) than in carotid-femoral (WMD: -0.39 m/s, 95% CI: −0.52, −0.27) PWV. Higher aerobic exercise intensity was associated with larger reductions in AIx (β: −1.55%, CI −3.09, 0.0001). In addition, aerobic exercise had a significantly larger effect in reducing PWV (WMD:−1.0 m/s, 95% CI: −1.43, −0.57) in participants with stiffer arteries (PWV ≥8 m/s). Resistance exercise had no effect on PWV and AIx. There was no significant effect of combined exercise on PWV and AIx.ConclusionsWe conclude that aerobic exercise improved arterial stiffness significantly and that the effect was enhanced with higher aerobic exercise intensity and in participants with greater arterial stiffness at baseline.Trial Registration PROSPERODatabase registration: CRD42014009744,.

Iron Regulation in Athletes: Exploring the Menstrual Cycle and Effects of Different Exercise Modalities on Hepcidin Production

The trace element iron plays a number of crucial physiological roles within the body. Despite its importance, iron deficiency remains a common problem among athletes. As an individual's iron stores become depleted, it can affect their well-being and athletic capacity. Recently, altered iron metabolism in athletes has been attributed to postexercise increases in the iron regulatory hormone hepcidin, which has been reported to be upregulated by exercise-induced increases in the inflammatory cytokine interleukin-6. As such, when hepcidin levels are elevated, iron absorption and recycling may be compromised. To date, however, most studies have explored the acute postexercise hepcidin response, with limited research seeking to minimize/attenuate these increases. This review summarizes the current knowledge regarding the postexercise hepcidin response under a variety of exercise scenarios and highlights potential areas for future research-such as: a) the use of hormones though the female oral contraceptive pill to manipulate the postexercise hepcidin response, b) comparing the use of different exercise modes (e.g., cycling vs. running) on hepcidin regulation.

The differential anti‐inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with Type 2 diabetes

Adipokines, visfatin, apelin, vaspin and ghrelin have emerged as novel cardiovascular risk factors. We aimed to evaluate the effects of different exercise modalities on the aforementioned novel adipokines and carotid intima-media thickness in patients with Type2 diabetes mellitus. One hundred patients with Type2 diabetes were equivalently (n=25) randomized into four groups: (1) a control group with patients encouraged to perform self-controlled exercise; (2) a supervised aerobic exercise group (exercise four times/week, 60min/session, 60-75% of maximum heart rate); (3) a resistance training group (60-80% baseline maximum load achieved in one repetition); and (4) a combined aerobic exercise plus resistance training group, as in groups2 and 3. All participants had HbA(1c) levels ≥48mmol/mol (≥6.5%), without overt diabetic vascular complications. Blood samples, clinical characteristics, peak oxygen uptake and carotid intima-media thickness measurements were obtained at baseline and at the end of the study, after 6months. At baseline, there were non-significant differences between groups. All active groups significantly ameliorated glycaemic profile, insulin sensitivity and triglycerides levels compared with the control group (P<0.05). Aerobic training further improved lipids, systolic blood pressure and exercise capacity compared with the resistance training and the control groups (P<0.05). Moreover, high-sensitivity C-reactive protein and visfatin decreased, while vaspin and apelin circulating levels increased within the aerobic exercise group and the aerobic exercise plus resistance training group, and compared with the other groups (P<0.05). Within- and between-group comparisons showed negligible alterations in ghrelin serum levels and body weight after all exercise modalities. Finally, aerobic training attenuated the carotid intima-media thickness progression (0.017±0.006mm) compared with the control subjects (0.129±0.042mm, P<0.001). That effect was independently associated with visfatin and amelioration of peak oxygen uptake. In subjects with Type2 diabetes, all exercise training modalities improved metabolic profile. Importantly, aerobic training predominantly ameliorated adipokines concentrations and carotid intima-media thickness progression.

Effect of different exercise modalities plus a hypocaloric diet on inflammation markers in overweight patients: A randomised trial

Inflammation markers (IM) have been associated with the development of chronic diseases. This study compares the effects on IM of three exercise programs combined with a hypocaloric diet. 119 overweight participants (73 women, 46 men) aged 18-50 years were randomised into four treatment groups: strength training (S; n = 30), endurance training (E; n = 30), combined S + E (SE; n = 30), and a diet and physical activity recommendations group (D; n = 29). Energy intake, anthropometric variables (AV), training variables (VO2peak, strength index, dynamometric strength index [DSI]) and plasma IM were recorded at baseline and after 22 weeks of treatment. 84 participants completed the study. At 22 weeks, all groups showed a significantly reduced energy intake (P < 0.001) and improved AV (P < 0.001). VO2peak significantly increased in all groups (P < 0.01). DSI increased in the exercise groups only (P < 0.05). Plasma leptin fell significantly (P < 0.001) in the S and E groups, but not significantly in the SE group (P = 0.029) (no significant differences between these groups). Tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP) concentrations decreased in all groups when examined together, but not when examined separately. No significant differences were seen in interleukin-6 (IL-6). Combining strength or endurance training with a hypocaloric diet improved AV and reduced plasma leptin concentrations. No differences were seen between groups in terms of TNF-α, IL-6 or CRP reduction. This trial was registered at clinical trials.gov as NCT01116856. http://clinicaltrials.gov/.

The Morganroth hypothesis revisited: endurance exercise elicits eccentric hypertrophy of the heart

The Morganroth hypothesis revisited: endurance exercise elicits eccentric hypertrophy of the heart

Effect of Exercise Training Modality on Skeletal Muscle mRNA Abundance in Young and Older Adults

PURPOSE: The specific effects of different exercise modalities on mitochondrial (mito) and myofibrillar (myo) protein gene expression are not fully understood. We determined the effects of endurance (ET), resistance (RT), and combined (CT) training on skeletal muscle mRNA abundance of mito and myo proteins in young and older adults. METHODS: 33 young (25+1y) and 27 older (70+2y) adults were randomized to one of three 8-wk training interventions: (i) Control: subjects maintained existing physical activity levels, (ii) ET: subjects cycled for 60 min at 65% of VO2 peak, 5×/wk. (iii), RT: subjects RT 4×/wk. Control subjects completed an additional 8-week (iv) CT training program following the completion of the control period. Subjects were assessed for VO2 peak, leg press 1RM, and had muscle biopsies before and 48 h after the last training session. Real-time PCR determined mRNA abundance of mito and myo proteins. ANOVA models were used to detect mean differences. RESULTS: At baseline, there were no significant differences between treatment groups for mRNA abundance. Also, the older subjects had lower VO2 peak (28+1 ml/kg/min vs. 18+1 ml/kg/min, p<0.05) and leg-press 1RM (130+8 kg vs. 80+6 kg, p<0.05). Table 1 presents the pre-posttraining % change values. CONCLUSIONS: ET increased VO2 peak and mRNA abundance of mito proteins in both young and older adults. RT increased skeletal muscle strength in both young and older adults. Although RT did not alter mRNA abundance of mito proteins in the young, these gene transcripts did increase in response to RT among the old. CT increased both VO2 peak and skeletal muscle strength, while also increasing mRNA abundance of mito and myo proteins in both young and older adults. Grants: R01AG09531, KL2RR084151Table 1: Percent change in fitness and mRNA abundance for mitochondrial and contractile proteins.

Effect of exercise training modality on skeletal muscle mitochondrial biogenesis in young and older adults

The specific effects of different exercise modalities on mitochondria (mito) biogenesis are not fully understood. We determined the effects of endurance (ET), resistance (RT), and combined (CT) training on skeletal muscle mito biogenesis in young (Y) and older (O) adults. 33 young (25±1 y) and 27 older adults (70±2 y) were randomized to one of three 8wk interventions: (i) Control: activity levels unchanged, (ii) ET: cycling 60 min at 65% VO2peak, 5x/wk. (iii), RT: RT 4x/wk. After completing the control condition, the controls completed an 8wk (iv) CT program. Percutaneous muscle biopsies were acquired before intervention and 48h following the last training session. rtPCR was used to determine mtDNA and mRNA abundance of genes encoding transcriptional regulators of mito biogenesis (PGC1α, TFAM, NRF1, NRF2, SIRT1, SIRT3) with statistical analysis by ANOVA (mean (SEM)). ET and CT increased mtDNA in the O [63 (26)%, and 86 (35)%, p<0.05], but not Y. ET increased PGC1α [41 (20)%, 23 (14)%], NRF2 [60 (14)%, 22 (14)%], and SIRT3 [24 (9)%, 24 (9)%] mRNA abundance in the Y and O (P<0.05). CT also increased PGC1α [65.5 (26.3)%, 84 (50)%], TFAM [28 (13)%, 32 (23)%], and SIRT3 [24 (6)%, 35 (13)%] mRNA abundance in the Y and O (P<0.05). In conclusion, both ET and CT were effective at increasing mRNA abundance of genes encoding transcriptional regulators of mito biogenesis in both Y and O adults. Funding: R01AG09531, KL2RR084151, UL1RR24150

Metabolic responses to submaximal treadmill walking and cycle ergometer pedalling in obese adolescents

Physical activity is essential in obesity management because of the impact of exercise-related energy expenditure (EE) and fat oxidation (Fox) rate on a daily balance, but the specific physiological effects of different exercise modalities are scarcely known in obese individuals. The objective of the study was to compare the metabolic responses to treadmill (TM) and cycle ergometer (CE) exercise in obese adolescents. Gas exchange, heart rate (HR), blood lactate (LA) concentration, EE and Fox were determined at different intensity levels (up to about 85% of maximal oxygen uptake) during TM and CE in 14 pubertal (Tanner stage: >3) obese (BMI SDS: 2.15-3.86) male adolescents (age: 13-18 years). At comparable HR, oxygen uptake, EE and Fox were higher, and LA lower, during TM than CE (P<0.05-0.001), suggesting that cycling imposes a metabolic involvement at the level of the single active muscles greater than walking. Therefore, due to different physiological responses to TM and CE, walking was more convenient than cycling in obese adolescents, permitting to attain the same EE at lower HR, with lower blood LA concentration and with greater Fox. These conclusions seem clinically relevant when using exercise as a part of multidisciplinary treatment for juvenile obesity and amelioration of related metabolic disturbances.

The Effects Of Different Exercise Modalities On Adipokines In Patients With Type 2 Diabetes

PURPOSE: Novel adipose-tissue derived cytokines, such as visfatin (nampt) and ghrelin, have emerged as novel cardiovascular risk factors. However, there is limited evidence about the exercise influence on these adipokines in patients with type 2 diabetes (T2D). The aim of our study was to evaluate the effects of different exercise modalities on novel adipokines in T2D. METHODS: 100 patients with T2D, aged 50-65 years, were equivalently (N=25) randomized into 4 groups: A) Control patients remained sedentary throughout the study; B) Supervised aerobic exercise (3 times/week, 45min/session, 60-80%VO2peak). C) Resistance training (similar characteristics as in group B, 60-80% baseline 1-RM). D) Exercise counselling to perform physical activity according to American Diabetes Association. All participants had no diabetic vascular complications and poor glycemic control (HbA1c>6.5%), despite the oral anti-diabetic regimen. At baseline blood samples and clinical parameters were obtained and participants underwent a gradually incremental exercise test on an ergocycle. Blood sampling and measurements were repeated after 6 months. Data were analyzed using ANOVA for repeated measures. RESULTS: At baseline there was no significant difference between groups. HbA1c decreased significantly in group B (-0.71±0.34%, p<0.001), C (-0.33±0.19%, p=0.030) and D (-0.29±0.18%, p=0.041) compared to group A (0.11±0.08%). Aerobic exercise improved all lipid parameters, while the rest of interventions considerably reduced only triglycerides (p<0.05). Body weight, insulin resistance (HOMA-IR), visfatin were significantly decreased in all active groups (p<0.05). Among groups the most pronounced amelioration of visfatin (-5.65±3.8ng/ml), ghrelin (3.74±1.52ng/ml), and VO2peak (3.12±1.02ml kg-1 min-1) was observed in group B compared to A, C and D groups (p<0.05). Besides, ghrelin was significantly increased in physical activity group D compared to groups A and C (p<0.05). CONCLUSIONS: Daytime physical activity, aerobic and resistance training are positively related to better cardiovascular risk profile in diabetic patients. Among those exercise modalities, supervised aerobic training seems to confer better anti-inflammatory results. NPE Kadoglou was granted by Alexander Onassis Public Benefit Foundation.

Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

Background and aims We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Methods and results Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA 1c decreased in Groups B–D. VO 2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO 2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. Conclusion Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.