Exercise Training Sessions Research Articles

The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial.

The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.

Barriers and strategies for implementing community-based interventions with minority elders: positive minds-strong bodies

BackgroundBy 2040, one out of three older adults in the USA are expected to belong to a racial/ethnic minority group. This population has an increased risk of mental and physical disability with significant barriers to access care. Community-based organizations (CBOs) often provide programming to serve minority and immigrant elders. Limited resources and other barriers such as lack of trained staff make it difficult to implement evidence-based interventions (EBIs) in CBOs for long-term adoption. Yet little is known about what factors can facilitate adoption of EBIs in CBOs serving minority elders.MethodsPositive-Minds–Strong Bodies (PM-SB), an evidence-based intervention offered in four languages, aims to reduce mental and physical disability for minority and immigrant elders through the efforts of community health workers and exercise trainers. The intervention consists of cognitive behavior therapy and exercise training sessions delivered over 6 months. During a recent clinical trial of this intervention, we elicited feedback from CBO staff to determine how best to facilitate the implementation and long-term sustainability of PM-SB within their agencies. We surveyed 30 CBO staff members, held four focus groups, and conducted 20 in-depth interviews to examine staff perspectives and to reveal factors or changes needed to facilitate long-term adoption in prospective CBOs.ResultsParticipants reported that staff motivation and implementation could be improved through the following changes: increasing patient compensation for treatment sessions, decreasing levels of organizational accountability, and reducing staff demands embedded in the intervention. Although most staff perceived that PM-SB improved their agency’s ability to address the health and well-being of elders, capacity-building strategies such as a “train-the-trainer” initiative were identified as priorities to address staff turnover for sustainability. Adapting the intervention to get financial reimbursement also emerged as vital.ConclusionsAugmenting financial incentives, streamlining procedures, and simplifying staff accountability were suggested strategies for facilitating the transition from a disability prevention clinical trial in minority and immigrant elders to a scalable implementation in routine services at CBOs.Trial registrationClinicalTrials.gov, NCT02317432.

Exercise-based cardiac rehabilitation for postcoronary artery bypass grafting and its effect on hemodynamic responses and functional capacity evaluated using the Incremental Shuttle Walking Test: A retrospective pilot analysis.

BackgroundCoronary artery bypass grafting (CABG) is a common surgical procedure for the restoration of blood flow into stenotic or blocked coronary arteries. Cardiac rehabilitation has been implemented to some extent worldwide for the management of postoperative CABG. However, studies about the effect of exercise training on hemodynamic responses of the heart using the Incremental Shuttle Walking (ISWT) test are limited in Saudi Arabia.ObjectivesTo investigate the effect of exercise-based cardiac rehabilitation (Phase 3, hospital-based) on some hemodynamic responses including blood pressure, heart rate (HR) and heart rate recovery (HRR), and rate pressure product (RPP) using ISWT on post-CABG patients.MethodsFifteen CABG (51.4 ± 6.4 years, 14 male, 1 female) patients without altering their medication were enrolled in a hospital-based cardiac rehabilitation program (Phase 3) between 2011 and 2012 for supervised individual exercise training sessions (three times per week for 8 weeks; 60-minute session at a moderate intensity). Patients performed two tests (ISWT1 and ISWT2) and one before exercise training program and one after, during which resting systolic blood pressure (SBP) and diastolic blood pressure (DBP), post-ISWT SBP and DBP, resting HR, peak HR, HRR (which was defined as the absolute change from peak HR to 1-minute post peak HR), and RPP at rest and at the end of the ISWT were measured. Exercise training sessions included both aerobic and resistance exercises, which were preceded by a cooling down period and followed by a recovery period.ResultsPaired t-test showed a significant reduction in both resting SBP (p = 0.04) and DBP (p = 0.03), and a significant increase in post-ISWT2 SBP (p = 0.004), peak HR (p = 0.003), HRR (p = 0.03), and RPP at maximum (p = 0.002) after 8 weeks of supervised exercise training. In addition, there was a significant increase in the speed and distance achieved on ISWT2 (p < 0.001) after the training program.ConclusionSupervised exercise training (cardiac rehabilitation) for 8 weeks was effective in improving hemodynamic responses and functional exercise capacity in CABG patients. Cardiac rehabilitation should be implemented more frequently and health-care providers should be aware of its importance. Further research is needed in this area to confirm these findings in the region.

Low force exercise training using muscle stimulation adapts physiologic phenotype in people with Spinal Cord Injury

Physical activity, even in short bursts, is critical to maintain human skeletal muscle. Low physical activity levels are associated with poor health, chronic non‐communicable diseases (NCDs), and impaired cognition in people with intact nervous systems as they age. Exercise as a form of medicine increases physical activity levels, attenuates the development of NCDs, and improves cognitive capacity. Because people with spinal cord injury (SCI) cannot volitionally activate their paralyzed muscles, the musculoskeletal system deteriorates with an increased risk for NCDs and cognitive decline as they age. High force electrically induced exercise is risky; therefore, a safe low‐force alternative is needed. Whether training using a low‐force electrically induced exercise can influence muscle and systemic health markers in people with SCI is unknown.PurposeTo determine if low‐force electrically induced exercise changes the phenotype and metabolic health of paralyzed skeletal muscle in people with SCI.Methods10 people with complete SCI completed electrically induced exercise training using low‐force (3Hz) stimulation of the quadriceps. Participants targeted at least 5 exercise training sessions per week. A muscle fatigue test and fasting venous blood draw, measuring CRP, insulin, leptin, BDNF, myostatin, and PTH, were performed before and after training. Muscle biopsies were obtained from a trained and untrained vastus lateralis. Gene expression was measured using the Affymetrix HTA 2.0 array from the trained and untrained muscle samples. All participants provided written consent approved by the University of Iowa Institutional Review Board in compliance with the Declaration of Helsinki.ResultsParticipants were compliant completing ~119±19% of the training sessions for ~7.2±1.2 months. There was a ~68% improvement in fatigue after of exercise training compared to baseline (p=0.002). There was a significant increase in the resting gene expression of slow‐twitch proteins MYH6(p=0.023), MYH7(p=0.034), and MYL3(p=0.022) compared to the untrained limb. Serum concentration of CRP, insulin, myostatin, and leptin were decreased by ~74% (p=0.089), ~179%(0.057), ~64%(p=0.096), and ~79%(p=0.021) after exercise training compared to baseline, respectively. Serum BDNF and PTH concentration were increased by ~70%(p=0.093) and ~78%(p=0.048) after exercise training, respectively.ConclusionsLow‐force electrically induced exercise training improved fatigability and phenotype of paralyzed muscle. Consistent with this change, the homeostatic gene expression of slow‐twitch proteins (MYH6, MYH7, and MYL3) were increased, but the transcription factors (PGC1a and MSTN) remained unchanged. Serum biomarkers (CRP, insulin, leptin, BDNF, myostatin and PTH) showed a consistent trend systemic metabolic health after training. Together, this study highlights the potential of low‐force electrically induced exercise to improve the health in people with chronic SCI, though the minimum duration of training required may be delayed compared to other exercises modalities.Support or Funding InformationResearch SupportThis study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development: R01HD084645, R01HD082109

Impact of Multiple Exertional Heat Strokes on Thermoregulation and Performance

Heat stress can result in beneficial acclimation and/or harmful injury depending on the severity of exposure. The impact of multiple heat exposures on thermoregulatory and physical performance has not been well‐studied, but is an important consideration for warfighters, athletes, and others who routinely encounter hot environments. The aim of this study was to examine the effects of multiple exertional heat strokes (EHS) on thermoregulatory and performance variables. C57BL/6J male mice were implanted with an intra‐abdominal radiotelemetry device to measure core temperature (Tc; ±0.1°C). Four exercise training sessions were conducted at thermoneutral conditions (25°C) prior to heat exposure to familiarize mice with the forced running protocol. For the EHS protocol, mice rested inside a running wheel for approximately 35 minutes until the environmental chamber reached 37.5°C and then began running at 2.5m/min, accelerating 0.3m/min every 10 minutes until reaching their max speed when Tc reached 41.0°C; mice were removed from the heat when they collapsed. After recovering for either one day (1D), three days (3D), or seven days (7D), mice repeated the EHS protocol. Regardless of the number of recovery days, mice spent more time in the heat prior to collapse during the second heat exposure compared to the first (1D: 335±9 minutes vs 275±8 minutes, p&lt;0.001; 3D: 331±9 minutes vs 275±7 minutes, p&lt;0.001; 7D: 320±9 minutes vs 274±7 minutes, p&lt;0.001). Maximum Tc (Tcmax) was higher during the second heat exposure after both 1D and 3D recovery compared to the first heat exposure (1D: 42.50±0.03°C vs 42.15±0.04°C, p&lt;0.001; 3D: 42.40±0.04°C vs 42.13±0.04°C, p&lt;0.001; 7D: 42.17±0.03°C vs 42.12±0.03°C, not significant) and during the second heat exposure Tcmax was higher in 1D compared to 3D (p&lt;0.05) and 7D (p&lt;0.001) and higher in 3D than 7D (p&lt;0.001). Hypothermia depth, a measure of injury severity, was less pronounced after the second heat exposure compared to the first heat (1D: 34.57±0.13°C vs 31.31±0.34°C, p &lt; 0.001; 3D: 33.33±0.19°C vs 31.86±0.22°C, p &lt; 0.001; 7D: 33.59±0.30°C vs 31.77±0.46°C, p &lt; 0.001). Hypothermia depth after the second heat was also less severe in 1D mice compared to 3D mice (p &lt; 0.05) and trended less severe compared to 7D mice (p = 0.07). Taken together, these results demonstrate that a single exertional heat exposure can induce acclimation‐like measures that enhance performance and may protect against injury during subsequent heat exposures. Author views are not official US Army or DoD policy.

Ischemic Preconditioning Improves Resistance Training Session Performance.

da Silva Novaes, J, da Silva Telles, LG, Monteiro, ER, da Silva Araujo, G, Vingren, JL, Silva Panza, P, Reis, VM, Laterza, MC, and Vianna, JM. Ischemic preconditioning improves resistance training session performance. J Strength Cond Res 35(11): 2993-2998, 2021-The aim of this study was to investigate the acute effect of ischemic preconditioning (IPC) in a resistance exercise (RE) training session on the number of repetitions performed, total volume, and rating of perceived exertion in recreationally trained and normotensive men. Sixteen recreationally trained and normotensive men completed 3 RE sessions in a counterbalanced and randomized order: (a) IPC protocol using 220 mm Hg followed by RE (IPC), (b) IPC cuff control protocol with 20 mm Hg followed by RE (CUFF), and (c) no IPC (control) followed by RE (CON). RE was performed with 3 sets of each exercise (bench press, leg press, lateral pulldown, hack machine squat, shoulder press, and Smith back squat) until concentric muscular failure, at 80% of one repetition maximum, with 90 seconds of rest between sets and 2 minutes of rest between exercises. Ischemic preconditioning and CUFF consisted of 4 cycles of 5 minutes of occlusion/low pressure alternating with 5 minutes of no occlusion (0 mm Hg) using a pneumatic tourniquet applied around the subaxillary region of the upper arm. For each condition, the number of repetitions completed, total volume of work performed, and rating of perceived exertion were determined. No significant difference was found for rating of perceived exertion between any experimental protocol. Ischemic preconditioning significantly (p < 0.05) increased the number of repetitions across exercises. Consequently, total volume performed (sum of total number of repetitions x load for each exercise) was significantly higher in IPC (46,170 kg) compared with CON (34,069 kg) and CUFF (36,590 kg) across all exercises. This work may have important implications for athletic populations because it demonstrates increase in muscle performance outcomes during a single RE session. Therefore, performing IPC before RE could be an important exercise prescription recommendation to increase maximum repetition performance and total volume of work performed and thus potentially increase desired training adaptations (i.e., strength and hypertrophy).

Supplementation of Re-Esterified Docosahexaenoic and Eicosapentaenoic Acids Reduce Inflammatory and Muscle Damage Markers after Exercise in Endurance Athletes: A Randomized, Controlled Crossover Trial.

This study aimed to analyse the effect of 10 weeks of a highly concentrated docosahexaenoic acid (DHA) + eicosapentaenoic (EPA) supplementation (ratio 8:1) on strength deficit and inflammatory and muscle damage markers in athletes. Fifteen endurance athletes participated in the study. In a randomized, double-blinded cross-over controlled design, the athletes were supplemented with a re-esterified triglyceride containing 2.1 g/day of DHA + 240 mg/day of EPA or placebo for 10 weeks. After a 4-week wash out period, participants were supplemented with the opposite treatment. Before and after each supplementation period, participants performed one eccentric-induced muscle damage exercise training session (ECC). Before, post-exercise min and 24 and 48 h after exercise, muscle soreness, knee isokinetic strength and muscle damage and inflammatory markers were tested. No significant differences in strength deficit variables were found between the two conditions in any of the testing sessions. However, a significant effect was observed in IL1β (p = 0.011) and IL6 (p = 0.009), which showed significantly lower values after DHA consumption than after placebo ingestion. Moreover, a significant main effect was observed in CPK (p = 0.014) and LDH-5 (p = 0.05), in which significantly lower values were found after DHA + EPA consumption. In addition, there was a significant effect on muscle soreness (p = 0.049), lower values being obtained after DHA + EPA consumption. Ten weeks of re-esterified DHA + EPA promoted lower concentrations of inflammation and muscle damage markers and decreased muscle soreness but did not improve the strength deficit after an ECC in endurance athletes.

Safety, Feasibility, and Efficacy of an Eccentric Exercise Intervention in People with Multiple Sclerosis with Ankle Contractures.

The primary aim of this study was to investigate the safety and feasibility of an eccentric exercise program for people with multiple sclerosis (MS) who have ankle contractures, ie, reduced ankle range of motion (ROM). Secondary aims were to explore the efficacy of this eccentric exercise on ankle joint ROM and functional mobility. Five adults with MS with ankle contractures (three women and two men; mean ± SD age, 50.8 ± 9.4; MS duration, 7.6 ± 5.6 years) completed two eccentric exercise training sessions (10-45 minutes) per week for 12 weeks. The training involved walking backward downhill on an inclined treadmill (gradient, 10°-14°) at a self-selected pace. The intervention was assessed for safety (adverse events), feasibility (recruitment rates, adherence rates, enjoyment levels, difficulty, and discomfort), and clinical outcomes, including passive/active ankle ROM and distance walked in 6 minutes. There were no adverse events during or after the eccentric exercise training. There was a 100% adherence rate. All participants enjoyed the training and experienced low levels of muscle soreness/discomfort. The training program improved passive/active ankle ROM in all participants; however, improvements did not translate to improvements in walking for all participants. Walking backward and downhill is a safe and feasible training modality for people with MS with ankle contractures. Clinical outcomes (greater passive/active ankle ROM) after this eccentric exercise training were evident. However, translation to clinically meaningful changes in walking function requires further examination.

Effect of high flow nasal cannula on peripheral muscle oxygenation and hemodynamic during paddling exercise in patients with chronic obstructive pulmonary disease: a randomized controlled trial.

BackgroundExercise training for patients with chronic obstructive pulmonary disease (COPD) improves their endurance and oxygenation. Supplemental oxygen delivered by high flow nasal cannula (HFNC) reportedly improves the clinical outcomes during high-intensity exercise. However, the physical benefits of the provision of supplemental oxygen with HFNC for the improvement of exercise performance have not been fully investigated. This randomized trial aimed to evaluate the effect of HFNC on the hemodynamic status and peripheral muscle microcirculation during exercise training.MethodsIn this multicenter, randomized controlled parallel two-group study, 32 patients with moderate to severe COPD were randomly assigned into the nasal cannula (NC) group (n=15) with a flow rate of 2–3 L/min or the HFNC group (n=17) with a flow rate of 45 L/min for twelve 40 min exercise training sessions.ResultsThe mean cardiac index (CI) and stroke volume (SV) of the NC group in the first session were significantly lower than those of the HFNC group (3.68±0.76 vs. 4.5±0.76 L/min/m2, P=0.014; 63.03±9.87 vs. 74.22±19.48, P=0.002, respectively). The systemic vascular resistance (SVR) of the NC group was significantly lower in the seventh session than in the first session (891±287 vs. 1,138±381 dyn-s/cm5, respectively, P=0.048). The mean deoxyhemoglobin level was higher in the HFNC group in the 1st session and lower in the 12th session (1.09±9.04 vs. 7.3±7.3 µm, P=0.046). The COPD Assessment Test score, Modified Medical Research Council scale score, maximum inspiratory pressure (MIP), and maximum expiratory pressure were different within and between the groups.ConclusionsHFNC, with a lower oxygen concentration than that used with a traditional NC, yielded lower deoxygenated hemoglobin levels after 12 suboptimal exercise training sessions. In contrast, the higher oxygen concentration delivered by NC reduced SVR. The COPD assessment score improved on exercise training, regardless of the supplemental oxygen delivery method.

Motivational self-talk improves time-trial swimming endurance performance in amateur triathletes

ABSTRACT The aim of this study was to compare the effects of an instructional and a motivational self-talk intervention on swimming endurance performance in amateur triathletes. To this purpose, we designed a parallel two groups, randomised, longitudinal (pre- and post-test) study. During 12 days in all exercise-training sessions, the motivational self-talk (M-ST) group (n = 10) was asked to rehearse motivational sentences driving to improve effort to finish the swimming test (750 m) as fast as they could. The instructional self-talk (I-ST) group (n = 11) was asked to rehearse sentences driven to keep pace and movement fluency. The performance in the swimming test increased significantly only in the M-ST group from pre- to post-intervention (2.8%, ). In addition, only the M-ST group increased significantly the swimming pace , which was measured every 150 m, and maintained the same perception of effort level when comparing pre- and post-intervention. The M-ST group also increased significantly their outcome expectancy (6%, = .34) from pre- to post-intervention, in which the variance of swimming performance was approximately 60% explained by the outcome expectancy (B = .656, SE = .086, p < .001, 95% CI [.482, .830]). Findings suggest that M-ST enhanced outcome expectancy, helping triathletes to improve endurance performance probably due to the higher level of potential motivation which mobilised more effort. Therefore, M-ST intervention has been probably effective to improve swimming endurance performance in amateur triathletes, whereas I-ST has maintained it.

Strength exercise suppresses STZ-induced spatial memory impairment and modulates BDNF/ERK-CAMKII/CREB signalling pathway in the hippocampus of mice.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that has generated scientific interest because of its prevalence in the population. Studies indicate that physical exercise promotes neuroplasticity and improves cognitive function in animal models and in human beings. The aim of the present study was to investigate the effects of strength exercise on the hippocampal protein contents and memory performance in mice subjected to a model of sporadic AD induced by streptozotocin (STZ). Swiss mice received two injections of STZ (3 mg/kg, intracerebroventricular). After 21 days, they began physical training using a ladde. Mice performed this protocol for 4 weeks. After the last exercise training session, mice performed the Morris Water Maze test. The samples of hippocampus were excised and used to determine protein contents of brain-derived neurotrophic factor (BDNF), extracellular signal-regulated kinase-Ca2+ (ERK), calmodulin-dependent protein kinase (CAMKII) and cAMP-response element-binding protein (CREB) signalling pathway. Strength exercise was effective against the decrease in the time spent and distance travelled in the target quadrant by STZ-injected mice. Strength exercise was also effective against the reduction of mature BDNF, tropomyosin receptor kinase B and neuronal nuclear antigen (NeuN) hippocampal protein levels in STZ mice. The decrease in the hippocampal ratio of pERK/ERK, pCAMKII/CAMKII and pCREB/CREB induced by STZ was reversed by strength exercise. Strength exercise decreased Bax/Bcl2 ratio in the hippocampus of STZ-injected mice. The present study demonstrates that strength exercise modulated the hippocampal BDNF/ERK-CAMKII/CREB signalling pathway and suppressed STZ-induced spatial memory impairment in mice.

729 Exercise Training Attenuates Anthracycline-Induced Myocardial Injury in Early-Stage Breast Cancer Patients

Anthracycline chemotherapy (AC) is associated with dose-dependent myocardial injury that is associated with increased risk of heart failure in breast cancer (BC) survivors. This study investigated whether supervised exercise training can attenuate AC-induced myocardial injury. This is a secondary and preliminary analysis of a 4-month randomized trial in which 61 women with early-stage BCa (mean age 51±8 years) scheduled for AC were randomized to usual care (UC, n=31) or three weekly sessions of multi-modal exercise training during AC (ET, n=30). Assessments were completed prior to- and 3-4 weeks following the completion of AC. Myocardial injury was assessed by troponin-I and regional and global left-ventricular (LV) function was assessed by echocardiography. 56 participants completed follow-up testing (n=28 in each group). Mean adherence to ET was 79%. Both groups experienced a significant increase in troponin [mean change, UC: 41.6 ng/L (95% CI 27.3, 55.9), p<0.001 vs ET: 26.4 ng/L (18.0, 34.8), p<0.001], but this was attenuated in ET [net difference: -15.9 ng/L (-31.0, -0.2), group-by-time, p=0.039]. There was a small reduction in LV ejection fraction [UC: -2.6% vs ET: -2.9%, time-effect p<0.01) and global longitudinal strain (UC: 1.3% vs ET: 1.1%, time-effect p<0.01) that was not different between trained and untrained subjects. Measures of diastolic function did not change with chemotherapy. AC results in biochemical evidence of myocardial injury that is attenuated by structured exercise training in BC survivors. The clinical significance of this effect requires further long-term follow-up.

Markers of perioperative myocardial injury in patients undergoing coronary artery bypass grafting depending on the prehabilitation program

Aim . To evaluate the morphological and functional cardiac parameters and to measure markers of myocardial injury in the perioperative period of patients undergoing coronary artery bypass grafting (CABG), depending on the prehabilitation program. Methods . 60 male patients with stable coronary artery disease (CAD) underwent screening in the preoperative period and were randomized into two groups. Group 1 (n = 30) underwent supervised treadmill exercises at intensity corresponding to 80% of VO2 peak during the preoperative management. Group 2 (n = 30) patients did not undergo any additional trainings. Patients underwent a standard echocardiographic (ECHO-CG) study in the preoperative period and at days 5-7 after CABG. Serum markers of myocardial injury (troponin I, NT-proBNP) were measured in both groups of patients in the preoperative period before training (measurement 1), at the end of exercise training sessions (measurement 2) and at days 5-7 (measurement 3) after CABG. Results. ECHO-CG findings reported that left ventricular end-systolic dimension (p = 0.039) and left ventricular end-systolic volume (p = 0.039) increased by 8.5% and 18% in patients who underwent supervised exercise trainings as compared to the baseline values. An increase in these parameters was more pronounced in the control group (17% (p = 0.00029) and 41% (p = 0.00028), respectively). NT-proBNP levels showed a downward trend in patients with prehabilitation at the end of the training sessions, while in the control group NT-proBNP levels increased. An increase in NT-proBNP levels was reliable in patients without exercise trainings (p = 0.003) after CABG compared to the preoperative values, while NT-proBNP levels did not differ significantly in patients who underwent prehabilitation (p>0.05). Conclusion . The safety of high-intensity exercise trainings in the prehabilitation program for CABG had been confirmed by laboratory markers of myocardial damage. The obtained data proved the efficiency of active prehabilitation for optimizing echocardiographic parameters and inducing cardioprotection.

Treadmill exercise improves LPS-induced memory impairments via endocannabinoid receptors and cyclooxygenase enzymes

Endocannabinoid system and cyclooxygenase enzymes are implicated in neuroinflammation-induced cognitive impairment. It is believed that non-pharmacological treatments such as physical exercise affect neural systems that control behavioral responses. This research examined the effects of treadmill aerobic exercise on the expression of cannabinoid receptors and cyclooxygenases against LPS-induced cognitive disorders in the hippocampus tissue of rats. For this purpose, rats received intraperitoneal injection of 0.25 mg/kg LPS or saline for 9 continuous days before exercise training. They again received a single i.p. injection with 0.5 mg/kg LPS or saline on days 20 and 41 after the beginning of exercise. The exercise groups were forced to run on a motorized treadmill 5 days per week for 8 weeks. After the last exercise training session, the water maze test was conducted to measure cognitive function. Finally, the hippocampus tissue samples of rats were removed and used to determine the levels of gene expression using the Real-Time PCR method. Data showed that the LPS-treated rats had longer escape distance and longer escape latency to reach the hidden platform and they spent less time than the other groups in the target quadrant, but exercise training improved them in the LPS + Exe (LPS + exercise) group. Exercise increased the expression of CB1 receptor in the Sal + Exe (saline + exercise) group and reduced the expression of CB2 receptor, COX-2 and mPGES-1 in the LPS + Exe group compared to the Sal + LPS group. The findings indicate that treadmill exercise may be beneficial for improvement of cognitive function by modulating the neuroinflammatory processes.

Effect of Intradialytic Exercise on Physical Performance and Cardiovascular Risk Factors in Patients Receiving Maintenance Hemodialysis: A Pilot and Feasibility Study

Introduction: Although intradialytic exercise is considered a form of “nonpharmacological medicine” for patients receiving maintenance hemodialysis (MHD), this practice has not been widely implemented in most dialysis centers because of clinical limitations. We, therefore, aimed to design an intradialytic exercise training program to improve the implementation of this practice and determine its impact on physical performance and cardiovascular risk factors in patients receiving MHD. Methods: A total of 132 MHD patients at 4 outpatient dialysis units were enrolled and assigned randomly into exercise (n = 67) and control groups (n = 65). During a 2-year period, patients in the exercise group participated in 20-min exercise training sessions within dialysis sessions on 3 days per week. All patients underwent assessments of physical function (6-min walk test) and cardiovascular risk factors (blood pressure [BP], total cholesterol [TC], low-density lipoprotein [LDL], high-sensitivity C-reactive protein [hsCRP], albumin [Alb], hemoglobin [Hb], and erythropoietin [EPO] dose) at the baseline and annually thereafter. Results: Of the participants, 50.8% had completed the study after 2 years. No statistically significant intragroup or intergroup differences were observed in the measures of 6MD, BP, TC, hsCRP, Alb, Hb, and EPO dose. Conclusion: The results suggest that although this low-intensity, nonprogressive intradialytic exercise program may be practical, it was not sufficient to improve physiological function and reduce cardiovascular disease risk factors in patients receiving MHD.

Exercise-based cardiac rehabilitation for postcoronary artery bypass grafting and its effect on hemodynamic responses and functional capacity evaluated using the Incremental Shuttle Walking Test: A retrospective pilot analysis

BackgroundCoronary artery bypass grafting (CABG) is a common surgical procedure for the restoration of blood flow into stenotic or blocked coronary arteries. Cardiac rehabilitation has been implemented to some extent worldwide for the management of postoperative CABG. However, studies about the effect of exercise training on hemodynamic responses of the heart using the Incremental Shuttle Walking (ISWT) test are limited in Saudi Arabia. ObjectivesTo investigate the effect of exercise-based cardiac rehabilitation (Phase 3, hospital-based) on some hemodynamic responses including blood pressure, heart rate (HR) and heart rate recovery (HRR), and rate pressure product (RPP) using ISWT on post-CABG patients. MethodsFifteen CABG (51.4 ± 6.4 years, 14 male, 1 female) patients without altering their medication were enrolled in a hospital-based cardiac rehabilitation program (Phase 3) between 2011 and 2012 for supervised individual exercise training sessions (three times per week for 8 weeks; 60-minute session at a moderate intensity). Patients performed two tests (ISWT1 and ISWT2) and one before exercise training program and one after, during which resting systolic blood pressure (SBP) and diastolic blood pressure (DBP), post-ISWT SBP and DBP, resting HR, peak HR, HRR (which was defined as the absolute change from peak HR to 1-minute post peak HR), and RPP at rest and at the end of the ISWT were measured. Exercise training sessions included both aerobic and resistance exercises, which were preceded by a cooling down period and followed by a recovery period. ResultsPaired t-test showed a significant reduction in both resting SBP (p = 0.04) and DBP (p = 0.03), and a significant increase in post-ISWT2 SBP (p = 0.004), peak HR (p = 0.003), HRR (p = 0.03), and RPP at maximum (p = 0.002) after 8 weeks of supervised exercise training. In addition, there was a significant increase in the speed and distance achieved on ISWT2 (p < 0.001) after the training program. ConclusionSupervised exercise training (cardiac rehabilitation) for 8 weeks was effective in improving hemodynamic responses and functional exercise capacity in CABG patients. Cardiac rehabilitation should be implemented more frequently and health-care providers should be aware of its importance. Further research is needed in this area to confirm these findings in the region.

Effect of short-term, high-intensity exercise training on human skeletal muscle citrate synthase maximal activity: single versus multiple bouts per session.

The legs of 9 men (age 21 ± 2 years, 45 ± 4 mL/(kg·min)) were randomly assigned to complete 6 sessions of high-intensity exercise training, involving either one or four 5-min bouts of counterweighted, single-leg cycling. Needle biopsies from vastus lateralis revealed that citrate synthase maximal activity increased after training in the 4-bout group (p = 0.035) but not the 1-bout group (p = 0.10), with a significant difference between groups post-training (13%, p = 0.021). Novelty Short-term training using brief intense exercise requires multiple bouts per session to increase mitochondrial content in human skeletal muscle.

3332Exercise training ameliorates vasodilator capacity of coronary microvessels in patients with vasospastic angina - A new therapeutic approach for the coronary functional disorder

Abstract Background We have recently demonstrated that coronary vasospasm could develop in both epicardial coronary arteries and intramuscular coronary microvessels in patients with vasospastic angina (VSA). However, it remains to be examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients and if so, whether exercise training could ameliorate vasodilator capacity of coronary microvessels on the top of calcium channel blockers. The effectiveness of exercise training is established for organic coronary artery disease but remained to be examined for VSA. Purpose We thus examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients without organic coronary stenosis using an adenosine-stress dynamic computed tomography perfusion (CTP) that can measure absolute value of myocardial blood flow (MBF). We also examined whether exercise training ameliorates not only vasodilator capacity of coronary microvessels but also exercise capacity and frequency of angina attack. Methods In the first protocol, we measured MBF using CTP in consecutive 32 VSA patients with acetylcholine-induced diffuse coronary spasm in the left anterior descending coronary arteries (LAD) and 12 non-VSA controls. In the second protocol, we conducted a randomized controlled trial (RCT; Exercise VSA trial, UMIN: ehz745.008423996), where 20 VSA patients were randomly assigned to either exercise group (Ex group: supervised exercise training session for 30-min using bicycle ergometer, once/week at the hospital and more than 3 times/week at home) or non-exercise group (Non-Ex group) (n=10 each) (Figure A). Before and 3 months after exercise training, we measured MBF with adenosine-stress dynamic CTP and peak VO2 by cardiopulmonary exercise tests, and also assessed angina attack with Seattle Angina Questionnaire (SAQ). Results In the first protocol, CTP showed that adenosine-stress MBF was significantly decreased in the VSA group compared with the non-VSA group (VSA, 137.2±6.6 vs. Non-VSA, 174.4±10.7 ml/100g/min, P&lt;0.01) (Figure B), although patient characteristics were comparable between the 2 groups. In the second protocol, exercise training was performed safely in all patients, and RCT showed that MBF was significantly increased in the Ex group compared with the non-Ex group (Figures C, D), although patient characteristics were also comparable between the 2 groups. Furthermore, peak VO2 was significantly increased in the Ex group compared with the non-Ex group (Figure E), and frequency of angina was significantly decreased in the Ex group compared with the non-Ex group (Figure F). Finally, there was a significant positive correlation between the extents of the changes in peak VO2 and the SAQ score for angina frequency in the Ex group (P&lt;0.01, R=0.67). Figures Conclusions These results provide the first evidence that vasodilator capacity of coronary microvessels is impaired in VSA patients, which can be ameliorated by exercise training.

Exercise and Sirtuins: A Way to Mitochondrial Health in Skeletal Muscle.

The sirtuins form a family of evolutionarily conserved nicotinamide adenine dinucleotide (NAD)-dependent deacetylases. Seven sirtuins (SIRT1–SIRT7) have been described in mammals, with specific intracellular localization and biological functions associated with mitochondrial energy homeostasis, antioxidant activity, proliferation and DNA repair. Physical exercise affects the expression of sirtuin in skeletal muscle, regulating changes in mitochondrial biogenesis, oxidative metabolism and the cellular antioxidant system. In this context, sirtuin 1 and sirtuin 3 have been the most studied. This review focuses on the effects of different types of exercise on these sirtuins, the molecular pathways involved and the biological effect that is caused mainly in healthy subjects. The reported findings suggest that an acute load of exercise activates SIRT1, which in turn activates biogenesis and mitochondrial oxidative capacity. Additionally, several sessions of exercise (training) activates SIRT1 and also SIRT3 that, together with the biogenesis and mitochondrial oxidative function, jointly activate ATP production and the mitochondrial antioxidant function.

Lifestyle and Exercise Intervention Reduces Blood Pressure: A Multiethnic Control Trial

The effect of ethnicity and medication on blood pressure (BP) have been widely described; however, less is known about the interaction between ethnicity, BP medication and regular exercise on hypertensive patients. PURPOSE: This study was aimed to determine the effectiveness of an exercise training and healthy lifestyle education program to reduce BP levels and improve adherence to pharmacological therapy on a multiethnic group of hypertensive patients. METHODS: An 8-month quasi-experimental longitudinal intervention with an exercise group (EG) and control group (CG) was designed. Five hundred and sixty-eight hypertensive patients (67.4±8.8 years; BMI, 26.4±3.1 kg/m2; systolic BP (SBP), 146±9 mmHg and diastolic BP (DBP), 95±7 mmHg; 18% Indigenous, 23% Colombian-African and 59% Hispanic) finalized the study (EG, n= 307 and CG, n= 261). EG participated in 3 weekly exercise training sessions (30 to 60 minutes of concurrent training), which were complemented by medication and lifestyle education. The average of three repeated measures of BP performed with an electronic sphygmomanometer was utilized as primary outcome. Health status, medication adherence, salt consumption, tobacco and alcoholic habits were recorded by questionnaires during clinic history assessment. Non-parametric tests were carried out to compare differences between EG and CG. Several logistic regression models were used to find independent variables predicting two levels (-3 or - 5 mmHg) of reduction in systolic (SBP) or diastolic blood pressures (DBP). RESULTS: We found significant reductions both SBP and DBP in EG (-5.92 mmHg and -5.0 mmHg, respectively, P<0.001 for both) but not in the CG. Also, prevalence of medication adherence was significantly improved in 28.7% (P<0.001) in the EG. In the logistic regression, all models confirmed the EG as the main explanatory variable of a 3 or 5 mmHg BP reduction, independently of other lifestyle risk factors and medication adherence. CONCLUSIONS: In accordance with other studies patients in EG showed more diminution in SBP and DBP than CG, which was independent of other risks factors. However, the main findings were that either ethnic or medication adherence did not influence statistically the reduction in BP associated with our exercise/lifestyle intervention.