High-intensity Aerobic Training Research Articles

Exercise Training for Women With Fibromyalgia Syndrome

Background: To identify in the literature the exercise training therapies for females with fibromyalgia that may improve pain management and quality of life (QOL). Methods: A literature search was conducted in MEDLINE and PEDro databases for human studies up to June 2021. We considered studies if they investigated exercise therapies and their impact on pain, QOL, physical function, and mental health in female patients with fibromyalgia. Results: We identified 112 clinical trials. After posterior analyses, 15 articles were selected, and 8 were considered eligible. Conclusions: Selected studies demonstrated that high-intensity and moderate-intensity aerobic training combined or not with muscle strength anaerobic exercise reduces pain and improves QOL in females with fibromyalgia.

Effect of Aerobic Training with Blood Flow Restriction on Strength and Hypertrophy: A Meta-analysis.

The objective of this meta-analysis is to compare the effects on muscle strength and hypertrophy of low and high-intensity aerobic training with BFR (LI-BFR and HI-BFR) versus low and high-intensity aerobic training without BFR (LI and HI). The search was performed in five databases, by two independent researchers, and the terms and keywords used to optimize the searches were related to blood flow restriction and aerobic training. All studies were evaluated for methodological quality using the PEDro scale and for quality of evidence using the GRADE system. Meta-analyses were conducted using RevMan software. After data extraction, 11 studies met all eligibility criteria and were included in the systematic review. The results of the overall analysis between LI-BFR vs. LI showed a significant difference in muscle strength of knee extensors; for hypertrophy, LI was superior to LI-BFR with clinical relevance. Comparing HI-BFR vs. HI there was no superiority for muscle strength. In conclusion, for strength gains very low-quality evidence was found to support no superiority between LI-BFR and HI-BFR compared to LI and HI, respectively. For muscle hypertrophy, superiority of LI was found compared to LI-BFR, with a very low level of evidence.

Physiological Responses and Performance during an Integrated High-Intensity Interval Aerobic and Power Training Protocol.

This study compared the acute physiological responses and performance changes during an integrated high-intensity interval aerobic and power protocol. Sixteen moderately trained athletes (age: 20.1 ± 2.2 years, body height: 180.0 ± 6.5 cm, body mass: 75.7 ± 6.4 kg, VO2max: 55.8 ± 4.3 mL/kg/min) performed a 2 × 6 min interval training protocol with 2 min passive recovery between sets on two different occasions in random and counterbalanced order. Each 6 min set included repeated periods of 15 s exercise interspersed with 15 s passive rest. On one occasion (RUN), all exercise periods included running at 100% of maximal aerobic speed, while on the other occasion an integrated protocol was used (INT) in which each of the two 6 min sets included 4 × 1.5 min periods of running exercise at 100% of maximal aerobic speed in combination with jumping (i.e., 2 × 15 running with 15 s rest and 1 × 15 s drop jumping with 15 s rest). Time spent above 85% HRmax was two-fold higher in INT compared to RUN (8.5 ± 3.6 vs. 4.3 ± 3.9 min, respectively, p = 0.0014). Interestingly, heart rate increased above 95% HRmax only in INT and almost no time was spent above 95% HRmax in RUN (1.4 ± 1.9 vs. 0.1 ± 0.2 min, respectively, p = 0.008). Blood lactate concentration at the end of the second set of INT was higher than RUN (7.3 ± 3.2 vs. 4.6 ± 2.7 mmol/L, p = 0.002). Countermovement jump was higher in INT after the end of second set by 6.4% (p = 0.04), 6.7% (p = 0.04), 7.8% (p < 0.01) and 7.3% (p < 0.001), at 2, 6 and 8 min after set 2. In conclusion, the comparison between INT and RUN shows that INT not only elicits higher physiological and metabolic responses, but also acutely enhances neuromuscular performance for at least 8 min after the end of exercise. The integrated running/jumping high-intensity interval exercise approach could be a very useful and time efficient method for strength and conditioning coaches, especially in team sports, in which the time available for the improvement of physical parameters is limited.

The effect of moderate and vigorous aerobic exercise training on the cognitive and walking ability among stroke patients during different periods: A systematic review and meta-analysis.

The study examined whether rehabilitation using aerobic exercise is more appropriate for patients less than 3 months post-stroke or more appropriate for patients more than 3 months post-stroke. PubMed, Embase, Web of Science, Scopus and CNKI databases were searched from inception to September 2023. All studies included must be written in English and grey literature was excluded. The quality of the study was evaluated using the PEDro scale. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated. The primary outcomes are cognitive ability and walking ability. The intervention of the experimental group must be or include high-intensity aerobic training or moderate-intensity aerobic training. In addition, we required low intensity routine exercises in control group. Only 15 studies were included in this meta-analysis. The results showed that aerobic exercise has a positive rehabilitation effect on cognitive and walking ability of stroke patients. Global Cognitive Function (SMD = 0.81 95%CI 0.49-1.12), Walking Capacity (SMD = 1.19, 95%CI 0.75-1.62), VO2peak (SMD = 0.97, 95%CI 0.66-1.28), and brain-derived neurotrophic factor (SMD = 2.73, 95%CI 2.03-3.43). We further observed that patients who suffered a stroke within the past three months exhibited superior rehabilitation outcomes compared to patients who suffered a stroke more than three months ago, specifically in terms of cognitive ability, walking tests, and cardiopulmonary function. It is recommended to carry out treatment for patients in the initial stage of stroke, and it is required to pay attention to exercise intensity in the process of treatment to ensure patient safety.

The Influence of the HIIT and Aerobic Training Programs on Body Composition.

Purpose: According to studies, the increased risk of obesity in today's general population is mainly caused by insufficient physical activity. In this study, we compared the effect of two types of endurance training. High-intensity interval training (HIIT) and aerobic (continuous) load training and their impact on selected aspects of body composition. Methods: This study included women (n = 14; 32 years old; height 166.3cm; weight 62.5kg) divided into two groups of seven participants. The tested groups were selected by a deliberate selection of 7 probands, training thrice a week for ten weeks. An entrance and exit examination was conducted using non-invasive techniques (anthropometric measurements, body composition analysis – bioimpedance analysis). A paired T-test (p &lt; 0.05) was used for parameter analysis. Cohen's d was used to assess material significance. Results: Despite the small sample of tested women, better results were achieved in the group implementing the high-intensity interval training. However, these data do not allow for assessing a statistically significant difference between the two types of training methods in reducing the percentage of body fat. Changes in monitored parameters were thus evaluated as statistically insignificant. Conclusion: Despite the relevant results, better results were achieved in the HIIT intervention program. The limiting factors of the study were a small research sample with a deliberate selection and insufficient possibility to control eating habits. Furthermore, it is necessary to pay attention to the higher readiness and motivation of the participants. High-intensity interval training, thanks to its variability and low time requirement, proved to be a suitable exercise program for changing body composition not only in people with obesity but also in the adult population in general.

High-intensity aerobic exercise training improves exercise capacity, dyspnea, and fatigue in patients with severe asthma using triple inhaler.

Asthma is a chronic respiratory disease that affects millions of people worldwide and causes severe symptoms such as wheezing, coughing, and breathing difficulty. Despite modern treatments, 3%-10% of patients develop severe asthma, which requires high-dose medications, and they may still experience frequent and severe symptoms, exacerbations, and psychological impacts. This study aimed to investigate the effects of high-intensity aerobic exercise training (HIAET) in patients with severe asthma. Patients with severe asthma were recruited, and cardiopulmonary exercise tests, dyspnea, and leg fatigue scores were performed before HIAET. Participants underwent a 12-week hospital-based HIAET, which involved exercising twice weekly to reach 80% of their peak oxygen uptake (VO2). Eighteen patients with severe asthma underwent HIAET, which resulted in significant improvement in peak VO2 (1214.0 ± 297.9-1349.4 ± 311.2 mL/min, P = 0.004) and work rate (80.6 ± 21.2-96.2 ± 24.8 watt, P < 0.001) and decrease in dyspnea (5.1 ± 1.8-4.1 ± 1.2, P = 0.017) and fatigue scores (5.2 ± 2.3-4.0 ± 1.2, P = 0.020) at peak exercise. No significant changes were observed in spirometry results, respiratory muscle strength, or circulatory parameters. HIAET can lead to improved exercise capacity and reduced dyspnea and fatigue scores at peak exercise without changes in spirometry, respiratory muscle strength, and circulatory parameters.

Effects of High-Intensity Resistance Versus Aerobic Training in PCOS Women at Risk for Psychological Trauma

Background: Polycystic ovarian syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. Its physical manifestations as the change in body image, fertility challenges, menstrual irregularities, and associated chronic health conditions increase their vulnerability to psychological trauma. Negative effects on psychological health significantly impact their quality of life. Objectives: The current study aimed to compare the effects of high-intensity resistance versus aerobic training on psychological health and quality of life in women with PCOS. Study Design: This was a single-blinded, randomized controlled trial. Methods: A randomized controlled trial was conducted from November 22 to April 23 at Riphah Rehabilitation Center, Islamabad, Pakistan. The female university students (n = 60), with an age range of 18 to 30 years, who were not part of any planned physical activity program, were not taking any medication, and were willing to participate in the exercise trial, were recruited. They were randomly allocated into 2 groups: high-intensity resistance (HIRG) and high-intensity aerobic (HIAG) groups. Both groups underwent exercise interventions for a duration of 12 weeks. Clinical and psychological health and quality of life were assessed using validated measures, including the polycystic ovary syndrome questionnaire (PCOS-Q) and the 36-item Short Form Survey (SF-36). Assessments were conducted at baseline, 6th, and 12th weeks. Data analysis was done using SPSS-21. Results: The mean age of women in the HIRG (n = 30) versus the HIAG (n = 30) was 22.40 ± 2.4 years versus 20.63 ± 2.1 years. Between-group analysis revealed no significant difference (P &gt; .05) between the groups in terms of postintervention total scores of the PCOS-Q and SF-36 quality of life. However, within-group analysis has shown statistically significant improvement (P &lt; .01) in both outcome measures. Conclusion: It is concluded that both high-intensity modes of exercise, resistance, and aerobic training were found to be equally effective interventions for improving psychological health and quality of life in women with PCOS. Individualizing exercise programs to meet individual needs and preferences may aid in maximizing the psychological benefits of each exercise modality. Further investigation into the underlying processes and long-term impact of these therapies in this vulnerable population is required.

Dose-response effects of exercise on mental health in community-dwelling older adults: Exploration of genetic moderators

Background/Objective(1) Examine the role of exercise intensity on mental health symptoms in a community-based sample of older adults. (2) Explore the moderating role of genetic variation in brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) on the effects of exercise on mental health symptoms. MethodThis study is a secondary analysis of a three-arm randomized controlled trial, comparing the effects of 6 months of high-intensity aerobic training vs. moderate-intensity aerobic training vs. a no-contact control group on mental health symptoms assessed using the Depression, Anxiety, and Stress Scale (DASS). The BDNF Val66Met polymorphism and APOE ε4 carrier status were explored as genetic moderators of exercise effects on mental health symptoms. ResultsThe exercise intervention did not influence mental health symptoms. The BDNF Val66Met polymorphism did not moderate intervention effects on mental health symptoms. APOE ε4 carrier status moderated the effect of intervention group on perceived stress over 6 months, such that APOE ε4 carriers, but not non-carriers, in the high-intensity aerobic training group showed a decline in perceived stress over 6 months. ConclusionsAPOE ε4 carrier status may modify the benefits of high-intensity exercise on perceived stress such that APOE ε4 carriers show a greater decline in stress as a result of exercise relative to non-APOE ε4 carriers.

Exercise Training Recommendations for Adults With and Without Chronic Disease to Improve Endothelial Health

The endothelium is the innermost layer of the blood vessels and is responsible for the production of chemicals that are used to regulate arterial diameter in response to changes in blood flow. Dysfunction of the endothelium is a key precursor for cardiovascular disease. However, exercise training may mitigate this dysfunction and promote endothelial health. Therefore, this infographic illustrates findings from an umbrella review (review of reviews; 10.1007/s40279-023-01837-w) that investigated the impact of any exercise training intervention (intervention) on adults with or without chronic disease (population), with, or without a comparator group (comparison), on endothelial function (outcome) using evidence from 27 reviews, including 19 meta-analyses (5464 unique participants). Overall, the included reviews provided evidence that the type of training to optimally improve endothelial function may vary based on disease condition. Specifically, the evidence suggests that healthy adults benefitted most from high intensity aerobic training and/or more frequent low-moderate resistance training. In addition, adults with type 2 diabetes benefitted most from low-intensity resistance or low-moderate aerobic exercise training, whereas those with cardiovascular conditions (i.e., heart transplant patients, peripheral artery disease, heart failure, hypertension, and cerebrovascular disease) should consider engaging in higher-intensity aerobic training to improve endothelial function, although may still need to consult a healthcare provider. Exercise training also improves endothelial function in other chronic conditions including cancer and autoimmune rheumatic disease, but the evidence is insufficient to provide specific guidelines. Although insufficient data exists to determine specific intervention characteristics (i.e., frequency, intensity, type, time), this information provides a high level of evidence to support exercise training, including aerobic, resistance, and combined training as effective strategies to improve endothelial-dependent vasodilatory function in adults. These findings should help guide the design of specific exercise programs or recommendations.

Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial.

A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n=42) or afternoon (PMEX; n=59) exercise training groups, or a non-training control group (Control; n=38). Exercise training was comprised of 48supervised high-intensity interval sessions distributed over 16weeks. Body composition, cardiorespiratory fitness (assessed by ), maximal fat oxidation (FOmax ), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P=0.002), waist circumference (-2.1 cm; P<0.001), diastolic blood pressure (-3.8mmHg; P=0.004) and (3.5mLkg-1 min-1 ; P<0.001) with no differences between training groups. AMEX, in comparison with PMEX, reduced systolic blood pressure (-4% vs. -1%; P=0.019), plasma fasting insulin concentration (-12% vs. -5%; P=0.001) and insulin resistance (-14% vs. -4%; P=0.006). Furthermore, MetS Zscore was further reduced in the AMEX compared to PMEX (-52% vs. -19%; P=0.021) after training. In summary, high-intensity aerobic exercise training in the morning in comparison to training in the afternoon is somewhat more efficient at reducing cardiometabolic risk factors (i.e. systolic blood pressure and insulin sensitivity). KEY POINTS: The effect of exercise time of day on health promotion is an area that has gained interest in recent years; however, large-scale, randomized-control studies are scarce. People with metabolic syndrome (MetS) are at risk of developing cardiometabolic diseases and reductions in this risk with exercise training can be precisely gauged using a compound score sensitive to subtle evolution in each MetS component (i.e. Z score). Supervised aerobic exercise for 16weeks (morning and afternoon), without dietary restriction, improved cardiorespiratory and metabolic fitness, body composition and mean arterial pressure compared to a non-exercise control group. However, training in the morning, without changes in exercise dose or intensity, reduced systolic blood pressure and insulin resistance further compared to when training in the afternoon. Thus, high-intensity aerobic exercise training in the morning is somewhat more efficient in improving the health of individuals with metabolic syndrome.

The effect of resistance training on PCSK9 levels in patients undergoing cardiac rehabilitation after coronary artery bypass grafting: a randomized study

BackgroundResistance training is commonly recommended as part of secondary prevention for post-coronary artery bypass graft (CABG) patients in conjunction with aerobic exercise. Despite its potential benefits, there is currently a lack of studies investigating the impact of resistance training on proprotein convertase subtilisin kexin 9 (PCSK9).AimTo evaluate the effect of intensive resistance training on proprotein convertase subtilisin kexin 9 (PCSK9) levels among post-CABG patients undergoing cardiac rehabilitation (CR).MethodsIn this prospective, open-label, randomized trial, 87 post-coronary artery bypass graft (CABG) patients were randomly assigned into two groups: moderate to high intensity resistance training and aerobic training (n = 44) or aerobic training alone (n = 43) for a total of 12 sessions. Changes in PCSK9 levels was determined as a primary endpoint, while secondary endpoints included changes in the six-minute walk test (6-MWT) results, aerobic capacity, WHO-5 well-being index, fasting blood glucose, and lipid profile. Both groups underwent intention-to-treat analysis.ResultsFollowing completion of cardiac rehabilitation program, the intervention group demonstrated a significant decrease in mean PCSK9 levels when compared to the control group (β = -55 ng/ml, 95% CI -6.7 to -103.3, p = 0.026), as well as significant improvements in the 6-MWT result (β = 28.2 m, 95% CI 2.4–53.9, p = 0.033), aerobic capacity (β = 0.9 Mets, 95% CI 0.1–1.7, p = 0.021), and WHO-5 well-being index (β = 8.1, 95% CI 2.0–14.4, p = 0.011) in patients who received resistance and aerobic training. No statistically significant changes were observed in fasting blood glucose, cholesterol, LDL-C, HDL-C, and triglyceride levels.ConclusionResistance training in CR significantly reduced PCSK­9 levels and increases patient’s functional capacity and quality of life. (NCT02674659 04/02/2016).

Periodized Aerobic Training between Thresholds Improves Submaximal Cardiorespiratory Parameters in Octogenarians.

The worldwide aging population is expanding, with more individuals living into their 80s. Physiological functions decline gradually with age, compounded by sedentary lifestyles. Incorporating physical activity into daily routine is crucial for maintaining independence. This study aimed to assess a periodized high-intensity aerobic training program (PEZO-BT) in octogenarians, focusing on submaximal ergospirometry effects. A total of 48 non-frail octogenarian subjects (12 females, 36 males) were randomized into control and intervention groups. All subjects underwent submaximal cardiopulmonary exercise testing with gas analysis at baseline, stopping after the respiratory compensation point (RCP). Our intervention group completed a 14-week PEZO-BT aerobic training program. The outcomes were oxygen consumption at first ventilatory threshold (VO2AT), ventilatory efficiency slope (VE/VCO2), oxygen uptake efficiency slope (OUES), cardiorespiratory optimal point (COP), oxygen pulse change (ΔVO2/HR) from anaerobic threshold (AT) to respiratory compensation point (RCP), and power output at anaerobic threshold (POAT). Mixed ANOVA examined time and treatment effects. If significance emerged, post hoc t-tests were used to compare significances between groups. The homogeneity of variance was assessed using Levene's test. Chi-square tests compared ergospirometry criteria and ventilatory performance within groups. The mean differences at post intervention were significant in VO2AT (p < 0.001), VE/VCO2 (p < 0.001), ΔVO2/HR (p < 0.05), and POAT (p < 0.001), while OUES and COP were not significant (p > 0.05). However, clinical effects were observed in the entire intervention group. Training improved exercise capacity and workload. Overall, this periodic aerobic and high-intensity interval training (HIIT) program yielded significant improvements in cardiorespiratory fitness (CRF) in previously untrained octogenarians with and without comorbidities. The findings suggest implications for promoting long-term healthy aging.

SAT100 Management Of Post-exercise Hyperglycemia In A Patient Using Control IQ Artificial Pancreas System - A Case Report

Abstract Disclosure: P. Sharma: None. A. Ramirez Berlioz: None. Introduction: The automated insulin delivery (AID) Tandem Control IQ (CIQ) system has improved glycemic control with increased time in range (∼10%) &amp; decreased hypoglycemic events (∼1%) through automatic basal rate modifications &amp; correction bolus administration. The sleep &amp; exercise activity (EA) decrease hypoglycemia risk. The CIQ EA decreases basal rate for predicted glucose =&amp;lt;140 mg/dl, increases basal rate for predicted glucose &amp;gt;160 mg/dl, and suspends insulin delivery for glucose =&amp;lt;80 mg/dl. It is designed for mild-moderate physical activity and is aggressive for high-intensity aerobic exercise or endurance training. High-intensity activity can cause post-exercise hyperglycemia. There is minimal data regarding management of post-exercise hyperglycemia when using AID systems. Case Report: A 40 year old female with uncomplicated type 1 diabetes mellitus managed by Tandem CIQ system reported post-exercise hyperglycemia after starting a new exercise routine. Previous routine included cardio and weight training on 4 days of the week. She had recently started a stationary cycling routine lasting 15-45 minutes with varying intensity. She would start the CIQ EA 1.5 hours prior to exercise and stop after completion. The pump report revealed hyperglycemia between 200-300 mg/dl occurring within 1 hour after exercise, lasting several hours after. Patient attempted using normal mode during exercise, manual bolusing immediately after exercise, and post-exercise insulin sensitivity factor modification without effect. Stopping EA 10-15 mins before completion led to elimination of post-exercise hyperglycemia. Discussion: The CIQ EA is designed to decrease exercise-induced hypoglycemia. After high-intensity exercise, the CIQ algorithm can exaggerate the hyperglycemia. High-intensity routines such as sprints, weight-lifting, intensive cycling, are associated with varying degrees of hyperglycemia. Our patient's new cycling routine was higher-intensity compared to what she previously did, leading to persistent hyperglycemia. Some recommendations to avoid post-exercise hyperglycemia in patients on AID systems include using CIQ normal mode during exercise, utilization of a temporary basal rate, or administration of a manual correction bolus. However, the use of normal mode or temporary basal rates can lead to glycemic variations during exercise. A manual correction bolus administered after exercise may be too late to avoid the hyperglycemia and leads to subsequent hypoglycemia due to enhanced insulin sensitivity post-activity. We tried stopping EA a few minutes before routine completion and found that 10 minutes was appropriate. We suggest that discontinuation of the EA 10 minutes before completion of exercise routine can alleviate post-exercise hyperglycemia. Additional studies are required to confirm whether this method would work on a larger scale. Presentation: Saturday, June 17, 2023

Neo-train: study protocol and feasibility results for a two-arm randomized controlled trial investigating the effect of supervised exercise during neoadjuvant chemotherapy on tumour response in patients with breast cancer

BackgroundPrehabilitation with exercise interventions during neoadjuvant chemotherapy (NACT) is effective in reducing physical and psychosocial chemotherapy-related adverse events in patients with cancer. In preclinical studies, data also support a growth inhibitory effect of aerobic exercise on the tumour microenvironment with possible improved chemotherapy delivery but evidence in human patients is limited. The aim of the study here described is to investigate if supervised exercise with high-intensity aerobic and resistance training during NACT can improve tumour reduction in patients with breast cancer.MethodsThis parallel two-armed randomized controlled trial is planned to include 120 women aged ≥ 18 years with newly diagnosed breast cancer starting standard NACT at a university hospital in Denmark (a total of 90 participants needed according to the power calculation and allowing 25% (n = 30) dropout). The participants will be randomized to usual care or supervised exercise consisting of high-intensity interval training on a stationary exercise bike and machine-based progressive resistance training offered three times a week for 24 weeks during NACT, and screening-based advice to seek counselling in case of moderate-severe psychological distress (Neo-Train program). The primary outcome is tumour size change (maximum diameter of the largest lesion in millimetre) measured by magnetic resonance imaging prior to surgery. Secondary outcomes include clinical/pathological, physical and patient-reported measures such as relative dose intensity of NACT, hospital admissions, body composition, physical fitness, muscle strength, health-related quality of life, general anxiety, depression, and biological measures such as intratumoural vascularity, tumour infiltrating lymphocytes, circulating tumour DNA and blood chemistry. Outcomes will be measured at baseline (one week before to 1–2 weeks after starting NACT), during NACT (approximately week 7, 13 and 19), pre-surgery (approximately week 21–29), at surgery (approximately week 21–30) and 3 months post-surgery (approximately 33–42 weeks from baseline).DiscussionThis study will provide novel and important data on the potential benefits of supervised aerobic and resistance exercise concomitant to NACT on tumour response and the tumour microenvironment in patients with breast cancer, with potential importance for survival and risk of recurrence. If effective, our study may help increase focus of exercise as an active part of the neoadjuvant treatment strategy.Trial registrationThe trial was registered at ClinicalTrials.gov (NCT04623554) on November 10, 2020.

Intense exercise for survival among men with metastatic prostate cancer: 12 months feasibility results from the INTERVAL-GAP4 trial.

81 Background: Exercise is now considered an important therapy to ameliorate treatment side effects, improve quality of life and physical function however, causation of survival benefit and the underlying mechanisms is not yet established. In 2015, the Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4) – a worldwide multicentre phase III trial – was launched to determine if high-intensity combined resistance and aerobic exercise plus psychosocial support improves overall survival in men with metastatic prostate cancer. Here, while exercise delivery and follow-up assessments are still taking place in 6 different countries, we aim to examine the feasibility, exercise compliance and safety of a 12-month exercise medicine program in patients with mCRPC. Methods: Experimental design was a longitudinal analysis of attrition rates, exercise attendance and compliance metrics and programme safety over the initial 12 months of patients participating in the INTERVAL-GAP4 trial at the Edith Cowan University site in Perth, Australia. Results: 201 patients were screened for participation and 46 patients (22.9%) were randomly assigned to the two study arms. Median time since prostate cancer diagnosis was 72.0 (interquartile range (IQR): 19.5-118.5) months. Most patients were previously treated with radiotherapy (53.3%). Metastases present mostly in the lymph nodes (53.3%), followed by bones (51.1%), lungs (2.2%) and bladder (2.2%). Participants attended a total of 2,907 out of 3,744 exercise sessions scheduled, with a median exercise attendance of 78.8% (IQR: 71.6%-82.7%) per participant. Majority of sessions were performed at an RPE of 7-8 indicating “vigorous intensity” or at an RPE of 5-6 indicating “moderate intensity” (67.2%). Tolerance was moderate-to-high in most sessions (83.0%). 191 adverse events (AEs) were observed throughout the study period. A total of 136 adverse events were reported by 19 participants from the exercise group, and these were mainly disease related (n= 69, 50.7%). Most AEs were grade 1 and 2 (n= 126, 92.7%). In the control group, 55 AEs were observed, and these were mainly disease related (n= 22, 40.0%) and grade 1 and 2 (n= 51, 92.7%). The most common intervention-related adverse events experienced in the exercise group were pain (n= 6, 50.0%; i.e., back pain, bone pain, lymph node pain, and general pain). Conclusions: Patients with mCPRC can participate in high-intensity aerobic and resistance training with moderate to high attendance and tolerance. The exercise intervention appears safe with limited intervention-related adverse events experienced and mostly minor and expected. However, with only 22.9% of screened patients deemed suitable and willing, this aspect of feasibility requires attention. Clinical trial information: NCT02730338 .

The effect of high-intensity interval, aerobic, resistance and spirulina supplement consumption on levels of UCP-1, TRPV1 and HOMA-IR in the white adipose tissue of diabetic rats

The purpose of this study was to investigate the effect of high-intensity interval, aerobic, and resistance training, and spirulina supplement consumption on the levels of Uncoupling Protein-1 (UCP1), Transient Receptor Potential Vanilloid (TRPV1) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the white adipose tissue of diabetic rats. A total of 42 male rats with diabetes type II were randomly assigned into seven groups as follows: aerobic training (n=6), resistance training (n=6), interval training (n=6), aerobic training combined with supplementation (n=6), resistance training combined with supplementation (n=6), interval training combined with supplementation (n=6) and control (n=6) groups. The training groups carried out the training (8 weeks/5 days) on a rodent treadmill and ladder. The paired sample t-test and one-way ANOVA were employed for data analysis. The three kinds of training, with and without supplementation, significantly reduced mass, glucose, insulin, and insulin resistance. In the three supplementation-combined training groups the difference on the HOMA-IR index was significant; however, the decline was larger in the resistance training with supplementation group. The concentration of UCP-1 and TRPV1 proteins significantly increased in all training groups, with and without supplementation. Nonetheless, the significant increase in the UCP-1 levels in the interval training with supplementation group was more than in the other groups. Furthermore, the TRPV1 protein levels were higher in the resistance training with supplementation group. Eight weeks of training, with and without Spirulina supplementation, reduced insulin resistance and gave rise to significant changes in UCP-1 and TPRV1 concentrations.

Acute Responses in Blood Flow Restriction Low-intensity Aerobic Training: A Meta-analysis.

The purpose was to determine the effect low-intensity training with blood flow restriction (LI-BFR) versus high-intensity aerobic training (HIT) on acute physiological and perceptual responses. The Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, Scopus, SPORTDiscus and Web of Science databases and the reference list of eligible studies were consulted to identify randomized experimental studies, published until July 4, 2022, that analyzed physiological or perceptual responses between LI-BFR versus HIT in healthy young individuals. Mean difference (MD) and standardized mean difference (SMD) were used as effect estimates and random effects models were applied in all analyses. Twelve studies were included in this review. During exercise sessions, HIT promoted higher values of heart rate (MD=28.9 bpm; p<0.00001; I 2 =79%), oxygen consumption (SMD=4.01; p<0.00001; I 2 =83%), ventilation (MD=48.03 l/min; p=0.0001; I 2 =97%), effort (SMD=1.54; p=0.003; I 2 =90%) and blood lactate (MD=3.85 mmol/L; p=0.002; I 2 =97%). Perception of pain/discomfort was lower in HIT (SMD=-1.71; p=0.04; I 2 =77.5%). In conclusion, LI-BFR promotes less pronounced physiological responses than HIT but with greater perception of pain.

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

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

A comparison of passive heat treatment-induced vascular adaptations relative to exercise training

Epidemiological data indicate that repeated heat stress improves cardiovascular health, making passive heat therapy (PHT) a potential alternative for those unable to exercise. Few studies to date have examined the potential exercise mimetic effects in humans, and it is unclear how adaptations compare in magnitude to exercise training. OBJECTIVE: To examine the effects of 6 weeks of localized, muscle-focused PHT on resistance artery vascular function, exercise hemodynamics, and exercise performance relative to the adaptations observed following high-intensity aerobic exercise training focused on the same muscles. HYPOTHESIS: 6 weeks of PHT, applied through pulsed shortwave diathermy (2 hr, 3 days/week), would increase resistance artery function, improve exercise hemodynamics, and enhance exercise performance more than a sham treatment, but less than single-leg knee extension (KE) exercise training (EX; 40 min, 3 days/week). We also hypothesized that these functional adaptations would be accompanied by increased skeletal muscle capillarity. METHODS: We randomized 34 sedentary but otherwise healthy, young adults (ages 18–36; n = 17 female, 17 male) to receive PHT, EX, or sham heating sessions (SHAM; 2 hr, 3 days/week) over 6 weeks. Vascular function was determined through the blood flow response during both a passive leg movement (PLM) assessment and a knee extension graded exercise test (GXTmax). Muscle biopsies were taken from the vastus lateralis at baseline and after 6 weeks of intervention. RESULTS: Peak muscle treatment temperature was significantly different between all groups with PHT exhibiting a higher peak temperature (~40.80°C) than those in the EX (~37.75°C, P&lt;0.001) and SHAM groups (~36.10°C, P&lt;0.001). Peak blood flow during PLM increased to the same extent (P=0.625) in both the EX (~10.5% increase, P=0.009) and PHT groups (~8.5% increase, P=0.044); but tended to decrease in the SHAM group (P=0.087). KE peak flow increased in EX (~19%, P=0.005), but did not change in PHT (P=0.523) and decreased in SHAM (~7%, P=0.020). Peak vascular conductance during KE significantly increased by ~25% in EX (P=0.030) and PHT (P=0.012). KE peak power increased in EX by ~27% (P=0.001) but did not significantly change in PHT(P=0.175) and SHAM groups (P=0.111). EX, but not PHT or SHAM increased muscle capillary-to-fiber ratio (P = 0.0003), capillary density (P = 0.0428), and the Capillary to Fiber Perimeter Exchange Index (P = 0.0089). CONCLUSIONS: 6 weeks of localized PHT, when applied to young healthy individuals, improved resistance artery function at rest and during exercise to the same extent as exercise training. However, PHT did not lead to increased KE peak flow, microvascular remodeling, or improved exercise performance. Therefore, PHT mimics many, but not all the vascular benefits of exercise training. Further research is necessary to determine the mechanism by which 6 weeks of PHT led to improved vascular function at rest and during exercise. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effect of Aerobic Exercise Training on Circulating s-Klotho in a Heart Transplant Recipient; A Case Report

Reduced circulating s-Klotho has been seen in heart failure patients, However, its values are increased following aerobic exercise training. The purpose of the case study was to examine whether high intensity aerobic exercise training increase serum s-Klotho levels in untrained heart transplant recipient, and to examine the relation between plasma s-Klotho concentration and peak oxygen uptake (VO2peak). Methods: Untrained heart recipient 25 years old trained for 60 min-1×4 times×wk-1 for 12 wks-1 at 85% of VO2peak. Testing sessions were performed at 0, and 12 weeks. Blood samples were analyzed for s-Klotho by an ELISA kit. Results: Subject increased its VO2peak from 25.1 to 31.2 mL×kg-1×min-1, s-Klotho increased from 349 to 467 pg×mL-1. Conclusions: This case report indicated that aerobic exercise was tolerated without any difficulties, along with significantly improve in s-Klotho and peak oxygen uptake values. In addition, it is apparent that training at 85% work capacity in young heart transplant recipients following heart failure benefits to reestablish functional of central oxygen delivery variables mainly; cardiac output. Thus, it may have a better prognosis for the entire heart transplant recipient's population.