High-intensity Exercise Training Research Articles

Hypomethylation in promoters of PGC-1α involved in exercise-driven skeletal muscular alterations in old age

Abstract Exercise training can significantly improve skeletal muscle mitochondrial function and has been proven to be highly relevant to alterations in skeletal muscle DNA methylation. However, it remains unclear whether late-in-life exercise has an effect on promoter methylation of PGC-1α, a key regulator of mitochondrial biogenesis. Here we employed two distinct exercise modalities, constant medium intensity exercise training (CMIT) and high-intensity interval exercise training (HIIT), to investigate their impacts on PGC-1α expression and methylation regulation in skeletal muscle of aged mice. The results revealed a notable decrease in PGC-1α expression in skeletal muscle of aged mice, accompanied by elevated methylation levels of the PGC-1α promoter, and increased DNA methyltransferase (DNMT) protein expressions. However, both forms of exercise training significantly corrected PGC-1α epigenetic changes, increased PGC-1α expression, and ameliorated skeletal muscle reduction. Furthermore, exercise training led to elevated expression of proteins related to mitochondrial biogenesis and energy metabolism in skeletal muscle, improving mitochondrial structure and function. In conclusion, late-in-life exercise improved skeletal muscle function, morphology, and mitochondria biogenesis, which may be associated with hypomethylation in promoters of PGC-1α and increased content of skeletal muscle PGC-1α. Notably, there was no clear difference between HIIT and CMIT in PGC-1α expression and skeletal muscle function.

Parkinson’s disease motor intervention patterns: a network meta-analysis based on patient motor function

BackgroundParkinson’s disease is characterized by symptoms such as bradykinesia and rigidity, which worsen as the disease progresses, significantly impacting patients’ independence and quality of life. This study utilizes a network meta-analysis approach to quantify information gathered from randomized controlled trials (RCTs) regarding motor interventions that effectively improve the motor function of Parkinson’s disease patients, aiming to provide evidence for selecting appropriate exercise intervention strategies for patients.MethodsA systematic search strategy for randomized controlled trials (RCTs) restricted to English was constructed based on multiple biomedical databases. Databases searched included PubMed, Embase, Cochrane, Web of Science, CINAHL, CBM, China National Knowledge Infrastructure (CNKI), Wan fang, VIP, etc., with searches conducted from inception to July 9, 2023. Two authors screened all studies, extracted data, and used frequency domain analysis methods. Network meta-analysis was performed using STATA software version 18.0 to compare and rank exercises that could effectively improve the motor function of Parkinson’s disease patients (measured by indicators such as MDS-UPDRS-III, TUG, BBS, Mini-BES Test, 6MWT scores). Additionally, a series of analyses and evaluations were conducted, such as assessing the methodological quality of included studies using the Cochrane risk of bias tool.ResultsThe network meta-analysis included a total of 111 studies involving 5,358 participants, 133 intervention experiments, and 31 intervention measures. Although most exercise interventions showed effectiveness, cumulative ranking curves under the surface (SUCRA) values showed that archery exercise significantly improved patients’ MDS-UPDRS-III scores (SUCRA = 95.6%), significantly superior to routine care [standardized mean difference (SMD = 16.92, 95%CI = −28.97, −4.87)]. High-intensity and agility exercise (High strength and agility) referred to as high-intensity exercise or agility training or a combination of both, collectively termed as high-intensity agility training, significantly improved patients’ completion time for the time-up-and-go test (SUCRA = 99.7%), (SMD = −7.88, 95%CI = −9.47, −6.28). Dance and Tai Chi exercises significantly improved patients’ balance abilities: Mini-Balance Evaluation Systems Test (SUCRA = 77.9%), (SMD = 5.25, 95%CI = −0.42, 10.92) for dance intervention and Berg Balance Scale (SUCRA = 94.7%), (SMD = 11.22, 95%CI = 3.26, 19.18) for Tai Chi intervention. Dance also significantly improved patients’ walking ability in the 6-min walk test (SUCRA = 80.5%), (SMD = 71.31, 95%CI = 13.77, 128.84).ConclusionCompared to other exercises, archery, dance, Tai Chi, and high-intensity agility exercises demonstrate superior efficacy in improving the motor function of Parkinson’s disease patients.

Right ventricular remodeling induced by prolonged excessive endurance exercise is mediated by upregulating Wnt/β-catenin signaling in rats

BackgroundThe aim of this study was to develop an animal model to investigate whether prolonged intensive endurance exercise induces RV remodeling, taking into account the involvement of Wnt/β-catenin signaling. MethodsFour-week-old male Wistar rats (100 to 125 g) were assigned to four groups (n = 8/group): 1) sixteen weeks of intensive (36 m/min) exercise (INT), 2) twelve weeks of the intensive exercise followed by four weeks of moderate intensity (18 m/min) exercise (INT + MOD), 3) twelve weeks of the intensive exercise followed by four weeks of detraining (INT + DT), and 4) sedentary rats (SED). The exercise protocols were performed five days a week for one h/day. Echocardiography, real-time PCR, western blotting, and histological staining were performed at the end of week sixteen. ResultsINT rats developed concentric hypertrophy without diastolic dysfunction compared to SED (p = 0.006) and INT + DT (p = 0.035). Wnt1, β-catenin and CyclinD1 proteins in the training groups were significantly higher than SED rats (p < 0.001). Interestingly, INT rats had higher protein levels than INT + DT and INT + MOD (p < 0.001), with higher gene expression compared to SED rats (p < 0.05). There was also a significant increase in collagen deposition in INT rats compared to SED (p = 0.046) and INT + DT (p = 0.034). Furthermore, INT + MOD and INT + DT rats did not show any adverse structural, functional, or histological changes. ConclusionsLong-term intensive endurance training seems to be associated with increased collagen deposition and wall thickness in the RV through Wnt/β-catenin signaling (which is concentration dependent), without changes in diastolic function. Clinical perspectiveOver the past decades, there has been an ongoing debate about whether the structural and functional adaptations of the cardiovascular system in trained endurance athletes are benign physiological responses to training or potentially pathological changes related to disease. While the adaptations of the left heart are well-documented, the remodeling of the right heart remains a subject of discussion. To gain insights into the ability of sustained high-intensity exercise to cause adverse right ventricular (RV) remodeling, we conducted an experimental study in which male rats were trained to run vigorously for 1 h daily over a 16-week period and compared them to a parallel group of sedentary control rats. Our findings revealed that intense long-term exercise induced morphological changes along with fibrosis affecting the RV. These fibrotic changes were a result of the 16-week vigorous exercise training regimen. If these results are confirmed in humans, they suggest that prolonged high-intensity endurance exercise training may lead to adverse cardiac remodeling. Our findings have important potential implications for the assessment of cardiac remodeling in individuals engaged in high-level exercise training.

Effects of Acute Piano Performance With Blood Flow Restriction on Upper Limb Muscle and Perceptual Response in Pianists.

Long-term and prolonged piano performance does not provide essential skeletal muscle training benefits while increasing the risk of injury to the upper extremities. Unlike high-intensity exercise training, moderate blood flow restriction (BFR) training has been found to improve neuromuscular mechanisms with a variety of physical exercises (machine, elastic band, walking, electrical stimulation, and body weight). We investigated the physiological and perceptual responses related to piano performance with or without BFRbased on acute responses of neuromuscular mechanisms.Student or professional pianists (n=7) performed the "Revolutionary Etude" on the piano with (Piano-BFR) and without (Piano-Ctrl) BFR. During the Piano-BFR performance, 150-180 mmHg of cuff pressure was applied around the most proximal region of both arms as a moderate BFR. Changes in upper limb girth, muscle thickness, and hand grip strength were measured before and immediately after the performance. After the performance, perceptual and other responses were recorded.Immediately after the performance, the Piano-BFR condition induced greater changes in girth (forearm and upper arm), muscle thickness (forearm), and handgrip strength than the Piano-Ctrl condition.Piano-BFRwas (p<0.01) higher than Piano-Ctrl on eight questions regarding perceptual response (upper arm fatigue and difficulty playing the piano). Piano performance with BFR was revealed to increase upper extremity muscle size and fatigue in pianists after playing. Piano performance with BFR was revealed to increase upper extremity muscle size and fatigue in pianists after playing. The effect of BFR on neuromuscular mechanisms on piano performance was greater in the forearm than in the upper arm.

Mood, Cognitive Function, and Plasma Kynurenine Metabolites Responses Following Severe Changes in Physical Activity.

To monitor changes in mood, cognitive function, brain electrical activity, and circulating kynurenine pathway metabolites in response to a three-week severe physical activity restriction, followed by three weeks of resumed activity adding resistance and high-intensity interval exercise training. Twenty healthy participants (14 males, six females; 25.4 ± 5.2 years) underwent three weeks of limited physical activity using forearm crutches with one leg suspended (INACT) and then three weeks of resumed activity plus supervised resistance and high-intensity interval training sessions (ACT, three to six sessions per week). At baseline, after INACT, and then after ACT, venous blood was sampled for analysis of major kynurenine pathway metabolites, a short version of the International Physical Activity Questionnaire (IPAQ-SF), Hospital Anxiety and Depression Scale (HADS) and Profile of Mood States (POMS) questionnaires were completed, and cognitive tests with EEG were performed. During INACT, the depression score on the HADS scale tended to increase (3.5 to 6.8; p = 0.065), while it was reduced with ACT compared with after INACT (2.8; p = 0.022). On the POMS scale, depression, fatigue, and confusion increased within INACT (p < 0.05). Notably, subjects exhibited considerable variability, and those experiencing depression symptoms recorded by the HADS scale (n = 4) displayed distinct mood disturbances on POMS. All HADS and POMS scores were fully restored to baseline with ACT. Neither INACT nor ACT induced significant changes in cognition, brain electrical activity, or kynurenine pathway metabolites (p > 0.05). While young healthy individuals with three weeks of severely restricted physical activity do not undergo changes in circulating kynurenine pathway metabolites, cognitive performance, and brain electrical activity, their mood response is quite variable, and depression develops in some. Three weeks of resuming mobility plus exercise training reversed the mood profile.

High-intensity exercise training in large yellow croaker is a compromise between disease resistance and fish welfare

Exercise training is being applied to improving the productivity and welfare of farmed fish species. Nonetheless, research into whether exercise training improves disease resistance and immune function in fish is still at an early stage, and more studies is required. This study examined the impact of exercise training on growth performance, disease resistance and immune function of large yellow croaker (Larimichthys crocea). Juvenile fish underwent a 12 days training regime at 2–3 BL.s−1, followed by a parasite disease challenge test (Cryptocaryon irritans). Fish muscle RNA-seq analyses was used to evaluate the influence of exercise on juvenile immune function. The results showed that: (1) exercising at 2–3 BL.s−1 had no impact on the growth of juvenile croakers, however it induced an inflammatory response in croakers, leading to increased mortality in the treatment group (T) compared to the control group (C); (2) exercising also enhanced the resistance of T to C. irritans, resulting in a significant 17.6% increase in the survival rate of T compared to that of C; and (3) the RNA-seq analysis of the muscles demonstrated that differentially expressed genes (DEGs) between T and C were primarily involved in regulating the expression of genes related to muscle development and immunity in croaker; (4) enrichment analyses using KEGG and GO revealed that the DEGs were significantly enriched in pathways related to metabolic processes and biosynthesis. In conclusion, it is suggested that exercise training with high water speed induces an inflammatory response in the large yellow croaker, compromising the welfare of the fish. However, this stimulates the expression of immune-regulation-related genes and pathways, thereby improving the disease resistance of exercising individuals. Our study reveals that exercise training can improve disease resistance of large yellow croaker, which has significant implications for the sustainability of the croaker aquaculture industry.

Effects of high-intensity interval exercise training on knee health and articular cartilage volume in patients with obesity: A comparative study between bicycle and treadmill groups

ObjectiveIt's a comparative study between bicycle and treadmill groups to observe the effects of high-intensity interval exercise training on knee health and articular cartilage volume in patients with obesity, thus to provide a scientific basis for the healthy exercise methods to lose weight. Methods60 patients with simple obesity were randomly divided into two groups of 30: the bicycle group and the treadmill group. Both groups received high-intensity interval exercise training, power bicycle training and moving treadmill training (MTT) were accepted respectively. Both groups received consecutive treatment for 12 weeks, five times a week, and every single time lasted for 30 min. Before and after treatment, the body mass index (BMI), the knee's articular cartilage volume was measured with magnetic resonance imaging (MRI),the pain of knee was assessed with visual analogue scale (VAS). Before and after each training session, the local skin temperature of the knee was measured with an electronic thermometer. ResultsAfter 12 weeks of treatment, the BMI was both decreased, the VAS and the local skin temperature of knee was increased significantly, the knee's articular cartilage volume in the treadmill group was reduced significantly, while the above indicators in the bicycle group did not change significantly, and the difference between the two groups was statistically significant (p < 0.001). ConclusionPower bicycle training can avoid a decrease in the volume of knee joint cartilage, while MTT can easily lead to a decrease in the volume of knee joint cartilage, an increase in local skin temperature and pain of knee joint.

High-intensity exercise training using a rotarod instrument (RotaHIIT)significantly improves exercise capacity in mice.

Voluntary or forced exercise training in mice is used to assess functional capacity as well as potential disease-modifying effects of exercise over a range of cardiovascular disease phenotypes. Compared to voluntary wheel running, forced exercise training enables precise control of exercise workload and volume, and results in superior changes in cardiovascular performance. However, the use of a shock grid with treadmill-based training is associated with stress and risk of injury, and declining compliance with longer periods of training time for many mouse strains. With these limitations in mind, we designed a novel, high-intensity interval training modality (HIIT) for mice that is carried out on a rotarod. Abbreviated as RotaHIIT, this protocol establishes interval workload intensities that are not time or resource intensive, maintains excellent training compliance over time, and results in improved exercise capacity independent of sex when measured by treadmill graded exercise testing (GXT) and rotarod specific acceleration and endurance testing. This protocol may therefore be useful and easily implemented for a broad range of research investigations. As RotaHIIT training was not associated cardiac structural or functional changes, or changes in oxidative capacity in cardiac or skeletal muscle tissue, further studies will be needed to define the physiological adaptations and molecular transducers that are driving the training effect of this exercise modality.

DOES EXERCISE PRESERVE FAT FREE MASS DURING A VERY LOW ENERGY DIET IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA?

INTRODUCTION AND AIMS Obesity is a major comorbidity of Obstructive Sleep Apnea (OSA), contributing to 58% of moderate to severe cases in adults. Very low energy diets (VLED) are effective for rapidly reducing weight however are associated with a greater fat free mass reduction compared to other energy restricted diets. Exercise may protect against this and has been shown to improve apnoea hypopnea index (AHI) independently of weight loss. We aimed to assess the feasibility and tolerability of rapid weight loss induced by VLED with or without high-intensity functional exercise in overweight and obese men with OSA. METHODS This two-arm open-label pilot randomised trial included 20 participants with a BMI of ≥27kg/m2 and moderate to severe OSA. Patients were randomised to VLED-only (VO) or VLED plus exercise (VEX) for 12-weeks. Both groups followed a VLED providing &amp;lt;800kcal/day for 8 weeks, followed by a 4-week refeeding period. The VEX group also participated in supervised high-intensity functional exercise training consisting of resistance and aerobic training of up to 5 days per week. RESULTS A total weight loss of -14.5kg [95%CI -17.5 to -11.5] and -9.3kg FM [95%CI -11.0 to -7.6] was achieved (measured by DEXA). Fat-free mass (FFM) reduction occurred (-3.9kg [95%CI -5.5 to -2.3]), with a trend towards preservation in the VEX group. The VO group reduced AHI by 42.9%, moving from severe to moderate OSA. The VEX group’s AHI change (-32.6%) approached but did not reach the moderate category post-intervention. CONCLUSION The VLED, with or without exercise, proved feasible and well-tolerated and demonstrated positive outcomes in body composition and AHI. The VEX group suggested a potential trend in preserving FFM compared to the VO group. These results are promising, indicating the need for a larger, definitive trial to confirm these findings and explore the impact of exercise on FFM preservation in this population.

Passive Heat Stress, Like Exercise Training, Leads to Improved Vascular Function

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 performance, molecular regulators of vascular tone, and skeletal muscle capillarization relative to the adaptations observed following high-intensity aerobic exercise training focused on the same muscles. HYPOTHESIS: 6 weeks of PHT, applied to the knee extensor muscles through pulsed shortwave diathermy (2 hr, 3 days/week), would improve both resistance artery function and exercise hemodynamics, as well as increase vascular tone regulators more than a sham treatment, but less than single-leg knee extension (KE) exercise training (EX; 40 min, 3 days/week). 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 blood flow during PLM increased to the same extent in both the EX (~10.5% increase, P=0.009) and PHT groups (~8.5% increase, P=0.044). 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 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). Protein expression of endothelial nitric oxide synthase (eNOS) increased significantly in both EX (P=0.0028) and PHT (P=0.0095), but only EX resulted in increased angiogenesis. 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. Moreover, our data suggest that these PHT-induced improvements can be primarily attributed to increased expression of the regulators of vascular tone and not neo-angiogenesis. In conclusion, passive heat therapy mimics many, but not all the vascular benefits of exercise training. Funding for this study was provided by the Department of Exercise Sciences at Brigham Young University. This is the full abstract presented at the American Physiology Summit 2024 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.

No causal association between the volume of strenuous exercise and coronary atherosclerosis: a two-sample Mendelian randomization study.

Several observational studies have shown that high-volume and high-intensity exercise training increases the prevalence and severity of coronary atherosclerosis, but the causal effect still remains uncertain. This study aims to explore the causal relationship between the volume of strenuous exercise (SE) and coronary atherosclerosis (CA) using the Mendelian randomization (MR) method. The exposure factors were two basic parameters of the volume of strenuous exercise (duration and frequency of strenuous exercise), the outcome factor was coronary atherosclerosis, and the relevant genetic loci were extracted from the summary data of the genome-wide association study (GWAS) as the instrumental variables, and MR analyses were performed using the inverse variance weighting (IVW) method, the weighted median method, and the MR-egger method. Sensitivity analyses were performed using heterogeneity analysis, pleiotropy analysis, and the "leave-one-out" method. The original results were tested using other coronary atherosclerosis data sets. IVW results showed no causal association between duration of strenuous exercise (DOSE) [OR = 0.9937, 95% CI (0.9847, 1.0028), P = 0.1757] and frequency of strenuous exercise (FOSE) in the last 4 weeks [OR = 0.9930, 95% CI (0.9808, 1.0054), P = 0.2660] and coronary atherosclerosis. All of the above results were validated with other coronary atherosclerosis data sets. The present study supports that the causal association of duration and frequency of SE with CA was not found, and provides valuable insights into the choice of scientific and correct volume of SE to cardiac rehabilitation (CR).

Effects of high-intensity interval training on cognitive flexibility among female teenagers

Background: Teenage is an important stage for brain development, with significant impacts on education and health. Exploring how high-intensity interval training (HIIT) affects cognitive function in this population is crucial to comprehending how HIIT can improve general well-being and academic performance. Objective: To determine the effects of high-intensity interval training on cognitive flexibility among female teenagers. Methodology: A randomized clinical trial was conducted on n=40 female participants between 13-19 years without any serious medical, physical, or psychological illness for 6 months. All participants (n=40) were randomly divided into experimental (HIIT) and control groups equally. The protocols were performed in 4 mins in the first three weeks, 8 mins in the 4th to 6th week, and 12 mins in the 7th and 8th week, with sessions thrice a week. Data on cognitive flexibility was collected at baseline, after 4th week and 8th week from both groups through Digit Span (DST). Results: With-in-group analysis the experimental group showed significant improvement (p&lt;0.001) at each level of assessment of DST (forward and backward) till the 8th-week session with a large effect size whereas the non-significant improvement (p≥0.05) was observed in the control group. For Group Analysis, significant results (p&lt;0.001) were obtained in the experimental group for DST (forward and backward) after the 4th week and at the end of intervention after the 8th week as compared to the control group. Conclusion: It is concluded that the high-intensity exercise training program is beneficial for female teenagers to enhance their physical strengthening along with their cognitive abilities. Keywords: cognitive flexibilitydigital span testhigh intensity exercisesmini mental state examination Clinicaltrials.gov Identifier: NCT05873478

The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results.

Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.

Comparing high-intensity versus moderate-intensity exercise training in coronary artery disease patients: a randomized controlled trial with 6- and 12-month follow-up

Abstract Aim This study aimed to investigate the long-term effects of two exercise-based CR programs on physical activity (PA), sedentary behavior, physical fitness, quality of life (QoL), and mental health in coronary artery disease (CAD) patients. Subject and methods Seventy-two CAD participants were randomized (1:1:1) into HIIT, MICT, and control groups. Both training programs spanned 6 weeks with three supervised treadmill exercise sessions per week. MICT targeted ≈70–75% of peak heart rate (HR), while HIIT aimed for ≈85–95% of peak HR. The control group adhered to standard medical recommendations. Assessments at 6- and 12-months post-intervention included body composition, aerobic capacity, muscle strength, PA, SB, QoL, anxiety, and depression. Results Over the 6- and 12-month follow-up periods, both exercise groups maintained the levels of aerobic capacity (HIIT ≈ 19.6 ml kg−1 min−1, MICT ≈ 17.8 ml kg−1 min−1), QoL, and PA compared to baseline (p &lt; .001). Symptoms of anxiety and depression remained lower than baseline (p &lt; .001). The HIIT group demonstrated a significant decreasing trend in waist circumference (∆m3−m2% −2 cm, p = .033) compared to MICT (p = .016) and control (p = .001) at 6 months of follow-up. It was maintained at 12 months of follow-up with significant differences to MICT (p = .018) and control (p = .001). In contrast, the control group experienced deteriorations in body composition, SB, symptoms of anxiety, and depression, along with a decline in aerobic capacity over time. Conclusion Encouraging CAD patients to maintain elevated PA levels can promote cardiovascular, WC, and mental health. CR exercise programs can reduce cardiovascular risk factors and induce favorable lifestyle changes. Notably, HIIT demonstrated sustained improvements surpassing those of MICT. These findings underscore the importance of structured exercise-based CR programs in optimizing long-term outcomes for CAD patients. Trial Registration https://clinicaltrials.gov/ct2/show/NCT03538119 on May 25, 2018.

High-Intensity Interval Versus Moderate-Intensity Continuous Exercise Training on Glycemic Control, Beta Cell Function, and Aerobic Fitness in Women with Type 2 Diabetes.

Objective: This study aimed to compare the effects of High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) on glycemic control, beta-cell function, and aerobic fitness in women with Type 2 Diabetes Mellitus (T2DM). Methods: Thirty-six women with T2DM were assigned equally to HIIT, MICT, and control (CON) groups. Participants in the exercise cohorts underwent a 12-week training regimen (three sessions per week), while the CON group maintained an inactive lifestyle. Glycaemia variables, beta-cell function, maximal oxygen uptake (VO2max), lipid profiles, and body composition were assessed at baseline and post-intervention. Results: Both HIIT and MICT interventions led to significant improvements in glucose, insulin, HbA1c, and insulin resistance index. Moreover, visceral adiposity index (VAI), lipid accumulation product (LAP), total cholesterol (TC), and low-density lipoprotein (LDL) levels significantly decreased in the HIIT and MICT groups after 12 weeks. Triglyceride (TG) levels decreased only after MICT, while high-density lipoprotein (HDL) levels increased after both interventions. Maximal oxygen uptake (VO2max), body mass, body mass index (BMI), and waist circumference (WC) significantly improved in all exercise groups. Notably, the HIIT group showed greater reductions in body mass compared to MICT. Nevertheless, beta-cell function remained unaltered after these two exercise regimens. Conclusion: Both HIIT and MICT interventions effectively managed T2DM in women, regardless of exercise intensity. The HIIT regimen can be considered for time-efficient lifestyle interventions in people with T2DM.

Moderate-Intensity and High-Intensity Interval Exercise Training Offer Equal Cardioprotection, with Different Mechanisms, during the Development of Type 2 Diabetes in Rats.

Endurance exercise training is a promising cardioprotective strategy in type 2 diabetes mellitus (T2DM), but the impact of its intensity is not clear. We aimed to investigate whether and how isocaloric moderate-intensity exercise training (MIT) and high-intensity interval exercise training (HIIT) could prevent the adverse cardiac remodeling and dysfunction that develop T2DM in rats. Male rats received a Western diet (WD) to induce T2DM and underwent a sedentary lifestyle (n = 7), MIT (n = 7) or HIIT (n = 8). Insulin resistance was defined as the HOMA-IR value. Cardiac function was assessed with left ventricular (LV) echocardiography and invasive hemodynamics. A qPCR and histology of LV tissue unraveled underlying mechanisms. We found that MIT and HIIT halted T2DM development compared to in sedentary WD rats (p < 0.05). Both interventions prevented increases in LV end-systolic pressure, wall thickness and interstitial collagen content (p < 0.05). In LV tissue, HIIT tended to upregulate the gene expression of an ROS-generating enzyme (NOX4), while both modalities increased proinflammatory macrophage markers and cytokines (CD86, TNF-α, IL-1β; p < 0.05). HIIT promoted antioxidant and dicarbonyl defense systems (SOD2, glyoxalase 1; p < 0.05) whereas MIT elevated anti-inflammatory macrophage marker expression (CD206, CD163; p < 0.01). We conclude that both MIT and HIIT limit WD-induced T2DM with diastolic dysfunction and pathological LV hypertrophy, possibly using different adaptive mechanisms.

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.

Translating scientific recommendations into reality: a feasibility study using group-based high-intensity functional exercise training in adolescents with cerebral palsy

Purpose To examine the feasibility and effects of a functional high-intensity exercise intervention performed in a group-setting on functionality, cardiovascular health and physical performance in adolescents with cerebral palsy (CP). Methods Ten adolescents with a diagnosis of CP (2 females; 16.6 ± 3.4 years; GMFCS: I-II) participated in a 12-week training intervention, containing progressive resistance training using free weights and high-intensity workouts twice a week. The six-minute walking test, arterial stiffness and physical performance (strength and power tests) were measured before and after the intervention. Results No adverse events were reported. We measured small increases in the six-minute walking test (Δ = 28.8 m, 95% CI [-1.78;52.7]; g = 0.34 [-0.04;0.72]) and a small reduction in arterial stiffness (Δ = −4.65% [-10.90;1.25]; g = −0.46 [-1.36;0.21]). All measures of physical performance increased (0.24 ≤ g ≤ 0.88). Conclusion Functional training with free weights in high-functioning adolescents with CP is safe and effective in increasing parameters of physical performance and cardiovascular health. Positively influenced indicators of everyday independence (i.e. strength parameters) showed a transfer into movements of daily life. Concerns about adverse events through high-intensity training in adolescents with CP appear unjustified when training is performed progressively, following basic training principles.

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.

Impact of high-intensity exercise training (HIIT) versus moderate continuous training (MCT) on skeletal muscle alterations in HFrEF: a substudy of the SMART-EX trial

Abstract Background Skeletal muscle dysfunction contributes to exercise intolerance in chronic heart failure. The randomized multicenter Study of Myocardial Recovery After Exercise Training in Heart Failure (SMART-EX) has shown that high-intensity exercise training (HIIT) but not moderate continuous training (MCT) reduced the left ventricular end diastolic diameter. Both training modalities significantly increased exercise tolerance as determined by cardiopulmonary exercise testing (CPET). However, the underlying molecular alterations within the skeletal muscle with respect to different exercise training modalities are largely unknown. Methods In patients with chronic heart failure with reduced ejection fraction (HFrEF) who participated in the SMART-EX skeletal muscle substudy needle biopsies from the vastus lateralis muscle were performed before and after 12 weeks of supervised HIIT, MCT, or recommendation of regular exercise (RRE) to allow molecular assessment of markers for muscle catabolism, inflammation and energy supply by RT-PCR and western blotting. Echocardiography and CPET were performed in all patients. Changes over time were tested within each group. Results Skeletal muscle biopsies at baseline and follow-up were available in 31 patients (HIIT n=9; MCT n=9; RRE n=13). The majority of patients were male (87%). Median left ventricular ejection fraction was 29%. Median improvement in peak VO2 was 2.0 (IQR -0.4-2.8) in HIIT vs. 1.4 (IQR -0.9-3.4) in MCT vs. 0.0 (IQR -2.9-2.1) ml/min/kg in RRE. This was statistically not significant. HIIT reduced mRNA levels of the E3 ligases of the ubiquitine proteasome system MuRF1 by -72% (p&amp;lt;0.01) and MafBx -45% (p=0.09) with no change in MCT (MuRF1 -31%, p=0.23; MafBx -47%, p=0.21) and RRE (MuRF1 -8%, p=0.20; MafBx -6%, p=0.46). There was no change in mRNA expression of the inflammatory markers interleukin 6 (HIIT 12%; MCT 29%; RRE -35%; n.s.) and TNFα (HIIT -9%; MCT 20%; RRE 27%; n.s.) in either group. The mRNA expression of the mitochondrial F1 subunit of complex V (ATP5F1) significantly increased in HIIT by 14% (p&amp;lt;0.05) with no change in MCT (-3%, p=0.75) and RRE (2%, p=0.76). The mRNA expression of mitochondrial complex I subunits NDUFB8 and NDUFB6 remained unchanged in all groups. Western blot analysis of porin expression, which is a marker of total mitochondrial content, revealed a significant increase in HIIT by 69% (p&amp;lt;0.05) whereas MCT (21%, p=0.18) and RRE (4%, p=0.79) remained unchanged. Conclusion High-intensity interval training in HFrEF for 12 weeks resulted in reduced markers of protein degradation via the ubiquitine proteasome system and increased markers of mitochondrial content and energy supply via mitochondrial complex V whereas moderate continuous exercise training had only minor (non-significant) effects. These molecular changes are probably one reason why exercise capacity improved in patients of the SMART-EX trail.