Leg Exercise Research Articles

Efektifitas Pelaksanaan Senam Kaki Diabetic dalam Menurunkan Intensitas Nyeri pada Pasien Diabetus Mellitus di Rumah Sakit Siti Khodijah Sepanjang

The incidence of diabetes mellitus is increasing which causes pain in the legs of sufferers. Safety and comfort needs will not be fulfilled if the patient experiences pain, therefore nurses as professional health workers who in their main task are to meet the basic needs of patients, must be able to understand the response and behave professionally in dealing with pain problems that occur inpatient. One effort to reduce pain intensity is by implementing diabetic foot exercises in patients with diabetes mellitus. The purpose of this implementation is to find out the effectiveness of the implementation of diabetic foot exercises in reducing pain intensity in patients with diabetes mellitus in the sacred hospital throughout. The design of this study is the study of experimental design of Static Group Comparison. The population is patients who are hospitalized in Siti Khodijah. Along with the technique of simple random sampling. Data collection through questionnaires and observations, then the data is processed using and analyzed by Spearman Rho analysis and then concluded. Based on the results of the study, it was found that before the leg exercises most respondents experienced moderate pain, namely 19 people (63%), after doing leg exercises most of the respondents experienced mild pain, 21 people (70%) experienced mild pain. While the results of statistical tests show that the provision of foot exercises is effective in reducing pain intensity in patients with Diabetes Mellitus with the results of ρ = 0.000.

EFEKTIVITAS LEG EXERCISE DAN KOMBINASI DEEP BREATHING TERHADAP MEAN ARTERIAL PRESSURE (MAP) PADA PASIEN POST OPERASI

Background : Patient post-operative had experienced a critical period after surgery and anesthesia, the body's physiological interference occurred among hypotension. The impact was hypoperfusion for the infarction brain tissue and death. Therefore, it was necessary interventions trigger cardiovascular system used the Leg Exercises and Deep Breathing exercises. Objectives : To examine the effectiveness combination of Leg Exercises and Deep Breathing for mean arterial pressure. Methods : This study used Quasi Experiment randomized pre-test post-test control group design, These samples were 51 respondents in Roemani Semarang Hospital on January 2 nd to February 24 th 2019. The technique collected at lottery simple random sampling and the tests used Kruskal Wallis post hoc Mann Whitney. Results : The results showed the highest average to increase MAP for the difference pre-post and the post was the combination group with p=0,000 on Kruskal Wallis test. The post hoc Mann Whitney test showed average to increase MAP in the control group and the Leg Exercise is same with the p value>0,05 and the combination higher than Leg Exercise with the p value<0,05. It’s meant that the combination most effectively to increase MAP and had clinical significant with p=0,000. Conclusion : This study presented the combination of Leg Exercise and Deep Breathing most effectively to prevent hypotension in patients post-surgery with spinal anesthesia in Roemani Semarang Hospital.

Effects of dynamic arm and leg exercise on muscle sympathetic nerve activity and vascular conductance in the inactive leg.

The influence of muscle sympathetic nerve activity (MSNA) responses on local vascular conductance during exercise are not well established. Variations in exercise mode and active muscle mass can produce divergent MSNA responses. Therefore, we sought to examine the effects of small- versus large-muscle mass dynamic exercise on vascular conductance and MSNA responses in the inactive limb. Thirty-five participants completed two study visits in a randomized order. During visit 1, superficial femoral artery (SFA) blood flow (Doppler ultrasound) was assessed at rest and during steady-state rhythmic handgrip (RHG; 1:1 duty cycle, 40% maximal voluntary contraction), one-leg cycling (17 ± 3% peak power output), and concurrent exercise at the same intensities. During visit 2, MSNA (contralateral fibular nerve microneurography) was acquired successfully in 12/35 participants during the same exercise modes. SFA blood flow increased during RHG (P < 0.0001) and concurrent exercise (P = 0.03) but not cycling (P = 0.91). SFA vascular conductance was unchanged during RHG (P = 0.88) but reduced similarly during concurrent and cycling exercise (both P < 0.003). RHG increased MSNA burst frequency (P = 0.04) without altering burst amplitude (P = 0.69) or total MSNA (P = 0.26). In contrast, cycling and concurrent exercise had no effects on MSNA burst frequency (both P ≥ 0.10) but increased burst amplitude (both P ≤ 0.001) and total MSNA (both P ≤ 0.007). Across all exercise modes, the changes in MSNA burst amplitude and SFA vascular conductance were correlated negatively (r = -0.43, P = 0.02). In summary, the functional vascular consequences of alterations in sympathetic outflow to skeletal muscle are most closely associated with changes in MSNA burst amplitude, but not frequency, during low-intensity dynamic exercise.NEW & NOTEWORTHY Low-intensity small- versus large-muscle mass exercise can elicit divergent effects on muscle sympathetic nerve activity (MSNA). We examined the relationships between changes in MSNA (burst frequency and amplitude) and superficial femoral artery (SFA) vascular conductance during rhythmic handgrip, one-leg cycling, and concurrent exercise in the inactive leg. Only changes in MSNA burst amplitude were inversely associated with SFA vascular conductance responses. This result highlights the functional importance of measuring MSNA burst amplitude during exercise.

Modified Supine Bridge Alters Muscle Coordination Patterns

Contributions of mono- and bi-articular hip extensor muscles while performing single leg supine bridge (SLB) and modified single supine bridge (mSLB) is not quite clear. To identify hip extensor muscles activation patterns among different unilateral-bridges, could be a key point for hip extensor strength and rehabilitation trainings. PURPOSE: To compare hip extensor muscles activation patterns during performing SLB and mSLB. METHODS: We have recruited healthy collegiate students for the project. Participants signed an informed consent form before data collection. They have performed SLB and mSLB at a constant pace (~2s up and ~2s down). mSLB was performed unilaterally with the exercise leg placed up on a box of 40 cm in height. Surface electromyography (sEMG) of the right gluteus maximus (Gmax), biceps long head (BFL), and semitendinosus (STN) muscles was recorded using a wireless surface electromyography system. Peak RMS sEMG of each muscle during SLB define as 100% and used as the base of comparison with that of mSLB. On- and off-set of sEMG bursts threshold were defined as 10% of the peak value. One-tailed paried-test was used for statistic examination. Alpha value was set at 0.05. RESULTS: The peak RMS of Gmax, BFL and STN sEMG while performing mSLB were 82.1±21.4, 141.5±36.4, and 155.0±2.5, respectively. The peal magnitude of the hamstring muscle activations were greater, although peak Gmax activity was lower (p<0.05), while performing mSLB than that of SLB (p<0.05). Muscle activation burst duration of BFL was 1.6±0.7s longer while performing mSLB than that of SLB (p<0.05). Muscle activation burst durations of STN (3.82±0.58s) and Gmax(3.53±1.72s)were (0.42±0.50s) and Gmax(0.47±0.44s)shorter than that of mSLB (p<0.05). CONCLUSIONS: Comparing to SLB, mSLB increased bi-articular hip extensor (BFL and ST) muscle activation level while reduced mono-hip extensor (Gmax) activation level accompanied by prolonged BFL activities and shortened Gmax/St activation durations.

Mitochondrial Bioenergetic Metabolism Is Associated with Total Body Composition and Influenced by Normal Weight Obesity (P21-039-19)

ObjectivesObesity, body composition, and mitochondrial dysfunction play important roles in the development of metabolic diseases, but it is unknown if increased visceral fat (VF) specifically alters mitochondrial bioenergetic capacity. We determined whether in vivo and ex vivo bioenergetic indexes are associated with total body composition, visceral fat (VF), and body composition subtypes. MethodsThis pilot study included 34 healthy adults (56% female, median age 27.9 y). Body composition and fat distribution were assessed by dual energy x-ray absorptiometry. Subjects were categorized as lean (BMI < 25 kg/m2, n = 14), normal weight obese (NWO, BMI < 25 kg/m2 and >30% body fat in women or >23% body fat in men, n = 8), or overweight/obese (O/O, BMI > 25 kg/m2, n = 12). Ex vivo mitochondrial function was assessed using a Seahorse extracellular flux analyzer in peripheral blood mononuclear cells (PBMC) and isolated monocytes. In a subset (n = 21), maximum in vivo ATP synthesis was assessed in the quadriceps using 31P-Magnetic resonance spectroscopy based on the phosphocreatine recovery time constant (τPCr) following a standardized leg exercise. Statistical analyses included Spearman correlations and Kruskal-Wallis tests. ResultsIn monocytes, but not PBMCs, % spare respiratory capacity was inversely associated with % body fat (r = −0.42, P = 0.02) and positively associated with lean body mass (r = 0.36, P = 0.04) but was not significantly associated with VF. Skeletal muscle τPCr was positively associated with % body fat (r = 0.58, P < 0.01) and total body fat (r = 0.53, P = 0.02) but not VF. Subjects with NWO had the highest τPCr (P = 0.01) and lowest % spare respiratory capacity (P = 0.09 and 0.03 in monocytes and PBMCs, respectively) compared to lean or O/O subjects. ConclusionsTotal body fat, but not VF, was associated with impaired mitochondrial function as shown by increased post-exercise recovery time in skeletal muscle and decreased response to energy demands in circulating cells. Adults with NWO had worse bioenergetic capacity than O/O or lean adults. These data provide insight on the relationships between human body composition and mitochondrial energy metabolism, which plays a role in metabolic disease progression. Funding SourcesNational Institutes of Health, Georgia Clinical and Translational Science Alliance.

Effect of Core Exercise on Static Balance and Pulmonary Function in Smokers

Purpose : The purpose of this study is to investigate the effects of core exercise on the lung capacity and static balance of smokers. Methods : Four smokers and four non-smokers were randomly selected. We performed core exercises( leg raises and flank exercises for 4 weeks) and measured breathing and static balance. Statistical analysis was performed using SPSS ver. 18.0 was not significantly different from the T-test(p <0.05). Result : There was a difference in respiration and there was no difference in static balance. However, depending on the amount of waste in the volume, depending on the number, the results were effective. In addition, the increase in respiration rate through core exercise on lung capacity increases the effect, so it can be said that it is effective for smokers. Conclusion : When muscle strength is strengthened through core exercise Leg raise / plank for smokers, it can be considered to give respiratory influence.

The impact of deep vein thrombosis prevention training on patients′ knowledge and self-management

Objective To investigate the effect of nurse-directed prevention of deep vein thrombosis (DVT) on deep vein thrombosis knowledge and self-management. Methods From April 2016 to April 2017, patients who underwent surgery in the Department of Thoracic Surgery, Urology, and General Surgery of Nanyang Central Hospital were divided into study group and control group. 80 patients in each group were included in the study. Patients in the study group were trained in DVT prevention, and the control group received routine nursing measures. The general condition of the patients was recorded, and the differences between the general conditions of the two groups and the DVT prevention questionnaire scores and the completion rate of self-care practice after DVT were compared. Results The scores of the DVT prevention questionnaires in the study group were significantly higher than those in the control group (U=-4.83--2.04, P < 0.05). The scores of the DVT prevention questionnaires of the study group aged 19-51 were significantly higher than those of the 52-82-year-old patients (U=63.7, P<0.05). The DVT prevention questionnaires of the highly educated patients were lower than those with low education. The DVT prevention questionnaire score was significantly increased (χ2=12.54, P<0.05). In the comparison of 13 self-care practices between the study group and the control group, the patient had bedside activities, raised the legs beyond the heart level, timed over, deep breathing exercises, foot exercises, leg exercises, standing, wearing antithrombotic socks, measuring the legs Surround, measure the pulse of the foot, check the leg, check the amount of self-liquid intake, and understand the completion rate of self-coagulation treatment (χ2=6.76-91.17, P < 0.05). Conclusion Through training, patients′ awareness of DVT is improved, and the ability of self-training to prevent postoperative DVT is improved. Key words: Deep vein thrombosis; Risk; Practice; Self-care

Muscle sympathetic nerve activity during exercise.

Appropriate cardiovascular adjustment is necessary to meet the metabolic demands of working skeletal muscle during exercise. The sympathetic nervous system plays a crucial role in the regulation of arterial blood pressure and blood flow during exercise, and several important neural mechanisms are responsible for changes in sympathetic vasomotor outflow. Changes in sympathetic vasomotor outflow (i.e., muscle sympathetic nerve activity: MSNA) in inactive muscles during exercise differ depending on the exercise mode (static or dynamic), intensity, duration, and various environmental conditions (e.g., hot and cold environments or hypoxic). In 1991, Seals and Victor [6] reviewed MSNA responses to static and dynamic exercise with small muscle mass. This review provides an updated comprehensive overview on the MSNA response to exercise including large-muscle, dynamic leg exercise, e.g., two-legged cycling, and its regulatory mechanisms in healthy humans.

Exercising on Different Unstable Surfaces Increases Core Abdominal Muscle Thickness: An Observational Study Using Real-Time Ultrasound.

The training of abdominal muscles has a positive impact on the functional capacity of healthy adults, being applied practically in fields of athletics and fitness through rehabilitation for lower back pain. The study compares abdominal muscle activity while performing graded isometric exercises on stable and unstable surfaces. The authors also examined perceived stability and comfort for the different surfaces. A total of 30 young, healthy adults performed 3 graded isometric exercises on a Pilates table, foam roller, and Oov (a newly developed tool). Ultrasound investigation measured transversus abdominis, internal oblique abdominis, and external oblique abdominis thickness during each task, comparing muscle thickness between conditions using general linear modeling. Core abdominal activation was greater on the foam roller than the Oov and Pilates table during crook lying (bilateral leg support). Both Oov and foam roller elicited greater contralateral transversus abdominis and internal oblique abdominis thickness than the Pilates table during tabletop and straight leg raises (unilateral leg exercises). For transversus abdominis only, the foam roller elicited more muscle thickness than the Oov during straight leg raises. The Oov was rated more comfortable than the foam roller. Exercises performed on the Oov and foam roller elicit core greater abdominal muscle thickness than those performed on a Pilates table. Unilateral leg exercises in a supine position elicit more contralateral muscle thickness than those with bilateral leg support. These results provide information to support choices in exercise progression from flat stable to more unstable surfaces and from those with bilateral foot support to unilateral foot support. The Oov was more comfortable that the foam roller, and this may help with exercise adherence.

Effects of Dynamic Arm and Leg Exercise on Muscle Sympathetic Nerve Activity and Vascular Conductance in the Inactive Leg

The aim of this study was to comprehensively assess the effects of rhythmic handgrip (RHG), one‐leg cycling, and concurrent arm and leg exercise on muscle sympathetic nerve activity (MSNA) and vascular conductance responses in the inactive leg. Thirty‐five participants completed two study visits in a randomized order. During visit 1, hemodynamic (Finometer) and superficial femoral artery (SFA) blood flow (Doppler ultrasound) measurements were assessed at rest and during 3 min of RHG (1:1 duty cycle; 40% MVC), one‐leg cycling (17 ± 3% peak power output), and concurrent exercise at the same intensities. During visit 2, hemodynamic and MSNA (fibular nerve microneurography) measurements were acquired during the same exercise modes (MSNA; n=12). SFA blood flow and MSNA were both acquired in the inactive leg. Heart rate, blood pressure, cardiac output, and respiration rate increased during each exercise mode (all, P&lt;0.0001), with the largest increases during concurrent exercise (all, P&lt;0.006); no differences were detected between visit 1 and 2 (all, P&gt;0.05). SFA mean blood flow increased during RHG (Δ24 ± 30 ml/min, P&lt;0.0001) and concurrent exercise (Δ10 ± 38 ml/min, P=0.03) but not cycling (Δ2.3 ± 30 ml/min, P=0.9). SFA vascular conductance was unchanged during RHG (Δ0.02 ± 0.29 ml·min−1·mmHg−1, P=0.9) but reduced similarly during concurrent and cycling exercise (Δ−0.14 ± 0.33 ml·min−1·mmHg−1; Δ−0.14 ± 0.38 ml·min−1·mmHg−1, P&lt;0.003). RHG increased MSNA burst frequency (Δ4 ± 8 burst/min, P=0.04) without altering burst amplitude (Δ7 ± 14 %, P=0.7) or total MSNA (Δ40 ± 40 %, P=0.07). In contrast, cycling and concurrent exercise had no effects on MSNA burst frequency (Δ−3 ± 6 burst/min and Δ4 ± 6 burst/min, P≥0.1) but increased burst amplitude (Δ34 ± 30 %; Δ31 ± 31 %, P≤0.001) and total MSNA (Δ59 ± 63 %; Δ94 ± 100 %, P≤0.007). In conclusion, during one‐leg cycling or concurrent exercise, reductions in inactive leg SFA vascular conductance occurred in parallel with increases in burst amplitude and total MSNA but not burst frequency. Exercise studies relying solely on measures of MSNA burst occurrence may not accurately reflect the corresponding changes in vascular conductance.Support or Funding InformationResearch was supported by a Natural Science and Engineering Research Council (NSERC) of Canada Discovery Grant (P.J.M; #06019), the Canada Foundation for Innovation (P.J.M.; #34379), and the Ontario Ministry of Research, Innovation, and Science (P.J.M. #34379).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Impact of Salt Restriction on Central and Peripheral Hemodynamics During Exercise in Essential Hypertension: A Systematic Investigation

BackgroundDietary salt restriction is a well‐established approach to lower blood pressure and reduce cardiovascular disease risk in hypertensive individuals. While high blood pressure increases the risk of cardiovascular events in hypertensive individuals during exercise, little is known regarding the effects of salt restriction on central and peripheral hemodynamic responses to exercise in individuals with hypertension.PurposeTherefore, this study sought to determine the impact of salt restriction on central and peripheral hemodynamic responses to handgrip and knee extension exercise, exercise modalities which circumvent the central limitations to whole body exercise.MethodsHypertensive patients (14M/8F, 51±10y, 173±11cm, 99±23kg) forwent antihypertensive medication use for at least 2 weeks prior to cross‐sectional enrollment on a 5‐d liberal salt (LS: 200mmol/d) followed by a 5‐d restricted salt (RS: 10mmol/d) diet. Patients were studied prior to and during: supine static intermittent handgrip (HG) exercise at 15, 30, 45% MVC (MVC: 20±4kg) and seated knee extension (KE) exercise at 40, 60, 80% KE Max (KE Max: 35±17W).ResultsSalt restriction lowered resting systolic blood pressure (SBP) (supine: −12±3mmHg, seated: −14±3mmHg, P&lt;0.05), diastolic blood pressure (DBP) (supine: −3±2mmHg, seated: −5±1mmHg, P&lt;0.05), and mean arterial pressure (MAP) (supine: −8±2mmHg, seated: −8±2mmHg, P&lt;0.05). Similar reductions in SBP, DBP, and MAP were maintained during HG and KE exercise (all p&lt;0.05). Despite lower blood pressure during exercise, peripheral blood flow and vascular conductance, were similar between groups during HG and KE exercise.ConclusionsSalt restriction appears to be an effective means to ameliorate blood pressure and reduce the risk of a cardiovascular event during exercise in hypertensive individuals without altering blood flow and vasodilatory ability during either arm or leg exercise.Support or Funding InformationVeteran Affairs Rehabilitation Research and Development Grant, 1KRX001215 CDA2, JD Trinity and Merit Grants, E1697R and E6910R, RS Richardson; American Heart Association Grant, 14SDG1850039, JD Trinity; National Heart, Lung, Blood Institute Grant, P01‐HL‐091830, RS Richardson.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Muscle Sympathetic Nerve Activity and Vascular Conductance Responses at the Onset of Arm and Leg Exercise in the Inactive Limb

Local mechanical and metabolic factors are known to regulate the blood flow response at the onset of exercise. However, little is known regarding the contribution of muscle sympathetic nerve activity (MSNA) to this onset blood flow response. The aim of the study was to examine the MSNA and vascular conductance response to exercise anticipation and onset in the inactive leg. Two identical visits were performed on 16 participants (n = 6 female). During visit 1, hemodynamic (Finometer) and MSNA (fibular nerve microneurography) measurements were acquired during rest (1‐minute), exercise anticipation (verbal preparation, 30‐seconds), and 1 minute of rhythmic handgrip (RHG, 1:1 duty cycle, 40% MVC) and one‐legged cycling (17 ± 3% peak power output). During visit 2, hemodynamic and superficial femoral artery (SFA) blood flow (Doppler ultrasound) measurements were acquired during the same exercise modes. Leg vascular conductance was calculated as SFA mean blood flow/mean arterial pressure. Total MSNA (burst frequency x burst area) was analyzed in 15‐second moving windows (5‐second progressions), and SFA blood flow was analyzed as 5‐second time bins aligned with the last 5 seconds of each MSNA moving window; both were expressed as relative change from baseline (%). Burst frequency, burst incidence, and total MSNA (height) followed the same pattern as total MSNA (area), and thus only total MSNA (area) is presented. Significance was set as p &lt; 0.05, and data are mean ± SE. When participants were prompted to prepare for upcoming exercise (i.e. anticipation), total MSNA decreased from baseline prior to RHG (−40 ± 6%, p &lt; 0.001) and cycling (−20 ± 6%, p = 0.03). During anticipation of RHG, this decrease in vasoconstrictor drive was followed 5 seconds later by a trend for increased SFA vascular conductance (+24 ± 12%, p = 0.07). At the onset of exercise, total MSNA decreased during RHG (−28 ± 6%, p = 0.002) and cycling (−39 ± 7%, p = 0.009). This was followed by an increase in SFA vascular conductance during both RHG (+34 ± 12%, p = 0.02) and cycling (+34 ± 20%, p = 0.005) conditions. In the absence of mechanical or metabolic factors in the inactive limb, these data suggest that a reduction in total MSNA can contribute to the exercise hyperemia that is observed at the onset of exercise. Furthermore, the anticipatory response of MSNA suggests a partial contribution of feedforward central command in this response.Support or Funding InformationNatural Science and Engineering Research Council of CanadaOntario Ministry of Research, Innovation, and ScienceCanadian Foundation for InnovationThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Impact of Acute Dietary Nitrate Supplementation on Exercise Blood Flow in Hypertension: Does Medication Status Matter?

Dietary nitrates are effective at lowering resting blood pressure (BP) in humans and improving skeletal muscle blood flow (BF) during exercise in animals. However, evidence of improved BP status and BF during exercise in hypertension is lacking. The purpose of this investigation was to determine if acute (3‐day) nitrate supplementation with beetroot juice (BR) lowers BP and augments BF in hypertensive individuals on and off antihypertensive medication during progressive handgrip (HG) and single‐leg knee extension (KE) exercise. In a double blind crossover study, placebo (nitrate depleted BR) and BR were administered in 14 subjects with controlled hypertension (ON‐MEDS; 53±11 yrs., 11 men, 3 women) and 14 subjects not taking antihypertensive medications (OFF‐MEDS; 49±13 yrs., 11 men, 3 women). Following either 3 days of BR or placebo supplementation, participants performed HG (15, 30, 45% of maximal voluntary contraction [MVC]) and single‐leg KE exercise (40, 60, 80% of work rate maximum [WRmax]). When OFF‐MEDs, BR significantly reduced resting diastolic BP (DBP) (BR: 84 ± 3 vs. PL: 88 ± 3 mmHg; p &lt; 0.01) and mean arterial pressure (MAP) (BR: 101 ± 3 vs. PL: 106 ± 3 mmHg; p &lt; 0.01), with systolic BP (SBP) trending lower (BR: 136 ± 4 vs. PL: 141 ± 5 mmHg; p = 0.067). BR did not change resting BP for the ON‐MEDS group. During HG exercise, BR supplementation only lowered SBP at 15% MVC (p &lt; 0.05) and 30% MVC (p = 0.05) when OFF‐MEDS, with no effect on BF or vascular conductance (VC). During KE exercise, in the OFF‐MEDS group, BR significantly lowered SBP and MAP at 80% WRmax, but not at the lower intensities. When OFF‐MEDS, BR significantly increased leg BF at 40% WRmax (BR: 2667 ± 173 vs. PL: 2461 ± 193 ml/min; p = 0.04) and leg VC at 40% (BR: 24 ± 2 vs. PL: 21 ± 1 ml/min/mmHg; p &lt; 0.01) and 60% (BR: 27 ± 2 vs. PL: 25 ± 2 ml/min/mmHg; p &lt; 0.03) WRmax. When ON‐MEDS, BR did not alter BP, BF or VC during HG or KE exercise. These findings reveal that BR can lower BP at rest and during exercise, as well as augment the blood flow response during leg exercise in unmedicated hypertensive individuals, suggesting a potential benefit of BR to this population.Support or Funding InformationThis study was supported by Veteran Affairs Rehabilitation Research and Development Grant IK2RX001215 CDA2 (to J. D. Trinity) and American Heart Association Grant 14SDG1850039 (to J. D. Trinity)This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Effect of Dynamic Eccentric Leg Exercise Training on Functional Fitness and Arterial Stiffness in Older Adults

Eccentric exercise is shown to offer musculoskeletal benefits in multiple populations, but little is known about the effect of chronic dynamic eccentric exercise training in older adults concerning functional physical fitness and cardiovascular health. Therefore, the purpose of this study was to determine if twelve weeks of dynamic eccentric leg exercise (Eccentron) could improve functional fitness and reduce arterial stiffness. Thirteen older adults (ages 65–79 years; M = 70±1) performed dynamic eccentric leg exercise twice per week at a light to somewhat hard rating of perceived exertion. Exercise duration increased from five minutes per session in the first week to 25 minutes per session during the final week. Timed up and go test significantly improved from pre‐ to post‐training (5.7±0.2 vs. 5.3±0.1 s; p&lt;0.05). Likewise, Berg Balance Score was statistically (p&lt;0.05) improved from pre‐ to post‐training. Participants demonstrated non‐significant increases in single‐leg knee extensor strength (43.0±2.6 vs. 45.2±2.8 kg; p=0.26). Aortic arterial stiffness, assessed via carotid‐femoral pulse wave velocity, did not change from pre‐ to post‐eccentric exercise training (8.6±0.7 vs. 9.2±0.5 m/s; p=0.44). Similarly, leg arterial stiffness, assessed as femoral to dorsalis pedis pulse wave velocity, was unchanged (9.9±0.8 vs. 9.2±0.5 m/s; p=0.31). Our results demonstrate how 12‐weeks of eccentric training can positively influence functional physical fitness measures in older adults without a negative influence on arterial stiffness. Significant improvements in timed up and go and the Berg Balance Score, and non‐significant increases in leg extensor strength, suggests that older adults could improve their agility and balance, and reduce their risk of falling through eccentric leg exercise.Support or Funding InformationSupported by the Portage Health Foundation and Michigan Tech Research Excellence Fund.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Central command increases muscle sympathetic nerve activity more to contracting than noncontracting muscle during rhythmic isotonic leg exercise.

We have previously shown that the increase in muscle sympathetic nerve activity (MSNA) to contracting muscle during sustained isometric exercise is due primarily to central command and that contracting muscle does not express a metaboreceptor-driven increase in MSNA. Here we tested the hypothesis that MSNA increases to the contracting muscle also during rhythmic isotonic exercise, in which muscle metabolites will not accumulate because the contraction is performed without external load. MSNA was recorded from the common peroneal nerve in 10 participants, and negative-going sympathetic spikes were extracted during 50 cycles of sinusoidal (0.15 Hz) isotonic dorsiflexions of the ipsilateral or contralateral ankle. Electromyographic activity (EMG) was recorded from the tibialis anterior muscle on both sides. Cross-correlation analysis between MSNA and EMG revealed a marked cyclic modulation of MSNA to the contracting (ipsilateral) muscle. This modulation, in which MSNA increased during the contraction phase, was three times greater than that to the noncontracting muscle (modulation index = 27.4 ± 3.2% vs. 9.2 ± 1.5%; P < 0.002). There were no differences in either the intensity or the magnitude of modulation of EMG during ipsilateral and contralateral contractions. We conclude that central command increases MSNA to the contracting muscle during rhythmic isotonic exercise. NEW & NOTEWORTHY Muscle sympathetic nerve activity (MSNA) increases to contracting muscle during isometric exercise, but whether this occurs during rhythmic isotonic exercise is unknown. We recorded MSNA to the pretibial flexors during cyclic dorsiflexion of the ipsilateral or contralateral ankle. MSNA showed a cyclic increase during the contraction phase that was significantly higher to the contracting than the noncontracting muscle, supporting central command as the primary mechanism responsible for increasing MSNA.

Acute Lower Leg Heating Increases Exercise Capacity in Patients With Peripheral Artery Disease.

In this pilot study, we tested the hypothesis that acute lower leg heating (LLH) increases postheating popliteal artery blood flow and 6-minute walk distance in patients with peripheral artery disease (PAD). Six patients (5 male, 1 female) with PAD (69 ± 6.9 years; claudication: ankle-brachial index < 0.90) participated in 3 randomized treatment sessions (2-7 days apart): control or bilateral LLH conducted via water bath immersion (42°C; ~40-cm depth) for either 15 or 45 minutes. Popliteal artery blood flow (Doppler ultrasound) and arterial pressure were measured before and after LLH. Six-minute walk distance was measured on the control day and each experimental day 35 minutes post-LLH. Popliteal artery blood flow increased after heating in a duration-dependent manner (P < .05, postheating vs control for both heating conditions and between them). Six-minute walk distance increased by 10% and 12% after 15- and 45-minute heating treatments, respectively (P < .05 vs control session). Lower leg heating, for as short as 15 minutes, increases postheating leg perfusion and exercise capacity in patients with PAD.

Are People With Joint Hypermobility Syndrome Slow to Strengthen?

ObjectivesTo investigate whether the rate of change of muscle strength in people with joint hypermobility syndrome (JHS) who have anterior knee pain (AKP) differs when compared to 2 control groups who have AKP and to evaluate the relationship between strength and pain as well as the effect of strength upon activity and knee function. DesignA cohort study, with 3 groups: JHS with AKP, generalized joint hypermobility with AKP (GJH), and normal flexibility with AKP (control group [CG]). Follow-up appointments were performed every 2 weeks for 16 weeks. SettingThe physiotherapy outpatient department within a London (United Kingdom) hospital. ParticipantsA total of 102 people, aged between 18 and 55 years, were recruited between July 2014 and March 2016; 47 JHS, 29 GJH, and 26 CG (N=102). After 16 weeks, 31, 20, and 21 participants completed the study, respectively. Participants were recruited from support groups, a London hospital group and university, local sports centers, and clubs. InterventionsIndividualized leg exercises for 16 weeks. Main Outcome MeasureMuscle torque generated from the lower limb, every 2 weeks for 16 weeks. ResultsThere was no difference in the rate of change of concentric muscle strength between the JHS group and the CG or GJH group (P>.88 and P>.97). There was no difference in the rate of change of eccentric muscle strength between the JHS group and the CG or GJH group (P>.60 and P>.94). However, people with JHS were significantly weaker than the other 2 groups, taking 3 to 4 months to reach the baseline strength of the GJH group. ConclusionPeople with JHS can strengthen at the same rate as other people in pain.

Activity Classification Feasibility Using Wearables: Considerations for Hip Fracture

Falls in the elderly are a common health issue that can involve severe injuries like hip fractures, requiring considerable medical attention, and subsequent care. Following surgery, physiotherapy is essential for strengthening muscles, mobilizing joints and fostering the return to physical activities. Ideally, physiotherapy programmes would benefit from active home-based monitoring of the elderly patients’ daily activities and exercises. This paper aims at providing a preliminary analysis addressing three key research questions. First, what are the key involved activities (at-hospital, home exercises, and activities of daily living) during the post-operative hip fracture rehabilitation process? Second, how can one monitor and identify a range of leg exercises accurately? Last, what is the most suitable sensor location that can categorize the majority of the physical activities thought to be important during the rehabilitation programme? During preliminary testing, it was noted that a standard deviation of the acceleration signal was suitable for classification of static activities like sitting, whereas classification of the ambulatory activities like walking, both the frequency content and related amplitude of the acceleration signal, plays a significant role. The research findings suggest that the ankle is an appropriate location for monitoring most of the leg movement physical activities.

Effect of increased inspiratory muscle work on blood flow to inactive and active limbs during submaximal dynamic exercise.

What is the central question of this study? Increased respiratory muscle activation is associated with neural and cardiovascular consequences via the respiratory muscle metaboreflex. Does increased sympathetic vasoconstriction originating from the respiratory musculature elicit a reduction in blood flow to an inactive limb in order to maintain blood flow to an active limb? What is the main finding and its importance? Arm blood flow was reduced whereas leg blood flow was preserved during mild leg exercise with inspiratory resistance. Blood flow to the active limb is maintained via sympathetic control of blood flow redistribution when the respiratory muscle-induced metaboreflex is activated. The purpose of this study was to elucidate the effect of increasing inspiratory muscle work on blood flow to inactive and active limbs. Healthy young men (n=10, 20±2years of age) performed two bilateral dynamic knee-extension and knee-flexion exercise tests at 40% peak oxygen uptake for 10min. The trials consisted of spontaneous breathing for 5min followed by voluntary hyperventilation either with or without inspiratory resistance for 5min (40% of maximal inspiratory mouth pressure, inspiratory duty cycle of 50% and a breathing frequency of 40 breathsmin-1 ). Mean arterial blood pressure was acquired using finger photoplethysmography. Blood flow in the brachial artery (inactive limb) and in the femoral artery (active limb) were monitored using Doppler ultrasound. Mean arterial blood pressure during exercise was higher (P<0.05) with inspiratory resistance (121±7mmHg) than without resistance (99±5mmHg). Brachial artery blood flow increased during exercise without inspiratory resistance (120±31mlmin-1 ) compared with the resting level, whereas it was attenuated with inspiratory resistance (65±43mlmin-1 ). Femoral artery blood flow increased at the onset of exercise and was maintained throughout exercise without inspiratory resistance (2576±640mlmin-1 ) and was unchanged when inspiratory resistance was added (2634±659mlmin-1 ; P>0.05). These results suggest that sympathetic control of blood redistribution to active limbs is facilitated, in part, by the respiratory muscle-induced metaboreflex.

The effect of exercise on local and systemic adverse reactions after vaccinations – Outcomes of two randomized controlled trials

IntroductionAn adverse reaction associated with vaccination is considered to be a key barrier to vaccinate, yet little attention has been given to interventions to reduce their occurrence. Exercise is a behavioural adjuvant which may also influence adverse reactions. Here, two randomized controlled trials are reported, examining the effects of exercise on self-reported adverse reactions following vaccination in adolescents and young adults. MethodsStudy one; 116 adolescents receiving the HPV vaccine were randomly allocated to either Control (n = 56) or Pre-vaccine Exercise (n = 60) group (2015–2016). Exercise consisted of 15-minutes upper body exercise. Study two; 78 young adults receiving the influenza vaccine were randomly allocated to either Control (n = 19), or one of 3 exercise groups: Pre-vaccine Arm (n = 19), Pre-vaccine Leg (n = 20) or Post-vaccine Arm (n = 20) (2017). Exercise included 15-minutes of arm or leg exercises prior to or after vaccination. All participants in both studies completed an adverse events diary for seven-days post-vaccination. ResultsStudy one; Reported days of tenderness in female adolescents that exercised were significantly lower than control (p = 0.032), with a similar trend in reported days of pain (p = 0.050). Furthermore, days of feeling ill (p = 0.070) and reduced appetite (p = 0.067) were found to be lower with exercise, although not significant. Overall, female adolescents reported significantly more days of pain (p = 0.003), tenderness (p < 0.001), swelling (p = 0.011), and feeling ill (p = 0.0040). Study two; Exercise groups reported reduced days of swelling (p = 0.018), fever (p = 0.013), and lowered appetite (p = 0.011) across both genders. Furthermore, females reported reduced days of medication use with exercise (p = 0.034), and a trend toward reduced days of swelling (p = 0.052). DiscussionIn two separate trials, a short bout of exercise reduced reported adverse reactions after vaccinations for local and systemic adverse reactions. Gender differences in reported local and systemic adverse reactions were more evident among adolescents than young adults. These findings support the need for further work to examine the potential benefit of exercise in improving vaccination procedures.