Low-intensity Exercise Research Articles

Amenorrhea and oligomenorrhea risk related to exercise training volume and intensity: Findings from 3705 participants recruited via the STRAVA™ exercise application.

To investigate associations between self-reported exercise training habits and amenorrhea/oligomenorrhea among physically active women. A cross-sectional survey was completed by 3705 women (median age = 40 years [quartile 1, quartile 3: 30, 45], body mass index = 22.1 kg/m2 [20.5, 24.2]) representing multiple nationalities and sports via the STRAVA™ exercise application. Respondents selected the amount of time they participated in low intensity, moderate intensity, and high intensity exercise training per week. Amenorrhea/oligomenorrhea was defined as self-reporting ≤10 menses in the last year. Associations between weekly exercise volume for low intensity training, moderate intensity training, and high intensity training and amenorrhea/oligomenorrhea were modeled with univariate logistic regression models, followed by adjustment for age and body mass index. Amenorrhea/oligomenorrhea prevalence was 16 % (n = 576/3705), with no difference by country of origin or most sport modes. In adjusted models, participating in low intensity training ≥7 h/week or moderate intensity training ≥6 h/week was associated with 1.43 (95 % confidence interval: 1.04-1.96) and 1.46 (1.10-1.95) greater odds of amenorrhea/oligomenorrhea compared to 2 to 3 h/week, respectively. Similarly, high intensity training ≥5 h/week was associated with 1.41 (1.03-1.92) greater odds of amenorrhea/oligomenorrhea compared to 1 to 2 h/week. Participating in low intensity training for ≤30 min/week compared to 2 to 3 h/week was associated with reduced amenorrhea/oligomenorrhea odds (0.65 [0.44-0.94]). Taken together, these associations suggest greater weekly exercise volume, irrespective of intensity, may increase amenorrhea/oligomenorrhea risk among physically active women.

Sex-related beneficial effects of exercise on cardiac function and rhythm in autistic rats.

Cardiovascular diseases are prevalent in autistic patients. As exercise is useful in the treatment of medical conditions, this study aimed to identify the effect of low-intensity endurance exercise (LIEE) and moderate-intensity endurance exercise (MIEE) on cardiovascular events in autistic rats. Valproic acid (VPA) was administrated once on gestational day 12.5 to pregnant rats to produce autism-like symptoms in offspring. Thirty-day-old offspring were divided into 12 groups: Male-CTL, Male-VPA, Male-CTL + LIEE, Male-CTL + MIEE, Male-VPA + LIEE, Male-VPA + MIEE, Female-CTL, Female-VPA, Female-CTL + LIEE, Female-CTL + MIEE, Female-VPA + LIEE, and Female-VPA + MIEE. LIEE and MIEE were performed 5 days a week for 30 days. Twenty-four hours after the last exercise session, electrocardiogram and hemodynamic and cardiac function indices were recorded. The results indicated that +dp/dt max and contractility index (CI) decreased in the Female-VPA group compared to the Female-CTL group. LIEE increased these parameters in the Female-VPA + LIEE group. However, MIEE normalized CI in the Male-VPA + MIEE compared to the Male-VPA group. Tau increased in the Female-VPA group compared to the Female-CTL group and it decreased in the Female-VPA + MIEE group compared to the Female-VPA group. LIEE and MIEE recovered the reduction of heart rate and the increase in P, R, and T amplitudes in Male-VPA group. LIEE and MIEE increased heart rate variability in the Male-VPA and Female-VPA groups. The findings showed that LIEE and MIEE alleviated cardiac dysfunction and disturbances in heart rhythm in the autistic offspring. Exercise may be recommended as a routine program for autistic patients to prevent and treat the harmful cardiovascular consequences of autism.

The Between-Day Reliability of Correlation Properties of Heart Rate Variability During Running.

The short-term scaling exponent of detrended fluctuation analysis (DFA-a1) of heart rate variability may be a helpful tool to assess autonomic balance as a prelude to daily, individualized training. For this concept to be useful, between-session reliability should be acceptable. The aim of this study was to explore thereliability of DFA-a1 during a low-intensity exercise session in both a non-fatigued and a fatigued condition in healthy males and females. Ten participants completed two sessions with each containing an exhaustive treadmill ramp protocol. Before and after the fatiguing ramp, a standardized submaximal low-intensity exercise bout was performed during which DFA-a1, heart rate, and oxygen consumption (VO2) were measured. We compared between-session reliability of all metrics prior to the ramps (i.e., non-fatigued status) and after the first ramp (i.e., fatigued status). Intraclass correlation coefficients (ICC) with 95% confidence intervals (CI), the standard error of measurement, and the smallest worthwhile change (SWC) were determined. The ICC and SWC pre fatiguing ramp were 0.85 (95% CI 0.39-0.96) and 5.5% for DFA-a1, 0.85 (0.38-0.96) and 2.2% for heart rate, and 0.84 (0.31-0.96) and 3.1% for VO2. Post fatiguing ramp, the ICC and SWC were 0.55 (0.00-0.89) and 7.9% for DFA-a1, 0.91 (0.62-0.98) and 1.6% for heart rate, and 0.80 (0.17-0.95) and 3.0% for VO2. DFA-a1 shows generally acceptable to good between-session reliability with a SWC of 0.06 and 0.07 (5.5-7.9%) during non-fatigued and fatigued conditions. This suggests that this metric may be useful to inform on training readiness.

The influence of volume-matched acute aerobic exercise on inhibitory control in late-middle-aged and older adults: A neuroelectric study.

Acute aerobic exercise has been shown to benefit inhibitory control; however, less attention has been devoted to the effects of varying intensity and duration with a predetermined exercise volume. The current study assessed the influence of three distinct exercise conditions, each equated with a predesignated exercise volume but varied in terms of exercise durations and intensities, on inhibitory control utilizing both behavioral and neuroelectric measures obtained among late-middle-aged and older adults. Thirty-four adults (61.76 ± 0.80 years) completed three exercise conditions [i.e., a 30-min low-intensity exercise (LIE), a 20-min moderate-intensity exercise (MIE), and a 16-min high-intensity exercise (HIE)] and a non-exercise reading control condition (CON) on separate days. The exercise volumes of LIE and HIE were designed to match the exercise volume of MIE. Following cessation of each condition, the Stroop task was performed while event-related potentials were recorded. Improved behavioral performance (i.e., shorter response time, higher accuracy, and smaller interference scores) was observed after LIE, MIE, and HIE than CON (ps < .005). Additionally, whereas a larger P3b amplitude was only observed following MIE compared to CON (p < .01), larger N2 and smaller N450 amplitudes were observed following all three exercise conditions compared to CON (ps < .005). These findings suggested that while MIE may provide additional benefits for attentional resource allocation, exercise conditions volume matched to MIE resulted in superior inhibitory control, paralleled by modulations of the neural underpinnings of conflict monitoring/detection.

Relationship between Total Flight Hours and Individual Factors with Low Back Pain in Indonesian Military Helicopter Pilots

Introduction: Helicopter pilots are potentially at risk of Low Back Pain (LBP) and are twice as likely as fighter pilots to experience it. Helicopter pilots’ LBP is caused by a combination of risk factors: engine and rotor vibration, ergonomic risks due to cockpit design, static seating position due to operations, and individual factors. These factors are incorporated into cumulative aviation risk exposure, which can be measured by total flight hours. The prevalence of LBP in Caucasians is high, at 50.5%-92%. However, there has not been any research on Indonesian military helicopter pilots who have a different posture from Caucasians.Objective: To determine the prevalence of LBP, to analyze the relationship between total flight hours and individual factors (age, height, BMI, exercise habits, and smoking habits) with LBP in Indonesian military helicopter pilots.Methods: The study was conducted at the Indonesian Army and Indonesian Air Force with total sampling method as many as 124 people. An explanation was carried out followed by filling in the consent to become a research subject, filling in personal data, anamnesis, Numeric Rating Scale (NRS), physical examination, neurological examination, and total flight hour data.Results: There were 124 subjects, consisting of 37.9% pilots and 62.1% copilots, 87.9% of pilots operate large helicopters, have average total flight hours of 450 hours, age of 30 years, the height of 172.66 cm, low intensity exercise habits of 61.3%, and smokers as much as 45.2%. A total of 57 people (46%) experienced LBP. Statistical results showed that total flight hours had an association with LBP (p = 0.035) where each 1 unit increase in total flight hours had a 1.02 times greater chance of LBP.Conclusion: The prevalence of LBP is 46% and there is an association between total flying hours and LBP in Indonesian military helicopter pilots.

Dissociated coupling between cerebral oxygen metabolism and perfusion in the prefrontal cortex during exercise: a NIRS study.

Purpose: The present study used near-infrared spectroscopy to investigate the relationships between cerebral oxygen metabolism and perfusion in the prefrontal cortex (PFC) during exercises of different intensities. Methods: A total of 12 recreationally active men (age 24 ± 6years) were enrolled. They performed 17min of low-intensity exercise (ExL), followed by 3min of moderate-intensity exercise (ExM) at constant loads. Exercise intensities for ExL and ExM corresponded to 30% and 45% of the participants' heart rate reserve, respectively. Cardiovascular and respiratory parameters were measured. We used near-infrared time-resolved spectroscopy (TRS) to measure the cerebral hemoglobin oxygen saturation (ScO2) and total hemoglobin concentration ([HbT]), which can indicate the cerebral blood volume (CBV). As the cerebral metabolic rate for oxygen (CMRO2) is calculated using cerebral blood flow (CBF) and ScO2, we assumed a constant power law relationship between CBF and CBV based on investigations by positron emission tomography (PET). We estimated the relative changes in CMRO2 (rCMRO2) and CBV (rCBV) from the baseline. During ExL and ExM, the rate of perceived exertion was monitored, and alterations in the subjects' mood induced by exercise were evaluated using the Profile of Moods Scale-Brief. Results: Three minutes after exercise initiation, ScO2 decreased and rCMRO2 surpassed rCBV in the left PFC. When ExL changed to ExM, cardiovascular variables and the sense of effort increased concomitantly with an increase in [HbT] but not in ScO2, and the relationship between rCMRO2 and rCBV was dissociated in both sides of the PFC. Immediately after ExM, [HbT], and ScO2 increased, and the disassociation between rCMRO2 and rCBV was prominent in both sides of the PFC. While blood pressure decreased and a negative mood state was less prominent following ExM compared with that at rest, ScO2 decreased 15min after exercise and rCMRO2 surpassed rCBV in the left PFC. Conclusion: Dissociated coupling between cerebral oxidative metabolism and perfusion in the PFC was consistent with the effort required for increased exercise intensity and associated with post-exercise hypotension and altered mood status after exercise. Our result demonstrates the first preliminary results dealing with the coupling between cerebral oxidative metabolism and perfusion in the PFC using TRS.

Exercise intensity and sex alter neurometabolic, transcriptional, and functional recovery following traumatic brain injury

Physical exercise represents a potentially inexpensive, accessible, and optimizable rehabilitation approach to traumatic brain injury (TBI) recovery. However, little is known about the impact of post-injury exercise on the neurometabolic, transcriptional, and cognitive outcomes following a TBI. In the current study, we examined TBI outcomes in adolescent male and female mice following a controlled cortical impact (CCI) injury. Mice underwent a 10-day regimen of sedentary, low-, moderate-, or high-intensity treadmill exercise and were assessed for cognitive function, histopathology, mitochondrial function, and oxidative stress. Among male mice, low-moderate exercise improved cognitive recovery, and reduced cortical lesion volume and oxidative stress, whereas high-intensity exercise impaired both cognitive recovery and mitochondrial function. On the other hand, among female mice, exercise had an intermediate effect on cognitive recovery but significantly improved brain mitochondrial function. Moreover, single nuclei RNA sequencing of perilesional brain tissue revealed neuronal plasticity-related differential gene expression that was largely limited to the low-intensity exercise injured males. Taken together, these data build on previous reports of the neuroprotective capacity of exercise in a TBI model, and reveal that this rehabilitation strategy impacts neurometabolic, functional, and transcriptional outcome measures in an intensity- and sex-dependent manner.

All’s well that ends well: an early-phase study testing lower end-session exercise intensity to promote physical activity in patients with Parkinson’s disease

Decreasing the intensity of exercise at the end of a session has been associated with greater post-exercise pleasure and enjoyment. Here, we investigated whether this manipulation can enhance affective attitudes toward physical activity (PA) and promote PA in patients with Parkinson’s disease (PD). Seven patients (72.9 ± 5.6 years, 3 women) were included in an eight-week within-subject study consisting of weekly exercise sessions. The first four weeks were used as a control condition. In the last four weeks, 9 minutes of lower-intensity exercise were added at the end of each session (experimental condition). Results of the linear mixed-effects models showed that the addition of lower-intensity exercise improved the explicit affective attitudes toward PA (b = 1.00, 95%CI = 0.36 to 1.64, P = 0.022). We found no evidence of an effect on implicit affective attitudes (P = 0.564), accelerometer-based PA (P = 0.417) and self-reported measures of PA (P = 0.122). Although not significant, self-reported PA per day was 36 minutes longer in the experimental than in the control condition. The findings of this early-phase study may suggest that reducing the intensity of an exercise at the end of the exercise sessions enhanced explicit affective attitudes toward PA in patients with PD. Yet, future well-powered and randomized studies are needed to provide more robust evidence.

Lower limb hyperthermia augments functional hyperaemia during small muscle mass exercise similarly in trained elderly and young humans.

What is the central question of the study? Ageing is postulated to lead to underperfusion of human limb tissues during passive and exertional hyperthermia, but findings to date have been equivocal. Thus, does age have an independent adverse effect on local haemodynamics during passive single-leg hyperthermia, single-leg knee-extensor exercise and their combination? What is the main finding and its importance? Local hyperthermia increased leg blood flow over three-fold and had an additive effect during knee-extensor exercise with no absolute differences in leg perfusion between the healthy, exercise-trained elderly and the young groups. Our findings indicate that age per se does not compromise lower limb hyperaemia during local hyperthermia and/or small muscle mass exercise. Heat and exercise therapies are recommended to improve vascular health across the lifespan. However, the haemodynamic effects of hyperthermia, exercise and their combination are inconsistent in young and elderly people. Here we investigated the acute effects of local-limb hyperthermia and exercise on limb haemodynamics in nine healthy, trained elderly (69±5 years) and 10 young (26±7 years) adults, hypothesising that the combination of local hyperthermia and exercise interact to increase leg perfusion, albeit to a lesser extent in the elderly. Participants underwent 90min of single whole-leg heating, with the contralateral leg remaining as control, followed by 10min of low-intensity incremental single-leg knee-extensor exercise with both the heated and control legs. Temperature profiles and leg haemodynamics at the femoral and popliteal arteries were measured. In both groups, heating increased whole-leg skin temperature and blood flow by 9.5±1.2°C and 0.7±0.2Lmin-1 (>3-fold), respectively (P<0.0001). Blood flow in the heated leg remained 0.7±0.6 and 1.0±0.8Lmin-1 higher during exercise at 6 and 12W, respectively (P<0.0001). However, there were no differences in limb haemodynamics between cohorts, other than the elderly group exhibiting a 16±6% larger arterial diameter and a 51±6% lower blood velocity following heating (P<0.0001). In conclusion, local hyperthermia-induced limb hyperperfusion and/or small muscle mass exercise hyperaemia are preserved in trained older people despite evident age-related structural and functional alterations in their leg conduit arteries.

Substrate oxidation during exercise in childhood acute lymphoblastic leukemia survivors

Children with acute lymphoblastic leukemia (ALL) are at high risk of developing long-term cardiometabolic complications during their survivorship. Maximal fat oxidation (MFO) is a marker during exercise of cardiometabolic health, and is associated with metabolic risk factors. Our aim was to characterize the carbohydrate and fat oxidation during exercise in childhood ALL survivors. Indirect calorimetry was measured in 250 childhood ALL survivors to quantify substrate oxidation rates during a cardiopulmonary exercise test. A best-fit third-order polynomial curve was computed for fat oxidation rate (mg/min) against exercise intensity (O2peak) and was used to determine the MFO and the peak fat oxidation (Fatmax). The crossover point was also identified. Differences between prognostic risk groups were assessed (ie, standard risk [SR], high risk with and without cardio-protective agent dexrazoxane [HR + DEX and HR]). MFO, Fatmax and crossover point were not different between the groups (p = .078; p = .765; p = .726). Fatmax and crossover point were achieved at low exercise intensities. A higher MFO was achieved by men in the SR group (287.8 ± 111.2 mg/min) compared to those in HR + DEX (239.8 ± 97.0 mg/min) and HR groups (229.3 ± 98.9 mg/min) (p = .04). Childhood ALL survivors have low fat oxidation during exercise and oxidize carbohydrates at low exercise intensities, independently of the cumulative doses of doxorubicin they received. These findings alert clinicians on the long-term impact of cancer treatments on childhood ALL survivors’ substrate oxidation.

Mental and Physical Function Improvement through Lifestyle Modification: The Model of Environmental Protection Volunteer Project

Abstract Objectives: The environmental protection volunteer (EPV) project comprises EPV activities and low-intensity aerobic environmental protection health exercise (EPHE). The project covered “three doing” components, i.e., cognitive enhancement, physical activity, and social network. In this study, we intended to evaluate the effect of real-world EPV projects on mean blood pressure (BP) variability, cognition, and psychophysiological functions in the elderly. Methods: Totally, 79 older adult volunteers were recruited from the community environmental protection station. They were divided into three groups (low participation frequency group [LPFG], middle participation frequency group [MPFG], and high participation frequency group [HPFG]) based on the participation frequency. All participants were evaluated three times using the measurements, including visit-to-visit BP, cognitive (Mini–Mental State Examination [MMSE] and clinical dementia rating) and psychophysiological function brief Geriatric Depression Scale (GDS), pain Visual Analog Scale (VAS), and suffering VAS. Results: There was a significant increase in the MMSE and a decrease in pain VAS after participating in the EPV activity (p &lt; 0.05). The diastolic BP variability (BPV) was significantly decreased after the EPV project containing EPHE (p &lt; 0.01). Those who participated in HPFG and MPFG showed a significant decrease in the brief GDS compared with LPFG (p &lt; 0.01 at T2 and p &lt; 0.05 at T3). Conclusion: Participating in the EPV project benefited cognitive function and reduced pain and BPV. In addition, engaging in the EPV project frequently as a daily routine may reduce depression levels.

Identification of Early Mobilization Interventions in Cardiovascular Disease Patients in Hospital

This study aims to categorize various early mobilization therapies in heart disease patients. The research method used is a systematic review by searching for articles using the Science Direct, PubMed, and Google Scholar databases. Key phrases included "early mobilization," "exercise training," and "cardiovascular disease and heart failure." The results showed that the interventions had 6MWT, CPET, progressive mobilization I, muscle breathing/inhalation training on day I, leg and limb exercises on the second and third days, ambulation, limb exercises, sitting, and walking. Around the bed, low-intensity resistance exercises in bed, and standing and tiptoe exercises on the floor beside the bed. Patients with acute heart failure often receive 20 to 40 minutes of therapy daily, including bedside exercises and a 50-step walk. In conclusion, there are still differences in time, scope, and implementation of early mobilization initiatives. However, mobilization therapy can be given to cardiac patients of all ages and is safe and practical. They help reduce re-hospitalization risk and improve a patient's VO2 and quality of life (QOL).&#x0D; &#x0D; Keywords: Heart Failure, Exercise, Early Mobilization, Exercise, Cardiovascular Disease

FUNCTIONAL TRAINING OF SAMBO WRESTLERS DURING THE PREPARATION PERIOD AT THE STAGE OF SPORTS SPECIALIZATION

The stage of sports specialization in sambo wrestling is characterized by a decrease in the share of general physical fitness and an increase in the role of special exercises in the training process of a wrestler. Against the background of an increase in the volume and intensity of tasks, the risks of forcing sports results may increase. The motor base becomes scarce, and stereotypical movements often lead to injuries. In turn, there is a need to modernize the training process in sambo wrestling, increasing the functionality of exercises. This approach is aimed at preserving the athlete’s health and improving the quality of physical and technical training of athletes. The purpose of the research is to study the influence of functional training in the preparatory period on the indicators of physical and technical training of sambo athletes at the stage of sports specialization. The results of the research. The basic principles of functional training of SAMBO wrestlers are defined, consisting in the use of low-intensity exercises that increase joint mobility, strength of priority muscle groups, coordination of movements and dexterity. Tasks should become more complicated and updated during the season. A pedagogical experiment was conducted with the participation of 24 female athletes engaged in sambo wrestling. Conclusions. 1. Functional training exercises should reflect the main motor tasks of sambo wrestlers, should be multiarticulate, diverse, and coordination complex. 2. The model of functional training of sambo wrestlers aged 13-14 years includes mobility, stability and control of the wrestler’s movements. 3. It has been experimentally proved that the use of exercises with high functional value in the preparatory period of training sambo athletes aged 13-14 years at the stage of sports specialization has a more pronounced effect on the indicators of physical and technical fitness of athletes.

Effects of exercise intensity on spatial memory performance and hippocampal synaptic function in SAMP8 mice

Learning and memory impairment is commonly noted in Alzheimer's disease (AD), which is regarded as a progressive synaptic failure disease. Exercise is a nonpharmacological strategy that may help prevent cognitive decline and reduce the risk of AD, which is usually thought to be related to synaptic damage in the hippocampus. However, the effects of exercise intensity on hippocampal memory and synaptic function in AD remain unclear. In this study, senescence-accelerated mouse prone-8 (SAMP8) mice were randomly assigned to the control group (Con), low-intensity exercise group (Low), and moderate-intensity exercise group (Mid). Here, we showed that eight weeks of treadmill exercise beginning in four-month-old mice improved spatial memory and recognition memory in six-month-old SAMP8 mice, while the Con group exhibited impaired spatial memory and recognition memory. Treadmill exercise also improved hippocampal neuron morphology in SAMP8 mice. Furthermore, dendritic spine density and the levels of postsynaptic density protein-95 (PSD95) and Synaptophysin (SYN) increased significantly in the Low and Mid groups as compared with the Con group. We further showed that moderate-intensity exercise (60 % of maximum speed) was more efficacious in increasing dendritic spine density、PSD95 and SYN, than low-intensity exercise (40 % of maximum speed). In conclusion, the positive effect of treadmill exercise is closely related to exercise intensity, with moderate-intensity exercise showing the most optimal effects.

Blood flow restriction training activates the muscle metaboreflex during low-intensity sustained exercise.

Blood flow restriction training (BFRT) employs partial vascular occlusion of exercising muscle and has been shown to increase muscle performance while using reduced workload and training time. Numerous studies have demonstrated that BFRT increases muscle hypertrophy, mitochondrial function, and beneficial vascular adaptations. However, changes in cardiovascular hemodynamics during the exercise protocol remain unknown, as most studies measured blood pressure before the onset and after the cessation of exercise. With reduced perfusion to the exercising muscle during BFRT, the resultant accumulation of metabolites within the ischemic muscle could potentially trigger a large reflex increase in blood pressure, termed the muscle metaboreflex. At low workloads, this pressor response occurs primarily via increases in cardiac output. However, when increases in cardiac output are limited (e.g., heart failure or during severe exercise), the reflex shifts to peripheral vasoconstriction as the primary mechanism to increase blood pressure, potentially increasing the risk of a cardiovascular event. Using our chronically instrumented conscious canine model, we utilized a 60% reduction in femoral blood pressure applied to the hindlimbs during steady-state treadmill exercise (3.2 km/h) to reproduce the ischemic environment observed during BFRT. We observed significant increases in heart rate (+19 ± 3 beats/min), stroke volume (+2.52 ± 1.2 mL), cardiac output (+1.21 ± 0.2 L/min), mean arterial pressure (+18.2 ± 2.4 mmHg), stroke work (+1.93 ± 0.2 L/mmHg), and nonischemic vascular conductance (+3.62 ± 1.7 mL/mmHg), indicating activation of the muscle metaboreflex.NEW & NOTEWORTHY Blood flow restriction training (BFRT) increases muscle mass, strength, and endurance. There has been minimal consideration of the reflex cardiovascular responses that could be elicited during BFRT sessions. We showed that during low-intensity exercise BFRT may trigger large reflex increases in blood pressure and sympathetic activity due to muscle metaboreflex activation. Thus, we urge caution when employing BFRT, especially in patients in whom exaggerated cardiovascular responses may occur that could cause sudden, adverse cardiovascular events.

Complex myocardial mechanics in adult patients with repaired TOF- A novel study assessing myocardial work and mechanical dispersion at rest and during exercise

Abstract Funding Acknowledgements Type of funding sources: None. Background Assessment of LV myocardial work (MW) and biventricular mechanical dispersion (MD) in patient with repaired TOF (rTOF) is novel. We sought to investigate the LV MW and biventricular MD response during stress echocardiography. Methods We analysed MW and MD at baseline and at low exercise intensity for 100 adult patients with repaired TOF, 60 patients with severe pulmonary regurgitation (SPR), and 40 patients with negligible PR (NPR). MW was derived as the area of pressure strain loop using speckle tracking echocardiography and blood pressure. MD was derived as the SD of time Q/R wave on ECG to peak longitudinal strain and expressed in millisecond. Results Reduced MW indices were observed in the entire population with mean global work efficiency (MWE) was 85±7%. Overall mean of global work index (GWI) was 1198±312mmHg%, 1701±303mmHg% for global constructive work (GCW), and 293±194mmHg% for global wasted work (GWW). The SPR group had lower MWE, lower GCW and higher GWW. During exercise, overall ΔMWE decreased by −2±10%, ΔGWI increased by 36±43%, ΔGCW increased by 68±40%, and ΔGWW increased by 120±110%. Overall resting mean value of RVMD was 46±18,ms, while 64±11,ms for LVMD, and higher values were observed during exercise. Changes in MWE, MWW, and LV and RVMD were closely associated with peak oxygen uptake (r=.33, r=.41, r=.36, r=.47, p&amp;lt;0.001). Conclusions LV MW indices are reduced and biventricular MD are pronounced in rTOF patients. Augmentation of MW parameters and timing were associated with objective exercise ability, suggesting that they are potential determinants of cardiopulmonary capability.

Effects of different modes and intensities of exercise on longevity proteins in middle-aged mouse skeletal muscle.

Physical exercise represents one of the most effective approaches to anti-aging. The goal of this study was to verify the effects of different modes and intensities of exercise on longevity proteins in the skeletal muscle in midlife. Middle-aged mice were trained in aerobic or resistance exercise for 8 weeks, and the changes in sirtuin 1 (SIRT1), adenosine monophosphate-activated kinase (AMPK), and mammalian target of rapamycin (mTOR) pathways in the skeletal muscle were evaluated by western blotting. Long-term exercise had no effects on skeletal muscle SIRT1 abundance, whereas high-intensity aerobic exercise increased AMPK phosphorylation and peroxisome proliferator-activated receptor-γcoactivator-1α (PGC-1α). Low-intensity resistance exercise facilitated Akt/mTOR/p70 ribosomal protein kinase S6 (p70S6K) signaling but did not induce muscle hypertrophy. Conversely, high-intensity resistance exercise stimulated muscle hypertrophy without phosphorylation of mTOR signaling-related proteins. These results suggest the importance of setting exercise modes and intensities for anti-aging in midlife.

Prescription of therapeutic exercise in migraine, an evidence-based clinical practice guideline

The main objective of this clinical practice guideline is to provide a series of recommendations for healthcare and exercise professionals, such as neurologists, physical therapists, and exercise physiologists, regarding exercise prescription for patients with migraine.This guideline was developed following the methodology and procedures recommended in the Appraisal of Guidelines for Research and Evaluation (AGREE). The quality of evidence and strength of recommendations were evaluated with the Scottish Intercollegiate Guidelines Network (SIGN). A systematic literature review was performed and an established appraisal process was employed to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology).The evaluation of the current evidence, the elaboration of the grades of recommendation, and their validation show a B grade of recommendation for aerobic exercise, moderate-continuous aerobic exercise, yoga, and exercise and lifestyle recommendations for the improvement of symptoms, disability, and quality of life in patients with migraine. Relaxation techniques, high-intensity interval training, low-intensity continuous aerobic exercise, exercise and relaxation techniques, Tai Chi, and resistance exercise obtained a C grade of recommendation for the improvement of migraine symptoms and disability.

Exercise in Hypertrophic Cardiomyopathy: Recent Conceptual Changes and Recommendations for Pre-Exercise Tests.

Traditionally, individuals with hypertrophic cardiomyopathy (HCM) have been advised not to participate in more than low-intensity exercises. HCM was originally described in the context of sudden death, and early literature from the registry showed that HCM was the most common cause of sudden cardiac death in young athletes. Therefore, there has long been a concern that exercise could trigger ventricular arrhythmia and sudden cardiac death. Although a few patients with HCM may progress along deteriorating disease pathways, many have no clinically significant symptoms or adverse events, no need for major treatment, and a normal life expectancy. Therefore, the routine restriction of any exercise intensity in this large group deprives them of the multiple benefits of exercise and may have detrimental effects on long-term clinical outcomes. However, it has been reported that light to moderate exercise is acceptable for many patients with HCM, and recent evidence suggests that vigorous exercise does not increase the risk of sudden death in this population. Thus, we reviewed previous literature regarding the effects of exercise in patients with HCM and provided cutting-edge information on the safety and concerns of exercise. In addition, based on our experience and previous research, we reviewed the conditions that should be met before starting exercise and the tests required to confirm them.

The Effects of Exercise during Pregnancy on Gestational Diabetes Mellitus, Preeclampsia, and Spontaneous Abortion among Healthy Women-A Systematic Review and Meta-Analysis.

The aim was to compare the effects of different exercise modalities (aerobic, resistance, aerobic and resistance combined, or mind-body exercise) on gestational diabetes mellitus (GDM), preeclampsia, spontaneous abortion, withdrawal from the study, and adverse events in healthy pregnant women. A systematic search was conducted in February 2022 using MEDLINE, EMBASE, Cochrane library, and SPORT Discus to identify eligible randomized trials. The meta-analysis of 18 studies that examined exercise compared to no exercise showed a reduced risk of GDM (RR: 0.66 (95% CI: 0.50 to 0.86)). No subgroup differences were found regarding modality, intensity, or supervision. Exercise did not reduce the risk of preeclampsia (nine studies, RR: 0.65 (95% CI: 0.42 to 1.03)); however, in subgroup analyses, mind-body exercise and low-intensity exercise seemed to be effective in reduction of preeclampsia. There was no effect of exercise on withdrawal or adverse events found. No studies reported on spontaneous abortion, therefore, exercise during pregnancy is beneficial and safe. In the prevention of GDM, any modality and intensity seem equally effective. Subgroup analyses support an association between mind-body exercise and physical activity with low intensity and reduced risk of preeclampsia, but more high-quality randomized studies are needed. PROSPERO: CRD42022307053.