Months Of Exercise Training Research Articles

Effect of Exercise Training in Heart Failure Patients Without Echocardiographic Response to Cardiac Resynchronization Therapy.

Background: Cardiac resynchronization therapy (CRT) is an effective treatment of heart failure (HF) with ventricular dyssynchrony, but not all patients respond to a similar extent. We investigated the efficacy and safety of exercise training (ET) in patients without response to CRT. Methods and Results: Thirty-four patients who participated in a 3-month ET program and underwent cardiopulmonary exercise testing at baseline and after the program were divided into 17 responders and 17 non-responders based on echocardiographic response criteria: either an increase in ejection fraction (EF) ≥10% or a reduction in left ventricular (LV) end-systolic volume ≥10%. Baseline characteristics including peak oxygen uptake (V̇O2) and isometric knee extensor muscle strength (IKEMS) were similar in both groups, but non-responders had lower EF and larger LV. During the ET program, neither group had exercise-related adverse event including life-threatening ventricular arrhythmia. Peak V̇O2 and IKEMS were significantly improved in both groups and there was no significant difference in change in peak V̇O2 or IKEMS between responders and non-responders. On multiple regression analysis, change in IKEMS was an independent predictor of change in peak V̇O2, whereas the response to CRT was not. Conclusions: In HF patients undergoing CRT implantation, ET safely improved exercise capacity regardless of response to CRT, suggesting that even advanced HF patients without response to CRT can possibly benefit from ET.

Reductions in whole-body fat mass but not increases in lean mass predict changes in cardiometabolic health indices with exercise training among weight-stable adults

We assessed whether body composition changes with 9 months of exercise training predicted changes in cardiometabolic health indices in weight-stable adults. We hypothesized that within ±5% weight change, changes in whole-body fat and lean masses would predict changes in cardiometabolic health indices with exercise training. Using a randomized parallel design, 152 adults (age: 49 ± 8 year; body mass index: 30.0 ± 2.7 kg/m2; mean ± SD) performed resistance exercises 2 d/wk and aerobic exercises 1 d/wk for 9 months. Participants consumed isoenergetic supplements with 0, 10, 20, or 30 g whey protein twice daily and remained weight stable within ±5% of baseline weight. Body weight and composition were measured using dual-energy x-ray absorptiometry pre- and postintervention. Multiple linear regression model was applied for data analyses. Independent of whey protein supplementation, reductions in fat mass predicted increases in high-density lipoprotein cholesterol (unstandardized beta-coefficient [β], −0.03; 95% confidence interval [CI], −0.06 to −0.01; P = .007) and insulin sensitivity index (β, −0.52; 95% CI, −0.95 to −0.09; P = .018) and decreases in waist circumference (β, 0.67; 95% CI, 0.17-1.18; P = .009). In contrast, increases in lean mass did not predict changes in any of the measured cardiometabolic health indices. Health improvements with training that emphasize resistance exercises are typically attributed to increases in lean mass; however, these results underscore reducing body fat to predict cardiometabolic health improvements.

PO-185 Lifestyle intervention modify DNA methylation of adipose tissue in overweight and obese men with insomnia symptoms

Objective To study whether diet and exercise intervention affect sleep and obesity-related genes’ DNA methylation in overweight and obese men with insomnia symptoms
 Methods The study participants were a subgroup of a large intervention and consisted of 10 overweight or obesity men aged 34-65 years with insomnia symptoms. They participated in a 6-month progressive aerobic exercise training and individualized dietary consoling program and were randomly selected from diet (n=4), exercise (n=3) and control (n=3) groups. Body composition included fat mass and lean mass in the whole body and abdominal android region were assessed by dual-energy X-ray densitometry. The fitness level (VO2max) was determined by 2-km walk test using a standard protocol. Blood samples from venous were taken at fasted state in the morning. Total cholesterol, high density lipid cholesterol, low density lipid cholesterol, triglycerides, glucose, insulin, non-esterified fatty acid, alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase were assessed by conventional methods. Subcutaneous adipose tissue was taken from abdominal region before and after the intervention. DNA was extracted from subcutaneous adipose tissue using a QIAamp DNeasy Tissue Kit. Whole genome-wide DNA methylation was obtained using MethylRAD-Seq. MethylRAD library preparation started from DNA digestion by FspEI, then digested products were run on agarose gel to verify digestion and DNA ligase was added to the digestion solution. After ligation products amplication, PCR was conducted by MyCycler thermal cycler (Bio-Rad). The target fragment was excised from polyacrylamide gel and DNA was diffused from the gel in nuclease-free water. For relative quantification of MethylRAD data, DNA methylation levels were determined using the normalized read depth (reads per million, RPM) for each site. For each restriction site, its methylation level was estimated by dividing the log-transformed depth of each site by the log-transformed maximum depth (representing 100% methylation; i.e. M-index ¼ log(depth site)/ log(depth max)), where depth max was summarized from the top 2% of sites (approx. 500 for the standard library) with the highest sequencing coverage. Heat map images are generated with Matlab 7.0 software and pathways are analysed by WEB-based Gene SeT AnaLysis Toolket. A statistical significance for methylated CpGs and pathways were set to p=0.001 and p=0.05, respectively.
 Results No significant group differences by time were found in sleep-related variables, body composition, lifestyle factors nor with measured lipid and glucose biomarkers. However, whole genome-wide DNA methylation was decreased after dietary intervention, but was increased after exercise intervention, respectively. Correspondingly, 1253 and 708 differentially methylated loci were found in diet and exercise groups by contrast to the control group. Among them, the overlap genes between diet and exercise had multiple differentially methylated CpGs, including e.g. MYT1L (4 CpGs), CAMTA1 (3 CpGs), NRXN1 (3 CpGs), RPS6KA2 (3 CpGs), SEMA4D (3 CpGs). DNA methylation in PCDH8 was negatively correlated with wake after sleep onset after exercise intervention and MYRIP associated with sleep duration showed lower methylation after the dietary intervention. Further, 13 (DIO1, GCK, GYS1,
 LMNA, LY86, PNMT, PPARA, PPARD, SERPINE1, TH, TMEM18, TNFRSF1B and UBL5) and 2 (SDCCAG8 and TNF) obesity-related genes’ DNA methylation profile changed in response to diet and exercise, respectively. Percentage changes of CpGs within KLHDC8A, ANKS1A, FGFRL1 and KDM3B were correlated with energy yield fat and carbohydrate, HOMA-IR and VO2max, respectively.
 Conclusions We found that both exercise and dietary interventions have impacts on these genes related to sleep indicating by DNA methylation in PCDH8 and MYRIP, respectively. Further diet may be more effective than aerobic exercise intervention since greater number of modified obesity-related genes observed after dietary intervention. Our results indicate that reduce insomnia symptoms may need to more focus on control obesity.

The Effect of Detraining after a Period of Training on Cardiometabolic Health in Previously Sedentary Individuals.

The purpose of this study was to quantify the time-magnitude changes in cardiometabolic health outcomes that occur with cessation of regular exercise training. All participants (n = 22) performed baseline testing, completed a 13-week exercise program, and completed post-program testing. Upon completion of the 13-week exercise program, participants were randomized to one of the following two treatment groups: (1) the treatment group that continued their exercise for 4 weeks (TRAIN); or (2) the treatment group that discontinued exercise (DETRAIN). Changes from baseline to 13 weeks in both the TRAIN and DETRAIN treatment groups for maximal oxygen consumption (VO2max), body fat percentage, mean arterial pressure, high-density lipoprotein (HDL) cholesterol, and triglycerides were significantly favourable (p < 0.05). VO2max, body fat percentage, and favourable cardiometabolic health adaptations continued to improve (p < 0.05) with an additional one month of exercise training. Upon cessation of exercise, all measures of VO2max and body fat percentage, along with mean arterial pressure, HDL cholesterol, and triglycerides significantly worsened (p < 0.05) in the DETRAIN treatment group. Favourable training adaptations were further enhanced with an additional month of continued exercise training, and cessation of regular exercise rapidly abolished all training adaptations within one month. These novel findings underscore the importance of sustained and uninterrupted exercise training.

1685PD - Effects of 6-month exercise training on quality of life in pancreatic cancer patients: Results from a randomized controlled trial

1685PD - Effects of 6-month exercise training on quality of life in pancreatic cancer patients: Results from a randomized controlled trial

Changes in the Brain-Derived Neurotrophic Factor Are Associated with Improvements in Diabetes Risk Factors after Exercise Training in Adolescents with Obesity: The HEARTY Randomized Controlled Trial

Obesity in youth increases the risk of type 2 diabetes (T2D), and both are risk factors for neurocognitive deficits. Exercise attenuates the risk of obesity and T2D while improving cognitive function. In adults, these benefits are associated with the actions of the brain-derived neurotrophic factor (BDNF), a protein critical in modulating neuroplasticity, glucose regulation, fat oxidation, and appetite regulation in adults. However, little research exists in youth. This study examined the associations between changes in diabetes risk factors and changes in BDNF levels after 6 months of exercise training in adolescents with obesity. The sample consisted of 202 postpubertal adolescents with obesity (70% females) aged 14–18 years who were randomized to 6 months of aerobic and/or resistance training or nonexercise control. All participants received a healthy eating plan designed to induce a 250/kcal deficit per day. Resting serum BDNF levels and diabetes risk factors, such as fasting glucose, insulin, homeostasis model assessment (HOMA-B—beta cell insulin secretory capacity) and (HOMA-IS—insulin sensitivity), and hemoglobin A1c (HbA1c), were measured after an overnight fast at baseline and 6 months. There were no significant intergroup differences on changes in BDNF or diabetes risk factors. In the exercise group, increases in BDNF were associated with reductions in fasting glucose (β = −6.57, SE = 3.37, p = 0.05) and increases in HOMA-B (β = 0.093, SE = 0.03, p = 0.004) after controlling for confounders. No associations were found between changes in diabetes risk factors and BDNF in controls. In conclusion, exercise-induced reductions in some diabetes risk factors were associated with increases in BDNF in adolescents with obesity, suggesting that exercise training may be an effective strategy to promote metabolic health and increases in BDNF, a protein favoring neuroplasticity. This trial is registered with ClinicalTrials.gov NCT00195858, September 12, 2005 (funded by the Canadian Institutes of Health Research).

Erratum: Effects of exercise training on stroke risk factors, homocysteine concentration, and cognitive function according the APOE genotype in stroke patients.

[This corrects the article on p. 267 in vol. 14, PMID: 29740562.].

Peak exercise stroke volume effects on cognitive impairment in community-dwelling people with preserved ejection fraction.

AimsThe association of vascular dysfunction and amyloid beta deposition attracted attentions for its relationship with cognitive decline. Previous studies show the correlation between the declined cardiac function and the cognitive impairment. In the present study, we analysed the association between cognitive functions and cardiac parameters in community‐dwelling people with preserved ejection fraction without heart failure.Methods and resultsSubjects were 108 Japanese community‐dwelling middle‐aged and older adults with preserved ejection fraction (25 men and 83 women; mean age 74.7 years). Cardiac functional parameters at rest were assessed with B‐type natriuretic peptide and echocardiography. The cardiopulmonary exercise test was used to test these parameters during exercise. Cognitive function was assessed with the Japanese version of the Montreal Cognitive Assessment (MoCA‐J). Other indices were assessed biochemically, physiologically, and physically. There were significant correlations between MoCA‐J score and age (r = −0.388), peak oxygen uptake (VO2, r = 0.201), peak VO2/heart rate (HR, r = 0.243), peak VO2/weight (r = 0.244), peak metabolic equivalents (r = 0.244), usual walking speed (r = −0.200), and the Timed Up and Go test (r = −0.230). Multiple linear regression analysis showed peak VO2/HR was an independent determinant of MoCA‐J score after adjusting for potential confounders (B = 0.424). After 6 months of exercise training with 64 subjects, we found that the per cent change of peak VO2/HR was related to the per cent change of MoCA‐J score (r = 0.296).ConclusionsThese results suggested that peak VO2/HR (an index of stroke volume at peak exercise) might be associated with cognitive impairment based on the vascular cascade hypothesis.

Exercise training as a novel primary treatment for localised prostate cancer: a multi-site randomised controlled phase II study

Alternative management strategies for localised prostate cancer are required to reduce morbidity and overtreatment. The aim of this study was to evaluate the feasibility, safety and acceptability of exercise training (ET) with behavioural support as a primary therapy for low/intermediate risk localised prostate cancer. Men with low/intermediate-risk prostate cancer were randomised to 12 months of ET or usual care with physical activity advice (UCwA) in a multi-site open label RCT. Feasibility included acceptability, recruitment, retention, adherence, adverse events and disease progression. Secondary outcomes included quality of life and cardiovascular health indices. Of the 50 men randomised to ET (n = 25) or UCwA (n = 25), 92% (n = 46) completed 12 month assessments. Three men progressed to invasive therapy (two in UCwA). In the ET group, men completed mean: 140 mins per week for 12 months (95% CI 129,152 mins) (94% of target dose) at 75% Hrmax. Men in the ET group demonstrated improved body mass (mean reduction: 2.0 kg; 95% CI −2.9,−1.1), reduced systolic (mean: 13 mmHg; 95%CI 7,19) and diastolic blood pressure (mean:8 mmHg; 95% CI 5,12) and improved quality of life (EQ.5D mean:13 points; 95% CI 7,18). There were no serious adverse events. ET in men with low/intermediate risk prostate cancer is feasible and acceptable with a low progression rate to radical treatment. Early signals on clinically relevant markers were found which warrant further investigation.

Effects of aerobic training with and without weight loss on insulin sensitivity and lipids.

PurposeThe purpose of this study is to evaluate the effect of exercise training with modest or greater weight loss (≥3%) or not (<3%) on insulin sensitivity, lipoprotein concentrations, and lipoprotein particle size in overweight and obese participants.MethodsAdults (N = 163, body mass index: 25–37 [kg/m2]) participated in 8 months of exercise training. Insulin sensitivity, lipid concentrations, lipid particle size and other cardiometabolic variables were measured at baseline and follow-up. Participants were categorized by whether they achieved at least modest weight loss (≥ 3%) or not (<3%) following the intervention.ResultsA greater improvement in insulin sensitivity was observed in adults performing exercise training with at least modest weight loss (2.2 mU·l-1 ·min -1, CI: 1.5 to 2.8) compared to those who did not (0.8 mU·l-1 ·min -1, CI: 0.5 to 1.2). Similar results were observed for acute insulin response, triglycerides, non-HDL cholesterol concentration, low density lipoprotein (LDL) particle size and high density lipoprotein (HDL) particle size (p<0.05), when all exercise groups were combined. No significant results across weight loss categories were observed for LDL, HDL, glucose, or insulin levels.ConclusionThe present study suggests that aerobic exercise combined with at least modest weight loss leads to greater improvements in insulin sensitivity, triglycerides as well as other non-traditional lipid risk factors (non-HDL cholesterol, HDL/LDL particle size). Clinicians should advocate patients who are overweight/obese to exercise and obtain modest weight loss for improved cardiovascular benefits.

The Effect of a Physical Training with the Use of an Exoskeleton on Depression Levels in Institutionalized Elderly Patients: A Pilot Study.

The Human Body Posturizer (HBP) is an exoskeleton used in the neurorehabilitation. The HBP may improve motor control by stimulating the pre-frontal cortex, a brain region involved also in the inhibitory modulation of the amygdala whose hyperactivity is involved in the mechanisms of depression. The aim of the study was to investigate in institutionalized elderly patients the effects on depression of a physical training with the use of the HBP compared to a traditional training. Randomized controlled trial. 20 institutionalized patients (mean age = 88, ds = ± 5, 3 males) with moderate depression levels. The participants were randomly assigned to: a) HBP Group, which carried out physical training using the HBP; b) Excercise Group, which carried out a training without the use of the orthosis. The training was conducted for 6 months (3 sessions each week), with the same kind of exercises with or without the HBP according to the assignment group. Participants were evaluated at baseline using the Tinetti balance and Gait scale, the Mini Mental State Examination and the Geriatric Handicap Scale. The Geriatric Depression Scale was administered to the participants before and after the period of training. The two groups were homogeneous for age, baseline motor ability (risk falls), handicap score, cognitive functioning and depression levels. After 6 months of exercise training a significant reduction in depression levels was reported only in the HBP Group (p <.01). A positive effect of the HBP in the modulation of mood in institutionalized elderly subjects was found. It is possible to hypothesis that a traditional training without the HBP may require more time to achieve significant results. Clinical implications will be discussed.

Cardiovascular Responses To Steady State Exercise In Well-healed Burned Survivors After Six Months Of Exercise Training

Cardiovascular Responses To Steady State Exercise In Well-healed Burned Survivors After Six Months Of Exercise Training

Effects of exercise training on stroke risk factors, homocysteine concentration, and cognitive function according the APOE genotype in stroke patients.

The apolipoprotein E (APOE) gene has been suggested to be associated with stroke and dementia. However, the effects of exercise training on dementia according to the APOE genotype are not consistent to those reported by previous studies. Therefore, we examined the effects of exercise training on stroke risk factors including blood pressure, lipid profiles, homocysteine (Hcy) concentrations, and cognitive function according to the APOE genotype in stroke patients. We examined the stroke risk factors, Hcy, and cognitive function in 28 ischemic stroke patients before and after 6 months of exercise training. After exercise training, body weight, body mass index (BMI), and percent body fat decreased significantly in both APOE groups. According to the APOE genotype, the changes in BMI in the APOE ɛ4 group higher than those in APOE ɛ3 group significantly. Total cholesterol (TC), low-density lipoprotein (LDL)-C, triglyceride (TG), and Hcy decreased and high-density lipoprotein (HDL)-C increased significantly in the both groups. According to the APOE genotype, systolic blood pressure in the APOE ɛ4 group decreased, but in the APOE ɛ3 group increased after exercise training. TC, LDL-C, and TG in the APOE ɛ4 group decreased more extensively than those in the APOE ɛ3 group after exercise training. VO2max (maximal oxygen consumption) and cognition increased significantly in both groups. Folate acid intake also increased significantly in both groups. The APOE genotype affects variations in the risk factors of stroke after exercise training. However, the Hcy and cognitive function did not differ based on the APOE genotype.

Left ventricular systolic function is improved in well‐healed burn survivors after six months of exercise training

Recent studies have identified that well‐healed burn survivors have altered resting cardiac responses that persist years after the initial burn injury. In healthy non‐burned individuals, prolonged exercise leads to beneficial cardiac remodeling and improved cardiac function. However, it is unknown whether burn survivors likewise demonstrate beneficial cardiac adaptations to long‐term aerobic exercise training. The purpose of this study was to test the hypothesis that six months of aerobic exercise training improves left ventricular systolic function in well‐healed burn survivors. Eleven participants (8 males; aged 43 ± 13 years) with well‐healed burn injuries covering an average total body surface area of 53 ± 25% (range: 22–88%), participated in a progressive 6‐month aerobic‐focused exercise training regimen. An index of cardiac systolic function was assessed via speckle tracking analysis to measure local longitudinal peak systolic strain (Tomtec software) at rest, prior to and after the 6‐month aerobic‐focused exercise training regimen. Exercise training improved resting left ventricular longitudinal systolic strain (Pre, −13.6 ± 2.9% vs. Post, −16.3 ± 2.9%, P=0.013). These data show that despite impaired resting cardiac responses that persist well past complete recovery, cardiovascular adaptations to long‐term aerobic exercise training can be obtained in well‐healed burned subjects.Support or Funding InformationWork funded by NIH GM068865This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Effects of menopause and high-intensity training on insulin sensitivity and muscle metabolism.

To investigate peripheral insulin sensitivity and skeletal muscle glucose metabolism in premenopausal and postmenopausal women, and evaluate whether exercise training benefits are maintained after menopause. Sedentary, healthy, normal-weight, late premenopausal (n = 21), and early postmenopausal (n = 20) women were included in a 3-month high-intensity exercise training intervention. Body composition was assessed by magnetic resonance imaging and dual-energy x-ray absorptiometry, whole body glucose disposal rate (GDR) by hyperinsulinemic euglycemic clamp (40 mU/m/min), and femoral muscle glucose uptake by positron emission tomography/computed tomography, using the glucose analog fluorodeoxyglucose, expressed as estimated metabolic rate (eMR). Insulin signaling was investigated in muscle biopsies. Age difference between groups was 4.5 years, and no difference was observed in body composition. Training increased lean body mass (estimate [95% confidence interval] 0.5 [0.2-0.9] kg, P < 0.01) and thigh muscle mass (0.2 [-0.1 to 0.6] kg, P < 0.01), and decreased fat percentage (1.0 [0.5-1.5]%, P < 0.01) similarly in the two groups. The postmenopausal women had lower eMR in vastus lateralis muscle than the premenopausal women (-14.0 [-26.0 to -2.0] μmol/min/kg, P = 0.02), and tended to have lower eMR in femoral muscles (-11.2 [-22.7 to 0.4] μmol/min/kg, P = 0.06), and also GDR (-59.3 [-124.8 to 6.3] mg/min, P = 0.08), but increased similarly in both groups with training (eMR vastus lateralis muscle: 27.8 [19.6-36.0] μmol/min/kg, P < 0.01; eMR femoral muscle: 20.0 [13.1-26.7] μmol/min/kg, P < 0.01, respectively; GDR: 43.6 [10.4-76.9] mg/min, P = 0.01). Potential mechanisms underlying the training-induced increases in insulin sensitivity included increased expression of hexokinase (19.2 [5.0-24.7] AU, P = 0.02) and glycogen synthase (32.4 [15.0-49.8] AU, P < 0.01), and also increased insulin activation of Akt2 (20.6 [3.4-29.0], P = 0.03) and dephosphorylation of glycogen synthase (-41.8 [-82.9 to -0.7], P = 0.05). Insulin sensitivity was reduced in early postmenopausal women. However, postmenopausal women increased peripheral insulin sensitivity, skeletal muscle insulin-stimulated glucose uptake, and skeletal muscle mass to the same extent as premenopausal women after 3 months of high-intensity exercise training.

Relationship between hand grip strength and peak VO2 in community‐dwelling elderly outpatients

AbstractBackgroundHand grip strength and peak oxygen uptake (VO2) are important components of frailty. However, the relationship between these two variables among community‐dwelling elderly people is still unclear. The present study aimed to investigate this relationship.MethodsParticipants were 190 Japanese community‐dwelling elderly outpatients (61 men and 129 women, mean age 78.0 years). Hand grip strength of participants' was measured using a Smedley‐type hand dynamometer. Peak VO2 levels were assessed with a cardiopulmonary exercise test. Skeletal muscle mass index (SMI) and usual walking speed were assessed physiologically and physically. Sample size was calculated using G*Power 3.1.9.2.ResultsThere were significant correlations between hand grip strength and age (r = −0.22), peak VO2 (r = 0.40), SMI (r = 0.51), and usual walking speed (r = 0.29). There were significant differences in age, peak VO2 and SMI after participants were divided into normal and low hand grip strength groups according to the Asian Working Group for Sarcopenia threshold, whether both sexes were combined or considered separately. Multiple logistic regression analysis showed that peak VO2, SMI and age were independent determinants of hand grip strength after adjusting for potential confounders (Exp(B) = 0.871; 0.475; 1.065). Longitudinal analysis after 6 months of exercise training showed the percentage of change in hand grip strength and peak VO2 were correlated positively (r = 0.22) for 92 participants.ConclusionPeak VO2 is independently associated with hand grip strength among community‐dwelling elderly outpatients.

Effect of Hospital-based Cardiac Rehabilitation on Quality of Life and Physical Capacity in Acute Myocardial Infarction Patients: 2 Years Follow Up

Objective: The aim of this study was to investigate the effect of hospital-based cardiac rehabilitation (CR) on quality of life (QOL) and physical functions in patients with acute myocardial infarction (AMI) during 2 years of followup. Methods: All AMI patients referred to the Cardiac Health and Rehabilitation Center (CHRC) were informed about CR and followed for 2 years on an outpatient basis from July 2010 to December 2015. Patients who were divided into a CR group and non-CR group. All patients took home-based self-exercise as CR programs of CHRC and in addition, the CR group received hospital-based supervised exercise training three times a week for 2 months. Both groups were evaluated for physical capacity and QOL at baseline, after 2 months of exercise training, and at 6 months, 1 year, and 2 years of follow-up. Results: The CR group showed significant improvements in physical functioning (PF), physical role functioning, bodily pain, vitality (VT), social role functioning, emotional role functioning, mental health, physical component summary (PCS), and mental component summary at all-time points compared to baseline. At 1 year of follow-up, the CR group displayed significantly greater PF, general health perceptions, VT, and PCS values than the non-CR group. Regarding physical capacity, the CR group exhibited significantly lower resting heart rate and significantly greater maximal oxygen consumption and metabolic equivalents than the non-CR group at 6 months of follow-up. Conclusion: Hospital-based CR was effective in promoting QOL and early improvement in exercise capacity in patients with AMI. Further, the improvement in QOL was maintained for up to 2 years.

Short-term combined exercise training improves cardiorespiratory fitness and autonomic modulation in cancer patients receiving adjuvant therapy.

The present study aimed to investigate the impact of a short-term exercise training (ET) on the cardiorespiratory fitness and autonomic modulation of women with breast cancer who were receiving adjuvant radiotherapy, chemotherapy or hormonotherapy. Eighteen women previously diagnosed with breast cancer receiving adjuvant radiotherapy, chemotherapy or hormone therapy were randomly allocated into breast cancer nonexercise (BC) and exercise groups (BC+Ex). Moreover, nine healthy physically inactive volunteers were recruited to compose the noncancer control group (CG). The BC+Ex group was underwent to a combined ET program, which was based on resistance, aerobic and flexibility exercises. ET was performed 3 times a week, on nonconsecutive days, for 4 weeks at the hospital room under the professional supervision. In turn, BC and CG remained without be engaged in physical exercise programs. Volunteers were evaluated regarding their cardiorespiratory fitness and autonomic modulation (i.e., time, frequency domains, and nonlinear [symbolic analysis]) before and after the end of the ET program. A priori, data indicate that women patients with breast cancer showed impaired exercise tolerance, as well as autonomic dysfunction in comparison with age-matched healthy control subjects. However, a 1-month combined ET program could reverse such impairments, so that after the intervention, BC+Ex and CG showing similar results in the cardiorespiratory test and heart rate variability analysis. In conclusion, data of the current study indicate that 1 month of ET is able to reverse impaired cardiorespiratory fitness and autonomic modulation in women with breast cancer receiving adjuvant therapy.

The Impact of Burst Exercise on Cardiometabolic Status of Patients Newly Diagnosed With Type 2 Diabetes

BackgroundThe impact of burst high-intensity exercise on physiological, cardiometabolic, and biochemical variables compared with traditional moderate-intensity continuous exercise training (MICT) has yet to be assessed in patients with type 2 diabetes (T2D). We compared the impact of multiple short-duration, high-intensity burst exercise sessions to MICT on cardiometabolic variables in patients with T2D. MethodsForty newly diagnosed patients with T2D not receiving lipid lowering or hypoglycemic medications were randomized to 40 minutes of MICT (60% of maximal heart rate) 5 days per week or 3 continuous bursts of 12 minutes of high-intensity exercise (85% of maximal heart rate) 5 days per week for 3 months. Body mass index, hemoglobin A1C (HbA1C), and lipid profile were assessed before and after 3 months of exercise training. ResultsBurst exercise resulted in greater body mass index reduction than did MICT (–2.1 ± 1.2 kg/m2 vs –0.7 ± 0.7 kg/m2, respectively; P < 0.05). There was a greater reduction at 3 months (P < 0.05) in HbA1C levels in the burst exercise group (8.14% ± 0.49% to 7.32% ± 0.39%) compared with the MICT group (8.18% ± 0.35% to 7.94% ± 0.41%). Compared with MICT, burst exercise was associated with a greater reduction in low-density lipoprotein cholesterol (–11 vs –4%; P < 0.05) and a greater increase in high-density lipoprotein cholesterol (22% vs 3%; all P < 0.05). After 3 months, patients in the burst exercise group attained greater exercise time on the treadmill (exercise capacity) than did those prescribed MICT (6.87 ± 1.44 minutes vs 5.40 ± 1.96 minutes; P < 0.001). ConclusionsFindings from the current study support better cardiometabolic benefits of burst exercise compared with MICT over 3 months in patients with newly diagnosed T2D.

EFFECTS OF EXERCISE ON PLASMA NITRITE/NITRATE LEVELS, AND NITRIC OXIDE SYNTHASE ACTIVITY IN ELDERLY AFRICAN AMERICANS WITH MILD COGNITIVE IMPAIRMENT

Studies have shown a positive correlation between exercise and vasodilatation, and this may be beneficial to brain perfusion and possibly memory. Proposed mediators for this observed effects of exercise include increases in nitric oxide (NO) via up-regulation of the rate controlling enzymes nitric oxide synthase (NOS) isoform (eNOS. Because endothelial dysfunction is an early marker of atherosclerosis, and hypoxia, impaired capacity of the vascular endothelium to release NO and NOS, and consequent vascular dysregulations have been implicated in cognitive impairment. This study seeks to establish whether mild cognitively impaired older adults exhibit NO and NOS dysregulation while on a supervised exercise program. African American older adult's ≥55 year, determined to have mild cognitive impairment, were enrolled and randomized into a six-month program of either treadmill exercise or stretch exercise. Both groups engaged in 40 minutes of supervised training three times per week. Aerobic exercise consisted of treadmill walking or jogging at an initial intensity that correlated with 50% VO2max and gradually increased to 70% VO2max. Stretch exercise consisted of a variety of dynamic stretch positions that were held for 15–30 second intervals. Fasting blood samples were taken at baseline, 3, 6, and 12 months of exercise training. Enzyme-linked photometric assay was used to measure nitrite/nitrate (NOx) levels in plasma and urine. Descriptive statistics were computed to assess patient baseline demographics for differences in exercise groups (Aerobic vs. Stretch). Significance level was set at P< 0.05 for all tests, and completed all analyses using the Statistical Analysis System (SAS) software 9.3. Six months of exercise resulted in decrease plasma NOx levels in both groups. Percent change in plasma NOx was significantly different from baseline to 12 months (p=0.05), but percent change in urine levels did not reach significance level. Plasma or urine NOx levels did not significantly correlate with age, MMSE, NO3 gene or VO2max. These results, suggests that exercise training-induced changes in NOx levels may be independent of eNOS gene in older African American MCI participants. Consequent vasodilatory effects of NOx may be beneficial to brain perfusion at the prodromal stage of AD.