No-exercise Group Research Articles

Exercise-based cardiac rehabilitation effects on severity of angina, HRQoL and exercise capacity in patients with microvascular angina: systematic review and meta-analysis

Abstract Background Microvascular angina (MVA) is a clinical syndrome caused by coronary microvascular dysfunction in patients with angina symptoms and no flow limiting blockages in their main coronary arteries. Patients experience recurrent angina, low health related quality of life (HRQoL) and limited exercise tolerance, making them more likely to repeatedly present to healthcare services. Aim To establish the effects of exercise-based cardiac rehabilitation (CR) on the severity of angina, HRQoL and exercise capacity among adults with a diagnosis of MVA compared to a no-exercise group. Methods Searches were performed in 14 online databases. We included randomised controlled trials (RCTs) that assessed the independent effect of CR versus a no-exercise group in adults with a probable or definite diagnosis of MVA according to the COVADIS criteria. Risk of bias was assessed via the Cochrane RoB2 tool at outcome level and the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Meta-analysis using random effects models were used to estimate mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI). Results Of the 15,873 reports identified, five studies (n=222) were included. Reasons for RoB judgements varied between studies and outcomes, however all were scored at either ‘high risk’ or ‘some concerns’. Participants were mostly female (97%), average ages ranged from 51 to 64 years. The CR programmes utilised aerobic exercise and resistance training. Meta-analysis of the effect of CR on severity of angina (2 RCTs; n=85) was not possible due to the limited data presented in one of the reports. The narrative synthesis concluded that there is no evidence of an effect of CR on severity of angina symptoms. Meta-analysis of the effects of CR versus no-exercise on HRQoL were conducted at domain level of the Short Form-36 (SF-36) questionnaire (2 RCTs; n=75), and exercise capacity as measured by peak VO2 (3 RCTs; n=101). The evidence of the effect of CR versus no-exercise intervention of the SF-36 domains from the meta-analyses was classified as ‘very low certainty’, meaning we have very little confidence in the effect estimates calculated. CR versus no-exercise intervention was estimated to result in a SMD of 1.06 (95% CI -0.7 to 2.19, low certainty of evidence) for measurements of peak VO2 in favour of CR. A SMD of 1.06 is estimated to be equivalent to a 4.42 ml/kg/min change in peak VO2, which is believed to represent a clinically meaningful difference. Conclusions CR may improve exercise capacity outcomes in patients with MVA compared to controls, however our confidence in the effect estimate is limited. We remain uncertain as to the effect of CR on the severity of angina symptoms and HRQoL. High-quality, well-reported RCTs are needed to more rigorously assess the benefits and harms of exercise-based CR for adults with MVA.

Effect of three months high-intensity anaerobic treadmill-based exercise on intuitive decision-making capability

Background. Quick decision making capability is critical for handling critical situation. Intuitive decision making is most desirable for situations requiring quick and heedful decisions. Decision making, just like other cognitive skills can be modified through several factors like physical activity. In this study we aim to decipher the effects of high-intensity treadmill-based exercise on intuitive ability. Methods. A prospective cohort design with convenience sampling with a sample of 80 participants from various gym centres. Following ethical approval and informed consent, participants were divided in to either no exercise (NE) (n = 38) condition or treadmill-based exercise (TBE) group (n = 42). Data on socio-demographic characters, self-reported mental health history and IDM scores were obtained. Data were obtained at baseline and after 34 sessions of treadmill-based exercise for TBE and 12 weeks of normal physical activity for NE group. Mixed-factor ANOVA, paired t-test and regression analysis was used utilizing SPSS version 21. Results. A significant improvement in IDM scores was observed in TBE group after 34 exercise sessions as compared to NE group (p < .01). A significant interaction of time points and group was also revealed through mixed-factor ANOVA (p < .01). Socio-demographic characters and mental health history had no significant impact on IDM scores. Chi-square analysis of the IDM sub-categories showed a significant increase in intuitive decision making individuals in the TBE group post intervention (p < .01). Conclusion. Exercise training can be used as a potential training tool for improving decision making outcomes in critical settings.

Tai chi, irisin and cognitive performance: a clinical and biological investigation in older adults.

Skeletal muscle is the main source of circulating irisin, both at rest and during physical activity. Previous studies have suggested that irisin can improve cognitive abilities. We explored whether six months of Tai Chi (TC) practice can modulate such a relationship in healthy older persons. This is a prospective clinical study to evaluate the effects of TC practice as compared with low intensity exercise (LI) and no exercise (NE) control groups on plasmatic irisin levels and cognitive performance. Forty-two healthy older persons were stratified into three groups according to physical activities. Biochemical assay and cognitive functions were assessed at the baseline and after six months. A significant change was found in circulating irisin levels in TC as compared with NE group (p = 0.050) across time. At six months in TC group irisin levels significantly correlated with a verbal memory test (p = 0.013) controlled by age and education. Our results suggest the potential benefits for cognitive health of TC practice by irisin levels modulation.

A study on the influence of a single bout of moderate-intensity exercise on processing bias towards emotional information of individuals with high psychosocial stress levels

To explore the impact of a single bout of moderate-intensity exercise on cognitive bias of individuals with high psychosocial stress levels. 42 college students with high stress levels were recruited and divided into a exercise group (N = 21) and a no-exercise group (N = 21). The psychological and behavioral characteristics were studied using word-face stroop task, memory bias task, and interpretion bias task. College students with high psychosocial stress levels have attention bias, memory bias, and Interpretion bias towards negative emotional information, and a single bout of moderate-intensity exercise can increase attention bias towards neutral and positive emotional information, and memory bias towards neutral emotional information, interpretation bias towdrds positive emotional information. A single bout of moderate-intensity exercise can increase the positive cognitive bias towards emotional information, which is beneficial for regulating psychosocial stress levels.

Pannexin 3 deletion in mice results in knee osteoarthritis and intervertebral disc degeneration after forced treadmill running.

Pannexin 3 (Panx3) is a glycoprotein that forms mechanosensitive channels expressed in chondrocytes and annulus fibrosus cells of the intervertebral disc (IVD). Evidence suggests Panx3 plays contrasting roles in traumatic versus aging osteoarthritis (OA) and intervertebral disc degeneration (IDD). However, whether its deletion influences the response of joint tissue to forced useis unknown. The purpose of this study was to determine if Panx3 deletion in mice causes increased knee joint OA and IDD after forced treadmill running. Male and female wildtype (WT) and Panx3 knockout (KO) mice were randomized to either a no-exercise group (sedentary; SED) or daily forced treadmill running (forced exercise; FEX) from 24 to 30 weeks of age. Knee cartilage and IVD histopathology were evaluated by histology, while tibial secondary ossification centers were analyzed using microcomputed tomography (µCT). Both male and female Panx3 KO mice developed larger superficial defects of the tibial cartilage after forced treadmill running compared with SED WT mice. Additionally, Panx3 KO mice developed reduced bone volume, and female PANX3 KO mice had lengthening of the lateral tubercle at the intercondylar eminence. In the lower lumbar spine, both male and female Panx3 KO mice developed histopathological features of IDD after running compared to SED WT mice. These findings suggest that the combination of deleting Panx3 and forced treadmill running induces OA and causes histopathological changes associated with the degeneration of the IVDs in mice.

Comparison of Metabolic Risk Factors Based on the Type of Physical Activity in Korean Adolescents: Results from a Nationwide Population-Based Survey.

Physical activity (PA) is associated with a favorable metabolic risk profile in adults. However, its role in adolescents remains unclear. In this study, using data (2019-2021) from the 8th Korea National Health and Nutrition Examination Survey, we investigated the optimal exercise type for preventing metabolic complications in adolescents. A total of 1,222 eligible adolescent participants (12-18-year-old) were divided into four groups as follows: aerobic exercise (AE), resistance exercise (RE), combined aerobic and resistance exercise (CE), and no exercise (NE). Daily PA was assessed using the international PA questionnaire. Blood samples were collected to measure lipid, glucose, and insulin levels. Additionally, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglyceride-glucose (TyG) indices were measured. Multivariate regression analysis was used to compare the metabolic risk factors across the PA groups before and after propensity score matching (PSM) adjustment for confounding variables. The CE group exhibited improved fasting glucose levels, lower TyG index, reduced white blood cell count, and higher high-density lipoprotein (HDL) cholesterol levels than the NE group. The RE group exhibited lower mean blood pressure, triglyceride, fasting insulin, HOMA-IR, TyG index and a reduced risk of metabolic syndrome than the NE group. The AE group had higher total and HDL cholesterol levels. In detailed comparison of the AE and RE groups, the RE group consistently exhibited favorable metabolic parameters, including lower blood pressure and total and low-density cholesterol levels, which persisted after PSM. These findings highlight the positive effects of PA on cardiovascular risk factors in adolescents. Thus, RE may have a more favorable metabolic effect than AE. Further studies are needed to validate the benefits of exercise according to the exercise type.

The necessity and timing of exercise after lumbar disc herniation surgery.

Physical therapy and rehabilitation may improve low back pain and quality of life after lumbar disc herniation. However, there is no agreement on its optimal start time and rehabilitative methods. This study evaluates the effects of early and late rehabilitation on low back pain and quality of life following unilateral microdiscectomy. A total of 204 patients who underwent surgery for lumbar disc herniation were included and subsequently randomized into five groups: 1. No exercise, 2. The 2nd-week walking group, 3. 1st-month walking group, 4. 2nd-week waist exercise, 5. 1st-month waist exercise. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were assessed at the 1st week, 1st, 3rd, and 6th, and 12th-month follow-up after surgery. 1st-month VAS scores were analyzed, and a significant difference was found between the VAS scores of the 2nd-week walk (3.60±0.78) and 2nd-week waist exercise (3.38±0.67) groups and the other groups (p<0.001). 3rd-month VAS results were analyzed, and the VAS scores of the 1st-month walk group (2.67±0.48) were significantly higher than those of the 2nd-week walk group (1.73±0.45) (p<0.001). A significant difference was observed between the no-exercise group (2.93±0.91) and the other groups according to the 12-month VAS scores, with the VAS scores of the no-exercise group being significantly higher than the other groups (p<0.001). There was a significant difference between the ODI scores of both the 2nd-week walk (38±8.55) and the 2nd-week waist (33.8±6.61) exercise groups and the other groups according to the 1st-month ODI scores (p<0.001). A significant difference was observed between the no-exercise group (35.2±8.25) and the other groups according to the 12-month ODI scores, and the ODI scores of the no-exercise group were significantly higher than the other groups (p<0.001). Regular exercise is highly recommended for long-term pain relief, as well as for achieving a speedy recovery after surgery, which is crucial to maintaining a high quality of life and preventing loss of earning potential. We believe that early implementation of exercises is ideal, but even if initiated later, standard back exercises can still expedite rehabilitation.

Early Exercise is Associated with Faster Concussion Recovery Among Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium.

Growing evidence indicates early exercise may improve symptoms and reduce clinical recovery time after concussion, but research examining collegiate student-athletes is scarce. The aim of this study was to compare symptom recovery time, clinical recovery time, and persisting post-concussion symptom (i.e., symptoms ≥ 28days) prevalence by the timing of light exercise initiation before the graded return to play (RTP) protocol among concussed participants. Collegiate student-athletes (n = 1228; age 18.4 ± 0.9years; 56.5% male, 76.3% divisionI; 33.7% ≥ 1 prior concussion) across 30 institutions enrolled in the CARE Consortium completed post-concussion assessments and were monitored over time. Symptom recovery (days from injury to symptom resolution) and clinical recovery (days from injury to return to play protocol completion) was determined by the student-athletes' clinicians. Student-athletes were categorized by timing of light exercise initiation. Early (< 2days post-concussion; n = 161), typical (3-7days post-concussion; n = 281), and late exercise (≥ 8days post-concussion; n = 169) groups were compared with the no-exercise group (n = 617; i.e., did not exercise prior to beginning the RTP protocol) for all analyses. Multivariable Cox regression models with hazard ratios (HR) and survival curves and a multivariable binomial regression model with prevalence ratios (PR) compared recovery outcomes between exercise groups while accounting for covariates. Compared to the no-exercise group, the early exercise group was 92% more probable to experience symptom recovery (HR 1.92; 95% CI 1.57-2.36), 88% more probable to reach clinical recovery (HR 1.88; 95% CI 1.55-2.28) and took a median of 2.4 and 3.2days less to recover, respectively. The late exercise group relative to the no-exercise group was 57% less probable to reach symptom recovery (HR 0.43; 95% CI 0.35-0.53), 46% less probable to achieve clinical recovery (HR 0.54; 95% CI 0.45-0.66) and took 5.3days and 5.7days more to recover, respectively. The typical exercise group did not differ in hazard for symptom or clinical recovery (p ≥ 0.329) compared with the no-exercise group. The prevalence of persisting post-concussion symptoms in the combined sample was 6.6%. Early exercise had 4% lower prevalence (PR 0.96, 95% CI 0.94-0.99) and typical exercise had 3% lower prevalence (PR 0.97, 95% CI 0.94-0.99) of persisting post-concussion symptoms, while the late exercise group had an elevated prevalence (PR 1.11, 95% CI 1.04-1.18) compared with the no-exercise group. Exercise < 2 days post-concussion was associated with more probable andfaster symptom and clinical recovery, and lower persisting post-concussion symptom prevalence. When considering our findings and existing literature, qualifiedclinicians may implement early exercise into their clinical practice to provide therapeutic treatment and improve student-athlete recovery.

Effect of High-Intensity Interval Training on Fatty Infiltration After Delayed Rotator Cuff Repair in a Mouse Model.

Fatty infiltration (FI) of the rotator cuff muscles is correlated with shoulder function and retear rates after rotator cuff repair. High-intensity interval training (HIIT) induces beige adipose tissue to express more uncoupling protein 1 (UCP1) to consume lipids. The beta-3 adrenergic receptor (β3AR) is located on adipocyte membrane and induces thermogenesis. To test the role of HIIT in improving muscle quality and contractility in a delayed rotator cuff repair mouse model via β3AR. Controlled laboratory study. Three-month-old C57BL/6J mice underwent a unilateral supraspinatus (SS) tendon transection with a 6-week delayed tendon repair. Mice ran on a treadmill with the HIIT program for 6 weeks after tendon transection or after delayed repair. To study the role of β3AR, SR59230A, a selective β3AR antagonist, was administered to mice 10 minutes before each exercise through intraperitoneal injection. The SS, interscapular brown adipose tissue (iBAT), and subcutaneous inguinal white adipose tissue (ingWAT) were harvested at the end of the 12th week after tendon transection and were analyzed by histology and Western blotting. Tests were performed to assess muscle contractility of the SS. Histologic analysis of SS showed that HIIT prevented and reversed muscle atrophy and FI. The contractile tests showed higher contractility of the SS in the HIIT groups than in the no-exercise group. In the HIIT groups, SS, iBAT, and ingWAT all showed increased expression of tyrosine hydroxylase, UCP1, and upregulated β3AR thermogenesis pathway. However, SR59230A inhibited HIIT, suggesting that the effect of HIIT depends on β3AR. HIIT improved SS quality and function after delayed rotator cuff repair through a β3AR-dependent mechanism. HIIT may serve as a new rehabilitation method for patients with rotator cuff muscle atrophy and FI after rotator cuff repair to improve postoperative clinical outcomes.

Alleviation of Cognitive and Physical Fatigue with Enzymatic Porcine Placenta Hydrolysate Intake through Reducing Oxidative Stress and Inflammation in Intensely Exercised Rats.

Intense exercise is reported to induce physical and cognitive fatigue, but few studies have focused on treatments to alleviate fatigue. We hypothesized that the oral supplementation of enzymatic porcine placenta hydrolysate (EPPH) prepared using protease enzymes could alleviate exercise-induced fatigue in an animal model. The objectives of the study were to examine the hypothesis and the action mechanism of EPPH in relieving physical and cognitive fatigue. Fifty male Sprague-Dawley rats aged 8 weeks (body weight: 201 g) were classified into five groups, and rats in each group were given oral distilled water, EPPH (5 mg nitrogen/mL) at doses of 0.08, 0.16, or 0.31 mL/kg body weight (BW)/day, or glutathione (100 mg/kg BW/day) by a feeding needle for 5 weeks, which were named as the control, L-EPPH, M-EPPH, H-EPPH, or positive-control groups, respectively. Ten additional rats had no intense exercise with water administration and were designated as the no-exercise group. After 2 weeks, the rats were subjected to intense exercise and forced swimming trial for 30 min once per week for an additional 4 weeks. At 5 min after the intense exercise, lactate concentrations and lactate dehydrogenase (LDH) activity in the serum and the gastrocnemius muscle were higher in the control group, whereas M-EPPH and H-EPPH treatments suppressed the increase better than in the positive-control (p &lt; 0.05). Intense exercise decreased glycogen content in the liver and gastrocnemius muscle, and M-EPPH and H-EPPH inhibited the decrement (p &lt; 0.05). Moreover, lipid peroxide contents in the gastrocnemius muscle and liver were higher in the control group than in the M-EPPH, H-EPPH, positive-control, and no-exercise groups (p &lt; 0.05). However, antioxidant enzyme activities such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were opposite to the lipid peroxide contents. Hypothalamic corticosterone and hippocampal mRNA expressions of tumor necrosis factor (TNF)-α and IL-1β were higher. However, hippocampal brain-derived neurotrophic factor (BDNF) mRNA expression and protein contents were lower in the control group than in the positive-control group. M-EPPH, H-EPPH, and positive-control suppressed the changes via activating hippocampal cAMP response element-binding protein phosphorylation, and H-EPPH showed better activity than in the positive-control (p &lt; 0.05). In conclusion, EPPH (0.16-0.31 mL/kg BW) intake reduced exercise-induced physical and cognitive fatigue in rats and could potentially be developed as a therapeutic agent for relieving fatigue in humans.

The Effects of Acute Exercise and Virtual Reality Tasks on Children’s Memory Function and Exercise Preference

Background: It is well established that regular participation in exercise and virtual reality (VR) environments are important tools for improving or maintaining human health and cognitive function. Objectives: This study examined the effects of acute exercise and VR environments on children’s memory function and exercise preference (i.e. cycling with or without the use of VR technology). Methods: Α 2×3 factorial design was adopted with two measures (pre, post) and three study groups. Forty-five healthy children aged 9 to 13 years (Mage = 10.91±1.24 years) voluntarily participated in the study. Participants were randomly assigned into three groups receiving different treatment: (1) an exercise+VR group that cycled for 15 min in a VR environment (forest path) combined with basic mathematical problem-solving tasks, (2) an exercise group that cycled for 15 min, and (3) a no-exercise group that sat in a specific place in a lab for 15 min (the control group). Before and after the acute exercise, all the groups completed the Sternberg Memory Task. Upon completion of the intervention, the two exercise groups completed measures of enjoyment, intention and attitudes towards cycling. The exercise+VR group also completed a scale capturing the VR’s usability. Results: The results show that the exercise group scored higher on Sternberg’s Memory Task (p .05) after the acute exercise treatment (post) than before it (pre). Similarly, the exercise+VR participants scored higher on the post-intervention memory task than did the exercise and control groups (p .05). Moreover, the exercise+VR group reported higher scores on enjoyment, intention and attitude towards cycling than the exercise group, but this difference was not statistically significant (p .05). Finally, the exercise+VR participants recorded high scores on the usability of the VR system during the acute exercise programme. Conclusions: These findings are in line with those of previous studies, underlining the important roles of exercise and VR environments on youths’ cognitive function.

Association between Walking Habit and Physical Frailty among Community-Dwelling Older Adults.

The aim of this cross-sectional study was to determine whether older adults who practice walking have a lower risk of physical frailty than those who do not. The study subjects were 846 older adults and were not certified as needing support or nursing care. The subjects were classified as being physically frail or pre-frail or being robust, according to the revision of the Cardiovascular Health Study criteria. We classified the subjects by questionnaire into a no-exercise group, walking-only group, walking plus other exercise group, and exercise other than walking group. In logistic regression analyses, the odds ratio (OR) and 95% confidence interval (95%CI) were shown. Compared to the no-exercise group, the OR (95%CI) for physical frailty was 0.85 (0.48–1.49) for the walking-only group, 0.54 (0.36–0.83) for the walking plus other exercise group, and 0.67 (0.47–0.97) for the exercise other than walking group. In the components of physical frailty, the walking plus other exercise group and the exercise other than group had significantly lower ORs for exhaustion. Older adults who only practiced walking as an exercise do not have lower risks of physical frailty and pre-frailty. Older adults who combine walking with other exercises or practice non-walking exercises have lower risks of them.

Physical Exercise Affects Quality of Life and Cardiac Autonomic Modulation in Patients With Chronic Kidney Failure Submitted to Hemodialysis: A Randomized Clinical Trial.

Performing physical exercise during hemodialysis has been debated regarding safety and efficacy for improving life quality for patients with chronic kidney disease (CKD). Thus, we explored the influence of physical exercise during hemodialysis on both autonomic modulation of heart rate and quality of life for patients with CKF in a randomized clinical trial. We randomly allocated participants requiring hemodialysis to an experimental exercise group (EG) and a control no-exercise group (CG) and assessed their quality of life with the Kidney Disease Quality of Life Short Form-KDQOL-SF™ 1.3 and with Polar RS800CX to monitor their heart rate variability (HRV) before and threemonths after the end of the exercise intervention. EG participants reported a significant increase in their quality of life (p = .05, physical function, physical aspects, pain, emotional well-being, emotional function; p = .03, energy and fatigue) and showed HRV improvement (p = .05, RMSSD, SDNN, and SD2; p = .004, SD1) after threemonths of exercise. Thus, we recommend supervised physical exercise during hemodialysis for carefully selected patients.

The Interaction between Exercise and Marital Status on Depression: A Cross-Sectional Study of the Taiwan Biobank.

Few studies evaluating the relationship between depression and exercise consider peoples’ socio-demographic characteristics. This cross-sectional study investigated the interaction between exercise and marital status and depression in Taiwanese adults. Data from the 2-item Patient Health Questionnaire (PHQ-2) was recruited from the Taiwan Biobank. Participants indicated their exercise status, showing 5015 no-exercise cases and 3407 exercise cases. Marital status, including unmarried, divorced or separated, and widowed, were all significant, especially among the no-exercise group. The relationship between exercise/no exercise and marital status was examined; no exercise and unmarried, divorced or separated, and widowed, as well as exercise and married were significant to PHQ-2. Gender was significant in both the married and unmarried groups. The association between exercise, marital status, gender, and education on PHQ-2 score was also significant. Married people, especially men, had lower depression scores. Additionally, exercise had a protective effect against depression for unmarried people, especially women.

Creative dance associated with traditional Portuguese singing as a strategy for active aging: a comparative cross-sectional study

BackgroundMultimodal forms of exercise can influence several physical and mental factors important for successful aging. In the present study, we introduce a new type of multimodal intervention, combining movement (creative dance) with traditional singing. This study aims to compare physical fitness, functional physical independence, depressive symptoms, general cognitive status, and daytime sleepiness among older adults participating in multimodal exercise, those participating in traditional physical exercise, and those not actively engaged in physical exercise.MethodsThis cross-sectional study included 112 people aged ≥ 65 years (75.3 ± 0.7 years) living independently in the community, divided into 3 groups: multimodal exercise (n = 34), traditional exercise (n = 41), and no physical exercise (n = 37).ResultsThe multimodal exercise group showed greater flexibility of the lower limbs and upper limbs/shoulders and better general cognitive status than the traditional exercise group (p < 0.05). The traditional exercise group had better agility and dynamic balance, aerobic endurance, and strength of the lower and upper limbs than the no-exercise group (p < 0.05).ConclusionsThe results suggest that the two types of programs studied may have different impacts on some of the variables investigated and support the design of future experimental studies that include interventions based on the combination of creative dance and traditional Portuguese singing.

Preconditioning Exercise in Rats Attenuates Early Brain Injury Resulting from Subarachnoid Hemorrhage by Reducing Oxidative Stress, Inflammation, and Neuronal Apoptosis.

Subarachnoid hemorrhage (SAH) is a catastrophic form of stroke responsible for significant morbidity and mortality. Oxidative stress, inflammation, and neuronal apoptosis are important in the pathogenesis of early brain injury (EBI) following SAH. Preconditioning exercise confers neuroprotective effects, mitigating EBI; however, the basis for such protection is unknown. We investigated the effects of preconditioning exercise on brain damage and sensorimotor function after SAH. Male rats were assigned to either a sham-operated (Sham) group, exercise (Ex) group, or no-exercise (No-Ex) group. After a 3-week exercise program, they underwent SAH by endovascular perforation. Consciousness level, neurological score, and sensorimotor function were studied. The expression of nuclear factor erythroid 2 p45-related factor 2 (Nrf2), heme oxygenase 1 (HO-1), 4-hydroxynonenal (4HNE), nitrotyrosine (NT), ionized calcium-binding adaptor molecule 1 (Iba1), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 1β (IL-1β), 14-3-3γ, p-β-catenin Ser37, Bax, and caspase-3 were evaluated by immunohistochemistry or western blotting. The terminal deoxynucleotidyl transferase-mediated biotinylated dUTP nick end labeling (TUNEL) assay was also performed. After SAH, the Ex group had significantly reduced neurological deficits, sensorimotor dysfunction, and consciousness disorder compared with the No-Ex group. Nrf2, HO-1, and 14-3-3γ were significantly higher in the Ex group, while 4HNE, NT, Iba1, TNF-α, IL-6, IL-1β, Bax, caspase-3, and TUNEL-positive cells were significantly lower. Our findings suggest that preconditioning exercise ameliorates EBI after SAH. The expression of 4HNE and NT was reduced by Nrf2/HO-1 pathway activation; additionally, both oxidative stress and inflammation were reduced. Furthermore, preconditioning exercise reduced apoptosis, likely via the 14-3-3γ/p-β-catenin Ser37/Bax/caspase-3 pathway.

Effect of exercise intensity and duration on the levels of stress hormones and hypothalamic-pituitary–gonadal axis in adult male rats: an experimental study

The effect of exercise on stress has been demonstrated in several studies which have shown that exercise intensity and duration have various effects on the reproductive axis. This study evaluated the effect of different intensities and durations of exercise on the hormonal indices of stress, such as corticosterone (CORT), norepinephrine (NEP), and also reproductive performance indices, including gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and testosterone (T). In this experimental study, 30 adult Wistar rats were randomly divided into five groups as follows: no-exercise, RME-1 (regular moderate exercise for 1month), RME-6 (regular moderate exercise for 6months), RIE-1 (regular intensive exercise for 1month), and RIE-6 (regular intensive exercise for 6months). At the end of the experiment, the serum levels of the abovementioned hormones and hypothalamic expressionof the Gnrh gene were measured using the enzyme-linked immunosorbent assay and the real-time polymerase chain reaction method, respectively. The levels of stress hormones, including CORT and NEP, increased only in the RIE-1 group compared with the no-exercise group. In addition, an increase was observed in T hormone levels in the RME-1 group compared with those in the no-exercise group, whereas LH and T hormone levels showed a greater decrease in the RIE-6 group than in the no-exercise group. Gnrh expression levels showed an increase and a decrease in the RME-1 and RIE-6 groups compared with the no-exercise group, respectively. These results confirmed the effects of different intensities and durations of exercise on sex hormone levels.

The effect of morning vs evening exercise training on glycaemic control and serum metabolites in overweight/obese men: a randomised trial

Aims/hypothesisWe determined whether the time of day of exercise training (morning vs evening) would modulate the effects of consumption of a high-fat diet (HFD) on glycaemic control, whole-body health markers and serum metabolomics.MethodsIn this three-armed parallel-group randomised trial undertaken at a university in Melbourne, Australia, overweight/obese men consumed an HFD (65% of energy from fat) for 11 consecutive days. Participants were recruited via social media and community advertisements. Eligibility criteria for participation were male sex, age 30–45 years, BMI 27.0–35.0 kg/m2 and sedentary lifestyle. The main exclusion criteria were known CVD or type 2 diabetes, taking prescription medications, and shift-work. After 5 days, participants were allocated using a computer random generator to either exercise in the morning (06:30 hours), exercise in the evening (18:30 hours) or no exercise for the subsequent 5 days. Participants and researchers were not blinded to group assignment. Changes in serum metabolites, circulating lipids, cardiorespiratory fitness, BP, and glycaemic control (from continuous glucose monitoring) were compared between groups.ResultsTwenty-five participants were randomised (morning exercise n = 9; evening exercise n = 8; no exercise n = 8) and 24 participants completed the study and were included in analyses (n = 8 per group). Five days of HFD induced marked perturbations in serum metabolites related to lipid and amino acid metabolism. Exercise training had a smaller impact than the HFD on changes in circulating metabolites, and only exercise undertaken in the evening was able to partly reverse some of the HFD-induced changes in metabolomic profiles. Twenty-four-hour glucose concentrations were lower after 5 days of HFD compared with the participants’ habitual diet (5.3 ± 0.4 vs 5.6 ± 0.4 mmol/l, p = 0.001). There were no significant changes in 24 h glucose concentrations for either exercise group but lower nocturnal glucose levels were observed in participants who trained in the evening, compared with when they consumed the HFD alone (4.9 ± 0.4 vs 5.3 ± 0.3 mmol/l, p = 0.04). Compared with the no-exercise group, peak oxygen uptake improved after both morning (estimated effect 1.3 ml min−1 kg−1 [95% CI 0.5, 2.0], p = 0.003) and evening exercise (estimated effect 1.4 ml min−1 kg−1 [95% CI 0.6, 2.2], p = 0.001). Fasting blood glucose, insulin, cholesterol, triacylglycerol and LDL-cholesterol concentrations decreased only in participants allocated to evening exercise training. There were no unintended or adverse effects.Conclusions/interpretationA short-term HFD in overweight/obese men induced substantial alterations in lipid- and amino acid-related serum metabolites. Improvements in cardiorespiratory fitness were similar regardless of the time of day of exercise training. However, improvements in glycaemic control and partial reversal of HFD-induced changes in metabolic profiles were only observed when participants exercise trained in the evening.Trial registrationanzctr.org.au registration no. ACTRN12617000304336.FundingThis study was funded by the Novo Nordisk Foundation (NNF14OC0011493).Graphical abstract

Outcomes of a COVID-19 recovery program for patients hospitalized with SARS-CoV-2 infection in New York City: A prospective cohort study.

BackgroundIn the spring of 2020, New York City was an epicenter of coronavirus disease 2019 (COVID‐19). The post‐hospitalization needs of COVID‐19 patients were not understood and no outpatient rehabilitation programs had been described.ObjectiveTo evaluate whether a virtual rehabilitation program would lead to improvements in strength and cardiopulmonary endurance when compared with no intervention in patients discharged home with persistent COVID‐19 symptoms.DesignProspective cohort study.SettingAcademic medical center.PatientsBetween April and July 2020, 106 patients discharged home with persistent COVID‐19 symptoms were treated. Forty‐four patients performed virtual physical therapy (VPT); 25 patients performed home physical therapy (HPT); 17 patients performed independent exercise program (IE); and 20 patients did not perform therapy.InterventionsAll patients were assessed by physiatry. VPT sessions were delivered via secure Health Insurance Portability and Accountability Act compliant telehealth platform 1‐2 times/week. Patients were asked to follow up 2 weeks after initial evaluation.Main Outcome MeasuresPrimary study outcome measures were the change in lower body strength, measured by the 30‐second sit‐to‐stand test; and the change in cardiopulmonary endurance, measured by the 2‐minute step test.ResultsAt the time of follow‐up, 65% of patients in the VPT group and 88% of patients in the HPT group met the clinically meaningful difference for improvement in sit‐to‐stand scores, compared with 50% and 17% of those in the IE group and no‐exercise group (P = .056). The clinically meaningful difference for improvement in the step test was met by 74% of patients in the VPT group and 50% of patients in the HPT, IE, and no‐exercise groups (P = .12).ConclusionsVirtual outpatient rehabilitation for patients recovering from COVID‐19 improved lower limb strength and cardiopulmonary endurance, and an HPT program improved lower limb strength. Virtual rehabilitation seems to be an efficacious method of treatment delivery for recovering COVID‐19 patients.

Synchronous and asynchronous remote exercise may improve motor and non-motor symptoms in people with Parkinson’s disease during the COVID-19 pandemic

BACKGROUND: Stay active is a good strategy to mitigate the negative effects of confinement in people with Parkinson’s Disease (PD). Synchronous (full-time class interaction) and asynchronous (without the live presence of the healthcare professional) exercises are two strategies to avoid the worsening of PD. AIM: To investigate the effect of the synchronous and asynchronous exercise on motor and non-motor symptoms in people with PD during the pandemic lockdown. METHOD: Fifty-eight people with PD responded to an online survey and were divided into synchronous, asynchronous, and no-exercise groups. The participants responded to questions regarding motor and non-motor symptoms, besides the questionnaire of quality of life, physical activity, anxiety and depression, and sleep quality. RESULTS: Synchronous group presents higher amounts of physical activity than the asynchronous and no-exercise groups. Also, the synchronous group presented lower anxiety symptoms, while the asynchronous group presented lower depression symptoms compared with the no-exercise group. Worse motor symptoms were presented by the three groups. CONCLUSION: Stay active during the pandemic lockdown, is beneficial to reduce anxiety and depression symptoms in people with PD. This population should be encouraged to perform synchronous classes to perform greater amounts of physical activity, which in the long-term could produce greater benefits.