Non-exercise Group Research Articles

PS-C25-9: COMPARISON OF ANTIHYPERTENSIVE EFFECTS OF ISOMETRIC HANDGRIP VERSUS AEROBIC EXERCISE IN ELDERLY HYPERTENSIVE PATIENTS: A RANDOMIZED CONTROLLED TRIAL

Purpose: The purpose of this study was to compare the antihypertensive effects of isometric handgrip exercise (IHG) versus aerobic exercise (AE) on clinic, central and 24-hour ambulatory blood pressures in elderly hypertensive patients. Methods: We conducted a randomized controlled trial with a three-arm design. Fifty-four elderly hypertensive patients (mean age 69 ± 6 years) were randomized to IHG training (n = 17), AE training (n = 19), or non-exercise control group (n = 18; CON) for 12 weeks (3 times per week). Bilateral IHG training was performed four times of 2 min at 30% of maximal voluntary contraction using a digital handgrip device. AE training was a brisk walking and bike exercise for 30-min at moderate intensity. Resting clinic, central, and 24-hour ambulatory blood pressures were obtained at baseline and after 12-week intervention. Results: Compared with CON, office and 24-hour systolic blood pressure were significantly reduced in both IHG and AE groups (P < 0.05, both) and the magnitude of SBP reduction was not significantly different between both the exercise intervention groups. However, office, central and 24-hour diastolic blood pressure were more decreased in IHG vs. AE group as compared with CON. Conclusion: These findings suggest that both IHG and AE training reduced resting office blood pressure and 24-hour ambulatory blood pressure, but IHG training is more effective in improving office, central and 24-h ambulatory diastolic blood pressure than AE. Thus, IHG training may be an alternative antihypertensive therapy for elderly hypertensive patients.

Exercise Training, Cardiac Biomarkers, and Cardiorespiratory Fitness in Type 2 Diabetes: The HART-D Study

BackgroundHigh-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are cardiac biomarkers commonly detected in adults with type 2 diabetes (T2D) and are associated with heart failure risk. ObjectivesThe purpose of this study was to evaluate the effects of exercise training (ET) on hs-cTnT and NT-proBNP and evaluate the associations of these biomarkers with cardiorespiratory fitness among adults with T2D. MethodsParticipants of the HART-D (Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes) trial who were randomly assigned to one of 3 ET groups or a non-exercise control group were included. Cardiac biomarkers and cardiorespiratory fitness (evaluated by peak oxygen uptake [VO2peak]) were assessed at baseline and after 9 months. The effects of ET (3 ET groups pooled) vs non-exercise control on hs-cTnT and NT-proBNP were assessed using separate analysis of covariance models. Multivariable-adjusted linear regression was performed to identify factors associated with follow-up biomarkers and ΔVO2peak. ResultsThe present study included 166 participants randomized to the ET (n = 135) and non-exercise control (n = 31) groups. Compared with the non-exercise control, ET did not significantly change hs-cTnT or NT-proBNP. In adjusted analysis, each ET group and ΔVO2peak were not significantly associated with hs-cTnT or NT-proBNP levels on follow-up. Among individuals in the ET group, baseline hs-cTnT was inversely associated with ΔVO2peak [per 1 SD higher log (hs-cTnT): β = −0.08 (95% CI = −0.15 to −0.01)]. ConclusionsAmong individuals with T2D, ET did not modify cardiac biomarkers. Higher baseline hs-cTnT was associated with blunted cardiorespiratory fitness improvement in response to exercise.

HOME-BASED EXERCISE PROGRAM WITH MEAL DELIVERY INCREASES DAILY STEP COUNT IN HOMEBOUND OLDER ADULTS

Abstract The United Nations projects adults aged 60 and older will reach 2.1 billion by 2050. With this trend, there will be an increase in older adults who are homebound, leading to more frailty with increased healthcare utilization and institutionalization. Improvements in frailty and homebound status may occur through increased physical activity, which has been shown in multiple randomized controlled trials to improve frailty. Our study aims to evaluate the effects of a home-based exercise program, administered through Meals on Wheels, on gait speed and frailty status in sixty-four homebound adults age 60 and older. All participants receive meal delivery for 12 weeks and half are randomized to receive an exercise kit with weekly exercise handouts. All participants are asked to wear an activity tracker with an additional longitudinal measure at 6 months. We now have 6 participants who have completed the study. Preliminary analysis was conducted on step count between the exercise and non-exercise group using two-sample t-tests. Average daily step count in the exercise group (n=3) was 2656 compared to 813 in the non-exercise group (n=3), p< 0.00001 during the first 12 weeks. The step count in the exercise group did decrease during the weeks after the intervention stopped, however they remained more active than the non-exercise group, 1112 vs 548, p< 0.0001. No adverse events were noted. As we continue to enroll participants, we are encouraged that the home-based exercise program with meal delivery appears to be a safe and effective way to increase physical activity in homebound older adults.

THE EFFECT OF SHORT DURATION BED REST AND TYPE 2 DIABETES MELLITUS ON ARTERIAL STRUCTURE AND FUNCTION IN OLDER ADULTS

Abstract Type 2 diabetes mellitus (T2DM) and inactivity individually accelerate changes related to vascular aging. These changes increase cardiovascular risk and contribute to morbidity and mortality in the elderly. It is unknown if T2DM and bed rest have an additive, deleterious effect on vascular structure and function in older adults. The objective of this study is to determine the magnitude of the effect of bed rest on vascular structure in older adults with T2DM compared to healthy controls and determine if resistance exercise is protective of this effect. So far, we have recruited T2DM (n=9) and healthy control (n=17) subjects (age: 67.0 ± 6.7 years) to undergo five days of bed rest. During bed rest, subjects were randomized to receive intensive bedside resistance exercise physical therapy or standard of care in-bed passive physical therapy. On bed rest days 1 and 5, popliteal artery diameter, area, blood velocity, and blood flow were measured using Doppler ultrasonography. Our preliminary data show that the T2DM, non-exercise group had significantly greater decreases in popliteal artery diameter (-0.59 mm ± 0.18) than the control, non-exercise group (-0.17 mm ± 0.11). Resistance exercise did not prevent artery size changes in either controls or T2DM. Resistance exercise showed a trend in preventing blood velocity and flow reduction in both T2DM and control groups. These preliminary data suggest that older adults with T2DM had greater structural popliteal artery changes compared to controls. Resistance exercise appears to help maintain blood flow by maintaining/increasing popliteal artery blood velocity, but not size.

Telerehabilitation during social distancing for people with Parkinson's disease: a retrospective study.

Clinical worsening has been common in people with Parkinson's disease (PD) during the social distancing due to pandemic. It is unclear if telerehabilitation applied during social distancing preserves clinical aspects of people with PD who are frequent exercisers before the pandemic. Thus, we compared the effects of 10months of supervised, home-based, real-time videoconferencing telerehabilitation (SRTT) and nonexercising control on clinical aspects in people with PD who are frequent exercisers before the pandemic. Fifty-seven (SRTT group) and 29 (nonexercising control group) people with PD were retrospectively assessed (Clinical Trials Registry: RBR-54sttfk). Only the SRTT group performed a 60-min online training sessions, 2-3days per week, for 10months (April 2020 to January 2021) during social distancing. Quality of life (PD Questionnaire [PDQ-39]), walking (item 28 from the Unified Parkinson's Disease Rating Scale part III [UPDRS-III]), posture (item 29 from the UPDRS-III), and freezing of gait (New-FOG questionnaire [NFOGQ]) were retrospectively assessed before (February-March 2020) and during social distancing (February-March 2021). The assessments were performed in-person and remotely before and during social distancing, respectively. There were no between-group differences at baseline (p > 0.05). SRTT preserves PDQ-39 and walking scores but not posture and NFOGQ scores, while nonexercising control worsens scores in all variables. In addition, SRTT is more effective than nonexercising control in preserving PDQ-39 and walking scores. During social distancing, long-term SRTT preserves the subjective quality of life and walking, but not subjective posture and FOG in people with PD who are frequent exercisers before the pandemic.

Another perspective on lumber spinal stenosis treatment: Should exercise be added to pre-surgical treatment?

Background/Aim: Lumbar spinal stenosis (LSS) is a disease that affects the quality of life of elderly individuals. Most patients undergoing surgery for lumbar spinal stenosis try physical therapy before opting to undergo surgery. The effect of pre-surgical exercise treatment is unclear. This study aimed to examine the effect of pre-surgical exercise treatment on functionality, quality of life, and balance. Methods: Patients between the ages of 40 and 70 who were scheduled for surgery based on a diagnosis of LSS were included in this cross-sectional study. The patients were randomly divided into two groups for which exercise therapy was added to the first group before the surgery, and the control group followed in the normal process. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Beck Depression and Anxiety Inventory (BDI and BAI, respectively), Berg Balance Scale (BBS), static and dynamic balance measurements holding hands on and off on the balance device (SBHON, DBHON, DBHOFF) and the SF-36 quality of life scale tests were administered pre-operatively and eight weeks post-operatively, and the results were compared between the two groups that did and did not exercise before surgery. Results: Post-operative SBHON values were found to be significantly lower in the exercise group compared to the other group (P < 0.001). While no differences between pre- and post-operative BBS, DBHON, and DBHOFF values in the non-exercising group were detected, a favorable significant difference in the exercising group was found (all P < 0.001). Conclusion: The addition of pre-surgical exercise therapy to patients can lead to improvements in the success of surgery and contribute to the functionality of patients with LSS diagnosis.

Abstract 11123: Effects of Home-Based Ischemic Leg Symptom-Inducing Exercise on Simultaneous Improvement in Treadmill Walking Distance and Patient Reported Outcomes and in Peripheral Artery Disease: The LITE Randomized Clinical Trial

Introduction: An optimal exercise intervention for individuals with peripheral artery disease (PAD) should improve both objective measures of walking and patient reported outcomes (PROs). This study evaluated whether home-based walking exercise conducted at a pace that induced ischemic leg symptoms (high intensity) improved both treadmill walking distance and related PROs more often than walking exercise conducted at a pace that did not induce ischemic leg symptoms (low intensity) and a non-exercise control group (control), respectively. Methods: Post-hoc analysis of PAD patients who participated in the 12-month LITE Trial and were assessed at 12 months follow-up. The LITE Trial randomized people with PAD into home-based high intensity exercise, low intensity exercise, or control. Objective measures of walking were pain-free treadmill walking distance (PFWD) and maximal treadmill walking distance (MWD). PROs related to physical functioning consisted of Walking Impairment Questionnaire (WIQ) and the Short Form-36 (SF-36) physical function score. Participants were categorized into one of four groups at 12-month follow-up: 1) improved both treadmill outcome and PRO, 2) improved treadmill outcome but not PRO, 3) improved PRO but not treadmill outcome; and 4) improved neither treadmill outcome or PRO. Improvement was defined as follow-up score minus baseline &gt0. Results: Of the 305 people with PAD randomized, 186 (61% Black, 46% female) had data for both treadmill testing and at least one PRO available at baseline and 12-month follow-up (age, sex, race). Participants randomized to high intensity exercise were significantly more likely to improve both MWD and WIQ distance and speed (Table), as well as both PFWD and WIQ speed, compared to the other groups. Conclusions: To improve both treadmill outcomes and PROs, patients with PAD should be encouraged to walk for exercise at a pace inducing ischemic leg symptoms, and not at a pace without ischemic leg symptoms.

Impact of Exercise Training at Different Intensity Levels on Cardiac Function and Exercise Capacity in Patients with Chronic Heart Failure: A Prospective Cohort Study.

To investigate training at different intensity levels on cardiac function, exercise capacity, and health-related quality of life in patients with chronic heart failure. This prospective cohort study enrolled patients with chronic heart failure at Beijing Rehabilitation Hospital, Beijing, China from January 2018 to January 2020. Participants received conventional therapy (non-exercise group) or therapy plus cycle ergometer exercises at an intensity of 80% anaerobic threshold (EA group) and Δ50% power above anaerobic threshold (EB group) for 12 weeks. The primary outcome was peak oxygen uptake. Forty-five patients (15/group) completed the study without serious complications. Exercise training at an intensity of Δ50% power above anaerobic threshold had better effects on exercise capacity than exercise at an intensity of 80% anaerobic threshold, as shown by a greater improvement in peak oxygen uptake (20.3 ± 4.1 vs 16.8 ± 3.2 mL/min/kg), peak O2 pulse (12.5 ± 2.3 vs 10.1 ± 2.1 mL/beat), and peak workload (123.1 ± 26.9 vs 102.8 ± 29.5 W) in patients with chronic heart failure (all p < 0.001). Exercise improved the 6-min walk test distance (control: 394.0 ± 74.1; EA: 481.4 ± 89.4; EB: 508.9 ± 92.5 m; p < 0.001) and health-related quality of life (control: 40.7 ± 12.3; EA: 16.2 ± 8.6; EB: 11.5 ± 6.4; p < 0.001). Compared with an intensity of 80% anaerobic threshold, exercise training at an intensity of Δ 50% power above anaerobic threshold was safe and had better effects on cardiac function, exercise capacity, and health-related quality of life.

Effects of Triple-task Step Exercise using Foot markers on Gait Pattern and Cognitive Function in Mental Retarded Children

Objectives The purpose of this study was to help neurological disorders seen of the children and improve their quality of life by investigating the triple-task step exercise using foot markers program on gait pattern and cognitive function in mental retarded children. Methods In order to achieve the purpose of this study, 30 mental retarded children at N located in K city, were selected at random and allocated 10 mental retarded children each for the Non Exercise group (NEG), Deficient Exercise group(DEG), Over Exercise group (OEG) and measured kinematic gait pattern and cognitive function before and after the experiment. The data obtained from this study were analyzed using the SPSS 26.0 statistical program the two-way repeated measures ANOVA and Bonferroni post-hoc test was performed. Results The conclusions obtained through this study were as follows. First, as a result of analyzing the change of gait pattern to functional cognitive gait pattern program, there were significantly improved in velocity, cadence, step length, stride length in OEG compared with NEG and DEG after 16 weeks. Second, as a result of analyzing the change of cognitive function according to functional cognitive gait pattern program, there were significantly improved in body part, number display, movement, operation in OEG compared with NEG and DEG after 16 weeks. Conclusions As conclusions, this study confirmed that the triple-task step exercise using foot markers program could improve the gait pattern and cognitive function in the mental retarded children.

척추 측만곡 변형이 있는 여성의 올바른 신체정렬을 위한 맞춤식 운동프로그램 및 처방결과 정량화

In this study, a 16-week exercise program was conducted for 19-29-year-old women with scoliosis deformity, and it was found to have a positive effect on the subject"s body composition, body alignment and balance ability. Until now, spinal disease has been considered a geriatric disease, but as the age of onset continues to decrease, it is considered that various studies are needed for the prevention and improvement of spinal diseases. However, in this study, the amount of physical activity and exercise were not restricted in the non-exercise group, and the diet and the cervical spine angle were not considered in the exercise group and the non-exercise group. Therefore, it is considered that it is necessary to develop and distribute an exercise program that considers all of the above factors through follow-up studies.

The Relationship between the Severity of Constipation and Exercise Status in the Japanese Population according to Questionnaire Survey

Objective. The Japanese guideline for the treatment of chronic constipation recommends that nonpharmacological treatment be applied. However, only a small proportion of patients with constipation seek medical care, and even when they do visit a hospital for constipation in Japan, most are only prescribed medication. This is because the effectiveness of exercise therapy for constipation is still unclear. The purpose of this study was to evaluate the prevalence of constipation in Japanese subjects and the relationship between constipation and exercise. Methods. We conducted a questionnaire survey over a period of four months to determine the prevalence of chronic constipation in nonexercise and exercise groups, as well as the effectiveness of exercise on chronic constipation. Subjective constipation was defined by the constipation scoring system. Multiple regression analysis was performed on risk factors for high constipation scoring system scores, and factors related to constipation symptoms were extracted. Result. We analysed responses regarding 556 participants ranging in mean age 35.6 ± 17.2 years. The constipation scoring system score was significantly higher in the nonexercise group than in the exercise group. Independent predictors for the constipation scoring system score were sex, implementation of exercise, and presence of disease under treatment. Conclusion. The result showed that independent predictors for the constipation scoring system score were sex, implementation of exercise, and presence of disease under treatment. Thus, the present study demonstrated that exercise affects constipation symptom.

The effects of high intensity interval training induced H2O2, Nrf2 changes on antioxidants factors in type 2 diabetes.

Nuclear factor erythroid-2-related factor 2 (Nrf2), is an inducible transcription factor that reduced in type 2 diabetes(T2D) and increases oxidative stress and then stimulating antioxidant expression. The purpose of this RCT was to investigate the effects of HIIT induced H2O2, Nrf2 changes on Glutathione Peroxidase (GPx), Glutathione Reductase (GR), Catalase (CAT) and superoxide dismutase (SOD) in T2D. Thirty-three male patients with T2D were randomly divided in 2 groups including to 12-weeks HIIT (10 rotations for 60seconds (10 × 60s) set in constant watt mode at a pedal cadence of 80-100 revolutions/min) or a non-exercise control group. Nrf2, H2O2 and GPx, GR, Cat and SOD protein were measured in response to 12weeks HIIT. Levels of Nrf2 and H2O2 showed high levels in HIIT with respect to control subjects after 12weeks' interventions (HIIT). Fasting plasma glucose (FPG) (p = 0.001), postprandial plasma glucose (PPG) (p = 0.001), glycated hemoglobin, (HbA1c) (p = 0.041), plasma total cholesterol (Tc) (p = 0.028), plasma triglyceride (TG) (p = 0.001), Na (p = 0.001), creatine kinase (Ck) (p = 0.035), alkaline phosphatase (ALP) (p = 0.025), hematocrit (Hct) (p = 0.008) and Cortisol (p = 0.001) were statistically significant in the T2D + HIITgroup. After 12weeks' interventions (HIIT), control group the Plasma CAT levels (p = 0.001) were found to be higher in HIIT group compared to control group. Our results provide evidence that HIIT causes an increase in oxidative stress levels, which ultimately the body responds to increased antioxidant levels. Therefore, it is suggested that these indicators (HIIT and H2O2, Nrf2) can be considered as a therapeutic target for type 2 diabetic patients.

Effects of structured exercises on selected psychological domains in individuals with type 2 diabetes mellitus in Southern Ethiopia institution-based study

BackgroundPsychological disorders are common among individuals with type 2 diabetes mellitus. The effect of exercise training on psychological disorders like anxiety and depression has not been well studied in Ethiopia. The objective of this study was to assess the effect of structured aerobic and resistance exercises on psychological domains among people with type 2 diabetes mellitus in southern Ethiopia.MethodWe began by approaching 97 type 2 diabetic patients who regularly attend follow-up clinics. The 24 study participants were randomly assigned to one of four groups: aerobic exercise (n = 6), resistance exercise (n = 6), combined aerobic and resistance exercise (n = 6), and control group (n = 6). For each arm, the interventions were a structured workout package that was completed without interrupting usual clinical follow-up. The control groups, on the other hand, were kept as follow-up clinical cases with daily routine work. A paired t-test was performed to compare the means and mean differences of each exercise group’s pretest and posttest. A Tukey’s post hoc test was performed to compare mean differences between groups. The significance level was set at P < 0.05.ResultA more significant change was obtained in the combined aerobic and resistance exercise on anxiety and depression (p = 0.006), social dysfunction (p = 0.009), loss of confidence (p = 0.012) in particular, and psychological wellbeing (p = 0.010) in general. Resistance exercise alone had a significant impact on social dysfunction (p = 0.010), anxiety and depression (p = 0.017), and psychological well-being (p = 0.012) in general. Changes in social dysfunction (p = 0.010), anxiety and depression (p = 0.030), and psychological well-being (p = 0.018) were also influenced by aerobic exercise. The study found no significant change in depression and anxiety among control groups.ConclusionAs a result, the combined effect of aerobic and resistance exercise had a greater influence on improving anxiety and depression, social dysfunction, loss of confidence in particular, and psychological well-being in general among patients with type 2 diabetes. In other words, the present evidence proves the betterment of combined aerobic and resistance exercises alone followed by resistance exercise alone and aerobic exercise alone compared with non-exercise groups seems to upgrade psychological wellbeing by setting up three main benefits named as: (1) anti-anxiety and depression effects; (2) anti-social dysfunction effects; and (3) anti-loss of confidence effects. This suggests that patients with diabetes who exercise regularly enhance their psychological well-being.

INFLUENCE OF HIGH INTENSIVE INTERVAL TRAINING ON STUDENTS

High-intensity interval training (HIIT) appeared as a replacement for long-term exercise programs, primarily continuous aerobic exercise in adults, while in adolescents it represents a more natural way of exercise, unlike traditional moderate-intensity exercise. The aim of this systematic review is to examine the impact of high-intensity interval training in elementary school students, based on the collected data and analyzed research. The literature search was performed using the following databases: PubMed, Google Scholar, DOAJ, MEDLINE. After a detailed analysis, 11 studies met the set criteria and were included in the systematic review. The results indicate that HIIT for a duration of 12 weeks gives statistically significant results in reducing body weight and visceral fat, lowering arterial blood pressure, reducing BMI and increasing VO2max and improving fitness parameters of children. HIIT is an effective way of improving various fitness parameters and health conditions in a school population, with our review research indicating significant improvements in body composition parameters, fitness parameters as well as cardiovascular disease compared to a non-exercising control group.

Effect of Sprint Interval Training on Cardiometabolic Biomarkers and Adipokine Levels in Adolescent Boys with Obesity.

This study investigated the effect of supervised sprint interval training (SIT) on different cardiometabolic risk factors and adipokines in adolescent boys with obesity. Thirty-seven boys were allocated to either a SIT group (13.1 ± 0.3 years; body mass index [BMI]: 30.3 ± 0.9 kg·m−2) or a control group (CONT) (13.7 ± 0.4 years; BMI: 32.6 ± 1.6 kg·m−2). The SIT group performed 4–6 × 30 s all-out cycling sprints, interspersed with 4 min rest, for 3 sessions/week, during a 12-week period, while the non-exercising CONT group maintained a habitual lifestyle. Anthropometric measurements, triglycerides, fasting insulin and glucose, total cholesterol (TC), high- (HDLc) and low-density (LDLc) cholesterol, leptin and adiponectin in blood, cardiorespiratory fitness (CRF), and a metabolic syndrome severity risk score (MSSS) were calculated before and after the 12-week period. Compared to baseline values, a significant reduction in MSSS was seen in the SIT group after intervention. LDLc showed favorable changes in SIT compared to CONT (−0.06 ± 0.1 vs. 0.19 ± 0.01 mmol·L−1; p = 0.025). Additionally, CRF increased in the SIT group compared to the CONT group (5.2 ± 1.1 vs. −2.1 ± 1.1 mL·min−1·kg−1, p < 0.001). Moreover, a 12-week all-out SIT training effectively improves cardiometabolic health in adolescent boys with obesity.

ESTUDO SOBRE A RELAÇÃO DO TURISMO ESPORTIVO DE LAZER COM A SAÚDE DO IDOSO

ABSTRACT Objective: To explore the influence of leisure sports tourism activities on the health of elderly tourists. Methods: Through investigating the leisure sports tourism activities of some elderly tourists who participated in travel agencies, the health status and quality of life of elderly tourists who participated in leisure sports tourism activities for a long time (exercising group) were compared with those who did not or occasionally participated in physical exercise (non-exercising group), to understand the influence of leisure sports tourism activities on the health of elderly tourists. Results: Regarding the attitude of participating in sports leisure tourism activities, the survey results show that the elderly tourists reached a basic consensus about participating in sports leisure tourism activities. Different types of landscapes have significant differences in improving tourists’ anxiety. The proportion of “very satisfied” in the exercise group was significantly higher than that in the non-exercise group. The duration of the trip has a significant impact on improving tourists’ anxiety. Conclusion: We should strengthen the advertising of leisure sport tourism activities, let more elderly tourists participate in leisure sport tourism activities, strengthen the behavioral guidance of elderly tourists in leisure sport tourism activities, and help them improve their health. Level of evidence II; Therapeutic studies - investigation of treatment results.

The impact of aquatic exercise programs on the systemic hematological and inflammatory markers of community dwelling elderly: A randomized controlled trial.

Evidence shows that physical exercise is important in maintaining an efficient immune system during ageing. However, there are few studies that test the impact of aquatic exercise programs on the immune system. This study aims to analyze the impact of different physical exercise programs in aquatic environment on the systemic hematological and inflammatory markers of community dwelling elderly. One hundred and two elderly were randomly allocated into four groups: a continuous aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an interval aerobic exercise group (IntG) (n = 28, 72.64 ± 5.22 years); a combined exercise group (ComG) (n = 29, 71.90 ± 5.67 years); a control group (CG) (n = 20, 73.60 ± 5.25 years). The AerG, IntG and ComG participants took part in three different aquatic exercise programs over a 28-weeks period. The CG participants maintained their usual routines during the same time period. Blood samples were collected from all participants in order to access hematologic indicators, by means of cell count, and the inflammatory profile by ELISA. After 28 weeks, significant differences were found for several hematologic variables in the AerG, IntG and ComG with increases in mean corpuscular hemoglobulin (MCH), mean corpuscular hemoglobulin concentration (MCHC), and hemoglobulin (Hb). Decreases in TNF-α levels were found for all exercising groups. An increase in IL-10 levels, granulocytes to lymphocytes ratio (GLR) and a decrease in the TNF-α/IL-10 ratio, were found for the IntG. For the ComG decreases were also found for the TNF-α, IL-1ß/IL-1ra ratios. The present study suggests that aquatic exercise programs were able to improve the inflammatory profile of the participants. Those in the exercise intervention groups showed a shift towards lower pro-inflammatory levels while the non-exercising group showed the opposite behaviour. The IntG and the ComG aquatic exercise programs appeared to be more effective than the AerG program in decreasing chronic low-grade inflammation by mediating the production of higher levels of anti-inflammatory cytokines. However, the differences found between the exercising groups were small and may not have clinical significance.

Effects of physical training on physical and functional fitness, physical activity level, endothelial function, hemodynamic variables, bone metabolism, and quality of life of post-bariatric patients: study protocol for a randomized controlled trial

BackgroundEvidence of the benefits induced from resistance exercise on health markers of post-bariatric patients is limited. The study will investigate the effects of a resistance training (RT) program on muscle mass and strength, bone metabolism biomarkers, bone mineral density (BMD), bone microarchitecture, and endothelial function of patients subjected to Roux-en-Y gastric bypass.Methods/designThis randomized controlled trial will include 60 post-bariatric patients, physically inactive, aging 18 to 50 years, with a post-surgery period ≥ 12 months. They will be randomly assigned into two groups: (i) the non-exercised control group, which will receive the standard clinical follow-up, or (ii) the intervention group which will consist of RT (60 min/session; 3 times/week, for 6 months). The primary outcomes will include muscle mass and strength, bone metabolism biomarkers, BMD, and bone microarchitecture. The secondary outcomes will be anthropometry, hemodynamic measurements, cardiovascular risk factors, health-related quality of life (QoL), and endothelial function. Outcomes will be assessed by blood biomarkers of bone formation and reabsorption, dual X-ray absorptiometry, repetition maximum and handgrip strength tests, high-resolution peripheral quantitative computed tomography, 36-Item Short-Form Health Survey, venous occlusion plethysmography, and nailfold videocapillaroscopy.DiscussionIt is expected that there are greater benefits from the RT program, possibly improving muscle mass and strength, bone metabolism, density and microarchitecture, QoL, and cardiovascular risk.Trial registrationClinicalTrials.gov NCT04193397. Registered on 7 December 2019.

Preoperative exercise induces endothelial progenitor cell mobilisation in patients undergoing major surgery – A prospective randomised controlled clinical proof-of-concept trial

IntroductionPrehabilitation is increasingly recognised as a therapeutic option to reduce postoperative complications. Investigating the beneficial effects of exercise on cellular mechanisms, we have previously shown that a single episode of exhaustive exercise effectively stimulates endothelial progenitor cells (a cell population associated with vascular maintenance, repair, angiogenesis, and neovascularization) in correlation with fewer postoperative complications, despite the ongoing debate about the appropriate cell surface marker profiles of these cells (common phenotypical definitions include CD45dim, CD133+, CD34+ and/or CD31+). In order to translate these findings into clinical application, a feasible prehabilitation programme achieving both functional and cellular benefits in a suitable timeframe to expedite surgery is necessary. ObjectiveThe objective of this study was to test the hypothesis that a four-week prehabilitation programme of vigorous-intensity interval exercise training is feasible, increases physical capacity (primary outcome) and the circulatory number of endothelial progenitor cells within peripheral blood. MethodsIn this unblinded, parallel-group, randomised controlled proof-of-concept clinical trial (German Clinical Trial Register number: DRKS00000527) conducted between 01st December 2014 and 30th November 2016, fifteen female adult patients scheduled for incontinence surgery with abdominal laparotomy at the University Hospital Cologne were allocated to either an exercise (n = 8, exclusion of 1 patient, analysed n = 7) or non-exercise group (n = 7, exclusion of 1 patient, analysed n = 6). The exercise group's intervention consisted of a vigorous-intensity interval training for four weeks preoperatively. Cardiopulmonary Exercise Testing accompanied by peripheral blood collection was performed before and after the (non-)training phase. Cellular investigations were conducted by flow cytometry and cluster-based analyses. ResultsVigorous-intensity interval training over four weeks was feasible in the exercise group (successful completion by 8 out of 8 patients without any harms), with significant improvements in patients' functional capacity (increased oxygen uptake at anaerobic threshold [intervention group mean + 1.71 ± 3.20 mL/min/kg vs. control group mean −1.83 ± 2.14 mL/min/kg; p = 0.042] and peak exercise [intervention group mean + 1.71 ± 1.60 mL/min/kg vs. control group mean −1.67 ± 1.37 mL/min/kg; p = 0.002]) and a significant increase in the circulatory number of endothelial progenitor cells (proportionate CD45dim/CD14dim/CD133+/CD309+/CD34+/CD31 + subpopulation within the circulating CD45-pool [p = 0.016]). ConclusionsWe introduce a novel prehabilitation concept that shows effective stimulation of an endothelial progenitor cell subpopulation within four weeks of preoperative exercise, serving as a clinical cell-mediated intervention with the aim to reduce surgical complications. FundingInstitutional funding. DFG (German Research Foundation, 491454339) support for the Article Processing Charge.

Psychological and Biochemical Effects of an Online Pilates Intervention in Pregnant Women during COVID-19: A Randomized Pilot Study.

The purpose of this study was to analyze the effect of real-time online Pilates exercise during COVID-19 on women’s body composition, blood lipids, and psychological health after childbirth. The participants were 16 pregnant women (24–28 weeks pregnant) enrolled at the C Women’s Culture Center in Seoul, South Korea, classified into online Pilates groups and non-exercise groups (PE, n = 8; CON, n = 8). The online Pilates program was conducted for 8 weeks, twice a week, and 50 min a day using a real-time video chat app. Participants visited the hospital twice for body composition and blood tests. Questionnaires on postpartum depression, sleep disorder, and stress were conducted at 6 weeks and 12 weeks after childbirth. We found a significant difference between groups in body composition. The weight, percentage of body fat, body fat mass, and BMI of the PE group decreased. Blood lipids showed significant differences between the groups in TC, TG, LDL and CRP, while insulin and HDL showed no difference. All blood lipids, insulin, and CRP in the PE group were reduced. There were significant differences between the groups in postpartum depression, sleep disorders, and perceived stress indices performed in the post-test, and the serotonin concentration in the PE group increased. Serotonin levels were significantly correlated with postpartum depression, body fat mass, and body fat rate. Pregnant women’s online Pilates in this study was effective at reducing weight and depression in women after childbirth and should be used to promote women’s mental health during COVID-19.