Post-training Levels Research Articles

P033 The Effect of Physical Training on Systemic Pro-inflammatory Cytokine Expression in Heart Failure Patients: A Systematic Review

Systemic inflammation is associated with cardiovascular disease, especially the end stages of heart failure (HF). The authors sought to determine by systematic review whether physical therapy reduces serum levels of pro-inflammatory cytokines in HF patients. Potential studies were identified from a systematic search of Medline (Ovid) (1950–October 2010), Embase.com (1974–current), Cochrane Central Register of Controlled Trials, CINAHL (1981–current), and Web of Science (2000–current). The search strategy included a mix of MeSH and free text terms for key concepts. A total of 11 studies were included, with 4 reporting a post-training reduction in tumor necrosis factor α (TNF-α), of which 3 used traditional aerobic or resistance exercise and 1 used functional electrical stimulation. Reduced post-training serum levels of interleukin 6 were reported by one exercise study. The one study that employed combined resistance and aerobic training only showed soluble receptors TNF-α1 and TNF-α2 to be lower. The one study of respiratory muscle training and two studies that employed electrical stimulation had limited effect on cytokines and peak maximal oxygen uptake. With the exception of one study, those therapies that employed ≥5 sessions per week lowered serum TNF-α. Our review data suggest that physical therapies employing ≥5 sessions per week are most likely to reduce serum levels of TNF-α in HF patients. No isolated study of resistance training has yet examined the relationship between muscle wasting, glycogen depletion, and the ability of exercise training to reverse both of these conditions in HF patients.

Actor Vocal Training for the Habilitation of Speech in Adolescent Users of Cochlear Implants

This study examined changes to speech production in adolescents with hearing impairment following a period of actor vocal training. In addition to vocal parameters, the study also investigated changes to psychosocial factors such as confidence, self-esteem, and anxiety. The group were adolescent users of cochlear implants (mean age at commencement of training 15.9 years), with approximately half of the group wearing a hearing aid in the contralateral ear. The mean age of implantation of the group was 7.6 years and the participants displayed a range of speech production abilities. Evaluation of posttraining outcomes was performed via a combination of perceptual and acoustic analyses. Significant posttraining changes to vocal parameters included increased pitch range and variability and decreased speaking rate. From a psychosocial perspective, posttraining stress levels were significantly lowered. This study suggested that actor vocal training may benefit young people with hearing impairment, both in the way in which they use their voices and in the way in which they view themselves.

Changes in Exercise Capacity Following Prolonged Endurance Training and Detraining in Mitochondrial Myopathy

Patients with mitochondrial myopathies (MM) due to mtDNA mutations in skeletal muscle often suffer disabling exercise intolerance. Our previous studies suggest that short duration (14 weeks) endurance training improves exercise capacity and increases the activity of rate-limiting enzymes. The effect of a longer duration exercise training program followed by a period of detraining of equal duration has not been studied. PURPOSE: To assess the effect of 26 weeks of regular endurance training followed by 26 weeks of detraining on exercise capacity in patients with severe muscle oxidative impairment due to mitochondrial myopathy. METHODS: Ten MM patients were randomized into two groups (MMA, n=5 & MMB, n=5) and underwent 26 weeks of cycle exercise training. Patients in MMA followed cycle training with a 26 week detraining period whereas patients in MMB did not complete a detraining period. Peak work, oxygen uptake (VO2) and submaximal heart rate and blood lactate were determined at baseline, after 26 weeks of cycle training and following 26 weeks of detraining. RESULTS: Compared to baseline, training increased peak work from 83+25 to 96+38 W and significantly increased VO2 from 1.233+0.334 to 1.432+0.478 L/min (p=0.047) in MMA. Similar changes were seen in MMB following training: 80+24 to 89+28W and 1.173+0.274 to 1.301+0.309 L/min. During submaximal exercise, peak heart rate significantly decreased 134+14 to 116+21 (p=0.028) in MMA and 137+10 to 124+15 bpm (p=0.036) in MMB as did venous lactate (5.1+3.9 to 3.1+2.4 in MMA & 3.9+1.0 to 2.7+0.9 mM (p=0.007) in MMB). After 26 weeks of detraining following 26 weeks of training, peak work and VO2 fell to 88+29 W and 1.306+0.385 L/min respectively. During submaximal exercise, after the 26 week detraining period compared to post training, heart rate (116+21 vs 123+16 bpm) and lactate levels (3.1+2.4 vs 4.1+3.2 mM) were higher. CONCLUSION: Twenty-six weeks of endurance training in MM improved tolerance of submaximal exercise and peak work and oxidative capacities. Detraining of an equal magnitude in duration resulted in a return of physiological adaptations toward baseline.

Response To Prolonged Endurance Training and Detraining In Mitochondrial Myopathy

Patients with mitochondrial myopathies (MM) due to mtDNA mutations in skeletal muscle often suffer disabling exercise intolerance. Our previous studies suggest that short duration (14 weeks) endurance training improves exercise capacity and increases the activity of rate-limiting enzymes. The effect of a longer duration exercise training has not been studied. PURPOSE: To assess the effect of 6 months of regular endurance training on exercise capacity and to determine if training adaptations are maintained after a prolonged period of self-selected activity in a patient with severe muscle oxidative impairment due to a mitochondrial myopathy. METHODS: A 26-year male with a heteroplasmic single large-scale deletion of mtDNA underwent 26 weeks of cycle exercise training followed by a 52 week period of self-selected activity level. Peak work, oxygen uptake (VO2), and submaximal heart rate and blood lactate were determined at baseline, after training and following 52 weeks of self-determined activity. RESULTS: Compared to baseline, training increased peak work from 110 to 130 watts and VO2 from 1.527 to 1.837 L/min. During submaximal (50 watt) exercise, peak heart rate decreased from 153 to 120 bpm and venous lactate from 6.41 to 3.25 mM. After 52 weeks of self-selected activity following 6 months of endurance training, peak work and VO2 fell to 110 watts and 1.684 L/min respectively. During submaximal exercise, after the self-selected activity period compared to post training, heart rate (133 vs. 120 bpm) and lactate levels (4.36 vs. 3.25 mM) were higher. CONCLUSION: Endurance training in MM improved work and oxidative capacity supporting the efficacy of this therapy in patients with mitochondrial myopathy due to single large-scale mtDNA deletions. Despite the substantial benefits of exercise training, the patient did not choose to maintain regular exercise training and after the 52 week period of self-selected activity, exercise capacity declined to near pre-training levels indicating that deconditioning contributes to exercise limitations in these patients and that the applicability of exercise training as therapy is limited by patient motivation.

Blood Parameters in Adults with Intellectual Disability at Rest and After Endurance Exercise

Clinically, adult with intellectual disability (ID) appear less physically fit than people without ID, yet formal endurance evaluation has not been reported previously. We hypothesized that the immune system in adults people with ID can be influenced positively from 4 weeks of endurance training. Healthy subjects with ID ages from 43 to 55 years were included in the study. The subjects (n = 22) exercised on a treadmill for 30–40 min/d for 4 day/wk/4 wks. Blood samples were drawn at rest and immediately after the last exercise training. Plasma concentration of creatine kinase (CK), myoglobin (Mb), glutamine, and uric acid (UA) as biomarkers of muscle stress were measured. The results indicate that following the exercise program, the plasma glutamine and UA increased significantly (p < 0.05) from pre-to post-training levels, whereas CK isoenzyme and Mb levels showed no changes. In conclusion, 4 weeks of endurance training increased concentration of plasma glutamine and UA, which might be useful in the monitoring of training responses in adults with ID.

Is there an association between PPARGC1A genotypes and endurance capacity in Chinese men?

Our purpose was to determine the possible association between genotypes of three polymorphisms (Gly482Ser, Thr394Thr and A2962G) of the peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PPARGC1A) gene, on one hand, and both the pre- (baseline) and post-training levels of maximal (i.e., maximal oxygen uptake [VO2max]) and submaximal human endurance capacity (i.e., running economy [RE]). We studied 102 young males (physically active, non-athletes; age: 19+/-1 yrs) from Northern China (of Han origin) who underwent a 18-week endurance training (running) program and were tested on a treadmill (for VO2max and RE determination) before and after training. None of the VO2max and RE related traits were associated with the Gly482Ser and Thr394Thr polymorphisms at baseline or after training. The A2962G polymorphism was however associated with VO2max at baseline, as carriers of the G allele (AG+GG genotypes; n=49) had higher levels of VO2max than the AA group (n=53) (58.2+/-4.3 vs 56.3+/-3.9 mL/kg/min; P=0.017). Our results do not support previous data on Caucasians showing an association between the Gly482Ser variant and VO2max but suggest the potential role of another polymorphism (A2962G) to explain individual VO2max differences in Chinese men.

The effects of energy-rich diets on discrimination reversal learning and on BDNF in the hippocampus and prefrontal cortex of the rat

Male rats received normal chow or high-fat diets rich in dextrose (HFD) or sucrose (HFS). Half of the rats received 90-day unrestricted access to their diet prior to training, whereas the other half were food restricted throughout the study. We evaluated the effects of these dietary manipulations on discrimination and reversal performance and on post-training levels of brain-derived neurotrophic factor (BDNF) in the prefrontal cortex and the ventral and dorsal hippocampus. Neither diet nor restriction condition affected discrimination acquisition. However, prior unrestricted access to the HFD diet impaired discrimination reversal learning and reduced BDNF in the prefrontal cortex and ventral hippocampus. Also, rats given the HFD diet responded more than controls to the previously rewarded cue at the outset of discrimination reversal. The results suggest that consumption of the HFD diet may have had enduring effects on learning processes, some of which may contribute to the control of intake regulation.

Effect of a 6-month endurance training program on fasting lactate.

0827 PURPOSE: The purpose of this study was to investigate the effect of a 6-month endurance training program on fasting plasma lactate (FL) response. METHODS: Sedentary overweight individuals were either Controls (n = 48) or performed ∼115 min/week of vigorous (∼12 miles jogging/wk at 65–80% VO2peak) physical activity (n = 47). FL was determined before and after training. Additionally, the exercise group was tested at both 4-days and at 2-weeks post training to investigate detraining responses. RESULTS: With training there was no significant weight loss or gain; however, %fat was significantly reduced (−1.7%, P<0.0001) and VO2peak was significantly increased (0.29 L/min, P<0.0001) in the exercise group only. Before training FL in the exercise group was not different than controls (1.72 ± .07 vs. 1.64 ± .08 mmol respectively, P>0.05). In contrast, the exercise group had significantly reduced FL levels compared with controls (1.46 ± .06 vs. 1.67 ± .08 mmol, respectively, P = 0.008) after training and was significantly lower than pre training values (∼18% decrease, P = 0.03). Fasting lactate levels after 4 days of detraining were not significantly different than post training or pre training levels but by 2 weeks had significantly returned from post training (∼15% increase, P = 0.01) levels. In the sedentary condition there was a significant relationship between FL and %fat (R = 0.27, P = 0.01) that was abolished with training. CONCLUSION: With moderate to high intensity endurance training fasting plasma lactate appears to change independent of changes in body composition.

Increased tumour necrosis factor-alpha plasma levels during moderate-intensity exercise in COPD patients.

Post-training downregulation of muscle tumour necrosis factor (TNF)-alpha messenger ribonucleic acid (mRNA) expression and decrease in cellular TNF-alpha levels have been reported in the elderly. It is hypothesised that chronic obstructive pulmonary disease (COPD) patients may not show these adaptations due to their reduced ability to increase muscle antioxidant capacity with training. Eleven COPD patients (forced expiratory volume in one second 40 +/- 4.4% of the predicted value) and six age-matched controls were studied. Pre- and post-training levels of TNF-alpha, soluble TNF receptors (sTNFRs: sTNFR55 and sTNFR75) and interleukin (IL)-6 in plasma at rest and during exercise and vastus lateralis TNF-alpha mRNA were examined. Moderate-intensity constant-work-rate exercise (11 min at 40% of pretraining peak work-rate) increased pretraining plasma TNF-alpha levels in COPD patients (from 17 +/- 3.2 to 23 +/- 2.7 pg x mL(-1); p<0.005) but not in controls (from 19 +/- 4.6 to 19 +/- 3.2 pg x mL(-1)). No changes were observed in sTNFRs or IL-6 levels. After 8 weeks' endurance training, moderate-intensity exercise increased plasma TNF-alpha levels similarly to pretraining (from 16 +/- 3 to 21 +/- 4 pg x mL(-1); p<0.01). Pretraining muscle TNF-alpha mRNA expression was significantly higher in COPD patients than in controls (29.3 +/- 13.9 versus 5.0 +/- 1.5 TNF-alpha/18S ribonucleic acid, respectively), but no changes were observed after exercise or training. It is concluded that moderate-intensity exercise abnormally increases plasma tumour necrosis factor-alpha levels in chronic obstructive pulmonary disease patients without exercise-induced upregulation of the tumour necrosis factor-alpha gene in skeletal muscle.

A role for brain glucocorticoid receptors in contextual fear conditioning: dependence upon training intensity

We studied the possible involvement of corticosteroids in the establishment and long-term expression of contextual fear conditioning and questioned whether a corticosteroid action might be dependent upon stimulus intensity at training. Experiments included: (i) the intracerebroventricular administration of specific antagonists for the two types of intracellular corticosteroid receptors to rats trained at either 1 mA or 0.4 mA shock intensity at conditioning; and (ii) the administration of corticosterone after conditioning rats to 0.2 mA shocks. The results showed that the administration of a type II glucocorticoid, but not a type I mineralocorticoid, receptor antagonist before conditioning rats to the intermediate shock condition attenuated long-term expression of contextual fear conditioning. However, treatment with the antagonists before conditioning to the high shock intensity failed to influence the extent of fear conditioning. In addition, an intraperitoneal corticosterone injection, given immediately after training rats at the low shock intensity, enhanced long-term expression of the fear response. The results support the view that post-training levels of circulating corticosterone, through an interaction with central type II glucocorticoid receptors, modulate the strength to which memory for contextual fear conditioning is established and maintained.

Norepinephrine and posttraining memory consolidation in neonatal rats.

Wistar rat pups, aged Postnatal Day 5, were trained in an olfactory associative learning task with citral odor as the conditioned stimulus (CS) and intraoral infusions of milk as the unconditioned stimulus (US). Following a 30-min training session, pups were injected with either the norepinephrine beta-receptor antagonist propranolol or the beta-receptor agonist isoproterenol. Pups were tested 24 hr later for an acquired relative odor preference for the CS. Propranolol injected immediately following training impaired memory for the CS in a dose-dependent manner. This posttraining effect lasted less than 4 hr. Isoproterenol injected immediately after training also impaired memory performance, even at very low doses. These results suggest that posttraining levels of norepinephrine play a critical role in memory consolidation in the newborn, with elevations or decrements in noradrenergic activity resulting in impaired memory.

Training and calibrating evaluators for a national private dental office assessment program.

The work described was conducted to train and calibrate ten general dentists to participate as evaluators in a national program in which methods were developed and tested for the in-office evaluation of private general dental practice. The methods used in conducting six days of initial training are described, as well as the approach taken in establishing the posttraining levels of individual and group calibration achieved. Training and calibration that occurred halfway through a two-year field experience also are described. Techniques employed included the use of slides in lecture format; review of records, radiographs, and other materials from dental offices; examination of patients; use of a videotaped simulation of an office visit; and evaluation of private dental offices by paired evaluators. Calculation of percent of comparability of evaluator performance was used in determining calibration levels. We concluded that evaluators can be trained in six days to achieve a high level of calibration. Additional benefits were derived from the additional training session at the midpoint of field activities. Evaluators perceived themselves to be well prepared as a result of the training described.

Training adolescents with severe handicaps to set up job tasks independently using picture prompts

Abstract Three adolescents functioning within the moderate to severe range of mental retardation were taught to use picture prompts to guide their performance on two vocational sequencing tasks. Evaluation of the effects of picture prompts was conducted within a multiple baseline (across subjects and tasks) with reversal design. Baseline was conducted on two tasks, valve assembly with 18 parts, and packaging with 20 parts. During baseline, students were to sequence a specified number of each part across three work stations. Following baseline, students were taught to use picture prompts to guide their performance on one of the tasks. All students completed the training task with at least 96% accuracy with the picture prompts, and generalized their performance with equal accuracy to the untrained task. When picture prompts were removed (reversal to baseline), the performance of all students decreased substantially, indicating that the pictures were controlling their performance. When the pictures were again available to guide behavior, the performance of all three adolescents returned to posttraining levels of accuracy.

Cardiac changes to signalled shock avoidance in dogs

Alterations in heart rate (HR), left ventricular pressure (LVP), and maximum left ventricular dp/dt (LVdp/dt max) during a signalled avoidance task were studied in eight chronically prepared dogs. Four of these animals comprised a non-shock control group. In experimental animals, HR increased during the first two days of the avoidance task but did not change significantly during the last two days, while LVP remained at the supranormal post-training levels and LVdp/dt max increased over the course of the experiment. Control animals showed no change in HR or LVP, but LVdp/dt max decreased over the four experimental days. Changes in LVdp/dt max in experimentals reflect a consistent increase in cardiac sympathetic activation. However, HR changes indicate an initial increase and a subsequent decrease in sympathetic activity. It was therefore postulated that either differential activation of sympathetic cardiac fibers occurred such that during non-stress periods and subsequent exposure to stress, sympathetic influences predominate which are reflected only in LVdp/dt max changes, or sympathetic and parasympathetic fibers differentially control cardiac function during stress and non-stress conditions.

A Follow‐Up Evaluation of Helping Skills Training

The retention of verbal helping skills by human service worker trainees who had completed the Danish and Hauer (1973) training program seven months earlier was explored. Twenty‐six trainees engaged in three helping interviews'before training, immediately following training, and seven months later. Consistent with other follow‐up studies, high skill levels at posttraining were generally not maintained at follow‐up. Contrary to these other studies, however, they remained higher than pretraining levels. Two specific verbal responses, affective responses and closed questions, remained at posttraining levels. The relationship of this study to other follow‐up studies is discussed.

Frontal EMG-biofeedback training of athetoid cerebral palsy patients

Six athetoid cerebral palsy patients participated in the following: speech and motor prebiofeedback training evaluation; frontal EMG biofeedback training, 6 wk; speech and motor postbiofeedback training evaluation. Frontal pretraining levels for the subjects averaged 28.9 muV p-p. Subjects' feedback consisted of an auditory signal (clicks) varying proportionately with frontal EMG activity. A visual meter display of the integrated EMG was also provided. Self-regulation of frontal EMG was evident for all subjects within session 1. Throughout all sessions, EMG levels of 2-4 mu V were often attained. Trend analysis of EMG acquisition curves showed significant reduction in frontal tension across sessions for all but one subject. Frontal posttraining levels averaged 13.0 muV p-p. Parents or subjects, or both, reported subtle improvements in various speech and motor functions, a finding confirmed by objective postbiofeedback training evaluation. Only the 2 most severely impaired subjects, JA and DS, failed to improve significantly on the speech measures. All subjects improved significantly on those measures that tapped fine and gross motor skills. Collectively, these results indicate that EMG biofeedback training shows promise as an additional treatment modality in the habilitation of cerebral palsy patients.

An automatic device for toilet training

A chain of subject-initiated toileting behavior was established and maintained in three enuretic and encopretic profoundly retarded adults through the use of an automatic device which both monitored eliminations and dispensed candy reinforcers. When the device reinforced elimination, the incidence of urinations and defecations in clothing was sharply reduced in each subject, while the frequency of appropriate toileting behavior increased. With the device nonoperative (extinction), the behavior relapsed toward pretraining levels. In reconditioning, with the device again functional, post-training levels were re-established. The device was reliable and was seen to eliminate many of the difficulties inherent in toilet training.

Increasing Empathy for Employment Service Counselors: A Practicum

Outservice practicum training of employment service counselors presents a particular challenge to counselor educators. An overview of a two‐week practicum‐laboratory training program is presented and discussed. The efficacy of the training is examined from the standpoint of helpful levels of empathy presented by the employment service counselors trained. The difference between pretraining and posttraining levels of empathy indicated statistically significant gains were realized.

Exercise blood flow changes in the human forearm during physical t raining.

Forearm blood flow measurements were made with a venous occlusion plethysmograph on six competitive swimmers and six control subjects at rest and during a prescribed rhythmic exercise throughout a 13-week training and detraining program. The swimmers‗ mean exercise forearm blood flow increased progressively during the training program, reaching a maximum at the peak of training toward the end of the 5th week, after which it decreased to near posttraining levels during the period of detraining. The increase in the swimmer's exercise flow between the 1st week of training (4.02 ± 0.59 ml/100 ml min) and the 5th week of training (6.40 ± 0.56 ml/100 ml min) was statistically significant; their decrease in mean exercise blood flow during the 3rd week of detraining (4.70 ± 0.24 ml/100 ml min) was also statistically significant. There was no significant change in the swimmers' resting blood flow; nor were there significant changes in either the exercise or the resting blood flows of the control group. The technique for measuring blood flow in the forearm during rhythmic exercise is explained. Submitted on December 11, 1962