Regular Exercise Training Research Articles

Oral Arginine Supplementation in Healthy Individuals Performing Regular Resistance Training.

Resistance exercise training is well documented as having cardiovascular benefits, but paradoxically, it seems to increase arterial stiffness, favoring the development of high blood pressure. The present study investigates the potential effects of oral supplementation with arginine in healthy individuals performing exercise resistance training. We studied 70 non-smoking male subjects between the ages of 30 and 45 with normal or mildly increased blood pressure on ambulatory monitoring (for 24 h) and normal blood samples and echocardiography, who performed regular resistance exercise training for at least five years with a minimum of three workouts per week. They were divided into two groups in a random manner: 35 males were placed in the arginine group (AG) that followed a 6-month supplementation of their regular diets with 5 g of oral arginine powder taken before their exercise workout, and the control (non-arginine) group (NAG) consisted of 35 males. All subjects underwent body composition analysis, 24 h blood pressure monitoring and pulse wave analysis at enrollment and at six months. After six months of supplementation, blood pressure values did not change in the NAG, while in the AG, we found a decrease of 5.6 mmHg (p < 0.05) in mean systolic blood pressure and a decrease of 4.5 mmHg (p < 0.05) in diastolic values. There was also a 0.62% increase in muscle mass in the AG vs. the NAG (p < 0.05), while the body fat decreased by 1% (p < 0.05 in AG vs. NAG). Overall, the AG gained twice the amount of muscle mass and lost twice as much body fat as the NAG. No effects on the mean weighted average heart rate were recorded in the subjects. The results suggest that oral supplementation with arginine can improve blood pressure and body composition, potentially counteracting the stress induced by resistance exercise training. Supplementation with arginine can be a suitable adjuvant for these health benefits in individuals undertaking regular resistance training.

The effects of aerobic and resistance exercise on blood pressure in uncomplicated and at risk pregnancies: A systematic review and meta-analysis.

Regular exercise performed during pregnancy has been shown to reduce the risk of developing perinatal gestational hypertensive conditions. Further evidence on the exact parameters of exercise needed to explain these beneficial responses is required, within both uncomplicated and at-risk pregnancies. The aim of this systematic review and meta-analysis was to investigate the effects of aerobic and resistance exercise on blood pressure during pregnancy. Systematic review and meta-analysis. An online search of six search engines was conducted up to February 2023. Randomized controlled trials, quasi-experimental, cohort, and longitudinal studies were included. Studies included an acute exercise bout or intervention of land-based aerobic and/or resistance exercise during any trimester in uncomplicated and at-risk pregnancies. Outcomes included mean arterial pressure (MAP), or systolic blood pressure (SBP) and diastolic blood pressure (DBP). Following the removal of duplicates, 1538 articles were screened with 59 studies meeting the inclusion criteria for the review (randomized controlled trials (RCTs) n = 34, clinical trials n = 19, cohort n = 5 and cross-sectional n = 2), and 21 studies included in the meta-analysis. A random effects model was used with mean difference calculated in mmHg. Overall, there were no statistically significant effects of exercise on resting blood pressure (BP) outcomes in pregnant women with normal blood pressure compared to control/usual care populations following intervention (SBP mean diff -1.54 mmHg (favours intervention), p = 0.38; DBP mean diff -2.25 mmHg (favours intervention), p = 0.1; MAP mean diff -1.75 mmHg (favours intervention), p = 0.31). In at-risk pregnant women, both aerobic and combination exercise significantly reduced BP outcomes compared to control (SBP mean diff -3.91 mmHg, p < 0.01; DBP mean diff -2.9 mmHg, p = 0.01; MAP mean diff -2.38 mmHg, p = 0.01). Twenty-seven studies reported an acute increase in SBP and DBP during aerobic exercise, with no difference found between uncomplicated and at-risk pregnancies. Compared to usual care, aerobic and/or resistance exercise performed throughout uncomplicated pregnancy had no influence on blood pressure. Pregnant women with no diagnosed complications should be encouraged to exercise regularly due to the multitude of known benefits. In women who are at risk of, or diagnosed, with gestational hypertensive conditions during pregnancy, moderate to vigorous exercise during pregnancy improves blood pressure outcomes. Higher risk pregnancies may reduce their risk of future cardiovascular complications through regular exercise training during pregnancy. CRD42020159998.

Improving Fitness Through Exercise Will Improve Our Heart and Mind

In the interview, Prof. Carl “Chip” J. Lavie gave suggestions on daily exercise, shared impressive cases of cardiovascular disease (CVD) patients, gave professional explanations of weight management and CVD outcomes, etc. His major viewpoints are: (a) psychological stress is a major risk factor for CVDs, (b) a low-level physical activity contributes to a high prevalence of most CVD risk factors, and regular exercise training can improve cardiac function and aerobic performance, and (c) the prognosis and survival among CVD patients with low physical activity are better in the obese than the lean.

Effect of multimodal exercise training on physical fitness indices, cognitive status, and depressive symptoms in Alzheimer's disease.

The aim of the present study was to investigate the effect of multimodal exercise training (MET) on aerobic endurance, muscular strength, agility, dynamic balance, cognitive status, and depressive symptoms in men with mild-to-moderate AD. A total of 25 elderly men with a diagnosis of mild-to-moderate AD were randomly categorized into an MET or a control group. The subjects in the MET group participated in a 12-week, three sessions per week MET program that included resistance, balance, and aerobic exercises. While the participants in the control group did not perform any regular exercise training during this period. Patients' cognitive status and depressive symptoms were assessed by Mini-Mental State Examination and the Geriatric Depression Scale-15 (GDS-15) questionnaires. PF indicators such as aerobic endurance, muscular strength, agility, and dynamic balance, as well as cognitive status and depressive symptoms, were taken from all the subjects before and after MET. The participants in the MET group improved handgrip, upper and lower body strength, agility, dynamic balance, and depressive symptoms (p<0.05). The intervention had no significant effect on aerobic endurance and cognitive status (p>0.05). MET is an effective strategy to improve muscular strength, agility, dynamic balance, and depressive symptoms in men with mild-to-moderate AD. It is recommended for AD patients to engage in this type of exercise to reduce AD complications.

TREINAMENTO PSICOLóGICO PRé-COMPETIçãO EM ATLETAS UNIVERSITáRIOS DE SALTO

ABSTRACT Introduction: The psychological state generates great effects on the athletes’ results. Adequate psychological preparation in sports before competitions is fundamental for good performance. The high jump athlete tends to strengthen his physical training during pre-competition practice. However, due to the difficulty of psychological control, emotional variations may occur that significantly limit the technical level of his presentation. Objective: Analyze the psychological training program of college high jumpers on physical fitness and competition performance. Methods: The physical fitness and competition situation of 22 college high jumpers in track and field are discussed. In this paper, 11 cases were randomly selected as the experimental group, and the remaining 11 cases were used as a control group. There was no involvement in directed mental training. The control group received regular exercise training, while the experimental group had regular physical training accompanied by directed psychological training. The fitness and competition results in both groups of athletes before and after the test were evaluated statistically. results: There was a significant difference in presentation performance between the experimental and control groups (P&lt;0.05). Improvements in physical performance were significant in the experimental group. Conclusion: Strengthening psychological training in athletes proved to be a critical factor in improving competition effectiveness. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Impact of Yoga on Global Cardiovascular Risk as an Add-On to a Regular Exercise Regimen in Patients With Hypertension

We aimed to determine whether the addition of yoga to a regular exercise training regimen improves cardiometabolic risk profile. Sixty individuals with diagnosed hypertension (≥ 140/90 mm Hg for 3 measurements on different days) were recruited in an exercise training program. In addition to aerobic exercise training, participants were randomised into either a yoga or a stretching control group. Participants, over the 3-month intervention regimen, performed 15 minutes of either yoga or stretching in addition to 30 minutes of aerobic exercise training 5 times weekly. Blood pressure, anthropometry, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid levels as well as the Framingham and Reynolds Risk Scores were measured. At baseline, there was no difference in age, sex, smoking status, body mass index, blood pressure, heart rate, lipid and glucose levels, and Framingham Risk Score between groups. After the 3-month intervention period, the decrement in systolic and diastolic blood pressures (before vs after stretching: 126 ± 11/76 ± 7 vs 122 ± 11/73 ± 8 mm Hg; before vs after yoga: 130 ± 13/77 ± 10 vs 119 ± 11/69 ± 8 mm Hg) and heart rate was greater (P < 0.001) in the yoga group, with similar decreases in lipid, glucose, and hs-CRP levels and Framingham Risk Score in both groups. Reynolds Risk Score decrement was higher in the yoga vs the control group (absolute reduction-1.2 ± 1.2 vs-0.6 ± 0.8; relative reduction 13.2 ± 11.8% vs 9.3 ± 6.5%; P < 0.05). In patients with hypertension, the practice of yoga incorporated in a 3-month exercise training program was associated with greater improvement in resting blood pressure and heart rate and Reynolds Risk Score compared with stretching.

Effect of regular exercise training on platelet function in patients with cardiovascular disease and healthy individuals: A systematic review

IntroductionRegular exercise training is essential in prevention and treatment of cardiovascular disease (CVD), yet the beneficial effects of exercise remain only partly explained. Platelets play a key role in CVD and may be affected by regular exercise training. We aimed to systematically summarise studies investigating the effect of regular exercise training on platelet function in patients with CVD and in healthy individuals. MethodsStudies were identified by PubMed, Embase and Web of Science May 16, 2022. We selected studies investigating markers of platelet function in relation to regular exercise training in patients with CVD and in healthy individuals. Regular exercise was defined as exercise training for four weeks or more. ResultsOf the included studies, 11 investigated patients with CVD and 29 were on healthy individuals. Studies were heterogeneous regarding design, study population and methodology, and the results were ambiguous. In total, 52 different markers of platelet function were investigated with platelet aggregation, soluble P-selectin, and thromboxane B2 (TXB2) as the most frequently examined. When evaluating between-group changes after regular exercise, two studies found a reduced platelet aggregation in the exercise group whilst three studies did not find a difference between groups. With respect to TXB2, three studies reported a reduction and two studies an increase in the exercise group. There were no between-group differences in the seven studies examining soluble P-selectin. ConclusionRegular exercise training has no clear impact on platelet function in patients with CVD or healthy individuals. Prospero registrationCRD42022350539.

Defining patients needs and expectations for eHealth-based cardiac rehabilitation in Germany and Spain: living lab data from the TIMELY study

Abstract Background eHealth innovations have set the stage to optimize personalized care and provide assistance for disease control to patients with CAD. TIMELY is the first artificial intelligence (AI)-driven eHealth approach that employs internet of things devices and is based on cardiac rehabilitation (CR) components. To guarantee acceptance and usability of eHealth solutions, patients are actively participating in development through a Living Lab approach. Purpose To define patients' needs for an eHealth-based lifestyle intervention and self-care support. Methods The Living Lab approach included a guided survey conducted among CAD patients at CR centers in Germany and Spain during inpatient or outpatient CR, respectively. Questions referred to current use of technology and patients' opinion on the usefulness of suggested features of a future eHealth application. Ratings for usefulness/importance were recorded on a 5-point Likert scale reported as median score. Results 79 patients (20% female) were interviewed (DE, n=49; ES, n=30). Patients' mean age was 57 years (range 37–79), educational level was 87% ≤ high school and 13% &amp;gt; high school. All patients owned a smartphone that they also used for information (76%) and documentation (43%). Patients rated the importance of all CR components (regular exercise, healthy diet, stress management, smoking cessation, risk factor reduction) along the continuum of care as “very high” (5/5). Individual need for regular exercise support after structured CR was rated “high” (4/5). Exercise reminders, suggestions on activities, update of recommended training heart rate, evaluation of training progress, and achieved goals were rated “useful” (4/5) to “very useful” (5/5). The importance of support for diet, stress management, overall risk factor management, and medication was rated 3/5. Usefulness of a learning/education tool was rated 4/5, while motivational messages scored 3/5 and individual feedback of a person or virtual agent scored 4/5 and 3/5, respectively. The availability of electronic health records was evaluated as “very useful” (5/5) remote ECG monitoring and blood pressure management were rated as “useful” (4/5). The range of all items accessed was 1–5, indicating large interindividual differences. No significant differences existed between female and male patients or German and Spanish patients, though the importance of sharing training progress with family/ friends was rated higher by men (3/5) compared to women (1/5) and higher by Spanish (4/5) compared to German patients (2/5). Conclusions CR patients expressed a strong need for individual support of regular physical exercise and updated training recommendations. The observed inter-individual differences regarding usefulness and acceptance indicate the need for a highly adaptive system to prevent exclusion from eHealth access. CR patients from Germany and Spain showed equally high acceptance of eHealth components for the management of CAD. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Commission Horizon 2020

Adherence to exercise and fitness following exercise-based outpatient cardiac rehabilitation: a cross-sectional survey for Germany

BackgroundExercise-based cardiac rehabilitation is safe and effective, evidence-based and implemented in national and international cardiac rehabilitation guidelines. Recent data show a decrease in cardiovascular mortality, reduced hospital admissions and an overall improvement in quality of life. To maintain positive effects and to prevent further cardiovascular events a major goal of cardiac rehabilitation is to induce a long-term health behaviour change and the integration of regular physical activity and exercise training in everyday life. The aim of this study is to evaluate the adherence of cardiac patients to exercise-based programs following rehabilitation phase III.MethodsA nationwide online cross-sectional survey was conducted. All outpatient aftercare providers who offer sports rehabilitation programs (heart groups) for cardiac patients in Germany were contacted. The questionnaire comprised 15 questions in five subcategories (general information regarding the outpatient aftercare provider, structure of rehabilitation sport programs, membership structure, content of heart groups, adherence to exercise-based programs).Results560 of 2447 outpatient aftercare providers participated in the survey (response rate: 23%). On average, rehabilitation sport facilities hosted 2 (IQR 2) heart groups per week, and 23 patients (IQR 30) (61% males; 31% females) per facility completed rehabilitation sport prescription in 2018. Almost all providers offer follow-up programs on a self-payer basis after rehabilitation sport prescription ends. Adherence to follow-up programs was at 54% (IQR 65; 55% males and 50% females). With 60% (IQR 71), patients with a statutory health insurance (mainly pensioners) adhere slightly more often to a follow-up program compared to privately insured persons (mainly population with a high income or civil servants) with 50% and significantly more often compared to persons who were insured by the German pension fund (covering working population) with only 9% (IQR 89) adherence.ConclusionAlmost all outpatient aftercare providers offer follow-up programs for cardiac rehabilitation patients but only half of them actually participate. Younger people (working population) do not adhere sufficiently to sport and exercise programs following rehabilitation phase III. This seems critical to address in terms of achieving long-term rehabilitation goals.

Aerobic exercise ameliorates insulin resistance in C57BL/6 J mice via activating Sestrin3

Skeletal muscle insulin resistance (IR) is closely linked to hyperglycemia and metabolic disorders. Regular exercise enhances insulin sensitivity in skeletal muscle, but its underlying mechanisms remain unknown. Sestrin3 (SESN3) is a stress-inducible protein that protects against obesity-induced hepatic steatosis and insulin resistance. Regular exercise training is known to increase SESN3 expression in skeletal muscle. The purpose of this study was to explore whether SESN3 mediates the metabolic effects of exercise in the mouse model of high-fat diet (HFD)-induced IR. SESN3−/− mice exhibited severer body weight gain, ectopic lipid accumulation, and dysregulation of glucose metabolism after long-term HFD feeding compared with the wild-type (WT) mice. Moreover, we found that SESN3 deficiency weakened the effects of exercise on reducing serum insulin levels and improving glucose tolerance in mice. Exercise training increased pAKT-S473 and GLUT4 expression, accompanied by enhanced pmTOR-S2481 (an indicator of mTORC2 activity) in WT quadriceps that were less pronounced in SESN3−/− mice. SESN3 overexpression in C2C12 myotubes further confirmed that SESN3 played an important role in skeletal muscle glucose metabolism. SESN3 overexpression increased the binding of Rictor to mTOR and pmTOR-S2481 in C2C12 myotubes. Moreover, SESN3 overexpression resulted in an elevation of glucose uptake and a concomitant increase of pAKT-S473 in C2C12 myotubes, whereas these effects were diminished by downregulation of mTORC2 activity. Taken together, SESN3 is a crucial protein in amplifying the beneficial effects of exercise on insulin sensitivity in skeletal muscle and systemic glucose levels. SESN3/mTORC2/AKT pathway mediated the effects of exercise on skeletal muscle insulin sensitivity.

Defining patients needs and expectations for eHealth-based cardiac rehabilitation in Germany and Spain: living lab data from the TIMELY study

Abstract Background eHealth innovations have set the stage to optimize personalized care and provide assistance for disease control to patients with CAD. TIMELY is the first artificial intelligence (AI)-driven eHealth approach that employs internet of things devices and is based on cardiac rehabilitation (CR) components. To guarantee acceptance and usability of eHealth solutions, patients are actively participating in development through a Living Lab approach. Purpose To define patients' needs for an eHealth-based lifestyle intervention and self-care support. Methods The Living Lab approach included a guided survey conducted among CAD patients at CR centers in Germany and Spain during inpatient or outpatient CR, respectively. Questions referred to current use of technology and patients' opinion on the usefulness of suggested features of a future eHealth application. Ratings for usefulness/importance were recorded on a 5-point Likert scale reported as median score. Results 79 patients (20% female) were interviewed (DE, n=49; ES, n=30). Patients' mean age was 57 years (range 37–79), educational level was 87% ≤ high school and 13% &amp;gt; high school. All patients owned a smartphone that they also used for information (76%) and documentation (43%). Patients rated the importance of all CR components (regular exercise, healthy diet, stress management, smoking cessation, risk factor reduction) along the continuum of care as “very high” (5/5). Individual need for regular exercise support after structured CR was rated “high” (4/5). Exercise reminders, suggestions on activities, update of recommended training heart rate, evaluation of training progress, and achieved goals were rated “useful” (4/5) to “very useful” (5/5). The importance of support for diet, stress management, overall risk factor management, and medication was rated 3/5. Usefulness of a learning/education tool was rated 4/5, while motivational messages scored 3/5 and individual feedback of a person or virtual agent scored 4/5 and 3/5, respectively. The availability of electronic health records was evaluated as “very useful” (5/5) remote ECG monitoring and blood pressure management were rated as “useful” (4/5). The range of all items accessed was 1–5, indicating large interindividual differences. No significant differences existed between female and male patients or German and Spanish patients, though the importance of sharing training progress with family/ friends was rated higher by men (3/5) compared to women (1/5) and higher by Spanish (4/5) compared to German patients (2/5). Conclusions CR patients expressed a strong need for individual support of regular physical exercise and updated training recommendations. The observed inter-individual differences regarding usefulness and acceptance indicate the need for a highly adaptive system to prevent exclusion from eHealth access. CR patients from Germany and Spain showed equally high acceptance of eHealth components for the management of CAD. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Commission Horizon 2020

Erythrocyte indices and localized stage II/III periodontitis in military young men and women: CHIEF oral health study

BackgroundPrior studies have shown an association between generalized periodontitis and anemia in older or undernourished adults. The aim of the study was to examine the associations of erythrocyte indices with localized periodontitis in robust young adults, which has never been reported before.MethodsThe study included 1286 military participants, aged 19–40 years, with regular exercise training in Hualien, Taiwan. Localized periodontitis was grouped to healthy/stage I and stage II/III (n = 803 and 325) in men and (n = 130 and 28) in women according to the 2017 criteria of the world workshop. Systemic inflammation was evaluated by leukocyte counts. Multiple logistic regression analysis with adjustment for age, tobacco smoking status, betel nut chewing status, body mass index and leucocyte counts were used to determine the associations.ResultsGreater mean corpuscular volume in young men [odds ratio (OR) and 95% confidence intervals 1.03 (1.01–1.06)], and greater hematocrit and hemoglobin levels in young women were associated with a higher risk of localized stage II/III periodontitis [OR: 1.17 (1.02–1.34) and 1.60 (1.06–2.41), respectively]. However, there were no associations for erythrocyte counts.ConclusionsThe localized stage II/III periodontitis risk increased with greater erythrocyte indices in robust young adults. This finding could be explained in part by that localized periodontitis may promote physical stress, possibly resulting in an increase of erythrocyte indices. On the other side, greater physical fitness associated with a lower risk of periodontitis may consume iron storage in the body, leading to exercise-induced anemia or smaller erythrocyte volume.

Effect of pulsed electromagnetic field as an intervention for patients with quadriceps weakness after anterior cruciate ligament reconstruction: a double-blinded, randomized-controlled trial

BackgroundThe ultimate goal of anterior cruciate ligament reconstructions (ACLR) is to fulfil the return-to-play (RTP) criteria. Quadriceps muscle strength is one of the key determinants for a patient’s successful return-to-play after ACLR. Quadriceps muscle atrophy can persist beyond the completion of the rehabilitation program in almost half the patients and the reason behind this is still unknown. There are emerging evidences showing that pulsed electromagnetic field (PEMF) can modulate mitochondrial activities for muscle gain. PEMF exposure on top of regular exercise training may promote muscle regeneration and tissue healing.MethodsThis is a double-blinded, randomized controlled trial to investigate the effects of PEMF treatment during the postoperative period on quadriceps muscle strength in ACL injured patient. Adult patients (aged 18–30) with a unilateral ACL injury, total quadriceps muscle volume is equal or more than 7% deficit on involved leg compared with uninvolved leg, sporting injury with a Tegner score of 7+, and both knees without a history of injury/prior surgery will be recruited. To estimate the improvement of patients, isokinetic muscle assessment, ultrasound imaging and MRI for quadriceps muscle thickness, self-reported outcomes with questionnaires, KT-1000 for knee laxity and biomechanical analysis, and Xtreme CT for bone mineral density will be performed. To investigate the mechanism of PEMF therapy on increasing quadriceps strength, samples of blood serum will be drawn before and after intervention.DiscussionThis is the first trial evaluating the effects of PEMF on quadriceps muscle recovery after ACLR. The proposed study addresses a huge research gap by evaluating practical use of PEMF as part of rehabilitation. The proposed study will provide much needed scientific support in the use of this noninvasive treatment modality to facilitate recovery of quadriceps strength after PEMF.Trial registrationClinicalTrials.gov NCT05184023. Registered on 5 January 2022

Aerobic exercise-induced circulating extracellular vesicle combined decellularized dermal matrix hydrogel facilitates diabetic wound healing by promoting angiogenesis

Background: Insufficient blood supply results in unsatisfactory wound healing, especially for challenging wound repair such as diabetic wound defects. Regular exercise training brings a lot of benefits to cardiovascular fitness and metabolic health including attenuation of T2DM progression. Circulating extracellular vesicles (EVs) are postulated to carry a variety of signals involved in tissue crosstalk by their modified cargoes, representing novel mechanisms for the effects of exercise. Prominently, both acute and chronic aerobic exercise training can promote the release of exercise-induced cytokines and enhance the angiogenic function of circulating angiogenic cell–derived EVs. Methods: We investigated the possible angiogenesis potential of aerobic exercise-induced circulating EVs (EXE-EVs) on diabetic wound healing. Circulating EVs were isolated from the plasma of rats subjected to 4 weeks of moderate aerobic exercise or sedentariness 24 h after the last training session. The therapeutic effect of circulating EVs was evaluated in vitro by proliferation, migration, and tube formation assays of human umbilical vein endothelial cells (HUVECs), as well as in vivo by quantification of angiogenesis and cutaneous wound healing in diabetic rats. Results: The number of circulating EVs did not change significantly in exercised rats 24 h post-exercise in comparison with the sedentary rats. Nevertheless, EXE-EVs showed remarkable pro-angiogenic effect by augmenting proliferation, migration, and tube formation of HUVECs. Furthermore, the findings of animal experiments revealed that the EXE-EVs delivered by decellularized dermal matrix hydrogel (DDMH) could significantly promote the repair of skin defects through stimulating the regeneration of vascularized skin. Discussion: The present study is the first attempt to demonstrate that aerobic exercise-induced circulating EVs could be utilized as a cell-free therapy to activate angiogenesis and promote diabetic wound healing. Our findings suggest that EXE-EVs may stand for a potential strategy for diabetic soft tissue wound repair.

Neuroprotective and metabotropic effect of aerobic exercise training in female patients with type 2 diabetes mellitus

Abstract Objectives We aimed to evaluate the effects of acute and chronic aerobic exercise on cognitive function and depression levels in patients with Type 2 Diabetes Mellitus (T2DM) and the changes in related neurotrophic and metabotropic factors. Methods Sixteen female patients (age=57.5 ± 7.3) diagnosed with T2DM were included. A and B sections of the Trail Making Test (TMT) and Beck Depression Inventory (BDI) were used to assess executive function and depression states. Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), irisin, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), fasting plasma glucose, hemoglobin A1c, and high-density lipoprotein (HDL) cholesterol were analyzed in blood. Aerobic exercise intensity was applied at 50–70% of the maximal heart rate for 40 min/day, three days weekly on the treadmill. All evaluations were repeated after one exercise session, a 12-week exercise program, and after one year for follow-up. Results TMT-A (p=0.001) and TMT-B (p=0.002) values were increased following both acute and chronic exercise. BDI scores were decreased after long-term exercise (p=0.031). Measurement of metabolic parameters revealed positive changes in HDL cholesterol (p=0.044), TAS (p=0.005), and OSI (p=0.009) values ​​after chronic period exercise. No significant difference was found in BDNF (p=0.271), NGF (p=0.230), and irisin (p=0.101) values ​​after acute or chronic exercise, on the other hand. Conclusions Although aerobic exercise training had a positive effect on metabolic and cognitive outcomes, this effect was independent of neurotrophic and metabotropic factors. Regular and long-term aerobic exercise training has protective and regulatory functions in T2DM.

Exercise timing influences multi-tissue metabolome and skeletal muscle proteome profiles in type 2 diabetic patients – A randomized crossover trial

Aims/hypothesisMetabolic effects of exercise may partly depend on the time-of-day when exercise is performed. We tested the hypothesis that exercise timing affects the adaptations in multi-tissue metabolome and skeletal muscle proteome profiles in men with type 2 diabetes. MethodsMen fitting the inclusion (type 2 diabetes, age 45–68 years and body mass index 23–33 kg/m2) and exclusion criteria (insulin treatment, smoking, concurrent systemic disease, and regular exercise training) were included in a randomized crossover trial (n = 15). Participants included in this metabolomics and proteomics analysis fully completed all exercise sessions (n = 8). The trial consisted of two weeks of high-intensity interval training (HIT) (three sessions/week) either in the morning (08:00, n = 5) or afternoon (16:45, n = 3), a two-week wash-out period, and an additional two weeks of HIT at the opposing time. Participants and researchers were not blinded to group allocation. Blood, skeletal muscle and subcutaneous adipose tissue were obtained before the first, and after each training period. Broad-spectrum, untargeted proteomic analysis was performed on skeletal muscle, and metabolomic analysis was performed on all biosamples. Differential content was assessed by linear regression and pathway set enrichment analyses were performed. Coordinated metabolic changes across tissues were identified by Spearman correlation analysis. ResultsMetabolic and proteomic profiles remained stable after two weeks of HIT, and individual metabolites and proteins were not altered, irrespective of the time of day at which the training was performed. However, coordinated changes in relevant metabolic pathways and protein categories were identified. Morning and afternoon HIT similarly increased plasma diacylglycerols, skeletal muscle acyl-carnitines, and subcutaneous adipose tissue sphingomyelins and lysophospholipids. Acyl-carnitines were central to training-induced metabolic cross-talk across tissues. Plasma carbohydrates, via the penthose phosphate pathway, were increased and skeletal muscle lipids were decreased after morning compared to afternoon HIT. Skeletal muscle lipoproteins were higher, and mitochondrial complex III abundance was lower after morning compared to afternoon HIT. Conclusions/interpretationWe provide a comprehensive analysis of a multi-tissue metabolomic and skeletal muscle proteomic responses to training at different times of the day in men with type 2 diabetes. Increased circulating lipids and changes in adipose tissue lipid composition were common between morning and afternoon HIT. However, afternoon HIT increased skeletal muscle lipids and mitochondrial content to a greater degree than morning training. Thus, there is a diurnal component in the metabolomic and proteomic response to exercise in men with type 2 diabetes. The clinical relevance of this response warrants further investigation.

Aquatic Exercise as an Adjunct Therapy for Erectile Dysfunction

Erectile dysfunction (ED) was the major men's health topic browsed by the public over the past 5 years in the United States. Globally, there might be a rise of 320 million cases by the year 2025. Adhering to regular physical activities along with a healthy diet is recommended for improving ED. Several studies highlight the positive effects of exercise interventions in improving erectile function. Exercising inside the water offers a pleasant sensation to the participants and the physical principles of water help to achieve the desired effect. The major aim of this study is to investigate the effect of various types of physical exercises among ED and to recommend aquatic exercises as a novel approach to manage ED. A relevant meta-analysis, systematic reviews, randomized clinical trials, and national and international guidelines were searched in the PubMed, PEDro, Scopus, and Cochrane databases. The literature review of randomized studies strongly recommends aerobic exercises for arteriogenic ED. Among the various types of exercise interventions, swimming and aquatic exercise have advantageous physiological and therapeutic changes to tackle the vascular and psychological causes of ED. The multifold advantages of aquatic exercises entitle it to an interesting and effective treatment approach to manage patients with ED. Aquatic exercises can be used as an adjunct to treat ED. Regular exercise training helps to overcome the risk of ED and supports to achieve high quality of life.

Relationship Between Exercise Training and Quality of Life in Heart Failure Patients

Background: Heart failure (HF) is a growing disease that affects up to 6.5 million Americans and greatly contributes to the rising expense of health care. HF affects almost 23 million individuals worldwide. Exercise training increased patients' quality of life (QoL) and may be connected with lower morbidity and mortality. Aim: To assess the association between exercise training and QoL in HF patients. Methods: We examined databases from 2008 to 2019 for research that looked at the association between exercise training and QoL in HF patients. For the analysis, eight controlled studies that met the inclusion criteria were chosen. The study's characteristics, as well as data on QoL in HF patients, exercise training, and aerobic capacity, were extracted and examined. Results: The investigation showed a more positive effect of the training exercise on patients' QoL after heart failure. Conclusion: Regular 30-minute exercise training three times a week for eight weeks is an effective strategy to improve all QoL aspects in individuals with chronic heart failure caused by various etiologies. These exercises had to be modified based on the patients' age and functional capacity.

Impact of exercise training on myocardial contractile functions assessed by cardiac magnetic resonance in post-myocardial infarction patients

BackgroundImprovement of functional capacity and mortality reduction in post-MI patients were found to be associated with regular exercise training. The cardiac magnetic resonance (CMR) is considered the most accurate non-invasive modality in quantitative assessment of left ventricular (LV) volumes and systolic functions. Our main objective was to investigate the impact of exercise training on LV systolic functions in patients post anterior MI using CMR. 32 patients on recommended medical treatment 4 week after having a successful primary PCI for an anterior MI were recruited, between May 2018 and May 2019. They were divided into two groups, training group (TG): 16 assigned to a 12 week exercise training program and control group (CG): 16 who received medical treatment without participating in the exercise training program. Treadmill exercise using modified Bruce protocol was done to TG before and after the training program in order to record the resting and maximum HR, metabolic equivalent (MET), and calculate HR reserve. CMR was performed for all patients 4 weeks after PCI and was repeated after completion of the study period to calculate ejection fraction (EF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and wall motion score index (WMSI).Results100% were males. 6 patients from CG dropped during follow-up, no statistically significant difference between the two groups regarding age, BMI, smoking status, hypertension, diabetes mellitus and dyslipidemia. Using the CMR, the TG showed significant improvement in EF (36.6 ± 14.2% to 43.1 ± 12.4%; P < 0.001) and WMSI (2.03 ± 0.57 to 1.7 ± 0.49; P < 0.001), without statistically significant change in LV volumes. Regarding CG no significant changes in EF, WMSI, LV volumes were found. There was significant improvement in EF and WMSI change before and after study in TG vs. CG [6.5 (2.3–9.0) vs. − 2.0 (− 6.8 to 1.3), P value < 0.001] and [− 0.3 (− 0.5 to 0.1) vs. 0.1 (− 0.1 to − 0.5), P value 0.001] respectively.Conclusions12 weeks of exercise training program in post-MI patients have a favorable impact on LV global and regional systolic functions without adversely affecting LV remodeling (as assessed by CMR).

The effect of regular exercise training on gene expression of Autophagy related protein 5 (ATG5) and Autophagy related protein 7 (ATG7) of white adipose tissue of mice with a high-fat diet

هدف: مطالعات نشان داده­اند که آتوفاژی (فرایند خود تجزیه­ای وابسته به لیزوزوم) در بافت چربی افراد چاق دارای تغذیه پرچرب افزایش تنظیمی می­یابد. پروتئین­های مرتبط به آتوفاژی یعنی ATG5و ATG7 در مراحل اولیه فرایند آتوفاژی نقش کلیدی ایفا می­کنند. از طرف دیگر نشان داده شده است که تمرینات ورزشی ، بدعملکردی یا بدسازگاری بافت چربی، که در افراد چاق بروز مییابد، را از طریق سازوکارهای سلولی مختلف اصلاح می­کنند. از این رو، این سوال مطرح می­شود که آیا تمرینات ورزشی می­تواند بیش تنظیمی آتوفاژی، که در بافت چربی افراد چاق و دارای تغذیه پرچرب بروز می­یابد، را تعدیل نماید. بنابراین، هدف از پژوهش حاضر، بررسی اثر تمرین منظم ورزشی بر بیان ژن­های 5GTA و 7GTA در بافت چربی سفید موشهای دارای تغذیه پرچرب است. مواد و روشها: 12 سر موش سوری نر نژاد 6/LB57C با سن تقریبی چهار هفته و با وزن تقریبی 12 گرم از مرکز مطالعات تجربی و مقایسه‌ای دانشگاه علوم پزشکی ایران خریداری شدند. این موش­ها به صورت تصادفی در سه گروه؛ کنترل (هفت سر)، تغذیه پرچرب (هفت سر) و تمرین ورزشی –تغذیه پرچرب (هفت سر) جای گرفتند. موشهای گروه تغذیه پرچرب، بهمدت 21 هفته رژیم غذایی پرچرب (24 درصد) دریافت کردند. موش­های گروه­ تمرین ورزشی-تغذیه پرچرب، علاوه بر اینکه رژیم غذایی پرچرب دریافت می­کردند، بهمدت شش هفته، تحت تمرین استقامتی تداومی بر روی نوارگردان قرار گرفتند. پس از پایان مداخله پژوهش، موش­ها بی­هوش شدند و بافت چربی احشائی منطقه اپیدیدیمال برای اندازه­گیری آزمایشگاهی با جراحی خارج شد. برای اندازه­گیری بیان نسبی ژن های یعنی 5GTA و 7GTA از روش RCP-emiT laeR استفاده شد. داده های پژوهش از طریق آزمون تحلیل واریانس یک طرفه و آزمون تعقیبی توکی تحلیل آماری شدند. نتایج: داده­های این پژوهش نشان داد که بیان mRNAی ژن­های ATG5 و ATG7 در بافت چربی گروه تغذیه پرچرب در مقایسه با گروه کنترل بیش از دو برابر بیشتر بود (p<0.05). همچنین بیان mRNA ی این ژنها در گروه تغذیه پرچرب-تمرین ورزشی در قیاس با گروه کنترل بیشتر بود (10.0>p). مهم­تر اینکه بیان ژن 7GTA در گروه تغذیه پرچرب-تمرین ورزشی در قیاس با گروه تغذیه پرچرب 5/1 برابر بیشتر بود (50.0>p). با این حال، بیان ژن 5GTA در گروه تغذیه پرچرب-تمرین ورزشی در قیاس با گروه تغذیه پرچرب تفاوت معنی دار نداشت (50.0<p). نتیجه­گیری: نتایج این پژوهش دلالت بر این دارد که تغذیه پرچرب در طولانی مدت موجب افزایش بیان ژنهای عوامل دخیل در مرحله اولیه فرایند آتوفاژی (یعنی 5GTA و 7GTA) در بافت چربی سفید می­شود و تمرین منظم ورزشی، افزایش بیان ژن 7GTA ناشی از تغذیه پرچرب را تقویت می­کند، اما این تمرین، میزان بیان افزایش یافته 5GTA ناشی از تغذیه پرچرب را تغییر نمی­دهد. بر این اساس می­توان استدلال کرد که توام شدن تمرین ورزشی و تغذیه پرچرب موجب تحریک بیشتر سازوکار آتوفاژی در بافت چربی سفید میشود که احتمالاً سازگاری مثبتی در جهت نمو بافت چربی باشد.