Exercise Sessions Research Articles

Inter-individual variability of aerobic capacity after rehabilitation exercise training in children with severe burn injury

IntroductionSevere burn trauma damages resting and exercise cardiac function that may affect long term cardiovascular health. The implementation of rehabilitation exercise training (RET) soon after hospital discharge improves cardiorespiratory fitness; however, it does not fully restore aerobic capacity and presents large inter-individual variability. We tested the hypothesis that the inter-individual variability of aerobic capacity for responders (R) compared to nonresponders (NR) would differ for exercise frequency and intensity. MethodsThirty-three children (11 female, [mean±SD] 12 ± 3 years, 145 ± 18 cm, 40 ± 11 kg, 49 ± 31 BMI percentile) with severe burns (49 ± 15 % total body surface area burned, with 35 ± 22 % third-degree burns) completed a 6-week RET program. Cardiorespiratory fitness (peak VO2) was measured before and after RET. Frequency (session days/week), intensity (% peak heart rate), time (min/session), and volume (min/week) were compared between responders and non-responders. Significance was set at p < 0.05. ResultsSixty-four percent of the study population improved peak VO2 after RET whereas 36 % showed no improvements. Using a 2-way factorial ANOVA (group [G] × week [WK]), we found that exercise frequency and session time were similar and increased slightly over 6 weeks between R and NR (main effect for WK; P < 0.002). Exercise volume was significantly lower on week 2 for NR compared to R (G × WK interaction, P < 0.028). Exercise intensity over 6-weeks was significantly lower in the NR compared to the R group (G × WK interaction, P < 0.022). ConclusionsExercise intensity and volume may be important contributors for improving the interindividual response to exercise training for peak VO2. These data suggest that the appropriate dose-response requirement for exercise intensity may be > 80 % peak heart rate and exercise volume of > 150 min per week. Further understanding of the exercise prescription will provide insights important for cardiovascular rehabilitation in children with severe burns. Subject codeInter-individual Variability, Exercise, Pediatrics, Exercise Training

Impact of Time of Day on Glycemia in Response to Postprandial Supramaximal Sprints in Adults With Type 1 Diabetes

ObjectivesIn this study we explore the impact of postprandial exercise timing (morning vs evening) on glycemia in individuals with type 1 diabetes (T1D) during short all-out sprints on a cycle ergometer. MethodsTen healthy physically sedentary male (n=7) and female (n=3) volunteers with type 1 diabetes, 22.8±2.8 years of age, and with a diabetes duration of 9.7±5.5 years and glycated hemoglobin level of 8.6±1.2%, underwent comprehensive screening and assessment of their physical health and fitness status before study participation, under the guidance of a physician. Each participant underwent 2 postprandial exercise sessions on separate days: the first in the morning at 8:00 AM and second in the evening at 8:00 PM, both conducted 60 minutes after a standardized meal. ResultsMorning exercise showed a less pronounced reduction in plasma glucose (PG) levels compared with evening exercise (−2.01±1.24 vs −3.56±1.6 mmol/L, p=0.03). In addition, higher cortisol levels were observed in the morning vs evening (128.59±34 vs 67.79±26 ng/mL, p<0.001). ConclusionsMorning repeated sprint exercise conducted in the postprandial state consistent with the protective effect of higher cortisol levels resulted in a smaller reduction in PG levels compared with evening exercise. This highlights the potential influence of exercise timing on glycemic responses and cortisol secretion in the management of T1D.

Is a 12-week home-based functional teletraining for individuals with type 2 diabetes an alternative for blood glucose control?

BackgroundVirtual or Tele-exercise programs have emerged due to safety concerns of COVID-19 contamination for at-risk groups. However, blood glucose (BG) comparisons concerning in-person and virtual exercise programs need to be scientifically researched. Understanding and monitoring home-based teletraining effects on glycemia is vital for safe management of people with type-2 diabetes (T2DM). Purpose: To verify a 12-week functional teletraining on the capillary BG and compare it with in-person exercise before the COVID-19 pandemic in people with T2DM. MethodsT2DM participants underwent tele-exercise during the COVID-19 pandemic. It consisted of functional training (functional resistance training (FRT) for 12 weeks, 2 times a week, ∼60 min). Capillary BG was performed before and after (pre-post) each exercise session. The pre-post ΔBG for each session was considered for statistical analysis. Friedman's test with repetitive measures over time was performed to compare the ΔBG of the teletraining and the results of these participants before the pandemic. The minimum detectable difference was performed to verify clinical ΔBG for each session over the weeks. ResultsSimilar responses were seen over time without a statistical time effect after the programs (p = 0.177). A noticeable minimum difference of 24.5 mg/dL was observed in the in-person group post-session in all sessions. The virtual group showed a minimum detectable difference of 21.1 mg/dL post-session with clinical relevance over the 12 weeks. ConclusionDespite the teletraining being twice weekly and the in-person program thrice weekly, both exhibited similar outcomes over time, with the virtual program showing significant clinical improvements in BG after each session.

The ASSIST trial: Acute effects of manipulating strength exercise volume on insulin sensitivity in obese adults: A protocol for a randomized controlled, crossover, clinical trial.

Type 2 diabetes mellitus is a disease in which insulin action is impaired, and an acute bout of strength exercise can improve insulin sensitivity. Current guidelines for strength exercise prescription suggest that 8 to 30 sets could be performed, although it is not known how variations in exercise volume impact insulin sensitivity. Additionally, this means an almost 4-fold difference in time commitment, which might directly impact an individual's motivation and perceived capacity to exercise. This study will assess the acute effects of high- and low-volume strength exercise sessions on insulin sensitivity. After being thoroughly familiarized, 14 obese individuals of both sexes (>40 year old) will undergo 3 random experimental sessions, with a minimum 4-day washout period between them: a high-volume session (7 exercises, 3 sets per exercise, 21 total sets); a low-volume session (7 exercises, 1 set per exercise, 7 total sets); and a control session, where no exercise will be performed. Psychological assessments (feeling, enjoyment, and self-efficacy) will be performed after the sessions. All sessions will be held at night, and the next morning, an oral glucose tolerance test will be performed in a local laboratory, from which indexes of insulin sensitivity will be derived. We believe this study will aid in strength exercise prescription for individuals who claim not to have time to exercise or who perceive high-volume strength exercise intimidating to adhere to. This trial was prospectively registered (ReBEC #RBR-3vj5dc5 https://ensaiosclinicos.gov.br/rg/RBR-3vj5dc5).

#2014 Exercise safety and efficacy as a rehabilitation therapy for patients on hemodiafiltration: a 6-month controlled study

Abstract Background and Aims Individuals with chronic kidney disease (CKD) stage 5D face challenges due to the accumulation of uremic toxins. Hemodiafiltration (HDF) stands out for its efficacy in removing solutes of various molecular weights, offering mortality benefits. Although exercise rehabilitation is established as a beneficial adjunct therapy for patients on maintenance hemodialysis, its impact on maintenance HDF programs remains understudied. The primary aim was to evaluate the safety and efficacy of exercise as rehabilitation in patients undergoing HDF. The secondary aim was to compare the outcomes between intra- and inter-HDF exercise sessions. Method This study enrolled CKD 5D patients at Fenix Nephrology Group from 2021 to 2023. The assessment occurred at the initiation of the exercise program and after six months of exercise rehabilitation. Physical tests included the step-test, handgrip, and one-repetition maximum (1RM), and the Kidney Disease Quality of Life Short Form (KDQOL-SF), a patient-reported outcome measure. The urea reduction ratio (URR) reflected HDF adequacy. Patients engaged in twice-weekly aerobic exercises achieving 70% of maximum heart rate and resistance exercises (60% 1RM). Results Data from 234 patients were obtained, and 81 were not on the exercise program. From the remaining 153 patients, we excluded 64. Twelve patients were excluded because underwent kidney transplantation during their participation, 41 had incomplete data, and 11 patients carried out less than 80% of the scheduled exercise sessions. We included in our final analysis data from 89 patients (55 ± 15 years; 58.4% male). The mean dialysis vintage was 9 ± 7 years, including high-flux hemodialysis and HDF. Specifically, for HDF, the mean dialysis vintage was 5 ± 4 years. Mean exercise session adherence was 94 ± 4%, and the mean number of sessions was 39 ± 4. Concerning the performance outcomes, we observed significant improvements in the step-test (80 ± 22 to 93 ± 25 steps; p &amp;lt; 0.001) and handgrip measurement (28 ± 7 to 30 ± 7 kgf; p &amp;lt; 0.001), alongside an approximate 4% increase in lean body mass (13 ± 2 to 14 ± 2 kg; p &amp;lt; 0.001) during the 6 months. The KDQOL-SF improved in physical functioning (64 ± 22 to 72 ± 23; p &amp;lt; 0.001), general health (55 ± 23 to 61 ± 2; p = 0.01), social function (73 ± 26 to 80 ± 21; p = 0.004), physical (43 ± 9 to 47 ± 8; p &amp;lt; 0.001) and mental composite scores (46 ± 10 to 48 ± 9; p = 0.04), along with a reduction in fatigue (57 ± 17 to 60 ± 17; p = 0.03). A similar favorable trend was observed for the URR (68 ± 10% vs. 71 ± 8%; p &amp;lt; 0.05). We also analyzed the exercise rehabilitation program in two different groups. Thirty-five patients carried out intradialytic exercise (i.e., during the dialysis session). In this group, the mean dialysis vintage was 10 ± 7 years and specifically 5 ± 3 years on HDF. The other group included 54 patients performing interdialytic exercise (i.e., pre- or post-session). In this group, the mean dialysis vintage was 8 ± 6 years and specifically 4 ± 2 years on HDF. We did not observe complications during the exercise program, and no sessions were interrupted due to adverse events. Demographic and anthropometric data (age, sex, weight, and body mass index) were comparable between the groups. Furthermore, exercise performance was equivalent in both groups. Conclusion Our findings suggest that a supervised exercise program for maintenance dialysis patients performing HDF is safe and efficacious, yielding substantial improvements in patient-reported and performance outcomes. Notably, the positive effects of exercise persisted whether conducted during intradialytic or interdialytic periods.

Creating a motivating environment in a programming course using a two-track exercise split

Abstract In our society, programming and IT literacy are important skills. However, in introductory courses in higher education, there is a struggle to design the coursework in a way that engages and motivates both beginners and people who already know some code. This paper presents a case study that explores the design of optional exercise sessions as a shorter 'fast track' for experienced or well-prepared students, and a longer 'normal track' for those who need help with the technical parts of the coursework. The case is analysed using self-determination theory to investigate student motivation in such a design. Students perform well and are generally happy to be able to choose between tracks to find their own fit. Whether a 2-day induction workshop or a track split leads to the best learning environment is a question for future research.

Ascorbic Acid Supplementation and Immune Response in Healthy Women during High-intensity Exercise

Introduction the benefits of consuming extra Ascorbic Acid (AA) while exercising are not well understood. Aim This study aims to explore the effects of AA supplementation on oxidative stress, the immunological response, and inflammation in healthy women after a single bout of high-intensity exercise. Materials and Methods In a crossover design, 20 sedentary women (aged 18-22) underwent 30 minutes of vigorous cycling. They were divided into two groups: one receiving daily 1,000 mg ascorbic acid supplementation (1,000AA) and the other without supplementation (0AA). This regimen was maintained for one week. Blood samples obtained pre-exercise, immediately post-exercise, and 24 hours post-exercise underwent analysis for oxidative stress, inflammatory markers, CD4+ and CD8+ lymphocytes, and neutrophil phagocytic activity. Results An AA supplement significantly increased plasma concentrations of AA (p&lt;0.05) and reduced post-exercise plasma MDA levels (p&lt;0.05) but did not affect creatine kinase activity. White blood cells, CD8+ T cells, and IL-6 increased significantly after exercise but remained unchanged in the 1,000AA group compared to the 0AA group, while the neutrophil count increased (p&lt;0.05) after exercise with no change in phagocytic function. A slight drop in phagocytic function was observed 24 hours after exercise in the 1,000AA group. Exercise and AA supplements had no effect on CD4+ T cells. Conclusion a single session of high-intensity exercise caused oxidative stress, muscle injury, and inflammation, as well as a transient increase in CD8+ T cells. A short administration of AA attenuated the exercise-induced oxidative stress and reduced inflammation by limiting the increase in IL-6 and CD8+ T cells.

The interactive effect of sustained sleep restriction and resistance exercise on skeletal muscle transcriptomics in young females.

Both sleep loss and exercise regulate gene expression in skeletal muscle, yet little is known about how the interaction of these stressors affects the transcriptome. The aim of this study was to investigate the effect of nine nights of sleep restriction (SR), with repeated resistance exercise (REx) sessions, on the skeletal muscle transcriptome of young, trained females. Ten healthy females aged 18-35 yr old undertook a randomized cross-over study of nine nights of SR (5 h time in bed) and normal sleep (NS; ≥7 h time in bed) with a minimum 6-wk washout. Participants completed four REx sessions per condition (days 3, 5, 7, and 9). Muscle biopsies were collected both pre- and post-REx on days 3 and 9. Gene and protein expression were assessed by RNA sequencing and Western blot, respectively. Three or nine nights of SR had no effect on the muscle transcriptome independently of exercise. However, close to 3,000 transcripts were differentially regulated (false discovery rate < 0.05) 48 h after the completion of three resistance exercise sessions in both NS and SR conditions. Only 39% of downregulated genes and 18% of upregulated genes were common between both conditions, indicating a moderating effect of SR on the response to exercise. SR and REx interacted to alter the enrichment of skeletal muscle transcriptomic pathways in young, resistance-trained females. Performing exercise when sleep restricted may not provide the same adaptive response for individuals as if they were fully rested.NEW & NOTEWORTHY This study investigated the effect of nine nights of sleep restriction, with repeated resistance exercise sessions, on the skeletal muscle transcriptome of young, trained females. Sleep restriction and resistance exercise interacted to alter the enrichment of skeletal muscle transcriptomic pathways in young, resistance-trained females. Performing exercise when sleep restricted may not provide the same adaptive response for individuals as if they were fully rested.

The Clinical Outcome of Cardiac Rehabilitation in Coronary Artery Disease Patients with Regard to the Presence of Left Ventricular Systolic Dysfunction.

Background: Despite the use of advanced treatment techniques, coronary artery disease (CAD) still remains the main cause of left ventricular (LV) dysfunction and heart failure. Participation in cardiac rehabilitation (CR) programs can lead to a number of beneficial effects, but some patients do not demonstrate the expected improvement. The aim of this study is to evaluate the impact of CR on changes in exercise capacity with regard to the presence of LV dysfunction. Methods: A group of 428 patients with CAD were consecutively admitted to an outpatient comprehensive cardiac rehabilitation program comprising 24 exercise sessions of interval training on cycle ergometers, three times a week for 45 min, and a health education. The patients were compared in two subgroups, i.e., with LV systolic dysfunction (LVEF < 50%, n = 175) and LVEF ≥ 50% (n = 253). Results: In the LVEF < 50% group, the exercise capacity improved by 1 ± 0.78 MET (median 1.15 MET), and 0.86 ± 0.77 MET (median 1.08 MET) in the LVEF ≥ 50% group. Women with LVEF < 50% demonstrated a significant increase in exercise capacity by 1.2 MET, while those with LVEF ≥ 50% did not display any such increase. All men, regardless of LVEF, exhibited a similar improvement in exercise capacity greater than 1 MET. Conclusions: An outpatient eight-week cardiac rehabilitation program based on 45 min aerobic interval training sessions three times a week appears less effective for women with CAD and EF ≥ 50%. In this group, the proposed training intervention is insufficient in improving exercise capacity to an extent that could indicate a reduction in mortality risk.

Effect of a Long-Term Online Home-Based Supervised Exercise Program on Physical Fitness and Adherence in Breast Cancer Patients: A Randomized Clinical Trial

The purpose of the present study was to analyze the effect of a synchronous-supervised online home-based exercise program (HBG) during 24 weeks on body composition, physical fitness and adherence compared to an exercise recommendation group (ERG) without supervision with patients undergoing breast cancer treatment. Fifty-nine female breast cancer patients (31 in HBG and 28 in the ERG) undergoing cancer treatments participated in the present randomized clinical trial. The exercise program consisted of a 60 min combined resistance and aerobic supervised exercise session (6–8 points on Borg Scale CR-10, moderate intensity), twice a week during 24 weeks. The exercise recommendation group only received general recommendations to comply with the current ACSM guidelines. Body composition and physical fitness were assessed at baseline, 12 weeks and 24 weeks of the program. Adherence to the intervention was measured according to the minutes of exercise completed per session during each week. A general linear model of two-way repeated measures showed significant improvements (p &lt; 0.05) in physical fitness that were observed in the home-based exercise group at the baseline, 12-week and 24-week assessments compared to the exercise recommendation group. Adherence was also higher in the home-based exercise group. However, no changes (p &gt; 0.05) in body composition between groups and moments were observed. In this sense, supervised home-based exercise interventions can be an interesting strategy to improve physical fitness and adherence rates in breast cancer patients undergoing treatment.

One-week quercetin intervention modifies motor unit recruitment patterns before and during resistance exercise in older adults: A randomized controlled trial

We investigated the effects of one-week quercetin ingestion on motor unit (MU) behavior and muscle contractile properties before, during, and after a single session of resistance exercise in older adults. Twenty-four older adults were divided into two groups: those receiving quercetin glycosides (QUE) or placebo (PLA), and they performed a single session of resistance exercise. MU behavior before and during resistance exercise and electrically elicited contraction before and after resistance exercise were measured (Day 1), and the same measurements were conducted again after 7 days of placebo or quercetin glycoside ingestion (Day 8). The MU recruitment threshold (RT) was decreased (p < 0.001, 25.6 ± 10.1 to 23.6 ± 9.5 %MVC) and the exerted force normalized by the MU firing rate (FR) was increased (p = 0.003, 1.13 ± 0.24 to 1.18 ± 0.22 %MVC/pps) from Days 1 to 8, respectively, in QUE but not PLA (p = 0.263, 22.6 ± 11.9 to 21.9 ± 11.6 %MVC; p = 0.713, 1.09 ± 0.20 to 1.10 ± 0.19 %MVC/pps, respectively). On Day 1, a significant correlation between MURT and%change in MUFR from the first to last contractions during the resistance exercise was observed in both groups (QUE: p = 0.009, rs = 0.308; PLA: p < 0.001, rs = 0.403). On Day 8 %change in MUFR was negatively correlated with MURT in QUE (p = 0.044, rs = -0.251), but there was no significant correlation in PLA (p = 0.844). There was no difference in electrically elicited contraction before and after the resistance exercise between QUE and PLA (p < 0.05). These results suggest that one-week quercetin ingestion in older adults lowered MURT and led to greater fatigue in MU with higher RT than with lower RT during resistance training.

Temporal Aspects of Psychosocial Mediators of the Exercise-Weight Loss Maintenance Relationship Within Scalable Behavior-Change Treatments.

Limited knowledge of psychological correlates of weight loss is associated with continuing failures of behavioral obesity treatments beyond the short term. This study aimed to inform health professionals' obesity interventions via an increased knowledge of mediators of the exercise-weight loss maintenance relationship. Women participated in 6-month obesity treatments within community settings emphasizing moderate exercise and self-regulation skills development via primarily in-person (n = 54) or primarily written (n = 54) means. Changes in mood, self-regulating eating, and weight over 6, 12, and 24 months were assessed. A moderated mediation model was tested using the PROCESS macro instruction. Improvements in mood, self-regulating eating, and weight were significantly greater in the in-person group. The relationship between a dichotomous measure of completing at least 3 sessions of exercise per week (or not) and change in weight over 6 months was no longer significant when the mediators of changes in negative mood and self-regulation of eating were sequentially entered. Paths of exercise→negative mood reduction→eating self-regulation increase→weight loss over 6, 12 and 24 months were significant. Exercise self-regulation at Month 3 significantly moderated the mood change→eating self-regulation change relationship. Based on the identified paths, scalable obesity-treatment content and emphases were informed. This could help guide health professionals' actions concerning the management of obesity.

Biofeedback-Based Proprioceptive Training to Improve Functional Prerequisites of Dragon Boating in Breast Cancer Survivors.

Breast cancer (BC)-related sequelae drastically impact the psychophysical functioning and quality of life of affected women. Adapted physical activity (APA) has proved to effectively counteract these impairments in a non-medicalized framework. In particular, dragon boats are able to promote body functionality, social interaction, and quality of life in BC survivors, but the literature on specific motor gestures is scarce and practice is still based more on a re-educative perspective than a performative one. In this context, the present longitudinal study investigated the benefits of an adapted biofeedback-based sensorimotor training intervention on upper body functionality in a team of dragon ladies. The 8-week intervention was conceived as integrated dry workout sessions led by an APA kinesiologist and applied a novel sensorized proprioceptive device, such as a Libra board. Post-protocol evaluation revealed a significant improvement in bilateral upper limb mobility, core endurance, and trunk stability along with a distress decrease and quality of life enhancement through validated assessment tools. Our findings suggest that integrating biofeedback-based workout sessions can effectively promote upper body functionality in BC survivors practicing dragon boating. Furthermore, our innovative approach could help spread methodological hints able to boost exercise adherence in this target population, thus counteracting cancer recurrence while promoting overall well-being.

Late-in-life Exercise Ameliorates the Aging Trajectory Metabolism Programmed by Maternal Obesity in Rats: It is Never Too Late

BackgroundMaternal obesity (MO) has been shown to adversely affect metabolic, oxidative, reproductive, and cognitive function in offspring. However, it is unclear whether lifestyle modification can ameliorate the metabolic and organ dysfunction programmed by MO and prevent the effects of metabolic syndrome in adulthood. This study aimed to evaluate whether moderate voluntary exercise in the offspring of rats born to obese mothers can ameliorate the adverse effects of MO programming on metabolism and liver function in mid-adulthood. MethodsOffspring of control (CF1) and MOF1 mothers were fed with a control diet from weaning. Adult males and females participated in 15 min exercise sessions five days/week. Metabolic parameters were analyzed before and after the exercise intervention. Liver oxidative stress biomarkers and antioxidant enzymes were analyzed before and after the intervention. ResultsMales showed that CF1ex ran longer than MOF1ex and increased the distance covered. In contrast, females in both groups ran similar distances and remained constant but ran further distances than males. At PND 300 and 450, male and female MOF1ex had higher leptin, triglycerides, insulin, and HOMA-IR levels than CF1. However, male MOF1ex had lower triglycerides, insulin, and HOMA-IR levels than MOF1. Improvements in liver fat and antioxidant enzymes were observed in CF1ex and MOF1ex males and females compared to their respective CF1 and MOF1 groups. ConclusionThese findings suggest that moderate voluntary exercise, even when started in mid-adulthood, can improve metabolic outcomes and delay accelerated metabolic aging in MO-programmed rats in a sex-dependent manner.

Acute effect of ischemic preconditioning with different pressures on training volume, work, and fatigue index in an upper limb session

This study aimed to assess the acute effects of ischemic preconditioning at varying pressures on training volume, work, and fatigue index during an upper limb workout session. The sample consisted of 13 participants, comprised of six women and seven men. Each subject was directed to two training sessions that included a bench press and a closed-row exercise. They executed three sets up to concentric failure at 75% of their one-repetition maximum, with two minutes of recovery between sets and exercises. Prior to each experimental session, participants underwent four cycles of five-minute ischemia-reperfusion applied unilaterally and alternately to the arms. In one protocol, the pressure point was set at 50 mmHg above the resting systolic blood pressure, while in the other, a fixed pressure of 220 mmHg was applied. The 50 mmHg protocol led to greater work (p=0.02) and volume (p=0.01) in the closed-row exercise, and additionally, it resulted in a higher overall work (p=0.04). For enhanced upper limb performance, the protocol of 50 mmHg above resting systolic blood pressure proved more effective. Keywords: Ischemic Preconditioning, Strength Training, Upper Limbs, Training Volume, Pressure Occlusion.

Progressive overload in cardiorespiratory exercise training for young and old: Is increasing duration or intensity of exercise more important?

People undertake endurance training to improve their health and cardio-respiratory fitness. Subsequent cardio-respiratory and skeletal muscle aerobic metabolic adaptations are gauged by improvements in maximum or peak oxygen uptake (V̇O2peak) and the blood lactate inflection point or threshold during incremental exercise – (LIP). To further improve physiological capability, subsequent homoeostatic disturbances from exercise should be progressively greater in succeeding exercise sessions. Therefore, exercise duration, frequency or intensity should be progressively increased during a training regimen to ensure adaptation potential is realized. A progressive increase in training workload is termed “progressive overload”. Despite the universal acknowledgment of the importance of progressive overload, it is unclear if systematically progressing altering either exercise intensity or duration (or distance covered) affect cardio-respiratory gains differently in young and older populations. As running faster results in higher heart rates and greater skeletal muscle metabolic stress than running the same distance at a lower speed, in this hypothesis we postulate that progressively increasing exercise run intensity will result in greater mean and higher incidence of V̇O2peak and LIP gains in young adults (<50 years). However, the mechanisms that initiate improvements in cardio-respiratory fitness and skeletal muscle aerobic function may be different in older adults due to the inevitable aging decline in cardio-vascular function and mechanical and morphological properties of muscle–tendon units. In older adults (>60 years) we hypothesize progressively increasing run distance while maintaining the same speed will just be as effective as to progressively increasing speed to improve V̇O2peak and LIP. To test these hypotheses, we propose a study that compares progressively increasing run intensity to a treatment of progressive matched run distance where speed remains constant in young and old adults.

Telerehabilitation in Children and Adolescents with Cystic Fibrosis: A Scoping Review.

Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies on telerehabilitation are scarce and dispersed. This scoping review aimed to identify which domains of rehabilitation intervention are mediated by information and communication technologies and how they are developed in the provision of care to children and adolescents with cystic fibrosis. The data collection was conducted in February and June 2023, following the three steps recommended by the JBI for this type of review: (1) the search was conducted in MEDLINE, CINAHL, Scopus, JBI, and Web of Science; (2) the bibliographic references obtained from the included articles were analysed; and (3) the grey literature was checked. The eligibility criteria were children and adolescents and rehabilitation interventions mediated by information and communication technologies. The five studies included in this review were subjected to analysis, and a narrative synthesis of the results was carried out. The interventions identified included physical exercise programs (60%), management of the therapeutic regimen (40%), and symptom control (40%). The information and communication technologies were web-based platforms, video games, and telephones. The use of telerehabilitation included face-to-face meetings to ensure participants performed the exercises correctly, monitor their response to exercise, and teach them how to avoid risky situations during home workouts. In all studies, exercise sessions were supervised by the participants' parents or caregivers.

Exploring the Effect of Acute and Regular Physical Exercise on Circulating Brain-Derived Neurotrophic Factor Levels in Individuals with Obesity: A Comprehensive Systematic Review and Meta-Analysis.

Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein crucial for neuronal growth and survival, plays a vital role in brain function and plasticity. Notably, obese individuals tend to exhibit lower BDNF levels, potentially contributing to cognitive decline. Physical exercise offers health benefits, including improved circulating BDNF levels and cognitive function, but the specific impacts of acute versus regular exercise on circulating BDNF levels in obesity are unclear. Understanding this can guide interventions to enhance brain health and counter potential cognitive decline in obese individuals. Therefore, this study aimed to explore the impact of acute and regular physical exercise on circulating BDNF in individuals with obesity. The target population comprised individuals classified as overweight or obese, encompassing both acute and chronic protocols involving all training methods. A comprehensive search was conducted across computerized databases, including PubMed, Academic Search Complete, and Web of Science, in August 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 98 studies were identified, from which 16 studies, comprising 23 trials, met the selection criteria. Substantial heterogeneity was observed for both acute (I2 = 80.4%) and long-term effects (I2 = 88.7%), but low risk of bias for the included studies. A single session of exercise increased circulating BDNF levels among obese patients compared to the control group (ES = 1.25, 95% CI = 0.19 to 2.30, p = 0.021). However, with extended periods of physical exercise, there was no significant increase in circulating BDNF levels when compared to the control group (ES = 0.49, 95% CI = -0.08 to 1.06, p = 0.089). These findings highlight the need to consider exercise duration and type when studying neurobiological responses in obesity and exercise research. The study's results have implications for exercise prescription in obesity management and highlight the need for tailored interventions to optimize neurotrophic responses. Future research should focus on elucidating the adaptive mechanisms and exploring novel strategies to enhance BDNF modulation through exercise in this population. However, further research is needed considering limitations such as the potential age-related confounding effects due to diverse participant ages, lack of sex-specific analyses, and insufficient exploration of how specific exercise parameters (e.g., duration, intensity, type) impact circulating BDNF.

A co-designed mixed methods study on community-based gym exercise for non-ambulant adults with childhood onset disability

Purpose Explore community-based gym exercise for non-ambulant adults with childhood-onset disability. Materials and methods Non-ambulant adults with childhood-onset disability participated in four, weekly gym sessions co-facilitated by physiotherapists and exercise professionals. Practicalities of participating in the sessions were recorded via uptake and attrition, weekly surveys, and focus groups. Perspectives of those who designed/delivered the study were gathered via weekly debrief meetings. Quantitative data were analysed descriptively, qualitative data were analysed thematically. Results Ten non-ambulant adults with childhood-onset disability participated; 70% completed all exercise sessions. Focus groups identified three themes. “I wouldn’t be able to exercise…there’s no option for a community-based setting” described the lack of opportunities for exercise in gyms. “You don’t realise the benefit of coming here” highlighted benefits of exercise. “We can do better” had two sub-themes: problem solving and ingredients for community-based gym exercise. Weekly feedback and debrief meetings identified practicalities related to equipment, exercises, and collaborative working between facilitators. Conclusions Whilst there is an interest in community-based gym exercise for non-ambulant adults with childhood-onset disability, there remains a lack of inclusive gyms. Co-design of inclusive gym guidelines and condition-specific physical activity referral scheme may enhance opportunities for participation in gym exercise for adults with childhood-onset disability.

Interactions between physical exercise, associative memory, and genetic risk for Alzheimer's disease.

The ε4 allele of the APOE gene heightens the risk of late onset Alzheimer's disease. ε4 carriers, may exhibit cognitive and neural changes early on. Given the known memory-enhancing effects of physical exercise, particularly through hippocampal plasticity via endocannabinoid signaling, here we aimed to test whether a single session of physical exercise may benefit memory and underlying neurophysiological processes in young ε3 carriers (ε3/ε4 heterozygotes, risk group) compared with a matched control group (homozygotes for ε3). Participants underwent fMRI while learning picture sequences, followed by cycling or rest before a memory test. Blood samples measured endocannabinoid levels. At the behavioral level, the risk group exhibited poorer associative memory performance, regardless of the exercising condition. At the brain level, the risk group showed increased medial temporal lobe activity during memory retrieval irrespective of exercise (suggesting neural compensatory effects even at baseline), whereas, in the control group, such increase was only detectable after physical exercise. Critically, an exercise-related endocannabinoid increase correlated with task-related hippocampal activation in the control group only. In conclusion, healthy young individuals carrying the ε4 allele may present suboptimal associative memory performance (when compared with homozygote ε3 carriers), together with reduced plasticity (and functional over-compensation) within medial temporal structures.