Single Exercise Research Articles

Acute exercise boosts NAD+ metabolism of human peripheral blood mononuclear cells

Nicotinamide adenine dinucleotide (NAD+) coenzymes are the central electron carriers in biological energy metabolism. Low NAD+ levels are proposed as a hallmark of ageing and several diseases, which has given rise to therapeutic strategies that aim to tackle these conditions by boosting NAD+ levels. As a lifestyle factor with preventive and therapeutic effects, exercise increases NAD+ levels across various tissues, but so far human trials are mostly focused on skeletal muscle. Given that immune cells are mobilized and redistributed in response to acute exercise, we conducted two complementary trials to test the hypothesis that a single exercise session alters NAD+ metabolism of peripheral blood mononuclear cells (PBMCs). In a randomized crossover trial (DRKS00017686) with 24 young adults (12 female) we show that acute exercise increases gene expression and protein abundance of several key NAD+ metabolism enzymes with high conformity between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT). In a longitudinal exercise trial (DRKS00029105) with 12 young adults (6 female) we confirm these results and reveal that – similar to skeletal muscle – NAD+ salvage is pivotal for PBMCs in response to exercise. Nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme of NAD+ salvage pathway, displayed a pronounced increase in gene expression during exercise, which was accompanied by elevated intracellular NAD+ levels and reduced serum levels of the NAD+ precursor nicotinamide. These results demonstrate that acute exercise triggers NAD+ biosynthesis of human PBMCs with potential implications for immunometabolism, immune effector function, and immunological exercise adaptions.

Effects of Nordic Hamstring Exercise on knee joint muscle strength in adolescent soccer players. A pilot study

Objective: Given the emerging imbalances in knee stabilising muscle strength, the aim of the study was to determine whether performing a single NHE intervention would alter the isometric strength of the knee flexor muscles (HAM). Material and Methodology: A group of 56 players of a youth football team (age range 13-16 years), were recruited for a pilot study. The group involved healthy players, training football at the central junior level. After meeting the inclusion criteria inclusion, 32 players were enrolled into the study. Participants were randomly allocated to a study group (A) and a control group (B). In the study group, the intervention consisted of a single NHE exercise in the form of a two series of trunk slumps, eight repetitions each. The control group performed one series of of forward trunk bends, five repetitions each. Participants (group A and B) were tested on the ForceFrame platform before the procedure experiment and immediately after the intervention was performed. Maximum force of the knee extensors (QUAD) and knee flexors (HAM) was measured. Results: Statistical analysis of the results indicated that maximal HAM muscle strength increased after a single NHE intervention (p = 0.04) relative to the control group. At the same time, after the intervention, there was no increase in the strength of the Quadriceps muscles (extensors of the knee joint) relative to the control group. Conclusions: The results obtained indicate that a single performance of the NHE exercise has the effect of increase in the maximum isometric strength of the HAM muscles. This increase, although not statistically significant, correlated with no change in quadriceps muscle strength. The work is pilot study and further research may have benefits in maintaining the balance between the two muscle groups, i.e. HAM and QUAD, which contributes to the prevention of musculoskeletal injuries.

Skeletal muscle from TBC1D4 p.Arg684Ter variant carriers is severely insulin resistant but exhibits normal metabolic responses during exercise.

In the Greenlandic Inuit population, 4% are homozygous carriers of a genetic nonsense TBC1D4 p.Arg684Ter variant leading to loss of the muscle-specific isoform of TBC1D4 and an approximately tenfold increased risk of type 2 diabetes1. Here we show the metabolic consequences of this variant in four female and four male homozygous carriers and matched controls. An extended glucose tolerance test reveals prolonged hyperglycaemia followed by reactive hypoglycaemia in the carriers. Whole-body glucose disposal is impaired during euglycaemic-hyperinsulinaemic clamp conditions and associates with severe insulin resistance in skeletal muscle only. Notably, a marked reduction in muscle glucose transporter GLUT4 and associated proteins is observed. While metabolic regulation during exercise remains normal, the insulin-sensitizing effect of a single exercise bout is compromised. Thus, loss of the muscle-specific isoform of TBC1D4 causes severe skeletal muscle insulin resistance without baseline hyperinsulinaemia. However, physical activity can ameliorate this condition. These observations offer avenues for personalized interventions and targeted preventive strategies.

A slow diaphragmatic breathing intervention for anxiety: How do respiration rate and inhalation/exhalation ratio influence self-reported anxiety?

The primary aim was to investigate how respiration rate and inhalation/exhalation ratio influence self-reported state anxiety during a single slow diaphragmatic breathing exercise session. Eight hundred and twenty-eight participants completed the study at two separate geographical locations (Poland and Spain). Participants performed a 10-min online guided breathing exercise. Respiration rates were sampled from a continuous uniform distribution (ranging from 6 to 12 breaths/min). Similarly, inhalation/exhalation ratios were treated as continuous variables and sampled from a uniform distribution for each participant. An application programed for this experiment displayed visual and auditory cues adjusted for each participant. Before and after the breathing exercise, each participant filled in the Current Anxiety Level Measure questionnaire. Self-trait anxiety was measured with the Clinically Useful Anxiety Outcome Scale. A linear regression model showed that respiration rate, trait anxiety, pre-test anxiety, and nationality (Polish/Spanish) were positively related to post-test anxiety levels. Adding quadratic terms of respiration rate and inhalation/exhalation ratio did not improve model fit. Polish participants exhibited higher post-test anxiety levels compared with the Spanish subsample. Age was negatively associated with post-test anxiety. No significant relationships between inhalation/exhalation ratio and post-test anxiety level were found. Slower respiration rates during a single-session breathing exercise are linearly associated with lower post-test anxiety levels in a large and varied sample. This study is the largest to date and may offer further guidance for predicting expected effect sizes for the relationships between anxiety and respiratory dynamics.

Effects of menstrual cycle on cognitive function, cortisol, and metabolism after a single session of aerobic exercise

Aim This study aimed to investigate the effects of the two pre-ovulatory and mid-luteal phases of the menstrual cycle on cognitive function, as well as possible mediators of metabolism and salivary cortisol, at rest and after an aerobic exercise session. Study design Twelve active young unmarried women aged 22–30 years volunteered to participate in the study. The participants performed a 20-min exercise session on a cycle ergometer at 60–70% of their reserve heart rate twice, during the follicular (pre-ovulation: days 7–10) and luteal (mid-luteal: days 21–24) phases of the menstrual cycle. Saliva samples were collected to measure cortisol. Fat utilization, respiratory exchange ratio (RER), and energy expenditure (during exercise) were measured using a spiroergometer. Cognitive function was assessed using the Stroop test. Cognitive function and cortisol levels were measured before and after each exercise session. Results The findings of this study indicated no significant differences in variables during the resting follicular and luteal phases. Cortisol levels and cognitive function were increased after exercise compared with before exercise in both the follicular and luteal phases. Cortisol and fat utilization after exercise were significantly higher in the follicular phase than in the luteal phase. There were no significant differences between the follicular and luteal phasesregarding the effects of exercise on cognitive function, energy expenditure, and RER. Conclusion In general, the follicular and luteal phases of menstruation may not affect cognitive function in response to a single aerobic exercise session, although they change some metabolic factors and cortisol.

A prehabilitation programme is feasible and acceptable for mild-to-moderately frail patients undergoing cardiac surgeries

Abstract Background Preoperative frailty is a strong prognostication in cardiac surgical patients to predict poorer health outcomes. Intervening at the preoperative stage through prehabilitation is gaining increasing research attention. Previous studies tested a single frailty-reversing strategy, either nutritional or exercise, the exercise protocols were mainly aerobic-focused, which deviates from the exercise prescription principles suggested for frailty management, rendering an effective prehabilitation intervention is yet to be developed in cardiac surgical patients. Purpose This study aimed to examine the preliminary effects and explore the feasibility of a multi-component frailty-specific prehabilitation programme for mild-to-moderately frail patients undergoing cardiac surgeries/procedures. We hypothesised that compared with patients who receive usual care, patients awaiting cardiac surgeries who participate in the prehabilitation programme would have improved functional capacity, frailty status, quality of life and psychological outcomes, increased serum albumin and reduced C-reactive protein. Methods This study adopted a mixed-method design comprising a pilot randomised controlled trial and a qualitative study. Adult patients with a Clinical Frailty Scale score between 4 and 6, waiting for coronary artery bypass grafting surgery and/or valve repair/replacement, with at least 5 weeks of procedural waiting time and without contraindications for exercise were recruited. They were randomized in a 1:1 ratio to receive the prehabilitation programme or usual care. The programme comprised a structured preoperative education, nutritional optimization, stress management; and a multi-component exercise training with 3 sessions/week and 60 minutes/session. The exercise training lasted at least 4 weeks and maintained throughout the preoperative period. Results Twenty participants were randomized into the intervention (n = 11) or control (n = 9) group. The programme was feasible, acceptable and no severe adverse events were recorded. The lost to follow-up rate was 7.9%, and the overall attendance was 96%. The intervention group showed significantly greater improvement in functional capacity, frailty status and psychological outcomes than the control group at post-intervention. Participants gave positive comments about the programme and its delivery mode. They expressed that the one-on-one home-based practice enabled them greater confidence to overcome kinesiophobia. Two participants voiced out the preference for exclusive home-based training, rather than having hospital-based training in the first two weeks. Conclusion(s) The prehabilitation programme is feasible and acceptable for patients waiting for cardiac surgeries. It improves the functional performance, frailty status and psychological outcomes in these patients. A full-scale randomised controlled trial is warranted to investigate its longer-term and clinical effects.

Single Strength Training Session Improves Short-Term Memory in Cognitively Preserved Older Adults.

The purpose of the present study was to examine the acute effect of a single aerobic or strength training session on memory of cognitively preserved older adults. In this randomized controlled clinical trial, in the first visit the participants (52.2% men, aged 68.65 ± 2.81years-old, BMI 26.94 ± 4.09), were randomly allocated in one of three groups: AG (aerobic exercise group), SG (strength exercise group, submitted to five exercises with 15 repetitions each), and CG (control group). Participants had a short-term memory assessment (word list memory test) followed by a single exercise session, and were retested immediately after. 24h later, participants were submitted to a long-term memory assessment about the story that was presented in the previous day. Results showed that the SG group had a significant improvement in the word list test, when comparing pre- and post-intervention scores, suggesting that a single strength training session significantly enhances short-term memory in this population.

Plasma Volume Shifts and Acid–Base Balance After a Single Bout of Resistance Training

Abstract Purpose Changes in plasma volume (PV), acid–base status and ventilation have rarely been investigated in relation to resistance training (RT). This study aimed to investigate the effect of a single set of exhaustive leg press exercise on these basic physiological parameters in an integrated manner. Methods Twenty-seven male individuals (27.1 ± 4.1 years, 1.82 ± 0.62 m, 84.4 ± 12.5 kg, BMI: 25.4 ± 3.0 k/gm2) performed a single set leg press exercise during which hemoglobin concentration ([Hb]), hematocrit (Hct), pH, oxygen (pO2) and carbon dioxide partial pressures (pCO2), hydrogen carbonate concentration ([HCO3−]), standard base excess (SBE) and lactate concentration ([La−]) were determined. Total buffer capacity was calculated based on pH, [HCO3−] and pCO2. Results Mean PV decreased by 559 ± 230 mL (13.7%). As a result, arterial oxygen content was significantly increased due to hemoconcentration (P < 0.001). At exhaustion, pH (7.30 ± 0.06), [HCO3−] (18.6 ± 2.0 mmol/L) and SBE (− 6.6 ± 2.4 mmol/L) were all significantly decreased (P < 0.0001). The pCO2 first remained unchanged (39.4 ± 4.3 mm Hg) but demonstrated a significant decrease one-minute post-exercise (34.4 ± 4.2 mmHg), indicating metabolic acidosis with respiratory compensation, which was maintained until t+15. Non-bicarbonate buffering remained constant during recovery while the respiratory component steadily increased until 15-min post-exercise (50.2 mmol/L per pH). Conclusion PV shifts following a single set of leg press exercise improve post-exercise arterial oxygen content. The moderate metabolic acidosis was not compensated during exercise because of restricted breathing but partly compensated during the following 15-min recovery period. The respiratory compensation as part of the bicarbonate buffering made up 50% of total buffer capacity in the course of recovery.

Breathing exercises for patients with early-stage lung cancer: a meta-analysis

BackgroundPostoperative pneumonia is a common but serious complication in patients with lung cancer. This meta-analysis aims to evaluate the effect of respiratory exercise on reducing postoperative pneumonia in patients with lung cancer and to provide a reliable basis for clinical treatment and nursing of patients with lung cancer.MethodsTwo reviewers searched PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Network, Wanfang, and Weipu databases. We searched for the randomized controlled trials (RCTs) published in Chinese or English on the breathing exercises in patients with lung cancer up to January 30, 2024. The quality of the literature was evaluated with the Cochrane Risk of Bias Tool 2 (ROB 2). RevMan 5.3 software was used for meta-analysis.ResultsEleven RCTs with 1429 patients with lung cancer were included, and 710 patients received breathing exercises. The meta-analysis results showed that breathing exercises could significantly reduce the incidence of postoperative pneumonia [RR = 0.35, 95%CI (0.25, 0.51)], improve the FEV1 [MD = − 0.49, 95%CI (− 0.73, − 0.24)], FVC [MD = − 0.59, 95%CI (− 0.83, − 0.35)] in patients with lung cancer (all P < 0.05). There were significant differences in the incidence of pneumonia for patients undergoing breathing exercises with single exercise time ≥ 15 min (RR = 0.37, 95%CI 0.24 ~ 0.62), breathing exercises for 1 week (RR = 0.29, 95%CI 0.16 ~ 0.55) or for 2 weeks (RR = 0.48, 95%CI 0.28 ~ 0.85) and breathing exercises > 4 times (RR = 0.36, 95%CI 0.23 ~ 0.57) per day (all P < 0.05).ConclusionBreathing exercises have shown the capacity to augment pulmonary function in patients with lung cancer, concurrently mitigating the risk of postoperative pneumonia.

The effect of Qigong exercise on state anxiety levels of inpatients in psychiatric wards: A randomized controlled study

BackgroundQigong is a mind-body exercise that originated in China and is often described as a form of meditation or movement therapy. While the existing literature has investigated the impact of Qigong exercises on trait anxiety in outpatients, there is limited research on their influence on state anxiety in inpatients. This study examined the effect of Qigong exercise on state anxiety levels of inpatients in psychiatric wards. MethodsThis study was a single-blind, randomized controlled trial. Patients were randomly assigned to either the intervention or control group. Seventy inpatients participated in the study, with 35 in each group. In the intervention group, the STAI-I form was used to assess state anxiety levels before (Test 1) and after (Test 2) a single 40-minute session of Qigong. ResultsThe mean post-test scores of the intervention group (27.20±5.57) were significantly lower than those of the control group (39.72±10.84). Additionally, a statistically significant difference was observed between the mean test-1 (38.42±9.7) and test-2 scores (27.2 ± 5.57) within the intervention group. ConclusionA single 40-minute Qigong exercise session reduced state anxiety levels in psychiatric inpatients and reduced the risk of potential adverse outcomes associated with state anxiety. Practitioners may consider the use of Qigong exercise in the management of state anxiety in clinical practice, when making clinical decisions.

Effects of Traditional Chinese Exercises on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises. To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes. The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session. A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] = - 0.64, 95% confidence interval [CI] - 0.85, - 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD = - 0.82, 95% CI - 1.03, - 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61;MD = - 1.03, 95% CI - 1.39, - 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD = - 0.37, 95% CI - 0.54, - 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD = - 0.34, 95% CI - 0.44, - 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD = - 0.44, 95% CI - 0.67, - 0.21; P = 0.0002) among patients with type 2 diabetes. Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30-50min/session, 4-5 sessions/week for at least 3months.

Acute effects of exercise on gaze fixation and affective response inhibition in children with autism spectrum disorder: A randomized cross-over study.

Children with autism spectrum disorder (ASD) show impairments in response inhibition, especially in socio-emotional contexts. A single aerobic exercise session has the potential to temporarily reduce such impairments as findings from neurotypical children support acute benefits of this exercise type for inhibitory control and emotion recognition. In children with ASD, we therefore aimed to investigate the effects of an aerobic exercise bout on response inhibition in an emotional Go/NoGo task and gaze fixation as possible mechanism underlying changes in performance. Using a cross-over design, 29 patients completed a 20-min aerobic exercise bout at moderate intensity on a cycling ergometer and a control condition in a randomized order. An emotional Go/NoGo task was administered before and after both experimental conditions. Eye-tracking was performed during the cognitive task to assess the duration of gaze fixation of eyes and mouth parts of faces expressing happy or sad emotions. The results support no beneficial effect of exercise on performance on the emotional Go/NoGo task. Instead, patients showed a greater decrease in accuracy on Go trials displaying happy faces in the exercise compared to the control condition. This change was associated with a more pronounced decrease in the fixation duration of the eyes for faces expressing either happy or sad emotions. In conclusion, while a single session of moderately intense aerobic exercise does not affect response inhibition, it temporarily aggravates ASD-specific deficits in the processing of and response to facial emotions.

The effect of the fat to starch ratio in young horses' diet on plasma metabolites, muscle endurance and fear responses.

High-starch diets may affect equine hindgut microbiota and increase blood glucose levels, which may cause unwanted physiological changes, but may also elicit behavioural changes such as increased fear reactions. The purpose of the current study was to feed a high starch (300) and low fat (43; HS_LF) or a low starch (60) and high fat (85; LS_HF, g/kg of DM) concentrate within the available commercial range and investigate how muscle endurance and fear reactions of horses respond to different diets. Twenty Danish Warmblood stallions (4 years) were randomly allocated to two treatments: LS_HF (n = 10) and HS_LF (n = 10) for 9 weeks. During the two last weeks, a single step exercise test was performed, and plasma metabolites and blood gases were measured before and after exercise in a 2 × 2 factorial design. The effect of two diets on fearfulness was tested by exposing the horses to novel objects test (T1 and T2). Plasma metabolites was not affected by diets. However, plasma level of glucose post-exercise (4.9) was lower than pre-exercise (5.6 mmol/L; p < 0.001). Similarly, plasma level of insulin post-exercise (4.2) was lower than pre-exercise (13.1 pmol/L; p < 0.001). Plasma level of lactate dehydrogenase (p < 0.001), non-esterified fatty acids (p = 0.002), β-hydroxybutyrate (p = 0.001), and fructosamine (p = 0.01) post-exercise was higher than pre-exercise. Regardless of type of diets, RRR-α-tocopherol was the dominance α-tocopherol stereoisomers in plasma. In conclusion, during aerobic exercise, fat to starch ratio in horse diets within the normal range had no significant effect on plasma metabolites. However, horses fed LS_HF tended to show more investigative behaviour than horses fed HS_LF.

MR Assessment of Acute Changes of Cerebral Perfusion, Metabolism, and Blood-Brain Barrier Permeability in Response to Aerobic Exercise.

It remains unclear how a single bout of exercise affects brain perfusion, oxygen metabolism, and blood-brain barrier (BBB) permeability. Addressing this unresolved issue is essential to understand the acute changes in cerebral physiology induced by aerobic exercise. To dynamically monitor the acute changes in cerebral physiology subsequent to a single aerobic exercise training session using noninvasive MRI measurements. Prospective. Twenty-three healthy participants (18-35 years, 10 females/13 males) were enrolled and divided into 10-minute exercising (N = 10) and 20-minute exercising (N = 13) groups. 3.0 T/Phase Contrast (PC) MRI (gradient echo), T2-Relaxation-Under-Spin-Tagging (TRUST) MRI (gradient echo EPI), Water-Extraction-with-Phase-Contrast-Arterial-Spin-Tagging (WEPCAST) MRI (gradient echo EPI) and T1-weighted magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE) (gradient echo). A baseline MR measurement plus four repeated MR measurements immediately after 10 or 20 minutes moderate running exercise. MR measurements included cerebral blood flow (CBF) as measured by PC MRI, venous oxygenation (Yv) and cerebral metabolic rate of oxygen (CMRO2) as assessed by TRUST MRI, water extraction fraction (E), and BBB permeability-surface-area product (PS) as determined by WEPCAST MRI. The time dependence of the physiological parameters was studied with a linear mixed-effect model. Additionally, pairwise t-tests comparison of the physiological parameters at each time point was conducted. A P-value of <0.05 was considered statistically significant. There was an initial drop (8.22 ± 2.60%) followed by a recovery in CBF after exercise, while Yv revealed a significant decrease (6.37 ± 0.92%), i.e., an increased oxygen extraction, and returned to baseline at later time points. CMRO2 showed a trend of increase (5.68 ± 3.04%) and a significant interaction between time and group. In addition, E increased significantly (3.86% ± 0.89) and returned to baseline level at later time points, while PS remained elevated (13.33 ± 4.79%). A single bout of moderate aerobic exercise can induce acute alterations in cerebral perfusion, metabolism, and BBB permeability. 2 TECHNICAL EFFICACY: Stage 2.

Identifying the Mechanisms of a Peripherally Limited Exercise Phenotype in Patients With Heart Failure With Preserved Ejection Fraction.

We identified peripherally limited patients using cardiopulmonary exercise testing and measured skeletal muscle oxygen transport and utilization during invasive single leg exercise testing to identify the mechanisms of the peripheral limitation. Forty-five patients with heart failure with preserved ejection fraction (70±7 years, 27 females) completed seated upright cardiopulmonary exercise testing and were defined as having a (1) peripheral limitation to exercise if cardiac output/oxygen consumption (VO2) was elevated (≥6) or 5 to 6 with a stroke volume reserve >50% (n=31) or (2) a central limitation to exercise if cardiac output/VO2 slope was ≤5 or 5 to 6 with stroke volume reserve <50% (n=14). Single leg knee extension exercise was used to quantify peak leg blood flow (Doppler ultrasound), arterial-to-venous oxygen content difference (femoral venous catheter), leg VO2, and muscle oxygen diffusive conductance. In a subset of participants (n=36), phosphocreatine recovery time was measured by magnetic resonance spectroscopy to determine skeletal muscle oxidative capacity. Peak VO2 during cardiopulmonary exercise testing was not different between groups (central: 13.9±5.7 versus peripheral: 12.0±3.1 mL/min per kg; P=0.135); however, the peripheral group had a lower peak arterial-to-venous oxygen content difference (central: 13.5±2.0 versus peripheral: 11.1±1.6 mLO2/dL blood; P<0.001). During single leg knee extension, there was no difference in peak leg VO2 (P=0.306), but the peripherally limited group had greater blood flow/VO2 ratio (P=0.024), lower arterial-to-venous oxygen content difference (central: 12.3±2.5 versus peripheral: 10.3±2.2 mLO2/dL blood; P=0.013), and lower muscle oxygen diffusive conductance (P=0.021). A difference in magnetic resonance spectroscopy-derived phosphocreatine recovery time was not detected (P=0.199). Peripherally limited patients with heart failure with preserved ejection fraction identified by cardiopulmonary exercise testing have impairments in oxygen transport and utilization at the level of the skeletal muscle quantified by invasive knee extension exercise testing, which includes an increased blood flow/V̇O2 ratio and poor muscle diffusive capacity. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04068844.

Does combining two evidence-based exercise programs in elderly people with incontinence have a triple effect on incontinence symptoms, balance and functional status?

Improving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of urinary incontinence (UI) in the elderly people. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI compared to PFMT alone. This study is an assessor-blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursing home were randomly assigned to the intervention (IG) and control groups (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. The duration of exercise for both groups was 45-60min per session three times a week for 12weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) were measured at baseline and after the intervention. The median age of the IG (n: 22) and CG (n: 21) was 73.5 and 77years, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p: 0.00) and the 2-min step test in the IG (p: 0.02) and CG (p: 0.01). A significant decrease was found in the 2.45m get up-and-go test, PFM work average onset, and PFM rest MVC EMG values (p: 0.01, p: 0.01, p: 0.00) in the IG. The PFM rest average value decreased (p: 0.04) in the CG. The findings of this study show that combining PFMT with Otago exercises, two evidence-based interventions, is beneficial for effectively treating incontinence symptoms, balance and functional status in elderly people. Thus, a triple effect can be achieved with a single exercise training in the same treatment session and for the same duration. Clinical trial number: NCT06331039.

Knockout of Hsp70 genes significantly affects locomotion speed and gene expression in leg skeletal muscles of Drosophila melanogaster.

The functions of the heat shock protein 70 (Hsp70) genes were studied using a line of Drosophila melanogaster with a knockout of 6 of these genes out of 13. Namely, the effect of knockout of Hsp70 genes on negative geotaxis climbing (locomotor) speed and the ability to adapt to climbing training (0.5-1.5 h/day, 7 days/wk, 19 days) were examined. Seven- and 23-day-old Hsp70- flies demonstrated a comparable reduction (twofold) in locomotor speed and widespread changes in leg skeletal muscle transcriptome (RNA sequencing) compared with w1118 flies. To identify the functions of genes related to decreased locomotor speed, the overlapped differentially expressed genes at both time points were analyzed: the upregulated genes encoded extracellular proteins, regulators of drug metabolism, and the antioxidant response, whereas downregulated genes encoded regulators of carbohydrate metabolism and transmembrane proteins. In addition, in Hsp70- flies, activation of transcription factors related to disruption of the fibril structure and heat shock response (Hsf) was predicted, using the position weight matrix approach. In control flies, adaptation to chronic exercise training was associated mainly with gene response to a single exercise bout, whereas the predicted transcription factors were related to stress/immune (Hsf, NF-κB, etc.) and early gene response. In contrast, Hsp70- flies demonstrated no adaptation to training as well as a significantly impaired gene response to a single exercise bout. In conclusion, the knockout of Hsp70 genes not only reduced physical performance but also disrupted adaptation to chronic physical training, which is associated with changes in the leg skeletal muscle transcriptome and impaired gene response to a single exercise bout.NEW & NOTEWORTHY Knockout of six heat shock protein 70 (Hsp70) genes in Drosophila melanogaster reduced locomotion (climbing) speed that is associated with genotype-specific differences in leg skeletal muscle gene expression. Disrupted adaptation of Hsp70- flies to chronic exercise training is associated with impaired gene response to a single exercise bout.

Delayed Onset Muscle Soreness Following Acute Resistance Exercise in Untrained Females: A Comparative Study Between Vegans and Omnivores.

This study aimed to assess the levels of delayed onset muscle soreness (DOMS) markers in individuals adhering to vegan and omnivore diets after engaging in acute resistance exercise. A total of 54 untrained young, healthy, normal-body-weight women (age: 26.8±4.1 years; body mass index: 22.5±2.7 kg/m2) participated in the study. Participants were categorized into two groups: vegans (n=27) and omnivores (n=27) based on their dietary preferences, with all subjects having adhered to their respective diets for a minimum of 2 years. DOMS was induced by a single eccentric resistance exercise session, comprising four exercises (leg press, chest press, leg curls, and arm curls), each consisting of four sets of 10 repetitions. Various measurements, including dietary factors, state of wellness, body composition, muscle circumferences, muscle pressure point thresholds (PPTs), and muscle strength, were recorded both before and 48 hours after the exercise session. The results showed that wellness and muscle circumferences remained unchanged or displayed similar changes between the vegan and omnivore groups following acute resistance exercise. However, notable differences were observed in PPTs in favor of vegans, specifically for the right biceps (95% CI: 1.4 to 10.2; p=0.01), the left vastus medialis (95% CI: 0.5 to 6.4; p=0.02), and the right vastus lateralis (95% CI: 3.2 to 12.1; p=0.001). Furthermore, significant differences in right grip strength were found in favor of vegans after the exercise session (95% CI: 3.1 to 26.2; p=0.01). In conclusion, our findings suggest that vegans may experience more favorable changes in DOMS levels following acute resistance exercise in comparison to omnivores. This discrepancy in DOMS markers may indicate enhanced muscle recovery in vegans.

Integrative effects of resistance training and endurance training on mitochondrial remodeling in skeletal muscle.

Resistance training activates mammalian target of rapamycin (mTOR) pathway of hypertrophy for strength gain, while endurance training increases peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) pathway of mitochondrial biogenesis benefiting oxidative phosphorylation. The conventional view suggests that resistance training-induced hypertrophy signaling interferes with endurance training-induced mitochondrial remodeling. However, this idea has been challenged because acute leg press and knee extension in humans enhance both muscle hypertrophy and mitochondrial remodeling signals. Thus, we first examined the muscle mitochondrial remodeling and hypertrophy signals with endurance training and resistance training, respectively. In addition, we discussed the influence of resistance training on muscle mitochondria, demonstrating that the PGC-1α-mediated muscle mitochondrial adaptation and hypertrophy occur simultaneously. The second aim was to discuss the integrative effects of concurrent training, which consists of endurance and resistance training sessions on mitochondrial remodeling. The study found that the resistance training component does not reduce muscle mitochondrial remodeling signals in concurrent training. On the contrary, concurrent training has the potential to amplify skeletal muscle mitochondrial biogenesis compared to a single exercise model. Concurrent training involving differential sequences of resistance and endurance training may result in varied mitochondrial biogenesis signals, which should be linked to the pre-activation of mTOR or PGC-1α signaling. Our review proposed a mechanism for mTOR signaling that promotes PGC-1α signaling through unidentified pathways. This mechanism may be account for the superior muscle mitochondrial remodeling change following the concurrent training. Our review suggested an interaction between resistance training and endurance training in skeletal muscle mitochondrial adaptation.

Aerobic Training With Blood Flow Restriction on Muscle Hypertrophy and Strength: Systematic Review and Meta-analysis.

de Lemos Muller, CH, Farinha, JB, Leal-Menezes, R, and Ramis, TR. Aerobic training with blood flow restriction on muscle hypertrophy and strength: systematic review and meta-analysis. J Strength Cond Res 38(7): 1341-1349, 2024-Integrating strength and endurance training in a single exercise session, even on separate days, can be physically demanding and time-consuming. Therefore, there is a growing interest in identifying efficient training methods that can concurrently enhance cardiovascular and neuromuscular performance through a singular training modality. This study conducted a systematic review and meta-analysis to explore the effects of aerobic training with blood flow restriction (AT + BFR) on muscle hypertrophy and strength gains in healthy individuals. Our study was registered at PROSPERO and used multiple databases (PubMed, Embase, Scopus, and Web of Science), seeking clinical trials that examined AT + BFR influence on muscle hypertrophy and strength gains in individuals aged 18-60 years and comparing with aerobic training without BFR. The risk of bias and method quality were assessed using the ROB2.0 tool and PEDro scale, respectively, and the quality of evidence was evaluated with the GRADE method. A random-effects model was used for meta-analysis, and standardized mean difference (SMD) was calculated for each outcome. Of 4,462 records, 29 full texts were assessed for eligibility, with 7 articles meeting the inclusion criteria. The results indicated that AT + BFR was more beneficial for inducing muscle hypertrophy than aerobic training without BFR (SMD [95% CI] = 0.86 [0.37-1.35]; I2 = 42%). Furthermore, AT + BFR was associated with greater improvements in muscle strength (SMD [95% CI] = 0.41 [0.10-0.72]; I2 = 0%). Despite the generally high risk of bias for both outcomes, these encouraging findings underscore the clinical significance of AT + BFR as a compelling tool for enhancing neuromuscular parameters.