Vigorous-intensity Exercise Research Articles

The effects of acute exercise intensity on memory: Controlling for state-dependence.

The present experiment evaluated the effects of varying intensities of acute exercise on free-recall memory performance while controlling for potential state-dependent effects. Forty-eight young adults completed a within-subject experiment involving seven primary laboratory visits. The encoding and retrieval phases were matched or mismatched by taking place either during rest or during a less than 5-min bout of acute exercise, and at moderate or vigorous intensity. We did not find evidence that the effects of acute exercise on memory were state-dependent but instead demonstrated that memory recall was greater when memory retrieval occurred during vigorous-intensity exercise compared to rest. These findings have important implications for the strategic placement of exercise during the phases of memory (e.g., acquisition, storage, retrieval) to optimize memory performance and suggest boundary conditions of state-dependent learning. We discuss various theoretical accounts (e.g., shift in metabolic resources across brain regions) to explain these findings.

Association between physical activity patterns of working-age adults and social jetlag, depressive symptoms, and presenteeism.

This study aimed to evaluate the association of physical activity with social jetlag, depressive symptoms, and presenteeism. This cross-sectional study included 8,247 working-age adults (females, 44.6%; age, 20-64 years). Social jetlag was defined as the absolute difference between the midpoint of bedtime and wake time on workdays and free days. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and presenteeism was evaluated using the Work Functioning Impairment Scale. Exercise habits were classified into four groups based on the World Health Organization guidelines: non-active (NA; n=4,223), insufficiently active (IA; n=3,009: exercise below guideline levels), weekend warriors (WW; n=220: exercise 1-2 times per week meeting guideline levels), and regularly active (RA; n=793: exercise at least 3 days per week meeting guideline levels). Using multiple and Poisson regression analyses, we examined the association between exercise habits and each outcome. Social jetlag, depression, and presenteeism were more favorable with shorter sedentary times and longer durations of moderate- and vigorous-intensity exercise. Compared with the RA group, the NA group had a significantly higher prevalence of social jetlag (prevalence ratio [PR]=1.30), depression (PR=1.31), and presenteeism (PR=1.35). The IA group had a significantly higher prevalence of depression (PR=1.33) and presenteeism (PR=1.38). Exercising with a certain frequency and intensity may help prevent symptoms of depression and social jetlag, and consequently prevent presenteeism.

Relation between wearable heart rate monitor derived training load and cardiac adaption in endurance athletes

Abstract Background No studies have effectively measured training load (TL) from wearable heart rate (HR) monitors and determined its relation to exercise induced left and right ventricular (LV, RV) remodeling. A better insight into drivers of exercise induced cardiac remodeling is of clinical relevance to guide training advice in athletes at risk of adverse remodeling. Purpose We determined the TL, based on HR monitoring by commercial wearables[1]. The number and duration of training sessions was quantified during a period of 3 months. Training-intensity was calculated as Edwards TRIMP (eTRIMP) based on the product of training duration in one of 5 HR zones (1=light, 5=very vigorous) and the coefficient related to the respective HR zone. Methods Training data was collected in 2 prospective multicenter studies. Master@Heart comprises endurance trained middle-aged men aged 45 to 70years[2]. Pro@Heart consists of elite athletes aged 16 to 23years[3]. For this analysis, all male athletes with complete training data recorded using a chest-worn HR monitor for 3 months were included. Using an in-house developed pipeline, maximal HR and TL were calculated from raw training data. Cardiac magnetic resonance imaging was performed to measure indexed LV/RV end-diastolic volume (LVEDVi, RVEDVi), end-systolic volume (LVESVi, RVESVi), ejection fraction (LVEF, RVEF) and LV mass (LVMi). Results Pro@Heart athletes (n=69; age 21.9 ± 4.2 years) trained more than Master@Heart athletes (n=82; age 55.2 ± 6.5 years) and their total 3-month TL (eTRIMP) was also higher (9718 ± 3190 vs. 5499 ± 3775min; P<0.05 and 22339 ± 7350 vs. 13438 ± 8880 AU; P< 0.05; Table 1). Considering all athletes, there was a strong correlation between both training duration and eTRIMP and LVEDVi, LVESVi, LVMi, RVEDVi and RVESVi. Training duration in zone 1&2 correlated well with LVEDVi, LVESVi, LVSV, LVMi, RVEDVi and RVESVi (Table 2). We found small significant negative correlations between duration and eTRIMP compared to LVEF and RVEF (Table 2). To filter out individual training factors influencing cardiac remodeling we used a partial least squares method which included time and percentage of time spent in training zones and age. Accordingly, training duration in zone 1&2 and age were the main predictors of cardiac volumes and LVMi. For LVEF, age and time in zone 3 was most predictive, whereas for RVEF zone 3 and to a lesser degree zone 1&2 were the main predictors, irrespective of age. Interestingly, time spent in high intensity zones 4 and 5 was not predictive. Conclusion We prospectively quantified TL in comparison to CMR-derived measures of cardiac remodeling and demonstrated that training duration in low intensity training zones is most predictive for cardiac volumes and mass, whereas LVEF and RVEF are more closely associated to time in zone 3. Very vigorous intensity exercise was not predictive, likely due to limited time training in zone 4 and 5.

Association of lifelong exercise characteristics with aortic pathology in patients with Marfan syndrome

Abstract Background Marfan syndrome (MFS) is a genetic connective tissue disease with an increased risk for aortic root dilatation and aortic dissection. Current guidelines, based on expert consensus, recommend exercise restrictions due to concerns that exercise-induced hemodynamic stress may accelerate aortopathy. Studies examining exercise characteristics and their association with aortopathy in MFS patients are lacking. Purpose To assess the association of lifelong exercise characteristics (volume, intensity and type) with the presence of aortic dilatation in MFS patients. Methods An international multi-centre study was conducted in MFS adults. Patients were classified as sedentary (<500 metabolic equivalent of task minutes per week [MET-min/wk]), active (500-1000 MET-min/wk), or highly active (≥1000 MET-min/wk) based on lifelong exercise volumes assessed by a validated questionnaire. Patient’s dominant exercise intensity was classified as moderate (3-6 MET) or vigorous (≥6 MET), and sport type as skill, power, mixed, or endurance. Echocardiography was used to assess diameters at the sinuses of Valsalva (SoV) and ascending aorta (AA), and Campens Z-scores were calculated. Aortic dilatation was evaluated as a diameter ≥40, ≥45 mm, a Z-score ≥2 or ≥3 respectively. Results 315 patients (36[27-49] years, 53% male) were included of which 104 were sedentary, 77 active and 134 highly active (Fig. 1). 42 patients did not perform sport-related exercise, whereas 147 and 121 patients predominantly participated in moderate or vigorous intensity sports. Patients performing sports were allocated to the skill (n=13), power (n=27), mixed (n=158), endurance (n=66) or non-dominant (n=9) exercise type group. Mean SoV and AA diameters were 42.9±7.7 mm and 33.9±7.3 mm. SoV or AA diameters of ≥40 mm were present in 200 (64%) and 41 (13%) patients, whereas 223 (71%) and 81 (26%) patients had a Z-score ≥2 for the SoV or AA. Exercise volume was not associated with SoV dilatation (Fig. 2). Moderate and vigorous intensity sports were associated with a lower prevalence of SoV Z-score ≥3. Power sport was associated with a lower prevalence of all definitions of SoV dilatation, whereas mixed and endurance sports were associated with a lower prevalence of SoV Z-score ≥3. No associations were found with AA dilatation. Of the 17 (5%) patients who suffered from an aortic dissection, 1 case occurred during walking (type A dissection) whereas all other cases were not exercise-related. Conclusions Lifelong exercise volumes were not associated with aortic dilatation in MFS patients. Power sports and vigorous intensity exercise were inversely related to SoV dilatation. Further investigation is warranted to clarify whether this association reflects that patients engaging in these activities have a less severe cardiovascular phenotype, or that they are protected from exercise-related aortic complications, and if patients may miss health benefits due to too exercise restrictions.

The Effects of Competition on Exercise Intensity and the User Experience of Exercise during Virtual Reality Bicycling for Young Adults.

Regular moderate-vigorous intensity exercise is recommended for adults as it can improve longevity and reduce health risks associated with a sedentary lifestyle. However, there are barriers to achieving intense exercise that may be addressed using virtual reality (VR) as a tool to promote exercise intensity and adherence, particularly through visual feedback and competition. The purpose of this work is to compare visual feedback and competition within fully immersive VR to enhance exercise intensity and user experience of exercise for young adults; and to describe and compare visual attention during each of the conditions. Young adults (21-34 years old) bicycled in three 5 min VR conditions (visual feedback, self-competition, and competition against others). Exercise intensity (cycling cadence and % of maximum heart rate) and visual attention (derived from a wearable eye tracking sensor) were measured continuously. User experience was measured by an intrinsic motivation questionnaire, perceived effort, and participant preference. A repeated-measures ANOVA with paired t-test post hoc tests was conducted to detect differences between conditions. Participants exercised at a higher intensity and had higher intrinsic motivation in the two competitive conditions compared to visual feedback. Further, participants preferred the competitive conditions and only reached a vigorous exercise intensity during self-competition. Visual exploration was higher in visual feedback compared to self-competition. For young adults bicycling in VR, competition promoted higher exercise intensity and motivation compared to visual feedback.

Assessment of Paraoxonase 1 and Arylesterase Activities and Lipid Profile in Bodybuilders: A Comparative Study of Physical Activity and Anthropometry on Atherosclerosis.

Background and Objectives: Atherosclerosis, driven by dyslipidaemia and oxidative stress, is a leading cause of cardiovascular morbidity and mortality. This study evaluates the effects of vigorous-intensity bodybuilding exercise (VIBBE) on atherosclerosis biomarkers-including paraoxonase-1 (PON1) and arylesterase (ARE) activities-and lipid profiles in male bodybuilders who do not use anabolic-androgenic steroids. Comparisons were made with individuals engaged in moderate-intensity aerobic exercise (MIAE), as well as overweight/obese sedentary (OOS) and normal-weight sedentary (NWS) individuals. Materials and Methods: A cross-sectional study was conducted involving 122 healthy male participants aged 18-45 years, divided into four groups: VIBBE (n = 31), OOS (n = 30), MIAE (n = 32), and NWS (n = 29). Anthropometric assessments were performed, and fasting blood samples were collected for biochemical analyses, including lipid profiles and PON1 and ARE activities. Statistical analyses compared the groups and evaluated correlations between adiposity measures and atherosclerosis biomarkers. Results: The VIBBE group exhibited significantly lower levels of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and logarithm of the TG to high-density lipoprotein cholesterol (HDL-C) ratio [log(TG/HDL-C)] compared to the OOS group (p < 0.05 for all), indicating improved lipid profiles. However, these improvements were not significant when compared to the NWS group (p > 0.05), suggesting that VIBBE may not provide additional lipid profile benefits beyond those associated with normal weight status. PON1 and ARE activities were significantly lower in the VIBBE group compared to the MIAE group (p < 0.05 for both), suggesting that VIBBE may not effectively enhance antioxidant defences. Correlation analyses revealed significant inverse relationships between PON1 and ARE activities and adiposity measures, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), fat mass index (FMI), and obesity degree (OD) (p < 0.05 for all). Positive correlations were observed between oxLDL and log(TG/HDL-C) and adiposity measures (p < 0.05 for all). Conclusions: Vigorous-intensity bodybuilding exercise improves certain lipid parameters compared to sedentary obese individuals but does not significantly enhance antioxidant enzyme activities or further improve lipid profiles beyond those observed in normal-weight sedentary men. Conversely, moderate-intensity aerobic exercise significantly enhances PON1 and ARE activities and improves lipid profiles, offering superior cardiovascular benefits. These findings underscore the importance of incorporating moderate-intensity aerobic exercise into physical activity guidelines to optimize cardiovascular health by balancing improvements in lipid metabolism with enhanced antioxidant defences.

Mechanisms of adaptations in cardiorespiratory fitness with exercise prescriptions differing in volume and intensity in middle-age men

Background: To examine the mechanisms of adaptations in cardiorespiratory fitness with different dose of amount and intensity exercise training in middle-aged men. Methods: A total of 67 sedentary subjects aged 40-49 yr were assigned to participate for 12 weeks in a control group or in one of three exercise groups: 1) low volume/moderate intensity 2) low volume/vigorous intensity and 3) high volume/vigorous intensity. They were tested for VO2max, cardiac output (Q) and stroke volume (SV) before and after training and maximal arterial-venous oxygen difference (a-vO2diff) calculated by the Fick Equation. Results: Contrasted to control group, VO2max increased similar in both LVVI and HVVI groups after 12 weeks; It indicated that the intensity of exercise appears to make a greater benefit than the amount of exercise on VO2max. However, Maximal cardiac output (Qmax) and a-vO2diff contributed to increase VO2max were differences in both of vigorous intensity groups. In LVVI group, Qmax together with maximal a-vO2diff contributed to the greater VO2max; in HVVI group, the majority of the increment in VO2max was relied on larger Qmax whereas a widened a-vO2diff. Conclusion: It is appropriate to recommend vigorous intensity exercise to improve cardiorespiratory fitness and encourage higher amount to confer additional benefit for Qmax.

Acute Effect of Three Aerobic Exercise Intensities on Glomerular Filtration Rate in Healthy Older Adults.

To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = -0.512, R = -0.582, R = -0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = -0.516; p < 0.05). Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised.

Effectiveness of community-based Baduanjin exercise intervention for older adults with varying frailty status: a randomized controlled trial

BackgroundDue to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status.MethodsA two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up.ResultsOverall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p = .047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention.ConclusionsOur study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal.Trial registrationClinicalTrials.gov NCT04549103. Registered September 16, 2020.

Exercise training improves cardiovascular fitness in dilated cardiomyopathy caused by truncating titin variants

BackgroundParticipation in regular exercise activities is recommended for patients with chronic heart failure. However, less is known about the effect of exercise in patients with genetic dilated cardiomyopathy (DCM). We...

Exceptional exercise capacity in a late bloomer octogenarian triathlete.

Maximal oxygen uptake (V̇O<inf>2max</inf>) gradually declines across the lifespan. However, little is known about the octogenarians. This is a knowledge gap given that individuals living >80 years old is the fastest expanding age-group world-wide. The increase in the elderly population has generated greater awareness in healthy ageing including psychosocial, physical, and cognitive domains, all of which benefit from engagement in physical activity or sport. In the present article are reported characteristics of an octogenarian man (GM), starting training for triathlon when he was 75 years old. GM performed an incremental Cardiopulmonary Treadmill-Running Exercise Test (CPX). A competitive 5-day consecutive triathlon event (sprint distance on days 1, 3, 4, 5 and Olympic distance on day 2) was monitored using an advanced smartwatch. Between 2021 and 2022, he trained for 10-to-12 hours/week, and participated in 59 and 39 competitions, respectively. The CPX showed a V̇O<inf>2max</inf> of 39.8 mL·min-1·kg-1, the 3rd highest value ever described in the literature among octogenarians and corresponding to the ≈60th percentile of 40-to-49-year-old men. During the 5-day triathlon (overall 12:15 h:min), 88% of time was spent at 77-95% of maximum heart rate (i.e., vigorous exercise intensity). In addition, GM was the 2022 Triathlon Olympic distance World Champion. The remarkably high V̇O<inf>2max</inf> and performance described herein were associated with exceptionally high exercise volume and intensity during training and competition, up to more than four times the recommended physical activity by current guidelines. These results further support the benefits of endurance exercise among octogenarians.

Exercise and Acute Cognitive Enhancement.

Substantial research has explored the effects of a single session of exercise on cognitive performance. Meta-analytic reviews provide summary statistics relative to these effects when the cognitive task is performed while exercising and when performed after exercise. When performed concomitantly the effects of exercise are typically small or negative with the exception of moderate effects for speed of cognitive performance during moderate intensity exercise. When cognitive performance is assessed following the cessation of exercise, the effects are typically positive. When considering the effects following exercise, most studies have focused on executive function and episodic memory as the cognitive outcomes of interest with meta-analyses supporting small-to-moderate benefits. When potential moderators related to exercise parameters or participants characteristics are examined, results suggest that 20 minutes of moderate to vigorous intensity exercise consistently benefits performance with larger effects evident for executive function tasks with higher cognitive demands, for long-term memory tasks when exercise is performed prior to information encoding, and when considering individuals with lower initial cognitive performance levels. These observed benefits are likely due to the impacts acute exercise can have on physiological arousal, brain function, and brain neurotrophic factors. Advancements in our understanding of the potential of a single session of exercise to benefit cognitive performance are important for exercise prescription and to inform chronic exercise programs designed to benefit cognition.

The independent and combined effects of aerobic exercise intensity and dose differentially increase post-exercise cerebral shear stress and blood flow.

This research examined the impact of aerobic exercise intensity and dose on acute post-exercise cerebral shear stress and blood flow. Fourteen young adults (27±5years of age, eight females) completed a maximal oxygen uptake ( ) treadmill test followed by three randomized study visits: treadmill exercise at 30% of for 30min, 70% of for 30min and 70% of for a duration that resulted in caloric expenditure equal to that in the 30% visit (EqEE). A venous blood draw and internal carotid artery (ICA) ultrasound were collected before and immediately following exercise. ICA diameter and blood velocity were determined using automated edge detection software, and blood flow was calculated. Using measures of blood viscosity, shear stress was calculated. Aerobic exercise increased ICA shear stress (time: P=0.005, condition: P=0.012) and the increase was greater following exercise at 70% (∆4.1±3.5dyn/cm2) compared with 30% (∆1.1±1.9dyn/cm2; P=0.041). ICA blood flow remained elevated following exercise (time: P=0.002, condition: P=0.010) with greater increases after 70% (Δ268±150mL/min) compared with 30% (∆125±149mL/min; P=0.041) or 70% EqEE (∆127±177mL/min; P=0.004). Therefore, aerobic exercise resulted in both intensity- and dose-dependent effects on acute post-exercise ICA blood flow whereby vigorous intensity exercise provoked a larger increase in ICA blood flow compared to light intensity exercise when performed at a higher dose.

A quasi-experimental study on the energy expenditure, exercise intensity, and rating of perceived exertion of a male bodybuilding posing training.

This study is novel in classifying bodybuilding posing training as vigorous intensity exercise using metabolic equivalents (METs) and heart rate (HR) responses. It provides empirical evidence showing that posing training meets the vigorous intensity benchmarks, with METs and %HRmax values comparable to established vigorous exercise standards. The research highlights the novel finding that stimulant usage and the peak week phase of preparation significantly influence physiological responses and perceived exertion in bodybuilders. Specifically, athletes using stimulants and those in peak week displayed higher ratings of perceived exertion (RPE) and maximum heart rates, indicating that these factors notably affect the intensity and perceived difficulty of posing training.

Gut microbiome related to metabolic diseases after moderate-to-vigorous intensity exercise

Background objectivesThe purpose of this study is to investigate changes in gut microbiota related to metabolic diseases after moderate and high-intensity exercise. A total of 24 participants were divided into three groups: Non-Exercise Group (NEG, n = 8, 28.6 ± 5.3 years, 176.0 ± 7.8 cm, 81.3 ± 14.6 kg), Moderate Intensity Exercise Group (MIEG, n = 8, 26.5 ± 3.3 years, 176.9 ± 5.0 cm, 75.4 ± 9.5 kg), and Vigorous Intensity Exercise Group (VIEG, n = 8, 30.6 ± 5.9 years, 174.2 ± 3.5 cm, 77.8 ± 12.2 kg). MethodsThe participants were selected by assessing physical activity, gut health status, presence of diseases, recent disease diagnoses, and dietary disorders. Those who reported any presence disease or recent disease diagnosis were excluded from the current study. Stool samples were collected after a 10-h fast for gut microbiome analysis. MIEG participants trained at 40–59 % heart rate reserve (HRR) for at least 150 min per week, while VIEG participants trained at ≥ 60 % HRR for at least 90 min per week. After 4 weeks, all participants provided stool samples for gut microbiome analysis.Data analysis was conducted using the Wilcoxon test, with statistical significance set at ≤ 0.05. ResultsThe results indicated an increase in Prevotella in MIEG, while Veillonella, Dorea_formicigenerans, and Dorea_longicatena exhibited a decrease (p < 0.05). In VIEG, there was an increase in Bacteroides, Butyricimonas, Odoribacter, and Alistipes (p < 0.05). ConclusionThese modified microbial groups were associated with factors related to metabolic diseases, including inflammatory bowel disease, obesity, colorectal cancer, diabetes, hypertension, metabolic liver diseases, and ischemic heart diseases. Additional research is essential to delve into the relationship between exercise and these alterations in the microbiome.

Random forest model used to predict the medical out-of-pocket costs of hypertensive patients.

Precise prediction of out-of-pocket (OOP) costs to improve health policy design is important for governments of countries with national health insurance. Controlling the medical expenses for hypertension, one of the leading causes of stroke and ischemic heart disease, is an important issue for the Japanese government. This study aims to explore the importance of OOP costs for outpatients with hypertension. To obtain a precise prediction of the highest quartile group of OOP costs of hypertensive outpatients, we used nationwide longitudinal data, and estimated a random forest (RF) model focusing on complications with other lifestyle-related diseases and the nonlinearities of the data. The results of the RF models showed that the prediction accuracy of OOP costs for hypertensive patients without activities of daily living (ADL) difficulties was slightly better than that for all hypertensive patients who continued physician visits during the past two consecutive years. Important variables of the highest quartile of OOP costs were age, diabetes or lipidemia, lack of habitual exercise, and moderate or vigorous regular exercise. As preventing complications of diabetes or lipidemia is important for reducing OOP costs in outpatients with hypertension, regular exercise of moderate or vigorous intensity is recommended for hypertensive patients that do not have ADL difficulty. For hypertensive patients with ADL difficulty, habitual exercise is not recommended.

Immersive Virtual Reality Decreases Work Rate and Manipulates Attentional Focus During Self-Regulated Vigorous Exercise

ABSTRACT To determine the effect of immersive virtual reality use on finishing time of a vigorous-intensity self-regulated exercise task, and on relevant psychological variables. Healthy untrained adults (N = 21; 10 men/11 women; age = 22.9 ± 7.2 years; BMI = 24.0 ± 4.5 kg/m2) completed 1500-m exercise bouts on a rowing ergometer in a counterbalanced and randomized order, with and without use of a headset-delivered virtual reality fitness program. Heart rate, rating of perceived exertion, affective valence, and attentional focus were collected every 300 m, in addition to finishing time. Data were analyzed with repeated measures as appropriate. Intensity of both exercise bouts was considered vigorous according to heart rate results (>77% maximal heart rate). Finishing time was faster in the control condition (449.57 ± 82.39 s) than in the virtual reality condition (463.00 ± 91.78 s), p = .007. Compared to the control condition, the virtual reality condition was characterized by a more external attentional focus (52.38 ± 18.22 vs. 38.76 ± 17.81, p < .001). No differences were observed for remaining variables as a result of condition (p > .05 for all). When a headset-delivered VR program was used during a self-regulated vigorous-intensity exercise task, participants were 13.6 seconds (~3%) slower than in a control condition. Attentional focus was manipulated to be more external with VR use, which may have ultimately distracted from the exercise objective. Recommendations for selecting an appropriate virtual reality experience for a given exercise task are discussed.

Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment

A major concern with weight loss is concomitant bone loss. Exercise and glucagon-like peptide-1 receptor agonists (GLP-1RAs) represent weight loss strategies that may protect bone mass despite weight loss. To investigate bone health at clinically relevant sites (hip, spine, and forearm) after diet-induced weight loss followed by a 1-year intervention with exercise, liraglutide, or both combined. This study was a predefined secondary analysis of a randomized clinical trial conducted between August 2016 and November 2019 at the University of Copenhagen and Hvidovre Hospital in Denmark. Eligible participants included adults aged 18 to 65 years with obesity (body mass index of 32-43) and without diabetes. Data analysis was conducted from March to April 2023, with additional analysis in February 2024 during revision. After an 8-week low-calorie diet (800 kcal/day), participants were randomized to 1 of 4 groups for 52 weeks: a moderate- to vigorous-intensity exercise program (exercise alone), 3.0 mg daily of the GLP-1 RA liraglutide (liraglutide alone), the combination, or placebo. The primary outcome was change in site-specific bone mineral density (BMD) at the hip, lumbar spine, and distal forearm from before the low-calorie diet to the end of treatment, measured by dual-energy x-ray absorptiometry in the intention-to-treat population. In total, 195 participants (mean [SD] age, 42.84 [11.87] years; 124 female [64%] and 71 male [36%]; mean [SD] BMI, 37.00 [2.92]) were randomized, with 48 participants in the exercise group, 49 participants in the liraglutide group, 49 participants in the combination group, and 49 participants in the placebo group. The total estimated mean change in weight losses during the study was 7.03 kg (95% CI, 4.25-9.80 kg) in the placebo group, 11.19 kg (95% CI, 8.40-13.99 kg) in the exercise group, 13.74 kg (95% CI, 11.04-16.44 kg) in the liraglutide group, and 16.88 kg (95% CI, 14.23-19.54 kg) in the combination group. In the combination group, BMD was unchanged compared with the placebo group at the hip (mean change, -0.006 g/cm2; 95% CI, -0.017 to 0.004 g/cm2; P = .24) and lumbar spine (-0.010 g/cm2; 95% CI, -0.025 to 0.005 g/cm2; P = .20). Compared with the exercise group, BMD decreased for the liraglutide group at the hip (mean change, -0.013 g/cm2; 95% CI, -0.024 to -0.001 g/cm2; P = .03) and spine (mean change, -0.016 g/cm2; 95% CI, -0.032 to -0.001 g/cm2; P = .04). In this randomized clinical trial, the combination of exercise and GLP-1RA (liraglutide) was the most effective weight loss strategy while preserving bone health. Liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss. EudraCT: 2015-005585-32.

Effects of Moderate- Versus Vigorous-Intensity Exercise Training on Asthma Outcomes in Adults

The therapeutic effects of exercise have prompted calls for it to be embedded into standard asthma care, but evidence informing the optimal exercise intensity is lacking. This study aimed to compare the effects of moderate- and vigorous-intensity aerobic exercise training on asthma outcomes and inflammation. This was a 12-week randomized controlled trial in 46 adults with asthma randomized to either (1) 45-minute moderate-intensity exercise training 3 times/wk, (2) 30-minute vigorous-intensity exercise training 3 times/wk, or (3) the control group. Asthma-related quality of life (AQLQ), asthma control (ACQ), cardiorespiratory fitness, body composition, and airway and systemic inflammation were assessed before and after the intervention. Forty-one participants completed the study (89% retention). The moderate-intensity group had a statistically and clinically significant improvement in AQLQ (0.63 [0.33-0.93], P < .001) and ACQ (-0.51 [-0.83 to -0.19], P= .003) relative to control. The vigorous-intensity group had a statistically, but not clinically, significant improvement in AQLQ (0.46 [0.14-0.80], P= .007) and ACQ (-0.36 [-0.69 to -0.02], P= .040) relative to control. After moderate-intensity training, there was a reduction in sputum macrophage (-1341 [-2491 to -191]× 104/mL, P= .024) and lymphocyte (-114 [-220 to -8]× 104/mL, P= .036) counts relative to control. A reduction in android fat mass, but not a change in fitness, was associated with improved AQLQ (rs= -0.341, P= .030) and reduced sputum IL-6 (rs= 0.422, P= .013). Our findings suggest that both moderate-intensity and vigorous-intensity aerobic exercise training are associated with improvements in clinical asthma outcomes and, therefore, both intensities could be recommended as an adjuvant asthma therapy.

Exercise does not cause post-exertional malaise in Veterans with Gulf War Illness: A randomized, controlled, dose–response, crossover study

Chronic multisymptom illnesses (CMI) such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Long-COVID, and Gulf War Illness (GWI) are associated with an elevated risk of post-exertional malaise (PEM), an acute exacerbation of symptoms and other related outcomes following exercise. These individuals may benefit from personalized exercise prescriptions which prioritize risk minimization, necessitating a better understanding of dose–response effects of exercise intensity on PEM. MethodsVeterans with GWI (n = 40) completed a randomized controlled crossover experiment comparing 20 min of seated rest to light-, moderate-, and vigorous-intensity cycling conditions over four separate study visits. Symptoms, pain sensitivity, cognitive performance, inflammatory markers (C-reactive protein and plasma cytokines) were measured before and within 1 h after exercise and seated rest. Physical activity behavior was measured ≥ 7 days following each study visit via actigraphy. Linear mixed effects regression models tested the central hypothesis that higher intensity exercise would elicit greater exacerbation of negative outcomes, as indicated by a significant condition-by-time interaction for symptom, pain sensitivity, cognitive performance, and inflammatory marker models and a significant main effect of condition for physical activity models. ResultsSignificant condition-by-time interactions were not observed for primary or secondary measures of symptoms, pain sensitivity, cognitive performance, and a majority of inflammatory markers. Similarly, a significant effect of condition was not observed for primary or secondary measures of physical activity. ConclusionsUndesirable effects such as symptom exacerbation were observed for some participants, but the group-level risk of PEM following light-, moderate-, or vigorous-intensity exercise was no greater than seated rest. These findings challenge several prior views about PEM and lend support to a broader body of literature showing that the benefits of exercise outweigh the risks.