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Rummler M, Ziouti F, Bouchard AL, Brandl A, Duda GN, Bogen B, Beilhack A, Lynch ME, Jundt F, Willie BM. Mechanical loading prevents bone destruction and exerts anti-tumor effects in the MOPC315.BM.Luc model of myeloma bone disease. Acta Biomater 2021; 119:247-258. [PMID: 33130307 DOI: 10.1016/j.actbio.2020.10.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/05/2020] [Accepted: 10/27/2020] [Indexed: 02/08/2023]
Abstract
Bone continually adapts to changing external loading conditions via (re)modeling (modeling and remodeling) processes. While physical activity is known to beneficially enhance bone mass in healthy individuals, little is known in how physical stimuli affect osteolytic bone destruction in patients suffering from multiple myeloma bone disease. Multiple myeloma (MM) is caused by malignant plasma cells in the bone marrow, shifting the balance in bone remodeling towards massive resorption. We hypothesized that in vivo tibial mechanical loading has anabolic effects in mice with locally injected MOPC315.BM.Luc cells. Conventional microCT analysis revealed enhanced cortical bone mass and microstructure in loaded compared to nonloaded mice. State-of-the-art time-lapse microCT based image analysis demonstrated bone (re)modeling processes at the endosteal and periosteal surfaces as the underlying causes of increased bone mass. Loading prevented the progression and development of osteolytic destruction. Physical stimuli also diminished local MM cell growth and dissemination evidenced by quantification of MM cell-specific immunoglobulin A levels in the serum of mice and by bioluminescence analysis. These data indicate that mechanical loading not only rescues the bone phenotype, but also exerts cell-extrinsic anti-myeloma effects in the MOPC315.BM.Luc model. In conclusion, the use of physical stimuli should be further investigated as an anabolic treatment for osteolytic bone destruction in patients with MM.
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Veiga RSD, Müller CB, Ferreira GD, Pinheiro EDS, Del Vecchio FB. Acute respiratory flow restriction affects average power, but not heart rate and subjective perceived exertion in healthy women. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2021. [DOI: 10.1590/rbce.43.e013420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT This study aims to verify the effect of the restriction of the ventilatory flow on HR, RPE, and power during HIT-test performed by healthy women. The participants (n=8) underwent HIT-test without and with ventilatory flow restriction. HR, power, and RPE was measured. HRpost showed no significant difference between conditions (p=0,053). The average power presented higher values in the condition without the restriction of ventilatory flow (619,51±144,33W; 565,99±108,43W; p=0,001), but without differences in the fatigue index (p=0,383). In both conditions, increases in RPE were observed during the efforts (p<0,001). It is concluded that HR and RPE did not suffer acute effects from the restriction of ventilatory flow; however, the average power is decreased during HIT-test.
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Voorn EL, Koopman FS, Nollet F, Brehm MA. Individualized Aerobic Exercise in Neuromuscular Diseases: A Pilot Study on the Feasibility and Preliminary Effectiveness to Improve Physical Fitness. Phys Ther 2020; 101:6039324. [PMID: 33332538 PMCID: PMC7940713 DOI: 10.1093/ptj/pzaa213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/25/2020] [Accepted: 11/19/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Clear guidelines to prescribe aerobic exercise in neuromuscular diseases (NMD) are lacking, which hampers effective application in neuromuscular rehabilitation. This pilot study evaluated the feasibility and preliminary effectiveness of an individualized aerobic exercise program according to a recently developed training guide (B-FIT) to improve physical fitness in individuals with NMD. METHODS Thirty-one individuals who were ambulatory and had 15 different slowly progressive NMD participated in a 4-month, polarized, home-based, aerobic exercise program. The program included 2 low-intensity sessions and 1 high-intensity session per week. Feasibility outcomes were the following: completion rate, proportion of followed sessions, adverse events, and participant and therapist satisfaction based on a self-designed questionnaire. Submaximal incremental exercise tests were used to assess the effects on physical fitness. RESULTS Twenty-six participants (84%) completed the B-FIT program, and the proportion of followed sessions was >75%. Three adverse events were reported and resolved. Regarding satisfaction, participants (based on n = 9) reported feeling fitter, but training was considered insufficiently challenging. Physical therapists (n = 5) reported that B-FIT provides a clear, well-grounded guidance. They perceived the time investment for initiating the program and the carry-over to primary care as the main barriers. The mean (SD) submaximal heart rate (based on n = 20) reduced significantly by -6.5 beats per minute (95% CI = -11.8 to -1.2), from 121.7 (16.5) at baseline to 115.2 (14.3) after intervention. Submaximal ratings of perceived exertion, anaerobic threshold, and peak workload also improved significantly (P < .05). CONCLUSION The outcomes of this pilot study suggest that individualized aerobic exercise according to B-FIT is feasible and has potential to improve physical fitness in a wide variety of slowly progressive NMD. However, some barriers must be addressed before investigating the efficacy in a randomized controlled trial. IMPACT The outcomes of this study demonstrate the feasibility of individualized aerobic exercise according to the B-FIT training guide and the potential to improve physical fitness in NMD. Physical therapists indicated that the use of B-FIT provides a clear, well-grounded guidance. The training guide can support health care professionals in the application of aerobic exercise in adult neuromuscular rehabilitation. LAY SUMMARY Individualized exercise according to the B-FIT training guide is feasible in a wide variety of slowly progressive NMD and might help improve physical fitness.
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Affiliation(s)
| | - Fieke S Koopman
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, the Netherlands
| | - Frans Nollet
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, the Netherlands
| | - Merel-Anne Brehm
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, the Netherlands
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104
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Cooper IR, Liu S, DeLorey DS. Effects of sex and exercise training on β-adrenoreceptor-mediated opposition of evoked sympathetic vasoconstriction in resting and contracting muscle of rats. J Appl Physiol (1985) 2020; 130:114-123. [PMID: 33090912 DOI: 10.1152/japplphysiol.00726.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study investigated the hypothesis that β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction would be enhanced in female compared with male rats, and that endurance exercise training would augment β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction in male and female rats. Sprague-Dawley rats were randomized into sedentary (male: n = 7; female: n = 8) and exercise-trained (male: n = 9; female: n = 9) groups. Following 4 wk of exercise training or being sedentary, rats were anesthetized and surgically instrumented for stimulation of the lumbar sympathetic chain, muscle contraction and measurement of arterial blood pressure and femoral artery blood flow (FBF). Femoral vascular conductance (FVC) was calculated as FBF/mean arterial pressure. The percentage change of FVC in response to sympathetic stimulation delivered at 2 and 5 Hz was measured at rest and during contraction of the triceps surae muscles before and after β-adrenoreceptor blockade (propranolol: 0.075 mg·kg-1 iv). We found that, at rest, β-adrenoreceptor blockade decreased (main effect of drug, 2 Hz: P < 0.001; 5 Hz: P < 0.001) sympathetic vasoconstriction. During contraction, sympathetic vasoconstrictor responsiveness was lower (main effect of sex, 2 Hz: P = 0.001; 5 Hz: P = 0.023) in female compared with male rats, and sympatholysis was enhanced (main effect of sex, 2 Hz: P = 0.001; 5 Hz: P < 0.001) in female rats. β-adrenoreceptor blockade decreased (main effect of drug, 2 Hz: P = 0.049; 5 Hz: P < 0.001) evoked sympathetic vasoconstriction in contracting muscle. The present study demonstrated that β-adrenoreceptors do not blunt sympathetic vasoconstriction in resting or contracting skeletal muscle of male or female rats. Sympatholysis was enhanced in female rats; however, this was not attributable to β-adrenoreceptor-mediated blunting of sympathetic vasoconstriction.NEW & NOTEWORTHY β-adrenoreceptors do not inhibit sympathetic vasoconstriction in resting or contracting muscle of male or female rats, regardless of training status. Sympatholysis was enhanced in female, compared to male rats; however, β-adrenoreceptors were not responsible for the enhanced sympatholysis. These findings indicate that β-adrenoreceptors do not contribute to the regulation of sympathetic vasoconstriction in resting and contracting skeletal muscle and suggest that β-adrenoreceptors do not underlie sex differences in the neural control of the circulation.
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Affiliation(s)
- Ian R Cooper
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Sixue Liu
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Darren S DeLorey
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Zwilling CE, Strang A, Anderson E, Jurcsisn J, Johnson E, Das T, Kuchan MJ, Barbey AK. Enhanced physical and cognitive performance in active duty Airmen: evidence from a randomized multimodal physical fitness and nutritional intervention. Sci Rep 2020; 10:17826. [PMID: 33077817 PMCID: PMC7572526 DOI: 10.1038/s41598-020-74140-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/15/2020] [Indexed: 11/24/2022] Open
Abstract
Achieving military mission objectives requires high levels of performance from Airmen who operate under extreme physical and cognitive demands. Thus, there is a critical need to establish scientific interventions to enhance physical fitness and cognitive performance-promoting the resilience of Airmen and aiding in mission success. We therefore conducted a comprehensive, 12-week randomized controlled trial in active-duty Air Force Airmen (n = 148) to compare the efficacy of a multimodal intervention comprised of high-intensity interval aerobic fitness and strength training paired with a novel nutritional supplement [comprised of β-hydroxy β-methylbutyrate (HMB), lutein, phospholipids, DHA and selected micronutrients including B12 and folic acid] to high-intensity interval aerobic fitness and strength training paired with a standard of care placebo beverage. The exercise intervention alone improved several dimensions of physical fitness [strength and endurance (+ 8.3%), power (+ 0.85%), mobility and stability (+ 22%), heart rate (- 1.1%) and lean muscle mass (+ 1.4%)] and cognitive function [(episodic memory (+ 9.5%), processing efficiency (+ 7.5%), executive function reaction time (- 4.8%) and fluid intelligence accuracy (+ 19.5%)]. Relative to exercise training alone, the multimodal fitness and nutritional intervention further improved working memory (+ 9.0%), fluid intelligence reaction time (- 7.7%), processing efficiency (+ 1.8%), heart rate (- 2.4%) and lean muscle mass (+ 1.5%). These findings establish the efficacy of a multimodal intervention that incorporates aerobic fitness and strength training with a novel nutritional supplement to enhance military performance objectives and to provide optimal exercise training and nutritional support for the modern warfighter.
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Affiliation(s)
- Christopher E Zwilling
- Decision Neuroscience Laboratory, University of Illinois, 405 North Mathews Avenue, Urbana, IL, 61801, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
| | - Adam Strang
- Applied Neuroscience Branch, Wright Patterson Air Force Base, Dayton, OH, USA
| | - Evan Anderson
- Decision Neuroscience Laboratory, University of Illinois, 405 North Mathews Avenue, Urbana, IL, 61801, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
| | - Jennifer Jurcsisn
- Applied Neuroscience Branch, Wright Patterson Air Force Base, Dayton, OH, USA
| | - Erica Johnson
- Applied Neuroscience Branch, Wright Patterson Air Force Base, Dayton, OH, USA
| | - Tapas Das
- Discovery Research, Abbott Nutrition, Columbus, OH, USA
| | | | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA.
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Champaign, IL, USA.
- Center for Brain Plasticity, University of Illinois, Urbana, IL, USA.
- Department of Psychology, University of Illinois, Urbana, IL, USA.
- Department of Bioengineering, University of Illinois, Champaign, IL, USA.
- Division of Nutritional Sciences, University of Illinois, Champaign, IL, USA.
- Neuroscience Program, University of Illinois, Champaign, IL, USA.
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106
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A 2-year longitudinal follow-up of performance characteristics in Chinese male elite youth athletes from swimming and racket sports. PLoS One 2020; 15:e0239155. [PMID: 33044967 PMCID: PMC7549762 DOI: 10.1371/journal.pone.0239155] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022] Open
Abstract
Training in elite sport aims at the optimization of the athletic performance, and to control the athletes`progress in physiological, anthropometrical and motor performance prerequisites. However, in most sports, the value of longitudinal testing is unclear. This study evaluates the longitudinal development and the influence of intense training over 2-years on specific physiological performance prerequisites, as well as certain body dimensions and motor abilities in elite youth athletes. Recruited between 11-13 years of age at Shanghai Elite Sport school, the sample of student-athletes (N = 21) was categorized as the swimming group (10 athletes), and the racket sports group (11 players: 7 table tennis and 4 badminton players). The performance monitoring took place over two years between September 2016 and September 2018 and included 5 test waves. In all the test waves, the athletes were assessed by means of three physiological measurements (vital capacity, hemoglobin concentration, heart rate at rest), three anthropometric parameters (body height, body weight, chest girth), and two motor tests (back strength, complex reaction speed). Seven out of eight diagnostic methods exhibit medium to high validity to discriminate between the different levels of performance development in the two sports groups. The investigated development of the performance characteristics is attributed partly to the inherited athletic disposition as well as to the different sport-specific training regimens of the two sports groups.
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107
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Wolf S, Zeibig JM, Giel K, Granz H, Sudeck G, Thiel A. [Sports Activity and Mental Diseases]. Psychother Psychosom Med Psychol 2020; 70:412-428. [PMID: 33045760 DOI: 10.1055/a-1193-2584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Current meta-analyses demonstrate convincing evidence regarding the efficacy of exercise on depression, insomnia, anxiety disorders, schizophrenia and ADHD. However, exercise and sports therapy approaches for patients with psychological disorders are mostly integrated in psychiatric inpatient or rehabilitation settings, but not applied in the outpatient sector. Thus, the German Health sector does not take the advantage of the compelling therapeutic effects of exercise. This review covers the theoretical and empirical fundamentals of the effects of exercise and illustrates practical implications by means of the presentation of the group-therapeutic exercise program ImPuls, that was specifically designed for patients with psychological disorders in outpatient settings. ImPuls integrates current evidence of the effects of exercise (type of sport, duration, frequency, intensity) and the facilitation of motivational and volitional strategies to support patients to integrate exercise in their daily life routines.
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108
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Streb AR, Passos da Silva R, Leonel LDS, Possamai LT, Gerage da Silva AM, Turnes T, Del Duca GF. Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial. J Strength Cond Res 2020; 36:2628-2634. [PMID: 33044366 DOI: 10.1519/jsc.0000000000003859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage da Silva, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res XX(X): 000-000, 2020-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) on cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V[Combining Dot Above]O2max), and ventilatory thresholds were determined before and after the intervention. The generalized estimation equation was used, adopting the level of significance for the interaction of 0.10, and 0.05 for the isolated effect of time or group or both. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V[Combining Dot Above]O2max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min; p = 0.05), whereas ventilatory thresholds improved in NG and CG (p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper- and lower-body strength regardless of periodization. However, for improvements in V[Combining Dot Above]O2max, linear periodization may be superior than nonperiodization in obese adults.
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Affiliation(s)
- Anne Ribeiro Streb
- Departament of Physical Education, Physical Exercise Study Group in Chronic Non-communicable Diseases, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Robert Passos da Silva
- Departament of Physical Education, Physical Exercise Study Group in Chronic Non-communicable Diseases, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Larissa Dos Santos Leonel
- Departament of Physical Education, Physical Exercise Study Group in Chronic Non-communicable Diseases, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Leonardo Trevisol Possamai
- Departament of Physical Education, Physical Effort Laboratory, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Aline Mendes Gerage da Silva
- Departament of Physical Education, Physical Exercise Study Group in Chronic Non-communicable Diseases, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Tiago Turnes
- Departament of Physical Education, Physical Effort Laboratory, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Giovani Firpo Del Duca
- Departament of Physical Education, Physical Exercise Study Group in Chronic Non-communicable Diseases, Center of Sports-CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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109
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Von Schulze AT, Deng F, Morris JK, Geiger PC. Heat therapy: possible benefits for cognitive function and the aging brain. J Appl Physiol (1985) 2020; 129:1468-1476. [PMID: 32969779 DOI: 10.1152/japplphysiol.00168.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease, yet there are no disease-modifying treatments available and there is no cure. It is becoming apparent that metabolic and vascular conditions such as type 2 diabetes (T2D) and hypertension promote the development and accumulation of Alzheimer's disease-related dementia pathologies. To this end, aerobic exercise, which is a common lifestyle intervention for both metabolic disease and hypertension, is shown to improve brain health during both healthy aging and dementia. However, noncompliance or other barriers to exercise response are common in exercise treatment paradigms. In addition, reduced intracellular proteostasis and mitochondrial function could contribute to the etiology of AD. Specifically, compromised chaperone systems [i.e., heat shock protein (HSP) systems] can contribute to protein aggregates (i.e., β-amyloid plaques and neurofibrillary tangles) and reduced mitochondrial quality control (i.e., mitophagy). Therefore, novel therapies that target whole body metabolism, the vasculature, and chaperone systems (like HSPs) are needed to effectively treat AD. This review focuses on the role of heat therapy in the treatment and prevention of AD. Heat therapy has been independently shown to reduce whole body insulin resistance, improve vascular function, activate interorgan cross talk via endocytic vesicles, and activate HSPs to improve mitochondrial function and proteostasis in a variety of tissues. Thus, heat therapy could offer immense clinical benefit to patients suffering from AD. Importantly, future studies in patients are needed to determine the safety and efficacy of heat therapy in preventing AD.
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Affiliation(s)
- Alex T Von Schulze
- Department of Molecular and Integrative Physiology, The University of Kansas Medical Center, Kansas City, Kansas
| | - Fengyan Deng
- Department of Molecular and Integrative Physiology, The University of Kansas Medical Center, Kansas City, Kansas
| | - Jill K Morris
- Department of Neurology, The University of Kansas Medical Center, Kansas City, Kansas
| | - Paige C Geiger
- Department of Molecular and Integrative Physiology, The University of Kansas Medical Center, Kansas City, Kansas
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110
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Regulation of microRNAs in Satellite Cell Renewal, Muscle Function, Sarcopenia and the Role of Exercise. Int J Mol Sci 2020; 21:ijms21186732. [PMID: 32937893 PMCID: PMC7555198 DOI: 10.3390/ijms21186732] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 02/07/2023] Open
Abstract
Sarcopenia refers to a condition of progressive loss of skeletal muscle mass and function associated with a higher risk of falls and fractures in older adults. Musculoskeletal aging leads to reduced muscle mass and strength, affecting the quality of life in elderly people. In recent years, several studies contributed to improve the knowledge of the pathophysiological alterations that lead to skeletal muscle dysfunction; however, the molecular mechanisms underlying sarcopenia are still not fully understood. Muscle development and homeostasis require a fine gene expression modulation by mechanisms in which microRNAs (miRNAs) play a crucial role. miRNAs modulate key steps of skeletal myogenesis including satellite cells renewal, skeletal muscle plasticity, and regeneration. Here, we provide an overview of the general aspects of muscle regeneration and miRNAs role in skeletal mass homeostasis and plasticity with a special interest in their expression in sarcopenia and skeletal muscle adaptation to exercise in the elderly.
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111
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Düking P, Holmberg HC, Kunz P, Leppich R, Sperlich B. Intra-individual physiological response of recreational runners to different training mesocycles: a randomized cross-over study. Eur J Appl Physiol 2020; 120:2705-2713. [PMID: 32918588 PMCID: PMC7674349 DOI: 10.1007/s00421-020-04477-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Pronounced differences in individual physiological adaptation may occur following various training mesocycles in runners. Here we aimed to assess the individual changes in performance and physiological adaptation of recreational runners performing mesocycles with different intensity, duration and frequency. METHODS Employing a randomized cross-over design, the intra-individual physiological responses [i.e., peak ([Formula: see text]) and submaximal ([Formula: see text]) oxygen uptake, velocity at lactate thresholds (V2, V4)] and performance (time-to-exhaustion (TTE)) of 13 recreational runners who performed three 3-week sessions of high-intensity interval training (HIIT), high-volume low-intensity training (HVLIT) or more but shorter sessions of HVLIT (high-frequency training; HFT) were assessed. RESULTS [Formula: see text], V2, V4 and TTE were not altered by HIIT, HVLIT or HFT (p > 0.05). [Formula: see text] improved to the same extent following HVLIT (p = 0.045) and HFT (p = 0.02). The number of moderately negative responders was higher following HIIT (15.4%); and HFT (15.4%) than HVLIT (7.6%). The number of very positive responders was higher following HVLIT (38.5%) than HFT (23%) or HIIT (7.7%). 46% of the runners responded positively to two mesocycles, while 23% did not respond to any. CONCLUSION On a group level, none of the interventions altered [Formula: see text], V2, V4 or TTE, while HVLIT and HFT improved [Formula: see text]. The mean adaptation index indicated similar numbers of positive, negative and non-responders to HIIT, HVLIT and HFT, but more very positive responders to HVLIT than HFT or HIIT. 46% responded positively to two mesocycles, while 23% did not respond to any. These findings indicate that the magnitude of responses to HIIT, HVLIT and HFT is highly individual and no pattern was apparent.
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Affiliation(s)
- Peter Düking
- Integrative and Experimental Exercise Science and Training, Department of Sport Science, University of Würzburg, Würzburg, Germany.
| | - Hans-Christer Holmberg
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Department of Physiology and Pharmacology, Biomedicum C5, Karolinska Institutet, Stockholm, Sweden
| | - Philipp Kunz
- Integrative and Experimental Exercise Science and Training, Department of Sport Science, University of Würzburg, Würzburg, Germany
| | - Robert Leppich
- Chair of Software Engineering, Department of Computer Science, University of Würzburg, Würzburg, Germany
| | - Billy Sperlich
- Integrative and Experimental Exercise Science and Training, Department of Sport Science, University of Würzburg, Würzburg, Germany
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112
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Hébert JJ, Sénéchal M, Fairchild T, Møller NC, Klakk H, Wedderkopp N. Developmental Trajectories of Body Mass Index, Waist Circumference, and Aerobic Fitness in Youth: Implications for Physical Activity Guideline Recommendations (CHAMPS Study-DK). Sports Med 2020; 50:2253-2261. [PMID: 32880817 DOI: 10.1007/s40279-020-01335-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Describe the trajectories of body mass index (BMI), waist circumference, and aerobic fitness in children and identify different outcomes of guideline-recommended physical activity (PA) in a subset of active children. METHODS We recruited students from 10 public primary schools and obtained repeated measures of BMI, waist circumference, and aerobic fitness over 30 months. Aerobic fitness was measured with the Andersen test. We objectively measured physical activity behaviour with accelerometers and classified children as 'physically active' when they achieved ≥ 60 min of moderate-to-vigorous PA per day (guideline concordance). Univariate trajectories of BMI, waist circumference, and aerobic fitness were calculated for all children, and we constructed a multi-trajectory model comprising all outcomes in the subgroup of physically active children. The construct validity of all models was investigated by examining for between-group differences in cardiovascular disease risk factors obtained from fasting blood samples. RESULTS Data from 1208 children (53% female) with a mean (SD) age of 8.4 (1.4) years were included. The univariate trajectory models identified three distinct trajectories for BMI, waist circumference, and aerobic fitness. The multi-trajectory model classified 9.1% of physically active children as following an 'overweight/obese/low fitness' trajectory. There were moderate-to-large differences in cardiovascular risk factors between all trajectory groups (p < 0.001; d = 0.4-1.20). CONCLUSION We identified distinct developmental trajectories of BMI, waist circumference, and aerobic fitness in children. Nearly one in 10 children who met PA guideline recommendations followed an unfavourable health trajectory. Health-related PA recommendations may be insufficient for some children.
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Affiliation(s)
- Jeffrey J Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada.
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia.
| | - Martin Sénéchal
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
- Cardiometabolic Exercise and Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Timothy Fairchild
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Niels Christian Møller
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Heidi Klakk
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- Center for Applied Health Science, University College Lillebælt, Odense, Denmark
| | - Niels Wedderkopp
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- The Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Martin-Rincon M, Calbet JAL. Progress Update and Challenges on V . O 2max Testing and Interpretation. Front Physiol 2020; 11:1070. [PMID: 33013459 PMCID: PMC7494971 DOI: 10.3389/fphys.2020.01070] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/04/2020] [Indexed: 01/07/2023] Open
Abstract
The maximal oxygen uptake ( V . O2max) is the primary determinant of endurance performance in heterogeneous populations and has predictive value for clinical outcomes and all-cause mortality. Accurate and precise measurement of V . O2max requires the adherence to quality control procedures, including combustion testing and the use of standardized incremental exercise protocols with a verification phase preceded by an adequate familiarization. The data averaging strategy employed to calculate the V . O2max from the breath-by-breath data can change the V . O2max value by 4-10%. The lower the number of breaths or smaller the number of seconds included in the averaging block, the higher the calculated V . O2max value with this effect being more prominent in untrained subjects. Smaller averaging strategies in number of breaths or seconds (less than 30 breaths or seconds) facilitate the identification of the plateau phenomenon without reducing the reliability of the measurements. When employing metabolic carts, averaging intervals including 15-20 breaths or seconds are preferable as a compromise between capturing the true V . O2max and identifying the plateau. In training studies, clinical interventions and meta-analysis, reporting of V . O2max in absolute values and inclusion of protocols and the averaging strategies arise as imperative to permit adequate comparisons. Newly developed correction equations can be used to normalize V . O2max to similar averaging strategies. A lack of improvement of V . O2max with training does not mean that the training program has elicited no adaptations, since peak cardiac output and mitochondrial oxidative capacity may be increased without changes in V . O2max.
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Affiliation(s)
- Marcos Martin-Rincon
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A. L. Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
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114
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Goodrich JA, Frisco DJ, Kim S, Holliday M, Rueda M, Poddar S, Byrnes WC. The importance of lean mass and iron deficiency when comparing hemoglobin mass in male and female athletic groups. J Appl Physiol (1985) 2020; 129:855-863. [PMID: 32881623 DOI: 10.1152/japplphysiol.00391.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hemoglobin mass (Hbmass) is important for athletes because it helps determine maximal aerobic power. This study examined how lean mass, iron deficiency (ID), and sex influence Hbmass in athletic and nonathletic groups. NCAA Division I student athletes (21 men, 75 women; altitude: 1,625 m) were recruited from six athletic teams; 14 male and 12 female full-time students (non-varsity athletes) served as control subjects. Hbmass, body composition, and iron homeostasis parameters, including ferritin, soluble transferrin receptor (sTfR), hepcidin, erythroferrone, and 10 inflammatory cytokines, were measured two to four times across a competitive/training season. ID was defined as ferritin < 25 ng/mL. Hbmass was more closely related to lean mass (r2 = 0.90) than body mass (r2 = 0.69, P < 0.01). Compared with female subjects, male subjects had 19.9% higher Hbmass relative to body mass (HbmassBM) but only 7.5% higher Hbmass relative to lean mass (HbmassLEAN) (both P < 0.001). Prevalence of ID was higher in female than male subjects (47% vs. 9%, P < 0.01) but did not vary between groups. HbmassLEAN was 5% lower in ID vs. non-ID female subjects; HbmassBM was not different. ID was associated with lower hepcidin, elevated sTfR, and elevated erythroferrone but not with differences in inflammatory cytokines. Hbmass varied significantly between athletic groups and across sex, but the majority of these differences are explained by differences in lean mass. ID was common in female subjects and was associated with lower HbmassLEAN and hepcidin but not with differences in HbmassBM or inflammatory cytokines. Hbmass relative to lean mass seems advantageous when monitoring iron deficiency.NEW & NOTEWORTHY Differences in hemoglobin mass (Hbmass) between groups and across sex are primarily due to differences in lean mass. Iron deficiency (ID) independently decreases Hbmass; this effect is best characterized with Hbmass relative to lean mass. ID is common in females and is associated with lower hepcidin and elevated erythroferrone but not with differences in inflammatory cytokines. Hbmass relative to lean mass accurately quantifies hematological alterations secondary to iron deficiency.
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Affiliation(s)
- Jesse A Goodrich
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Dillon J Frisco
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Sewan Kim
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Marissa Holliday
- Department of Intercollegiate Athletics, University of Colorado Boulder, Boulder, Colorado
| | - Miguel Rueda
- Department of Intercollegiate Athletics, University of Colorado Boulder, Boulder, Colorado
| | - Sourav Poddar
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado
| | - William C Byrnes
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
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El ejercicio continuo de moderada intensidad es superior al ejercicio interválico de alta intensidad en mejorar el VO2 pico en pacientes tras SCA. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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116
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The association between practicing sport and non-sport physical activities and health-related quality of life of Brazilian adolescents: A cross-sectional study. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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117
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MacDonald TL, Pattamaprapanont P, Pathak P, Fernandez N, Freitas EC, Hafida S, Mitri J, Britton SL, Koch LG, Lessard SJ. Hyperglycaemia is associated with impaired muscle signalling and aerobic adaptation to exercise. Nat Metab 2020; 2:902-917. [PMID: 32694831 PMCID: PMC8278496 DOI: 10.1038/s42255-020-0240-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/12/2020] [Indexed: 12/11/2022]
Abstract
Increased aerobic exercise capacity, as a result of exercise training, has important health benefits. However, some individuals are resistant to improvements in exercise capacity, probably due to undetermined genetic and environmental factors. Here, we show that exercise-induced improvements in aerobic capacity are blunted and aerobic remodelling of skeletal muscle is impaired in several animal models associated with chronic hyperglycaemia. Our data point to chronic hyperglycaemia as a potential negative regulator of aerobic adaptation, in part, via glucose-mediated modifications of the extracellular matrix, impaired vascularization and aberrant mechanical signalling in muscle. We also observe low exercise capacity and enhanced c-Jun N-terminal kinase activation in response to exercise in humans with impaired glucose tolerance. Our work indicates that current shifts in dietary and metabolic health, associated with increasing incidence of hyperglycaemia, might impair muscular and organismal adaptations to exercise training, including aerobic capacity as one of its key health outcomes.
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Affiliation(s)
- Tara L MacDonald
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pattarawan Pattamaprapanont
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Prerana Pathak
- Research Division, Joslin Diabetes Center, Boston, MA, USA
| | | | - Ellen C Freitas
- School of Physical Education and Sport, University of São Paulo, Ribeirão Preto, Brazil
| | - Samar Hafida
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Joanna Mitri
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Steven L Britton
- Department of Molecular and Integrative Physiology, and Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Lauren G Koch
- Department of Physiology and Pharmacology, The University of Toledo, Toledo, OH, USA
| | - Sarah J Lessard
- Research Division, Joslin Diabetes Center, Boston, MA, USA.
- Harvard Medical School, Harvard University, Boston, MA, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Olsson K, Salier Eriksson J, Rosdahl H, Schantz P. Are heart rate methods based on ergometer cycling and level treadmill walking interchangeable? PLoS One 2020; 15:e0237388. [PMID: 32760167 PMCID: PMC7410327 DOI: 10.1371/journal.pone.0237388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/24/2020] [Indexed: 01/01/2023] Open
Abstract
Introduction The heart rate (HR) method is a promising approach for evaluating oxygen uptake ( V˙O2), energy demands and exercise intensities in different forms of physical activities. It would be valuable if the HR method, established on ergometer cycling, is interchangeable with other regular activities, such as level walking. This study therefore aimed to examine the interchangeability of the HR method when estimating V˙O2 for ergometer cycling and level treadmill walking in submaximal conditions. Methods Two models of HR‐V˙O2 regression equations for cycle ergometer exercise (CEE) and treadmill exercise (TE) were established with 34 active commuters. Model 1 consisted of three submaximal intensities of ergometer cycling or level walking, model 2 included also one additional workload of maximal ergometer cycling or running. The regression equations were used for estimating V˙O2 with seven individual HR values based on 25–85% of HR reserve (HRR). The V˙O2 estimations were compared between CEE and TE, within and between each model. Results Only minor, and in most cases non-significant, average differences were observed when comparing the estimated V˙O2 levels between CEE and TE. Model 1 ranged from -0.4 to 4.8% (n.s.) between 25–85%HRR. In model 2, the differences between 25–65%HRR ranged from 1.3 to -2.7% (n.s.). At the two highest intensities, 75 and 85%HRR, V˙O2 was slightly lower (3.7%, 4.4%; P < 0.05), for CEE than TE. The inclusion of maximal exercise in the HR‐V˙O2 relationships reduced the individual V˙O2 variations between the two exercise modalities. Conclusion The HR methods, based on submaximal ergometer cycling and level walking, are interchangeable for estimating mean V˙O2 levels between 25–85% of HRR. Essentially, the same applies when adding maximal exercise in the HR‐V˙O2 relationships. The inter-individual V˙O2 variation between ergometer cycling and treadmill exercise is reduced when using the HR method based on both submaximal and maximal workloads.
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Affiliation(s)
- Karin Olsson
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Jane Salier Eriksson
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Peter Schantz
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- * E-mail:
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Bonafiglia JT, Brennan AM, Ross R, Gurd BJ. An appraisal of the SD IR as an estimate of true individual differences in training responsiveness in parallel-arm exercise randomized controlled trials. Physiol Rep 2020; 7:e14163. [PMID: 31325240 PMCID: PMC6642277 DOI: 10.14814/phy2.14163] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/27/2022] Open
Abstract
Calculating the standard deviation of individual responses (SDIR) is recommended for estimating the magnitude of individual differences in training responsiveness in parallel‐arm exercise randomized controlled trials (RCTs). The purpose of this review article is to discuss potential limitations of parallel‐arm exercise RCTs that may confound/complicate the interpretation of the SDIR. To provide context for this discussion, we define the sources of variation that contribute to variability in the observed responses to exercise training and review the assumptions that underlie the interpretation of SDIR as a reflection of true individual differences in training responsiveness. This review also contains two novel analyses: (1) we demonstrate differences in variability in changes in diet and physical activity habits across an intervention period in both exercise and control groups, and (2) we examined participant dropout data from six RCTs and found that significantly (P < 0.001) more participants in control groups (12.8%) dropped out due to dissatisfaction with group assignment compared to exercise groups (3.4%). These novel analyses raise the possibility that the magnitude of within‐subject variability may not be equal between exercise and control groups. Overall, this review highlights that potential limitations of parallel‐arm exercise RCTs can violate the underlying assumptions of the SDIR and suggests that these limitations should be considered when interpreting the SDIR as an estimate of true individual differences in training responsiveness.
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario
| | - Andrea M Brennan
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario
| | - Robert Ross
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario
| | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario
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Gronwald T, Törpel A, Herold F, Budde H. Perspective of Dose and Response for Individualized Physical Exercise and Training Prescription. J Funct Morphol Kinesiol 2020; 5:jfmk5030048. [PMID: 33467264 PMCID: PMC7739365 DOI: 10.3390/jfmk5030048] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022] Open
Abstract
Physical interventions are used to increase physical (sports) performance and considered as effective low-cost strategies in the fields of healthcare, disease or injury prevention, and medical treatment. In general, a considerable amount of evidence buttress the application of physical interventions in various fields as it has been demonstrated to contribute to the maintenance and recovery of physical performance, cognitive function, and overall state of health. To implement physical interventions effectively, it is essential to provide an appropriate exercise and training prescription. Exercise and training prescription are key for "dose" specification and for the individualization (personalizing) of physical exercise and training, precisely adjusted and controlled like medication. Since the physiological response to physical interventions is demonstrably individual and dependent on many influencing factors, individualization is an emerging approach aiming to maximize the efficiency of an intervention by accounting for the interindividual heterogeneity. The present brief viewpoint article aims to distinguish and to redefine between the terms dose and response in order to improve the understanding of practitioners, the methodology of study protocols, and to relate future findings to the actual biological (interindividual) variability of acute and chronic responses.
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Affiliation(s)
- Thomas Gronwald
- Faculty of Health Sciences, Department of Performance, Neuroscience, Therapy and Health, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany
- Correspondence:
| | - Alexander Törpel
- German Swimming Federation, Korbacher Straße 93, 34132 Kassel, Germany;
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany;
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Henning Budde
- Faculty of Human Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany;
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Prehabilitation before major intra-abdominal cancer surgery: A systematic review of randomised controlled trials. Eur J Anaesthesiol 2020; 36:933-945. [PMID: 31188152 PMCID: PMC6855314 DOI: 10.1097/eja.0000000000001030] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Supplemental Digital Content is available in the text BACKGROUND Although prehabilitation programmes for patients undergoing major intra-abdominal cancer surgery have been shown to improve pre-operative physical fitness, the conclusions regarding any postoperative benefits are inconsistent. OBJECTIVES The aim of this study was to evaluate the content of and the outcome measures used in studies of prehabilitation programmes for these patients. It was hypothesised that the content of prehabilitation programmes is often therapeutically invalid, and that the postoperative outcomes assessed are inadequate to evaluate the impact of complications. DESIGN A systematic review of randomised controlled trials. DATA SOURCES Studies published between January 2009 and January 2019 were retrieved from PubMed, Embase and PEDro. ELIGIBILITY CRITERIA Studies were included when they investigated the effects of prehabilitation in patients undergoing intra-abdominal surgery for cancer, reported pre-operative and/or postoperative outcome measures and were conducted as a randomised controlled trial. Studies for which the full text was not available were excluded, as were studies of patients undergoing nonabdominal cancer surgery. RESULTS Eight studies (565 patients) were included. Therapeutic validity was low in five studies. Most studies included low-risk surgical patients and considerable variation was observed between prehabilitation programmes in terms of supervision, training context, frequency, intensity, duration and training type. Objective monitoring of training progression was typically not performed, and most trials did not include nutritional or psychological support. Postoperative complications were reported in seven studies, but no study reported the impact of postoperative complications, nor on long-term postoperative outcomes. CONCLUSION The content of prehabilitation programmes was heterogeneous. Studies with a high therapeutic validity found unequivocal evidence that prehabilitation had beneficial effects on postoperative outcomes. Future research should focus on adequate selection and inclusion of high-risk surgical patients and provide personalised and probably multimodal (partly) supervised prehabilitation, with objective monitoring of progress. Measuring the incidence and impact of postoperative complications may contribute to demonstrating the clinical value of prehabilitation.
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Schantz P, Salier Eriksson J, Rosdahl H. Perspectives on Exercise Intensity, Volume and Energy Expenditure in Habitual Cycle Commuting. Front Sports Act Living 2020; 2:65. [PMID: 33345056 PMCID: PMC7739755 DOI: 10.3389/fspor.2020.00065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Knowledge about exercise intensity and energy expenditure combined with trip frequency and duration is necessary for interpreting the character and potential influencing capacity of habitual cycle commuting on e.g., health outcomes. It needs to be investigated with validated methods, which is the purpose of this study. Methods: Ten male and 10 female middle-aged habitual commuter cyclists were studied at rest and with maximal exercise tests on a cycle ergometer and a treadmill in the laboratory. During their normal commute in the Stockholm County, Sweden, their oxygen uptake, heart rate, energy expenditure, ventilation, blood lactate, rated perceived exertion, number of stops, durations, route distances and cycling velocities were monitored with validated methods. The frequency of trips was self-reported. Results: The relative exercise intensity was 65% of maximal oxygen uptake, and the energy expenditure was 0.46 kcal per km and kg body weight for both sexes. Sex differences in MET-values (men, 8.7; women 7.4) mirrored higher levels of cycling speed (20%), body weight (29%), oxygen uptake (54%) and ventilation (51%) in men compared to women. The number of METhours per week during peak cycling season averaged 40 for the men and 28 for the women. It corresponded to a total energy expenditure of about 3,500 and 1,880 kcal for men and women, respectively. The number of trips per year was about 370, and the annual distance cycled was on average 3,500 km for men and 2,300 for women. Conclusion: Cycle commuting is characterized by equal relative aerobic intensity levels and energy requirements for a given distance cycled by men and women. Based on an overall evaluation, it represents a lower range within the vigorous intensity category. The combined levels of oxygen uptake, durations and trip frequencies lead to high levels of METhours and energy expenditure in both men and women during both peak cycling season as well as over the year. Overall, the study presents a novel basis for interpreting cycle commuting in relation to various health outcomes.
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Affiliation(s)
- Peter Schantz
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Jane Salier Eriksson
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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A Discussion on Different Approaches for Prescribing Physical Interventions - Four Roads Lead to Rome, but Which One Should We Choose? J Pers Med 2020; 10:jpm10030055. [PMID: 32605044 PMCID: PMC7565695 DOI: 10.3390/jpm10030055] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023] Open
Abstract
It is well recognized that regular physical exercise has positive effects on physical and mental health. To use the beneficial health effects of physical exercise, there are worldwide movements encouraging health care providers to include physical exercise in their care and treatments strategies. However, a crucial point in administering the "exercise polypill" is the dosing and, in turn, the prescription of the physical intervention (PI). In this perspective article, we discuss the advantages and disadvantages of different approaches to prescribe PI. In this context, we also highlight outstanding questions and potential areas of opportunity for further investigations.
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Rettedal EA, Cree JME, Adams SE, MacRae C, Skidmore PML, Cameron-Smith D, Gant N, Blenkiron C, Merry TL. Short-term high-intensity interval training exercise does not affect gut bacterial community diversity or composition of lean and overweight men. Exp Physiol 2020; 105:1268-1279. [PMID: 32478429 DOI: 10.1113/ep088744] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does short-term high-intensity interval training alter the composition of the microbiome and is this associated with exercise-induced improvements in cardiorespiratory fitness and insulin sensitivity? What is the main finding and its importance? Although high-intensity interval training increased insulin sensitivity and cardiovascular fitness, it did not alter the composition of the microbiome. This suggests that changes in the composition of the microbiome that occur with prolonged exercise training might be in response to changes in metabolic health rather than driving exercise training-induced adaptations. ABSTRACT Regular exercise reduces the risk of metabolic diseases, and the composition of the gut microbiome has been associated with metabolic function. We investigated whether short-term high-intensity interval training (HIIT) altered the diversity and composition of the bacterial community and whether there were associations with markers of insulin sensitivity or aerobic fitness. Cardiorespiratory fitness ( V ̇ O 2 peak ) and body composition (dual energy X-ray absorptiometry scan) were assessed and faecal and fasted blood samples collected from 14 lean (fat mass 21 ± 2%, aged 29 ± 2 years) and 15 overweight (fat mass 33 ± 2%, aged 31 ± 2 years) men before and after 3 weeks of HIIT training (8-12 × 60 s cycle ergometer bouts at V ̇ O 2 peak power output interspersed by 75 s rest, three times per week). Gut microbiome composition was analysed by 16S rRNA gene amplicon sequencing. The HIIT significantly increased the aerobic fitness of both groups (P < 0.001) and improved markers of insulin sensitivity (lowered fasted insulin and HOMA-IR; P < 0.001) in the overweight group. Despite differences in the abundance of several bacterial taxa being evident between the lean and overweight group, HIIT did not affect the overall bacterial diversity or community structure (α-diversity or β-diversity). No associations were found between the top 50 most abundant bacterial genera and cardiorespiratory fitness markers; however, significant associations (P < 0.05) were observed between the abundance of the bacterial species Coprococcus_3, Blautia, Lachnospiraceae_ge and Dorea and insulin sensitivity markers in the overweight group. Our results suggest that short-term HIIT does not greatly impact the overall composition of the gut microbiome, but that certain microbiome genera are associated with insulin sensitivity markers that were improved by HIIT in overweight participants.
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Affiliation(s)
- Elizabeth A Rettedal
- Food Nutrition & Health Team, AgResearch Grasslands, Palmerston North, New Zealand
| | - Julia M E Cree
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand.,Human Nutrition Unit, School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | - Shannon E Adams
- Human Nutrition Unit, School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | - Caitlin MacRae
- Human Nutrition Unit, School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | | | - David Cameron-Smith
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Nicholas Gant
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Cherie Blenkiron
- Department of Molecular Medicine and Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Troy L Merry
- Human Nutrition Unit, School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
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Abstract
BACKGROUND Increases in maximal oxygen uptake (VO2max) are strongly associated with improved cardiovascular health. OBJECTIVE The aim was to perform a systematic review and meta-analysis to determine whether VO2max responses to endurance training (ET), the most effective intervention to improve VO2max, are influenced by sex. METHODS We conducted a systematic search of MEDLINE and Web of Science since their inceptions until February 2019 for articles assessing the VO2max response to a given sex-matched dose of ET in healthy age-matched men and women. Meta-analyses were performed to determine the mean difference between VO2max responses in men versus women. Subgroup and meta-regression analyses were used to assess potential moderating factors. RESULTS After systematic review, eight studies met the inclusion criteria. All studies implemented common modalities of ET in healthy untrained individuals, comprising a total of 175 men and women (90 ♂, 85 ♀). ET duration and intensity were sex-matched in all studies. After data pooling, ET induced substantially larger increases in absolute VO2max in men compared with women (mean difference = + 191 ml·min-1, 95% CI 99, 283; P < 0.001). A greater effect of ET on relative VO2max was also observed in men versus women (mean difference = + 1.95 ml·min-1·kg-1, 95% CI 0.76, 3.15; P = 0.001). No heterogeneity was detected among studies (I2 = 0%, P ≥ 0.59); the meta-analytical results were robust to potential moderating factors. CONCLUSION Pooled evidence demonstrates greater improvements in VO2max in healthy men compared with women in response to a given dose of ET, suggesting the presence of sexual dimorphism in the trainability of aerobic capacity.
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Tzemah Shahar R, Koren O, Matarasso S, Shochat T, Magzal F, Agmon M. Attributes of Physical Activity and Gut Microbiome in Adults: A Systematic Review. Int J Sports Med 2020; 41:801-814. [PMID: 32455454 DOI: 10.1055/a-1157-9257] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Growing evidence shows the contribution of physical activity interventions to the gut microbiome. However, specific physical activity characteristics that can modify the gut microbiome are unknown. This review's aim was to explore the contribution of physical activity intervention characteristics on human gut microbiome composition, in terms of diversity, specific bacterial groups, and associated gut microbiome metabolites. A literature search in PubMed; Cochrane Library; CINAHL-EBSCO; SCOPUS; Web of Science; ClinicalTrials.gov; PROSPERO; and ProQuest. Five studies met the inclusion criteria of a physical activity intervention duration of at least five weeks, with any description of the type or dose used. All included studies reported an endurance training; two studies used endurance and an additional muscle-strengthening training regimen. All studies reported using a dietary intervention control. Reported gut microbiome α-diversity changes were non-significant, β-diversity changes were mixed (three studies reported an increase, two reported non-significant changes). All studies reported significant changes in the abundances of specific bacterial/archaea groups and bacteria-related metabolites following interventions. In conclusion, physical activity (regardless of specific characteristics) has significant contribution to gut microbiome composition and associated metabolites. There are no current recommendations for physical activity to promote gut microbiome composition. Future studies should focus on the contribution of current recommended physical activity dose to gut microbiome composition.
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Affiliation(s)
- Roy Tzemah Shahar
- The Cheryl Spencer Institute of Nursing Research, University of Haifa, Haifa, Israel
| | - Omry Koren
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Sarah Matarasso
- Internal Medicine C, Bnei Zion Medical Centre, Haifa, Israel
| | - Tamar Shochat
- The Cheryl Spencer Institute of Nursing Research, University of Haifa, Haifa, Israel
| | - Faiga Magzal
- Laboratory of Human Health and Nutrition Sciences, MIGAL-Galilee Research Institute, Kiryat Shmona, Israel
| | - Maayan Agmon
- The Cheryl Spencer Institute of Nursing Research, University of Haifa, Haifa, Israel
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Houzelle A, Dahlmans D, Nascimento EBM, Schaart G, Jörgensen JA, Moonen-Kornips E, Kersten S, Wang X, Hoeks J. MicroRNA-204-5p modulates mitochondrial biogenesis in C2C12 myotubes and associates with oxidative capacity in humans. J Cell Physiol 2020; 235:9851-9863. [PMID: 32452584 PMCID: PMC7586823 DOI: 10.1002/jcp.29797] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 03/24/2020] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
Abstract
Using an unbiased high‐throughput microRNA (miRNA)‐silencing screen combined with functional readouts for mitochondrial oxidative capacity in C2C12 myocytes, we previously identified 19 miRNAs as putative regulators of skeletal muscle mitochondrial metabolism. In the current study, we highlight miRNA‐204‐5p, identified from this screen, and further studied its role in the regulation of skeletal muscle mitochondrial function. Following silencing of miRNA‐204‐5p in C2C12 myotubes, gene and protein expression were assessed using quantitative polymerase chain reaction, microarray analysis, and western blot analysis, while morphological changes were studied by confocal microscopy. In addition, miRNA‐204‐5p expression was quantified in human skeletal muscle biopsies and associated with in vivo mitochondrial oxidative capacity. Transcript levels of PGC‐1α (3.71‐fold; p < .01), predicted as an miR‐204‐5p target, as well as mitochondrial DNA copy number (p < .05) and citrate synthase activity (p = .06) were increased upon miRNA‐204‐5p silencing in C2C12 myotubes. Silencing of miRNA‐204‐5p further resulted in morphological changes, induced gene expression of autophagy marker light chain 3 protein b (LC3B; q = .05), and reduced expression of the mitophagy marker FUNDC1 (q = .01). Confocal imaging revealed colocalization between the autophagosome marker LC3B and the mitochondrial marker OxPhos upon miRNA‐204‐5p silencing. Finally, miRNA‐204‐5p was differentially expressed in human subjects displaying large variation in oxidative capacity and its expression levels associated with in vivo measures of skeletal muscle mitochondrial function. In summary, silencing of miRNA‐204‐5p in C2C12 myotubes stimulated mitochondrial biogenesis, impacted on cellular morphology, and altered expression of markers related to autophagy and mitophagy. The association between miRNA‐204‐5p and in vivo mitochondrial function in human skeletal muscle further identifies miRNA‐204‐5p as an interesting modulator of skeletal muscle mitochondrial metabolism.
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Affiliation(s)
- Alexandre Houzelle
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Dennis Dahlmans
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Emmani B M Nascimento
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Gert Schaart
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Johanna A Jörgensen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Esther Moonen-Kornips
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sander Kersten
- Division of Human Nutrition, Nutrition, Metabolism and Genomics Group, Wageningen University, Wageningen, The Netherlands
| | - Xu Wang
- Joint Center for Single Cell Biology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, China.,Laboratory of Integrative Systems Physiology, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Joris Hoeks
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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Hetherington-Rauth M, Magalhães JP, Júdice PB, Melo X, Sardinha LB. Vascular improvements in individuals with type 2 diabetes following a 1 year randomised controlled exercise intervention, irrespective of changes in cardiorespiratory fitness. Diabetologia 2020; 63:722-732. [PMID: 31960071 DOI: 10.1007/s00125-020-05089-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/18/2019] [Indexed: 12/20/2022]
Abstract
AIMS/HYPOTHESIS Vascular changes in individuals with type 2 diabetes mellitus majorly contribute to the development of cardiovascular disease. Increased cardiorespiratory fitness (CRF) has been associated with improvements in vascular health. Although CRF tends to improve with exercise training, there remains a portion of participants with little or no improvement. Given the importance of vascular function in individuals with type 2 diabetes, we assessed whether individuals who failed to improve CRF following a 1 year exercise intervention also failed to improve arterial stiffness and structural indices. METHODS Individuals with type 2 diabetes with no major micro- and macrovascular complications and aged between 30 and 75 years old (n = 63) participated in a three-arm, 1 year, randomised controlled exercise intervention in Lisbon, Portugal. The study involved a non-exercise control group, a moderate continuous training combined with resistance training (RT) group and a high-intensity interval training with RT group. Allocation of participants into the intervention and control groups was done using a computer-generated list of random numbers. An improvement in CRF was defined as a change in [Formula: see text] ≥5%. Vascular stiffness and structural indices were measured using ultrasound imaging and applanation tonometry. Generalised estimating equations were used to compare changes in vascular measures across individuals in the control group (n = 22) and those in the exercise groups who either had improved CRF (CRF responders; n = 14) or whose CRF did not improve (CRF non-responders; n = 27) following 1 year of exercise training. RESULTS Compared with the control group, exercisers, with and without improvements in CRF, had decreased carotid intima-media thickness (IMT) (CRF responders: β = -2.84 [95% CI -5.63, -0.04]; CRF non-responders: β = -5.89 [95% CI -9.38, -2.40]) and lower-limb pulse wave velocity (PWV) (CRF responders: β = -0.14 [95% CI -0.25, -0.03]; CRF non-responders: β = -0.14 [95% CI -0.25, -0.03]), the latter being an indicator of peripheral arterial stiffness. Only CRF responders had decreased PWV of the upper limb compared with control participants (β = -0.12 [95% CI -0.23, -0.01]). As for central stiffness, CRF non-responders had increased aortic PWV compared with CRF responders (β = 0.19 [95% CI 0.07, 0.31]), whereas only the CRF non-responders had altered carotid distensibility coefficient compared with the control group (β = 0.00 [95% CI 3.01 × 10-5, 0.00]). No interaction effects between the CRF responders and non-responders vs control group were found for the remaining stiffness or haemodynamic indices (p>0.05). CONCLUSIONS/INTERPRETATION Regardless of improvements in CRF, individuals with type 2 diabetes had significant improvements in carotid IMT and lower-limb arterial stiffness following a 1 year exercise intervention. Thus, a lack of improvement in CRF following exercise in people with type 2 diabetes does not necessarily entail a lack of improvement in vascular health. TRIAL REGISTRATION ClinicalTrials.gov NCT03144505 FUNDING: This work was supported by fellowships from the Portuguese Foundation for Science and Technology. This work is also financed by a national grant through the Fundação para a Ciência e Tecnologia (FCT), within the unit I&D 472.
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Affiliation(s)
- Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
- Ginásio Clube Português, GCP Lab, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Abstract
It is well established that exercise is an important component in the maintenance of good health, and yet recent studies have demonstrated that a sub-section of individuals experience no significant improvements following an exercise training intervention. Such individuals are commonly termed “non-responders”. However, recently a number of researchers have taken a skeptical view as to whether exercise non-response either exists, or is clinically relevant. Here, we explore the research underpinning exercise response, to determine whether non-response to exercise actually exists. We discuss the impact of measurement error and assessment type on the identification of “non-responders”, and whether such non-response is global- or modality-specific. Additionally, we discuss whether, if non-response to an exercise intervention is meaningful and relevant, certain additional interventions—in the form of increasing exercise intensity, volume, or duration—could be made in order to enhance training adaptations. Consequently, based on our interpretations of the available evidence, we suggest that it is unlikely that global non-responders to exercise exist. Furthermore, we suggest this realization effectively counters the perception that some individuals will not positively respond to exercise, and that in turn, this insight serves to encourage health professionals to create more nuanced, efficacious, and individually-focused exercise prescriptions designed to circumvent and overcome apparent non-responsiveness. Adopting a more individually-adaptive approach to exercise prescription could, subsequently, prove a powerful tool in promoting population health.
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Affiliation(s)
- Craig Pickering
- Institute of Coaching and Performance, School of Sport and Wellbeing, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, UK. .,Exercise and Nutritional Genomics Research Centre, DNAFit Ltd, London, UK.
| | - John Kiely
- Institute of Coaching and Performance, School of Sport and Wellbeing, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, UK
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Valenzuela PL, Ortiz-Alonso J, Bustamante-Ara N, Vidán MT, Rodríguez-Romo G, Mayordomo-Cava J, Javier-González M, Hidalgo-Gamarra M, López-Tatis M, Valadés-Malagón MI, Santos-Lozano A, Serra-Rexach JA, Lucia A. Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults. J Clin Med 2020; 9:E797. [PMID: 32183381 PMCID: PMC7141266 DOI: 10.3390/jcm9030797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/16/2022] Open
Abstract
We analyzed inter-individual variability in response to exercise among acutely hospitalized oldest-old adults. In this ancillary analysis of a randomized controlled trial, 268 patients (mean age 88 years) were assigned to a control (n = 125, usual care) or intervention group (n = 143, supervised exercise, i.e., walking and rising from a chair [1-3 sessions/day]). Intervention group patients were categorized as responders, non-responders, or adverse responders (improved, no change, or impaired function in activities of daily living [ADL, Katz index] from hospital admission to discharge, respectively). We analyzed the association between responsiveness to exercise and variables assessed at baseline (2 weeks pre-admission), admission, during hospitalization, at discharge, and during a subsequent 3-month follow-up. An impaired ADL function and worse nutritional status at admission were associated to a greater responsiveness, whereas a better ADL function at admission, longer hospitalization and lower comorbidity index were associated with a poorer response (p < 0.05). Adverse responders had worse outcomes at discharge and during the follow-up (e.g., impaired physical performance and greater fall number) (p < 0.05). Although exercise intervention helps to prevent ADL function decline in hospitalized oldest-old people, a number of them-particularly those with a better functional/health status at admission and longer hospitalization-are at higher risk of being adverse responders, which can have negative short/middle-term consequences.
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Affiliation(s)
| | - Javier Ortiz-Alonso
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain;
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
| | | | - María T. Vidán
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain;
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
- School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Gabriel Rodríguez-Romo
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
- Sports Department, Instituto Nacional de Educación Física, Universidad Politécnica de Madrid, 20040 Madrid, Spain
| | - Jennifer Mayordomo-Cava
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain;
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
| | - Marianna Javier-González
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
| | - Mercedes Hidalgo-Gamarra
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
| | - Myriel López-Tatis
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
| | - Maria Isabel Valadés-Malagón
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, 47012 Valladolid, Spain;
- Research Institute Hospital 12 de Octubre (‘imas12′), 28041 Madrid, Spain
| | - José Antonio Serra-Rexach
- Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.O.-A.); (M.T.V.); (M.J.-G.); (M.H.-G.); (M.L.-T.); (M.I.V.-M.); (J.A.S.-R.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain;
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
- School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Alejandro Lucia
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain;
- Research Institute Hospital 12 de Octubre (‘imas12′), 28041 Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
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Blood volume expansion does not explain the increase in peak oxygen uptake induced by 10 weeks of endurance training. Eur J Appl Physiol 2020; 120:985-999. [PMID: 32172291 PMCID: PMC7181565 DOI: 10.1007/s00421-020-04336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/25/2020] [Indexed: 12/20/2022]
Abstract
Purpose The endurance training (ET)-induced increases in peak oxygen uptake (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak) and cardiac output (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙peak) during upright cycling are reversed to pre-ET levels after removing the training-induced increase in blood volume (BV). We hypothesised that ET-induced improvements in \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak and \documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙peak are preserved following phlebotomy of the BV gained with ET during supine but not during upright cycling. Arteriovenous O2 difference (a-\documentclass[12pt]{minimal}
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\begin{document}$$\bar{\text{v}}$$\end{document}v¯O2diff; \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2/\documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙), cardiac dimensions and muscle morphology were studied to assess their role for the \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak improvement. Methods Twelve untrained subjects (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak: 44 ± 6 ml kg−1 min−1) completed 10 weeks of supervised ET (3 sessions/week). Echocardiography, muscle biopsies, haemoglobin mass (Hbmass) and BV were assessed pre- and post-ET. \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak and \documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙peak during upright and supine cycling were measured pre-ET, post-ET and immediately after Hbmass was reversed to the individual pre-ET level by phlebotomy. Results ET increased the Hbmass (3.3 ± 2.9%; P = 0.005), BV (3.7 ± 5.6%; P = 0.044) and \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak during upright and supine cycling (11 ± 6% and 10 ± 8%, respectively; P ≤ 0.003). After phlebotomy, improvements in \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak compared with pre-ET were preserved in both postures (11 ± 4% and 11 ± 9%; P ≤ 0.005), as was \documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙peak (9 ± 14% and 9 ± 10%; P ≤ 0.081). The increased \documentclass[12pt]{minimal}
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\begin{document}$$\bar{\text{v}}$$\end{document}v¯O2diff accounted for 70% and 30% of the \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak improvements, respectively. Markers of mitochondrial density (CS and COX-IV; P ≤ 0.007) and left ventricular mass (P = 0.027) increased. Conclusion The ET-induced increase in \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak was preserved despite removing the increases in Hbmass and BV by phlebotomy, independent of posture. \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}$$\end{document}V˙O2peak increased primarily through elevated \documentclass[12pt]{minimal}
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\begin{document}$$\dot{Q}$$\end{document}Q˙peak but also through a widened a-\documentclass[12pt]{minimal}
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\begin{document}$$\bar{\text{v}}$$\end{document}v¯O2diff, potentially mediated by cardiac remodelling and mitochondrial biogenesis.
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Differences in Training Adaptations of Endurance Performance during Combined Strength and Endurance Training in a 6-Month Crisis Management Operation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051688. [PMID: 32150971 PMCID: PMC7084630 DOI: 10.3390/ijerph17051688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022]
Abstract
Decreases in aerobic fitness during military operations have been observed in several studies. Thus, differences in training adaptations during a 6-month crisis-management operation were compared by using the change in endurance performance as the outcome measure. Sixty-six male soldiers volunteered for the study, consisting of pre-post assessments of blood biomarkers, body composition, physical performance, and the military simulation test (MST) performance. Physical training volume was self-reported. After the follow-up, the data were divided based on individual changes in endurance performance. Endurance performance was improved in the high-responder group (HiR, n = 25) and maintained or decreased in the low-responder group (LoR n = 24). During the operation, the LoR group decreased while the HiR group increased their endurance training frequency from the pre-deployment level (Δ 28 ± 57% vs. -40 ± 62%, p = 0.004). Fat mass decreased (-7.6 ± 11.7% vs. 14.2 ± 20.4%, p < 0.001), and 1-min push-up (27.7 ± 21.9% vs. 11.7 ± 26.1%, p = 0.004) and MST performance improved (-13.6 ± 6.8% vs. -7.5 ± 6.5%, p = 0.006) more in the HiR group. No differences were observed in the changes of other physical performance test results or analyzed biomarkers. In conclusion, soldiers who were initially leaner and fitter in terms of lower body strength and power were more likely to decrease their aerobic fitness during the operation.
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Gray ID, Kross AR, Renfrew ME, Wood P. Precision Medicine in Lifestyle Medicine: The Way of the Future? Am J Lifestyle Med 2020; 14:169-186. [PMID: 32231483 PMCID: PMC7092395 DOI: 10.1177/1559827619834527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Precision medicine has captured the imagination of the medical community with visions of therapies precisely targeted to the specific individual's genetic, biological, social, and environmental profile. However, in practice it has become synonymous with genomic medicine. As such its successes have been limited, with poor predictive or clinical value for the majority of people. It adds little to lifestyle medicine, other than in establishing why a healthy lifestyle is effective in combatting chronic disease. The challenge of lifestyle medicine remains getting people to actually adopt, sustain, and naturalize a healthy lifestyle, and this will require an approach that treats the patient as a person with individual needs and providing them with suitable types of support. The future of lifestyle medicine is holistic and person-centered rather than technological.
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Affiliation(s)
- Ian D. Gray
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Andrea R. Kross
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Melanie E. Renfrew
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
| | - Paul Wood
- Avondale College of Higher Education, Cooranbong,
New South Wales, Australia
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134
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Joyner MJ, Dominelli PB. Central cardiovascular system limits to aerobic capacity. Exp Physiol 2020; 106:2299-2303. [PMID: 32058638 DOI: 10.1113/ep088187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 02/12/2020] [Indexed: 01/13/2023]
Abstract
NEW FINDINGS What is the topic of this review? The limits to maximal aerobic capacity. What advances does it highlight? A synthesis of data and ideas about what limits maximal aerobic capacity demonstrates the central roles of cardiac output, stroke volume and red blood cell mass in the complex physiological responses to maximal exercise. In healthy humans these factors, along with skeletal muscle blood flow, dominate systemic delivery of oxygen to the contracting muscles and set the upper limit of aerobic energy production by skeletal muscles. In elite athletes and patients with pulmonary disease the lungs can also limit oxygen uptake and delivery. ABSTRACT In this paper we review the physiological determinants of V ̇ O 2 max and discuss the role this variable plays as a determinant of endurance exercise performance. Because the ability to sustain a given pace during a competitive athletic event requires competitors to 'manage' fatigue and go as fast as possible without fatiguing prematurely, V ̇ O 2 max is one of the variables that sets the physiological upper limit for sustained energy production by the contracting skeletal muscles.
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Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Paolo B Dominelli
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada, N2L 3G1
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135
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Brand C, Martins CMDL, Lemes VB, Pessoa MLF, Dias AF, Cadore EL, Mota J, Gaya ACA, Gaya AR. Effects and prevalence of responders after a multicomponent intervention on cardiometabolic risk factors in children and adolescents with overweight/obesity: Action for health study. J Sports Sci 2020; 38:682-691. [PMID: 32050850 DOI: 10.1080/02640414.2020.1725384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study aimed to verify the effect of a multicomponent intervention on cardiometabolic risk factors (CMRF), and to determine the prevalence of responders on CMRF among children and adolescents with overweight/obesity. This is a quasi-experimental study, developed with 35 children and adolescents with overweight/obesity (control group (CG) = 18; intervention group (IG) = 17), aged between 7 and 13 years. Participants in IG underwent a multicomponent intervention for 12 weeks. The following variables were evaluated: anthropometric measures, maturational stages and CMRF (body fatness, HOMA-IR, triglycerides, high-density and low-density lipoprotein) (HDL-C, LDL-C), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. There was a significant time x group interaction on body fatness (p < 0.001), HOMA-IR (p = 0.01), HDL-C (p < 0.001), LDL-C (p = 0.009) and TC (p < 0.001). The prevalence of responders for CMRF in IG and CG was respectively: body fatness (47%; 0%; p = 0.04), HOMA-IR (58.8%; 16.6%; p = 0.04); triglycerides (17.6%; 5.5%; p = 0.31); HDL-C (76.4%; 5.5%; p = 0.01), LDL-C (35.3%; 5%; p = 0.08), TC (64.7%; 5%; p = 0.01), AST (5.8%; 0%; p = 0.87), ALT (29.4%; 11.1%; p = 0.24) and AST/ALT ratio (24.4%; 22.2%; p = 0.67). Multicomponent intervention induced positive changes on CMRF along with a higher prevalence of positive adaptations in IG than the CG in some of the cardiometabolic outcomes assessed.
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Affiliation(s)
- Caroline Brand
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Vanilson Batista Lemes
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Luisa Félix Pessoa
- Research Center on Physical Activity, Health and Leisure, Federal University of Paraiba, João Pessoa, Brazil.,Health Science Centre, Federal University of Paraíba, João Pessoa, Brazil
| | - Arieli Fernandes Dias
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Lusa Cadore
- School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Adroaldo Cezar Araujo Gaya
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Reis Gaya
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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136
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Ellingsgaard H, Seelig E, Timper K, Coslovsky M, Soederlund L, Lyngbaek MP, Wewer Albrechtsen NJ, Schmidt-Trucksäss A, Hanssen H, Frey WO, Karstoft K, Pedersen BK, Böni-Schnetzler M, Donath MY. GLP-1 secretion is regulated by IL-6 signalling: a randomised, placebo-controlled study. Diabetologia 2020; 63:362-373. [PMID: 31796986 DOI: 10.1007/s00125-019-05045-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/01/2019] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS IL-6 is a cytokine with various effects on metabolism. In mice, IL-6 improved beta cell function and glucose homeostasis via upregulation of glucagon-like peptide 1 (GLP-1), and IL-6 release from muscle during exercise potentiated this beneficial increase in GLP-1. This study aimed to identify whether exercise-induced IL-6 has a similar effect in humans. METHODS In a multicentre, double-blind clinical trial, we randomly assigned patients with type 2 diabetes or obesity to intravenous tocilizumab (an IL-6 receptor antagonist) 8 mg/kg every 4 weeks, oral sitagliptin (a dipeptidyl peptidase-4 inhibitor) 100 mg daily or double placebos (a placebo saline infusion every 4 weeks and a placebo pill once daily) during a 12 week training intervention. The primary endpoints were the difference in change of active GLP-1 response to an acute exercise bout and change in the AUC for the concentration-time curve of active GLP-1 during mixed meal tolerance tests at baseline and after the training intervention. RESULTS Nineteen patients were allocated to tocilizumab, 17 to sitagliptin and 16 to placebos. During the acute exercise bout active GLP-1 levels were 26% lower with tocilizumab (multiplicative effect: 0.74 [95% CI 0.56, 0.98], p = 0.034) and 53% higher with sitagliptin (1.53 [1.15, 2.03], p = 0.004) compared with placebo. After the 12 week training intervention, the active GLP-1 AUC with sitagliptin was about twofold that with placebo (2.03 [1.56, 2.62]; p < 0.001), while GLP-1 AUC values showed a small non-significant decrease of 13% at 4 weeks after the last tocilizumab infusion (0.87 [0.67, 1.12]; p = 0.261). CONCLUSIONS/INTERPRETATION IL-6 is implicated in the regulation of GLP-1 in humans. IL-6 receptor blockade lowered active GLP-1 levels in response to a meal and an acute exercise bout in a reversible manner, without lasting effects beyond IL-6 receptor blockade. TRIAL REGISTRATION Clinicaltrials.gov NCT01073826. FUNDING Danish National Research Foundation. Danish Council for Independent Research. Novo Nordisk Foundation. Danish Centre for Strategic Research in Type 2 Diabetes. European Foundation for the Study of Diabetes. Swiss National Research Foundation.
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Affiliation(s)
- Helga Ellingsgaard
- Centre of Inflammation and Metabolism (CIM)/ Centre for Physical Activity Research (CFAS), Rigshospitalet 7641, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
| | - Eleonora Seelig
- Clinic of Endocrinology, Diabetes and Metabolism University Hospital Basel, Basel, Switzerland
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Katharina Timper
- Clinic of Endocrinology, Diabetes and Metabolism University Hospital Basel, Basel, Switzerland
- Max Planck Institute for Metabolism Research Cologne, Center for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany
| | - Michael Coslovsky
- Department of Clinical Research, CTU, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Line Soederlund
- Centre of Inflammation and Metabolism (CIM)/ Centre for Physical Activity Research (CFAS), Rigshospitalet 7641, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Mark P Lyngbaek
- Centre of Inflammation and Metabolism (CIM)/ Centre for Physical Activity Research (CFAS), Rigshospitalet 7641, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | | | - Arno Schmidt-Trucksäss
- Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Walter O Frey
- Balgrist MoveMed, Swiss Olympic Medical Center, University Hospital Balgrist, Zurich, Switzerland
| | - Kristian Karstoft
- Centre of Inflammation and Metabolism (CIM)/ Centre for Physical Activity Research (CFAS), Rigshospitalet 7641, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Bente K Pedersen
- Centre of Inflammation and Metabolism (CIM)/ Centre for Physical Activity Research (CFAS), Rigshospitalet 7641, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | | | - Marc Y Donath
- Clinic of Endocrinology, Diabetes and Metabolism University Hospital Basel, Basel, Switzerland
- Department Biomedicine, University of Basel, Basel, Switzerland
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137
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IANNETTA DANILO, INGLIS ERINCALAINE, MATTU ANMOLT, FONTANA FEDERICOY, POGLIAGHI SILVIA, KEIR DANIELA, MURIAS JUANM. A Critical Evaluation of Current Methods for Exercise Prescription in Women and Men. Med Sci Sports Exerc 2020; 52:466-473. [DOI: 10.1249/mss.0000000000002147] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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138
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Diaz-Canestro C, Haider T, Lundby C, Montero D. Relationship between plasma volume and essential blood constituents in patients with heart failure and preserved ejection fraction. Clin Physiol Funct Imaging 2019; 40:131-138. [PMID: 31823430 DOI: 10.1111/cpf.12614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Notwithstanding recent progress on molecular mechanisms underlying heart failure with preserved ejection fraction (HFpEF), multiple pathophysiological aspects of this condition including the basis of anaemia and other haematological disorders remain unresolved. In this study, we sought to determine the relationship of plasma volume (PV), a plausible confounding factor for the concentration of solutes in blood, with key haematological markers in HFpEF patients. METHODS Total circulating PV was determined with high precision, automated carbon monoxide rebreathing in 24 stable HFpEF patients (70 ± 8 years, left ventricular ejection fraction = 55±5%) and 18 healthy age- and sex-matched control (HC) individuals. Linear regression analyses were performed to determine the association of PV with a comprehensive set of haematological variables. RESULTS Haematocrit (40·1 ± 4·9 versus 43·6 ± 2·7%, P = 0·004) and haemoglobin concentration (131 ± 16 versus 142 ± 7 g l-1 , P = 0·003) were reduced in HFpEF patients compared with HC individuals. In regression analyses, PV was negatively associated with haematocrit (r = -0·45, P = 0·029) and haemoglobin concentration (r = -0·44, P = 0·030) in HFpEF patients, whereas these variables were not associated with PV in HC individuals (P≥0·198). Regarding blood electrolytes, PV was negatively associated with K+ (r = -0·43, P = 0·036) and Ca2+ (r = -0·44, P = 0·032) in HFpEF patients but not in HC individuals (P≥0·734). None of the above associations were detected in HFpEF patients when using ideal instead of measured PV. CONCLUSION The blood concentration of routine markers of anaemia and electrolyte balance is specifically and linearly associated with PV in HFpEF patients. Excess or deficit of circulating PV may confound clinical diagnosis in this population.
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Affiliation(s)
- Candela Diaz-Canestro
- Faculty of Kinesiology, Cumming School of Medicine, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Thomas Haider
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Carsten Lundby
- Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - David Montero
- Faculty of Kinesiology, Cumming School of Medicine, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
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139
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Thiel A, Sudeck G, Gropper H, Maturana FM, Schubert T, Srismith D, Widmann M, Behrens S, Martus P, Munz B, Giel K, Zipfel S, Nieß AM. The iReAct study - A biopsychosocial analysis of the individual response to physical activity. Contemp Clin Trials Commun 2019; 17:100508. [PMID: 31890988 PMCID: PMC6928277 DOI: 10.1016/j.conctc.2019.100508] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 12/15/2022] Open
Abstract
Background Physical activity is a substantial promoter for health and well-being. Yet, while an increasing number of studies shows that the responsiveness to physical activity is highly individual, most studies focus this issue from only one perspective and neglect other contributing aspects. In reference to a biopsychosocial framework, the goal of our study is to examine how physically inactive individuals respond to two distinct standardized endurance trainings on various levels. Based on an assessment of activity- and health-related biographical experiences across the life course, our mixed-method study analyzes the responsiveness to physical activity in the form of a transdisciplinary approach, considering physiological, epigenetic, motivational, affective, and body image-related aspects. Methods Participants are randomly assigned to two different training programs (High Intensity Interval Training vs. Moderate Intensity Continuous Training) for six weeks. After this first training period, participants switch training modes according to a two-period sequential-training-intervention (STI) design and train for another six weeks. In order to analyse baseline characteristics as well as acute and adaptive biopsychosocial responses, three extensive mixed-methods diagnostic blocks take place at the beginning (t0) of the study and after the first (t1) and the second (t2) training period resulting in a net follow-up time of 15 weeks. The study is divided into five modules in order to cover a wide array of perspectives. Discussion The study's transdisciplinary mixed-method design allows to interlace a multitude of subjective and objective data and therefore to draw an integrated picture of the biopsychosocial efficacy of two distinct physical activity programs. The results of our study can be expected to contribute to the development and design of individualised training programs for the promotion of physical activity. Trial registration The study was retrospectively registered in the German Clinical Trials Register on 12 June 2019 (DRKS00017446).
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Affiliation(s)
- Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, Eberhard Karls University of Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Hannes Gropper
- Institute of Sports Science, Eberhard Karls University of Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Felipe Mattioni Maturana
- Department of Sports Medicine, Medical University Hospital Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Tanja Schubert
- Institute of Sports Science, Eberhard Karls University of Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Duangkamol Srismith
- Department of Psychosomatic Medicine & Psychotherapy, Medical University Hospital Tübingen, Germany.,Max Planck Institute for Intelligent Systems, Department of Perceiving Systems, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Germany
| | - Manuel Widmann
- Department of Sports Medicine, Medical University Hospital Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Simone Behrens
- Department of Psychosomatic Medicine & Psychotherapy, Medical University Hospital Tübingen, Germany.,Max Planck Institute for Intelligent Systems, Department of Perceiving Systems, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Eberhard Karls University of Tübingen, Germany
| | - Barbara Munz
- Department of Sports Medicine, Medical University Hospital Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
| | - Katrin Giel
- Department of Psychosomatic Medicine & Psychotherapy, Medical University Hospital Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine & Psychotherapy, Medical University Hospital Tübingen, Germany
| | - Andreas Michael Nieß
- Department of Sports Medicine, Medical University Hospital Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Germany
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Moderate-intensity continuous exercise is superior to high-intensity interval training in the proportion of VO 2peak responders after ACS. ACTA ACUST UNITED AC 2019; 73:725-733. [PMID: 31837947 DOI: 10.1016/j.rec.2019.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/25/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND OBJECTIVES We compared the effects of 12 weeks of low-volume high-intensity interval training (LV-HIIT) vs moderate-intensity continuous exercise training (MICET) on cardiopulmonary exercise test parameters and the proportion of non/low responders (NLR) to exercise training in post-acute coronary syndrome (ACS) patients. METHODS Patients with a recent ACS were randomized to LV-HIIT, MICET, or a usual care group. LV-HIIT consisted of 2 to 3 sets of 6 to 10minutes with repeated bouts of 15 to 30seconds at 100% of peak workload alternating with 15 to 30seconds of passive recovery. Cardiopulmonary exercise test parameters were assessed, and key exercise variables were calculated. Training response was assessed according to the median VO2peak change post vs pretraining in the whole cohort (stratification NLR vs high response). RESULTS Fifty patients were included in the analysis (LV-HIIT, n=23; MICET, n=18; usual care, n=9) and 74% were male. The proportion of NLR was higher in the LV-HIIT group than in the MICET group (LV-HIIT 61%, MICET 21%, and usual care 80%; P=.0040). VO2peak-dependent variables (VO2peak, percent-predicted VO2peak) improved in both training groups (P=.002 and P <.0001 for time with LV-HIIT and MICET, respectively), but the improvement was more pronounced with MICET (P=.004 and P=.001 for interaction, respectively). The ΔVO2/Δworkload slope improved only with MICET (P=.021). CONCLUSIONS In patients with a recent ACS, several prognostic VO2peak-dependent variables were improved after LV-HIIT, but the improvement was more pronounced or only found after MICET. Low-volume HIIT resulted in a higher proportion of NLR than isocaloric MICET. Clinical trialsregistered at ClinicalTrials.gov (Identifiers: NCT03414996 and NCT02048696).
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141
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Weatherwax RM, Harris NK, Kilding AE, Dalleck LC. Incidence of V˙O2max Responders to Personalized versus Standardized Exercise Prescription. Med Sci Sports Exerc 2019; 51:681-691. [PMID: 30673687 DOI: 10.1249/mss.0000000000001842] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Despite knowledge of cardiorespiratory fitness (CRF) training responders and nonresponders, it is not well understood how the exercise intensity prescription affects the incidence of response. The purpose of this study was to determine CRF training responsiveness based on cohort-specific technical error after 12 wk of standardized or individually prescribed exercise and the use of a verification protocol to confirm maximal oxygen uptake (V˙O2max). METHODS Sedentary adult participants (9 men, 30 women; 48.2 ± 12.2 yr) completed exercise training on 3 d·wk for 12 wk, with exercise intensity prescribed based on standardized methods using heart rate reserve or an individualized approach using ventilatory thresholds. A verification protocol was used at baseline and 12 wk to confirm the identification of a true V˙O2max and subsequent relative percent changes to quantify CRF training responsiveness. A cohort-specific technical error (4.7%) was used as a threshold to identify incidence of response. RESULTS Relative V˙O2max significantly increased (P < 0.05) from 24.3 ± 4.6 to 26.0 ± 4.2 and 29.2 ± 7.5 to 32.8 ± 8.6 mL·kg·min for the standardized and individualized groups, respectively. Absolute V˙O2max significantly increased (P < 0.05) from 2.0 ± 0.6 to 2.2 ± 0.6 and 2.4 ± 0.8 to 2.6 ± 0.9 L·min for the standardized and individualized groups, respectively. A significant difference in responsiveness was found between the individualized and standardized groups with 100% and 60% of participants categorized as responders, respectively. CONCLUSIONS A threshold model for exercise intensity prescription had a greater effect on the incidence of CRF training response compared with a standardized approach using heart rate reserve. The use of thresholds for intensity markers accounts for individual metabolic characteristics and should be considered as a viable and practical method to prescribe exercise intensity.
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Affiliation(s)
- Ryan M Weatherwax
- Human Potential Centre, Auckland University of Technology, Auckland, NEW ZEALAND.,Recreation, Exercise & Sport Science, Western State Colorado University, Gunnison, CO
| | - Nigel K Harris
- Human Potential Centre, Auckland University of Technology, Auckland, NEW ZEALAND
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, NEW ZEALAND
| | - Lance C Dalleck
- Recreation, Exercise & Sport Science, Western State Colorado University, Gunnison, CO
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Lundby C, Montero D. Did you know-why does maximal oxygen uptake increase in humans following endurance exercise training? Acta Physiol (Oxf) 2019; 227:e13371. [PMID: 31465612 DOI: 10.1111/apha.13371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Carsten Lundby
- Innland University of Applied Sciences Lillehammer Norway
- Center for Physical Activity Research, Rigshospitalet Copenhagen Denmark
| | - David Montero
- Faculty of Kinesiology Libin Cardiovascular Institute of Alberta University of Calgary Calgary Canada
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143
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Dias KA, Lawley JS, Gatterer H, Howden EJ, Sarma S, Cornwell WK, Hearon CM, Samels M, Everding B, Liang ASW, Hendrix M, Piper T, Thevis M, Bruick RK, Levine BD. Effect of acute and chronic xenon inhalation on erythropoietin, hematological parameters, and athletic performance. J Appl Physiol (1985) 2019; 127:1503-1510. [DOI: 10.1152/japplphysiol.00289.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the efficacy of acute subanesthetic dosages of xenon inhalation to cause erythropoiesis and determine the effect of chronic xenon dosing on hematological parameters and athletic performance. To assess the acute effects, seven subjects breathed three subanesthetic concentrations of xenon: 30% fraction of inspired xenon (FiXe) for 20 min, 50% FiXe for 5 min, and 70% FiXe for 2 min. Erythropoietin (EPO) was measured at baseline, during, and after xenon inhalation. To determine the chronic effects, eight subjects breathed 70% FiXe for 2 min on 7 consecutive days, and EPO, total blood, and plasma volume were measured. Phase II involved assessment of 12 subjects for EPO, total blood volume, maximal oxygen uptake, and 3-km time before and after random assignment to 4 wk of xenon or sham gas inhalation. FiXe 50% and 70% stimulated an increase in EPO at 6 h [+2.3 mIU/mL; 95% confidence interval (CI) 0.1–4.5; P = 0.038] and at 192 h postinhalation (+2.9 mIU/mL; 95% CI 0.6–5.1; P = 0.017), respectively. Seven consecutive days of dosing significantly elevated plasma volume (+491 mL; 95% CI 194–789; P = 0.002). Phase II showed no significant effect on EPO, hemoglobin mass, plasma volume, maximal oxygen uptake, or 3-km time. Acute exposure to subanesthetic doses of xenon caused a consistent increase in EPO, and 7 consecutive days of xenon inhalation significantly expanded plasma volume. However, this physiological response appeared to be transient, and 4 wk of xenon inhalation did not stimulate increases in plasma volume or erythropoiesis, leaving cardiorespiratory fitness and athletic performance unchanged. NEW & NOTEWORTHY This is the first study to examine each element of the cascade by which xenon inhalation is purported to take effect, starting with measurement of the hypoxia-inducible factor effector, erythropoietin, to hemoglobin mass and blood volume and athletic performance. We found that acute exposure to xenon increased serum erythropoietin concentration, although major markers of erythropoiesis remained unchanged. While daily dosing significantly expanded plasma volume, no physiological or performance benefits were apparent following 4 wk of dosing.
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Affiliation(s)
- Katrin A. Dias
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Justin S. Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Erin J. Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Christopher M. Hearon
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
| | | | - Max Hendrix
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Thomas Piper
- German Sport University Cologne, Institute of Biochemistry/Centre for Preventive Doping Research, Cologne, Germany
| | - Mario Thevis
- German Sport University Cologne, Institute of Biochemistry/Centre for Preventive Doping Research, Cologne, Germany
| | | | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas, Texas
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144
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Herold F, Müller P, Gronwald T, Müller NG. Dose-Response Matters! - A Perspective on the Exercise Prescription in Exercise-Cognition Research. Front Psychol 2019; 10:2338. [PMID: 31736815 PMCID: PMC6839278 DOI: 10.3389/fpsyg.2019.02338] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/01/2019] [Indexed: 01/03/2023] Open
Abstract
In general, it is well recognized that both acute physical exercises and regular physical training influence brain plasticity and cognitive functions positively. However, growing evidence shows that the same physical exercises induce very heterogeneous outcomes across individuals. In an attempt to better understand this interindividual heterogeneity in response to acute and regular physical exercising, most research, so far, has focused on non-modifiable factors such as sex and different genotypes, while relatively little attention has been paid to exercise prescription as a modifiable factor. With an adapted exercise prescription, dosage can be made comparable across individuals, a procedure that is necessary to better understand the dose-response relationship in exercise-cognition research. This improved understanding of dose-response relationships could help to design more efficient physical training approaches against, for instance, cognitive decline.
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Affiliation(s)
- Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Patrick Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Thomas Gronwald
- Department Performance, Neuroscience, Therapy and Health, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Notger G. Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
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145
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Gevaert AB, Adams V, Bahls M, Bowen TS, Cornelissen V, Dörr M, Hansen D, Kemps HM, Leeson P, Van Craenenbroeck EM, Kränkel N. Towards a personalised approach in exercise-based cardiovascular rehabilitation: How can translational research help? A 'call to action' from the Section on Secondary Prevention and Cardiac Rehabilitation of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2019; 27:1369-1385. [PMID: 31581819 DOI: 10.1177/2047487319877716] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The benefit of regular physical activity and exercise training for the prevention of cardiovascular and metabolic diseases is undisputed. Many molecular mechanisms mediating exercise effects have been deciphered. Personalised exercise prescription can help patients in achieving their individual greatest benefit from an exercise-based cardiovascular rehabilitation programme. Yet, we still struggle to provide truly personalised exercise prescriptions to our patients. In this position paper, we address novel basic and translational research concepts that can help us understand the principles underlying the inter-individual differences in the response to exercise, and identify early on who would most likely benefit from which exercise intervention. This includes hereditary, non-hereditary and sex-specific concepts. Recent insights have helped us to take on a more holistic view, integrating exercise-mediated molecular mechanisms with those influenced by metabolism and immunity. Unfortunately, while the outline is recognisable, many details are still lacking to turn the understanding of a concept into a roadmap ready to be used in clinical routine. This position paper therefore also investigates perspectives on how the advent of 'big data' and the use of animal models could help unravel inter-individual responses to exercise parameters and thus influence hypothesis-building for translational research in exercise-based cardiovascular rehabilitation.
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Affiliation(s)
- Andreas B Gevaert
- GENCOR Department, University of Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital (UZA), Belgium.,Heart Centre Hasselt, Jessa Hospital, Belgium
| | - Volker Adams
- Department of Molecular and Experimental Cardiology, TU Dresden, Germany
| | - Martin Bahls
- Department of Internal Medicine B, University of Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - T Scott Bowen
- School of Biomedical Sciences, University of Leeds, UK
| | | | - Marcus Dörr
- Department of Internal Medicine B, University of Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Belgium.,Faculty of Rehabilitation Sciences, Hasselt University, Belgium
| | - Hareld Mc Kemps
- Fitheid, Leefstijl, Ontwikkeling en Wetenschap (FLOW), Máxima Medical Centre, The Netherlands
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, University of Oxford, UK
| | - Emeline M Van Craenenbroeck
- GENCOR Department, University of Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital (UZA), Belgium
| | - Nicolle Kränkel
- Department of Cardiology, Charité Universitätsmedizin, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Berlin, Germany
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146
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Montero D, Diaz-Canestro C, Oberholzer L, Lundby C. The role of blood volume in cardiac dysfunction and reduced exercise tolerance in patients with diabetes. Lancet Diabetes Endocrinol 2019; 7:807-816. [PMID: 31255583 DOI: 10.1016/s2213-8587(19)30119-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/20/2019] [Accepted: 03/27/2019] [Indexed: 11/18/2022]
Abstract
Blood volume is an integral component of the cardiovascular system, and fundamental to discerning the pathophysiology of multiple cardiovascular conditions leading to exercise intolerance. Based on a systematic search of controlled studies assessing blood volume, in this Personal View we describe how hypovolaemia is a prevalent characteristic of patients with diabetes, irrespective of sex, age, and physical activity levels. Multiple endocrine and haematological mechanisms contribute to hypovolaemia in diabetes. The regulation of intravascular volumes is altered by sustained hyperglycaemia and hypertension. Chronic activation of endocrine systems controlling fluid homeostasis, such as the renin-angiotensin-aldosterone system and vasopressin axis, has a role in progressive kidney desensitisation and diabetic nephropathy. Furthermore, albumin loss from the intravascular compartment reduces the osmotic potential of plasma to retain water. Hypovolaemia also affects the loading conditions and filling of the heart in diabetes. The elucidation of modifiable volumetric traits will plausibly have major health benefits in the diabetes population.
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Affiliation(s)
- David Montero
- Faculty of Kinesiology, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
| | - Candela Diaz-Canestro
- Faculty of Kinesiology, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Laura Oberholzer
- Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Lundby
- Inland Norway University of Applied Sciences, Lillehammer, Norway
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147
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Bonafiglia JT, Nelms MW, Preobrazenski N, LeBlanc C, Robins L, Lu S, Lithopoulos A, Walsh JJ, Gurd BJ. Moving beyond threshold-based dichotomous classification to improve the accuracy in classifying non-responders. Physiol Rep 2019; 6:e13928. [PMID: 30488594 PMCID: PMC6429972 DOI: 10.14814/phy2.13928] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/01/2018] [Accepted: 10/26/2018] [Indexed: 12/02/2022] Open
Abstract
We examined maximal oxygen consumption responses following exercise training to demonstrate the limitations associated with threshold‐based dichotomous classification of responders and non‐responders and proposed alternative methods for classification. Specifically, we: 1) calculated individual probabilities of response, and 2) classified individuals using response confidence intervals (CI) and reference points of zero and a smallest worthwhile change of 0.5 METs. Our findings support the use of individual probabilities and individual CIs to improve the accuracy in non‐response classification.
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Matthew W Nelms
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Camille LeBlanc
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Lauren Robins
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Simo Lu
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Alexander Lithopoulos
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Jeremy J Walsh
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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148
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Chrzanowski-Smith OJ, Piatrikova E, Betts JA, Williams S, Gonzalez JT. Variability in exercise physiology: Can capturing intra-individual variation help better understand true inter-individual responses? Eur J Sport Sci 2019; 20:452-460. [PMID: 31397212 DOI: 10.1080/17461391.2019.1655100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Exploring individual responses to exercise training is a growing area of interest. Understanding reasons behind true observed inter-individual responses may help personalise exercise training to maximise the benefits received. While numerous factors have been explored, an often underappreciated consideration in the sport and exercise science field is the influence intra-individual variation, both in a single measurement and in response to an intervention, may have on training outcomes. Several study designs and statistical approaches are available to incorporate intra-individual variation into interventions and accordingly provide information on whether 'true' inter-individual responses are present or if they are an artefact of intra-individual variation. However, such approaches are sparingly applied. Moreover, intra-individual variation may also be important when true inter-individual response differences are present. In this perspective piece, the concept of intra-individual variation is described before briefly summarising study designs and statistical practices to account for intra-individual variation. We then outline two examples of physiological practices (stratified randomisation and prescribing exercise programmes upon training parameters) to demonstrate why sport and exercise scientists should acknowledge intra-individual variation prior to the implementation of an intervention, which potentially offers an additional explanation behind observed true inter-individual responses to training. Repeated testing pre-implementation of exercise training would conceptually provide more confident estimates of training parameters, which if utilised in a study design will help attenuate biases that may dictate inter-individual differences. Moreover, the incorporation of intra-individual differences will facilitate insights into alternative factors that may predict and/or explain true observed individual responses to an exercise training programme.
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149
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Birkett ST, Nichols S, Sawrey R, Gleadall-Siddall D, McGregor G, Ingle L. The effects of low-volume high-intensity interval training and circuit training on maximal oxygen uptake. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00552-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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150
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Inter-Individual Differences in Cognitive Response to a Single Bout of Physical Exercise-A Randomized Controlled Cross-Over Study. J Clin Med 2019; 8:jcm8081101. [PMID: 31349593 PMCID: PMC6723732 DOI: 10.3390/jcm8081101] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022] Open
Abstract
Recent reviews have shown that acute exercise can improve cognitive functions, especially executive functions. However, a closer look at the included studies revealed a wide inter-individual variability in the effects of exercise on cognition. Therefore, thirty-nine healthy adults (age: 19–30 years) were analyzed in a randomized, controlled cross-over study with two exercise groups (n = 13 each) and a sedentary control group (n = 13). The exercise conditions included moderate (30 min at 40–59% VO2max) and high intensity interval (five × 2 min at 90% VO2max with 3 min active recovery at 40% VO2max) treadmill exercise. The main outcome assessed was cognitive performance (attention, inhibitory control, cognitive flexibility) and underlying inter-individual variability in young adults. On the group level no significant group or group × time interaction effects were observed. Using a median split, we found significant differences between low and high cognitive performers regarding cognitive function following moderate and high intensity interval treadmill exercise. Furthermore, using a pre-determined threshold we could identify responders and non-responders to acute exercise. Therefore, future research should consider individual performance requirements.
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