Skeletal Muscle Hyperemia: A Potential Bridge Between Post-exercise Hypotension and Glucose Regulation

Scoping Review of the Health Benefits of Stretching Exercises in Patients with Type 2 Diabetes Mellitus

This study aimed to clarify the current state of research on the effects of stretching exercises on the health of patients with type 2 diabetes mellitus (T2DM). A scoping review of the literature was conducted in December 2024, using four databases. Experimental and clinical studies were included if they compared stretching exercises with non-stretching exercises for T2DM-related health outcomes. The primary search terms used were "diabetes mellitus, type 2," "muscle stretching exercises," and "range of motion, articular.". Eleven studies met our inclusion criteria. Eight studies focused on blood glucose levels, one of which assessed the functional capacity. The remaining studies investigated plantar pressure, shoulder joint mobility/pain/disability, and fatigue, with one study addressing each outcome. This review indicates that stretching exercises may affect a variety of health parameters, including blood glucose regulation, in patients with T2DM but emphasizes the need for further high-quality research to determine their effectiveness.

One minute of light-intensity stair-stepping decreases postprandial glycaemia in the evening in non-diabetic adults: A randomized controlled trial

Prior studies have investigated the efficacy of a single 1 min bout of stair-stepping on reducing postprandial blood glucose (BG) in the morning, but none have investigated this effect in the evening when glycaemic responses are larger due to circadian regulation and β-cell responsiveness. This work investigated the efficacy of a 1 min bout of self-selected, low-intensity stair-stepping performed in the evening on reducing the change from baseline to the 60 min time point postprandial BG. Thirty people (43% male, 29 (10) years) participated in a randomized crossover-controlled trial. Participants completed two separate evening trials following an oral glucose tolerance test (OGTT) (75 g of dextrose dissolved in water): (a) 0 min of stair-stepping seated control condition, and (b) 1 min of stair-stepping condition. One minute of stair-stepping attenuated the change from baseline to 60 min postprandial BG versus control condition (2.5 (2.8) vs. 4.3 (2.3) mmol/L (P < 0.001). Area under the curve (AUC) and incremental area under the curve (iAUC) were lower for the 1 min condition versus control (mean difference = -0.4,95% CI: 0.1-0.8 (P = 0.023) and (mean difference = -0.6, 95% CI 0.1-1.1 mmol/L-1 min-1 (P = 0.043), respectively. The modified BORG rate of perceived exertion scale showed participants perceived the exercise as light intensity (1.9 (1.1)). A single, 1 min bout of low-intensity stair stepping at a self-selected pace reduced evening postprandial BG levels following an OGTT in young non-diabetic adults.

Effects of coffee intake on skeletal muscle microvascular reactivity at rest and oxygen extraction during exercise: a randomized cross-over trial

PURPOSE

The effects of coffee ingestion on skeletal muscle microvascular function are not well understood. This study aimed to investigate the acute effects of coffee intake with varying levels of caffeine on skeletal muscle microvascular reactivity at rest and oxygen extraction during maximal incremental exercise in physically active individuals.

METHODS

Twenty healthy young male participants were administered coffee with low caffeine (3 mg/kg body weight; LC), high caffeine (6 mg/kg body weight; HC), and placebo (decaf) in different sessions. Skeletal muscle reactivity indexes, including tissue saturation index 10s slope (TSI10) and TSI half time recovery (TSI ½) following 5-minute ischemia were measured at rest and were measured at baseline and post-coffee consumption using near-infrared spectroscopy (NIRS). Post-coffee intake, NIRS was also used to measure microvascular oxygen extraction during exercise via maximal incremental exercise. Peak oxygen consumption and peak power output (Wpeak) were simultaneously evaluated.

RESULTS

Post-coffee consumption, TSI10 was significantly higher in the LC condition compared to placebo (p = 0.001) and significantly higher in the HC condition compared to placebo (p < 0.001). However, no difference was detected between LC and HC conditions (p = 0.527). HC condition also showed significant less TSI ½ compared to placebo (p = 0.005). However, no difference was detected for microvascular oxygen extraction during exercise, despite the greater Wpeak found for HC condition (p < 0.001) compared to placebo.

CONCLUSION

Coffee ingestion with high caffeine level (6 mg/kg body weight) significantly enhanced skeletal muscle reactivity at rest. However, the improvement of exercise performance with coffee intake is not accompanied by alterations in muscle oxygen extraction.

Central and peripheral mechanisms underlying postexercise hypotension: a scoping review

Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews - 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).

The Effects of Stretching Exercise on Levels of Blood Glucose: A Systematic Review with Meta-Analysis

BACKGROUND

Physical activity plays an important role in the management of blood glucose levels. However, compelling evidence exists only for aerobic and resistance training. In this review, we aimed to identify the potential effects of stretching exercises on blood glucose levels.

METHODS

A systematic literature search was performed using the following databases: Scopus, NLM PubMed, and Web of Science. Studies regarding the effects of stretching exercise in humans on blood glucose or any related variable were included. Further inclusion criteria were: (1) original articles (published from database inception to October 2022), (2) applying stretching as a unique exercise modality, (3) having either longitudinal or acute interventions, (4) including healthy and pathological populations, and (5) having within each study a pre- and post-intervention measure. Quality assessment of the studies was conducted using the Downs and Black checklist.

RESULTS

A total of 13 articles were included. The quality assessment revealed an overall moderate quality of the included records. Ten articles included patients with type 2 diabetes (T2D), whereas the remaining three included at-risk populations. A total of 731 people with a mean age of 56.7 ± 6.1 years old were analysed. Fasting blood glucose, 2 h post-oral glucose uptake, post-stretching intervention blood glucose levels, and HbA1c were identified as variables related to blood glucose within the studies. After the stretching interventions, a significant reduction was observed in either blood glucose (ES = - 0.79; p = 0.0174) or HbA1c (ES = - 1.11; p =  < 0.0001). Meta-analytic results highlighted greater effects in T2D patients (ES = - 1.15; p = 0.02) and for studies applying stretching as an exercise intervention (ES = - 1.27; p = 0.006) rather than considering stretching as a control exercise modality.

CONCLUSION

The results of this systematic review highlight the potential of stretching exercises to reduce blood glucose levels. In particular, if stretching is applied as a specific form of exercise intervention in patients with T2D greater effects are observed. However, further studies with more solid research designs are required, therefore, caution is needed before prescribing stretching as an exercise intervention for glycaemic management.

Post-Exercise Hypotension: An Alternative Management Strategy for Hypertension and Cardiovascular Disease?

Cardiovascular disease (CVD), including hypertension, is a leading cause of death worldwide and imposes an enormous burden on our societies [...].