Aerobic vs anaerobic exercise training effects on the cardiovascular system

Aerobic and Anaerobic Exercise's Impact on Cognitive Functions in Eighth Grade Students

The present study examined the impact of aerobic and anaerobic exercise on cognitive abilities in eighth grade students at one middle school in southeastern US. It is known that youth do not meet recommended physical activity levels, yet there is research demonstrating a clear connection between aerobic exercise and academic performance. There is a gap in evidence regarding anaerobic exercise and cognitive capabilities. If professionals know which type of exercise is most beneficial for enhancing cognition in youth, it will behoove them to incorporate these practices in physical education and other areas throughout the school day for students. Thus, this research aimed to answer the following question: what is the effect of both aerobic and anaerobic exercise on the cognitive functions of eighth grade students, specifically measuring working memory, attention, and impulsivity? Fifty research participants (N = 31 males, 18 females, 1 other), aged 13-14, consented/assented to the complete study protocols. Participants engaged in an experiment containing three different cognitive tasks after partaking in three separate exercise conditions. The cognitive measures were the Stroop color-word task, the Flanker test, and the Go/No Go task, which all measured reaction time and the number of correct responses. The exercise conditions were baseline (after no exercise), aerobic (after a continuous running activity in PE), and anaerobic (after completing an interval dumbbell workout in PE). Each condition took place on a separate day to decrease the effect of confounding variables. The data were analyzed using the Scheffe modification of the MANOVA to determine whether multiple levels of the independent variable influenced the dependent variables (the reaction time and number of correct responses) or if a combination of variables influenced the outcomes. Each cognitive test was analyzed separately. The results showed that the exercise condition did significantly impact the reaction time and the number of correct responses for the Stroop color-word task [F(4, 254) = 8.59, p < 0.001; Pillai's Trace = 0.24]. Specifically, aerobic exercise improved both reaction time (p < 0.001) and the number of correct responses (p = 0.001) compared to baseline, while anaerobic exercise improved just reaction time compared to baseline. To find out more detailed information about the specific dependent variable affected by the exercise program, individual ANOVA tests were conducted, resulting in statistical significance for both the number of correct responses and reaction time regarding the program. The partial Eta2 of 0.07 for the number of correct responses and 0.24 for reaction time indicated that 7% of the variance in correct responses and 24% of the variance in reaction time could be explained by the exercise program. While both are significant, reaction time is more impacted by exercise program than correct responses are. Given these findings, it is recommended that aerobic physical activity be offered in school prior to assigning cognitively challenging tasks, while quick anaerobic activity breaks should be used to refocus students' attention. More research should be conducted to examine other cognitive abilities, as well as in other populations.

Revitalizing the Gut Microbiome in Chronic Kidney Disease: A Comprehensive Exploration of the Therapeutic Potential of Physical Activity

Both physical inactivity and disruptions in the gut microbiome appear to be prevalent in patients with chronic kidney disease (CKD). Engaging in physical activity could present a novel nonpharmacological strategy for enhancing the gut microbiome and mitigating the adverse effects associated with microbial dysbiosis in individuals with CKD. This narrative review explores the underlying mechanisms through which physical activity may favorably modulate microbial health, either through direct impact on the gut or through interorgan crosstalk. Also, the development of microbial dysbiosis and its interplay with physical inactivity in patients with CKD are discussed. Mechanisms and interventions through which physical activity may restore gut homeostasis in individuals with CKD are explored.

Mechanisms and benefits of cardiac rehabilitation in individuals with stroke: emerging role of its impact on improving cardiovascular and neurovascular health

Human and animal studies have demonstrated the mechanisms and benefits of aerobic exercise for both cardiovascular and neurovascular health. Aerobic exercise induces neuroplasticity and neurophysiologic reorganization of brain networks, improves cerebral blood flow, and increases whole-body VO2peak (peak oxygen consumption). The effectiveness of a structured cardiac rehabilitation (CR) program is well established and a vital part of the continuum of care for people with cardiovascular disease. Individuals post stroke exhibit decreased cardiovascular capacity which impacts their neurologic recovery and extends disability. Stroke survivors share the same risk factors as patients with cardiac disease and can therefore benefit significantly from a comprehensive CR program in addition to neurorehabilitation to address their cardiovascular health. The inclusion of individuals with stroke into a CR program, with appropriate adaptations, can significantly improve their cardiovascular health, promote functional recovery, and reduce future cardiovascular and cerebrovascular events thereby reducing the economic burden of stroke.

Combined Aerobic Exercise with Intermittent Fasting Is Effective for Reducing mTOR and Bcl-2 Levels in Obese Females

The integration of combined aerobic exercise and intermittent fasting (IF) has emerged as a strategy for the prevention and management of obesity, including its associated health issues such as age-related metabolic diseases. This study aimed to examine the potential of combined aerobic exercise and IF as a preventative strategy against cellular senescence by targeting mTOR and Bcl-2 levels in obese females. A total of 30 obese women, aged 23.56 ± 1.83 years, body fat percentage (FAT) 45.21 ± 3.73% (very high category), BMI 30.09 ± 3.74 kg/m2 were recruited and participated in three different types of interventions: intermittent fasting (IF), exercise (EXG), and a combination of intermittent fasting and exercise (IFEXG). The intervention program was carried out 5x/week for 2 weeks. We examined mTOR and Bcl-2 levels using ELISA kits. Statistical analysis used the one-way ANOVA test and continued with Tukey's HSD post hoc test, with a significance level of 5%. The study results showed that a combination of aerobic exercise and IF significantly decreased mTOR levels (-1.26 ± 0.79 ng/mL) compared to the control group (-0.08 ± 1.33 ng/mL; p ≤ 0.05). However, combined aerobic exercise and IF did not affect Bcl-2 levels significantly (-0.07 ± 0.09 ng/mL) compared to the control group (0.01 ± 0.17 ng/mL, p ≥ 0.05). The IF-only group, exercise-only group, and combined group all showed a significant decrease in body weight and fat mass compared to the control group (p ≤ 0.05). However, the combined aerobic exercise and IF program had a significant effect in reducing the total percentage of body fat and fat mass compared to the IF-only group (p ≤ 0.05). Therefore, it was concluded that the combined intermittent fasting and exercise group (IFEXG) undertook the most effective intervention of the three in terms of preventing cellular senescence, as demonstrated by decreases in the mTOR level, body weight, and fat mass. However, the IFEXG did not present reduced Bcl-2 levels.

Functional Exercise Capacity and Perceived Exertion in Patients with Empty Nose Syndrome

Empty nose syndrome (ENS) is a complex condition characterized by symptoms such as dyspnea, nasal discomfort, and emotional challenges. This study aimed to evaluate functional exercise capacity and perceived exertion in patients with ENS. Patients with ENS who presented with a range of severe symptoms were prospectively enrolled. Pulmonary function was evaluated using spirometry, and functional exercise capacity was measured via the 6 min walk test (6-MWT). Perceived exertion was quantified using the Borg scale, and cardiopulmonary function was evaluated by monitoring peripheral oxygen saturation (SpO2). These parameters were assessed before and after nasal reconstruction surgery. A total of 44 patients with ENS were enrolled and classified into mild-to-moderate (n = 20) and severe (n = 24) symptom groups. Spirometry results showed no significant differences before and after surgery in the entire cohort. Perceived exertion showed significant postoperative improvement (p = 0.006). The severe ENS symptom group experienced significant improvement in SpO2 (p = 0.013) and perceived exertion (p = 0.002) at the end of the 6-MWT after surgery. Surgical intervention significantly enhanced functional exercise capacity (p = 0.038) in patients with mild-to-moderate ENS symptoms. Surgical reconstruction positively affected perceived exertion and SpO2 at the end of the 6-MWT in patients with ENS. The severity of ENS symptoms, as assessed by SNOT-25 scores, influenced these outcomes. These findings underscore the potential benefits of surgical intervention for enhancing exercise tolerance and respiratory efficiency.

Effectiveness of aerobic exercise on cognition in individuals with traumatic brain injury: A systematic review

Cognitive deficits are among the most common impairments in individuals with traumatic brain injury (TBI). Aerobic exercise is a repetitive and structured physical activity that influences structural and functional brain alterations differently. This review aims to examine the effects of aerobic exercise on cognition in individuals with TBI. PubMed, CINAHL, EMBASE, SCOPUS, MEDLINE, and Web of Science were searched from inception to December 20, 2023. Studies designed as randomized controlled trials (RCT), clinical controlled trials (CCT), and pilot studies included individuals with a confirmed diagnosis of TBI, comparing aerobic exercise with passive, active, or no control group and included at least one outcome measure assessing any cognitive domain were selected. The quality of the selected studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Six studies met the eligibility criteria (n = 118), with 53% of participants being female. Four studies were of good quality, fair quality (n = 1), and poor quality (n = 1) on the PEDro. Two of the selected studies showed significant improvements in cognition after moderate and vigorous aerobic exercises, while four studies indicated that moderate and vigorous aerobic exercise did not improve cognition post-TBI. The evidence on the effects of moderate and vigorous aerobic exercise on cognitive function post-TBI remains limited. Additional studies are strongly warranted to understand aerobic exercise's effects on cognition post-TBI.

The Impact of Physical Exercise on microRNAs in Hemodialysis Patients: A Review and a Protocol for an Ancillary Study

Physical inactivity is considered a significant risk factor for mortality and morbidity among chronic hemodialysis (HD) patients. Therefore, physical exercise is recommended in the treatment of HD patients. Although the beneficial effects of physical exercise in HD patients are well-described in the literature, the underlying physiological mechanisms still need to be fully understood. Recently, microRNAs (miRNAs) have emerged as potential mediators of the therapeutic effects of physical exercise in healthy individuals. miRNAs are short, single-stranded, noncoding RNAs involved in gene expression regulation. Specifically, upon forming the RNA-induced silencing complex, miRNAs selectively bind to specific miRNAs within cells, reducing gene expression. miRNAs can be secreted by cells in an accessible form or enclosed within exosomes or extracellular vesicles. They can be detected in various body fluids, including serum (circulating miRNAs), facilitating the study of their diverse expression. Currently, there is no available data regarding the impact of physical exercise on the expression of miRNAs involved in osteogenic differentiation, a fundamental mechanism in the development of vascular calcification, for HD patients. Therefore, we have designed an observational and longitudinal case-control study to evaluate the expression of miR-9 and miR-30b in HD patients participating in a 3-month interdialytic physical exercise program. This paper aims to present the study protocol and review the expression of circulating miRNAs in HD patients and their modulation through physical exercise.

Energy expenditure, oxygen consumption, and heart rate while exercising on seven different indoor cardio machines at maximum and self-selected submaximal intensity

Objective

One of the main objectives of practicing indoor cardiovascular exercise is to maximize caloric expenditure. This study aimed to compare energy expenditure (EE), oxygen consumption (VO2), and heart rate (HR) recorded in middle-aged adults while exercising on seven different indoor cardiovascular machines at self-selected maximal and submaximal intensity.

Method

Thirty recreational-active adult males (Age: 41.69 ± 4.64) performed 12-min bouts at RPE (Rate of perceived exertion) 17 and maximum intensity (MAX INT) on the following indoor cardio machines: Recumbent bike (r_BIKE), upright bike (u-BIKE), spin bike (s-BIKE), rowing machine (ROW), elliptical trainer (ELLIP), stair climber (STAIR), and treadmill (TMILL). Heart rate (HR) and oxygen consumption (VO2) were measured during exercise, whereas EE (energy expenditure) was calculated indirectly.

Results

Overall, TMILL induced the highest levels of EE, VO2, and HR, followed by STAIR, ELLIP, s_BIKE, u_BIKE, ROW, and r_BIKE. RPE was reliable across exercise modalities (r_BIKE, u-BIKE, s-BIKE, ROW, ELLIP, STAIR, and TMILL) and intensities (RPE 17 and MAX INT) for EE, HR, and VO2 measurements.

Conclusion

To maximize EE while performing indoor cardiovascular exercise for recreational active middle-aged male participants, the TMILL is the best option, followed by the STAIR and the ELLIP. The least recommended options are, respectively, s_BIKE, u_BIKE, ROW, and r_BIKE. Beyond caloric expenditure considerations, promoting exercises that participants genuinely enjoy can enhance adherence, fostering sustained health benefits. Furthermore, RPE is a reliable tool for assessing EE, VO2, and HR across different exercise modalities and intensities.

Understanding the mechanisms of disease modifying effects of aerobic exercise in people with Alzheimer's disease

Alzheimer's disease (AD) is a very disabling disease. Pathologically, it is characterized by the presence of amyloid plaques and neurofibrillary tangles in the brain that results in neurodegeneration. Its clinical manifestations include progressive memory impairment, language decline and difficulty in carrying out activities of daily living (ADL). The disease is managed using interventions such as pharmacological interventions and aerobic exercise. Use of aerobic exercise has shown some promises in reducing the risk of developing AD, and improving cognitive function and the ability to carry out both basic and instrumental ADL. Although, the mechanisms through which aerobic exercise improves AD are poorly understood, improvement in vascular function, brain glucose metabolism and cardiorespiratory fitness, increase in antioxidant capacity and haemoglobin level, amelioration of immune-related and inflammatory responses, modulation of concentration of circulating Neurotrophins and peptides and decrease in concentration of tau protein and cortisol level among others seem to be the possible mechanisms. Therefore, understanding these mechanisms is important to help characterize the dose and the nature of the aerobic exercise to be given. In addition, they may also help in finding ways to optimize other interventions such as the pharmacological interventions. However, more quality studies are needed to verify the mechanisms.

EFFECT OF RESISTANCE TRAINING THROUGH IN-PERSON AND TELECONFERENCING SESSIONS IN REHABILITATION OF ACUTE STROKE PATIENTS

Objective

To determine whether application of a strength training regimen yields measurable results on stroke survivors and compare different methods for the proposed intervention.

Design Patients and Methods

Ninety stroke patients were recruited from the neurological clinic of a local third-level clinic. Sixty patients participated in a strength training regimen with trainings taking place 3 times a week for 12 weeks with the use of resistance bands. Thirty of these patients were given face-to-face sessions and 30 patients were given trainings through an on-line platform. The last 30 patients who comprised the control group only followed usual care after the stroke.

Results

The applied strength regimen had a statistically significant effect on Visual Analog Scale scores of stroke patients who received it (p = 0.009), as well as in the teleconferencing group (p = 0.004). The measured arteriovenous oxygen difference was elevated for stroke patients who received the intervention as a whole (p = 0.007). Patients who were trained in person and the ones who were trained via teleconferencing yielded similar results as evaluated through the VAS index.

Discussion and Conclusion

Administration of strength training 3 times weekly for 12 weeks to stroke patients yielded measurable results in terms of general function and quality of life.

Physical Exercise-Induced DNA Methylation in Disease-Related Genes in Healthy Adults-A Systematic Review With Bioinformatic Analysis

ABSTRACT

Vasileva, F, Hristovski, R, Font-Lladó, R, Georgiev, G, Sacot, A, López-Ros, V, Calleja-González, J, Barretina-Ginesta, J, López-Bermejo, A, and Prats-Puig, A. Physical exercise-induced DNA methylation in disease-related genes in healthy adults-A systematic review with bioinformatic analysis. J Strength Cond Res 38(2): 384-393, 2024-This study aimed to systematically review the existing literature regarding physical exercise (PE) and DNA methylation (DNAm) in healthy adults. Specific goals were to (a) identify differently methylated genes (DMGs) after PE intervention, their imprinting status, chromosome and genomic location, function, and related diseases; and (b) to screen for core genes and identify methylation changes of the core genes that can be modified by PE intervention. Our search identified 2,869 articles from which 8 were finally included. We identified 1851 DMGs ( p < 0.05) after PE intervention, although 45 of them were imprinted. Aerobic exercise (AE) seems to induce more DNA hypermethylation rather than hypomethylation, whereas anaerobic exercise (AN) seems to induce more DNA hypomethylation rather than hypermethylation. Aerobic exercise induced highest % of methylation changes on chromosome 6, whereas AN and mixed type (MT) on chromosome 1. Mixed type induced higher % of methylation changes close to transcription start site in comparison to AE and AN. After PE intervention, DMGs were mainly involved in fat metabolism, cell growth, and neuronal differentiation, whereas diseases regulated by those genes were mainly chronic diseases (metabolic, cardiovascular, neurodegenerative). Finally, 19 core genes were identified among DMGs, all related to protein metabolism. In conclusion, our findings may shed some light on the mechanisms explaining PE-induced health benefits such as the potential role that PE-induced DNAm may have in disease prevention and disease treatment.

Harnessing the Systemic Biology of Functional Decline and Cachexia to Inform more Holistic Therapies for Incurable Cancers

Options for treatment of incurable cancer remain scarce and are largely focused on limited therapeutic mechanisms. A new approach specific to advanced cancers is needed to identify new and effective treatments. Morbidity in advanced cancer is driven by functional decline and a number of systemic conditions, including cachexia and fatigue. This review will focus on these clinical concepts, describe our current understanding of their underlying biology, and then propose how future therapeutic strategies, including pharmaceuticals, exercise, and rehabilitation, could target these mechanisms as an alternative route to addressing incurable cancer.

Exercise and cardiac rehabilitation in hypertensive patients with heart failure with preserved ejection fraction: A position statement on behalf of the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology

Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life. However, the instructions for the prescriptive or recommended exercise in hypertensive patients and, more specifically, in those with HFpEF are not well defined. Moreover, the evidence is based on observational or small randomized studies, while well-designed clinical trials are lacking. Despite the proven benefit and the guidelines' recommendations, exercise programs and cardiac rehabilitation in patients with hypertensive heart disease and HFpEF are grossly underutilized. This position statement provides a general framework for exercise and exercise-based rehabilitation in patients with hypertension and HFpEF, guides clinicians' rehabilitation strategies, and facilitates clinical practice. It has been endorsed by the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology and is focused on the Health Care System in Greece.

Feasibility of Different Exercise Modalities for Community-Dwelling Residents With Physical Inactivity: A Randomized Controlled Trial

BACKGROUND

Exercise interventions can promote health, but they can be difficult to implement. Moreover, no consensus has been reached regarding which exercise modality promotes the most significant improvement in metabolic health.

PURPOSE

This feasibility study was conducted to (a) determine the implementation efficacy of supervised and home-based exercise interventions by investigating their respective rates of intervention adherence, adherence to targeted intensity, attrition, and adverse events and (b) explore the preliminary efficacy of 12-week exercise programs among aerobic exercise, aerobic exercise combined with resistance exercise, and high-intensity interval training on body composition, anthropometric parameters, and lipid profiles for community-dwelling residents with physical inactivity.

METHODS

This randomized controlled trial was conducted from April to October 2020. Seventy-two sedentary participants aged 40-70 years were enrolled and randomized into one of four groups: 12-week aerobic exercise, aerobic exercise combined with resistance exercise, high-intensity interval training, and control. The three exercise groups performed at least moderate-intensity supervised exercise twice a week and home-based exercise once a week, whereas the control group maintained their usual daily activities. The target variables, including body composition, anthropometric parameters, and lipid profiles, were measured before and after the 12-week intervention.

RESULTS

The intervention adherence rates were 74.01%-87.54% for the supervised exercise group, 64.98%-83.90% for the home-based exercise group, and 82.65%-92.65% for the target exercise intensity group. The attrition rate ranged from 12.50% to 17.65%, and no adverse events were reported in any of the exercise groups. Preliminary efficacy data show the reductions in body weight (95% CI [0.01, 1.20], p = .048) and low-density lipoprotein (95% CI [2.76, 30.32], p = .02) were greater in the exercise groups than the control group, although the intergroup differences were not significant.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Body weight and low-density lipoprotein may be efficiently reduced in a 12-week period using any of the three exercise modalities with at least 82.65% adherence to moderate-intensity exercise and 70.84% adherence to exercising 3 times a week.

Major Depressive Disorder and Gut Microbiota: Role of Physical Exercise

Major depressive disorder (MDD) has a high prevalence and is a major contributor to the global burden of disease. This psychiatric disorder results from a complex interaction between environmental and genetic factors. In recent years, the role of the gut microbiota in brain health has received particular attention, and compelling evidence has shown that patients suffering from depression have gut dysbiosis. Several studies have reported that gut dysbiosis-induced inflammation may cause and/or contribute to the development of depression through dysregulation of the gut-brain axis. Indeed, as a consequence of gut dysbiosis, neuroinflammatory alterations caused by microglial activation together with impairments in neuroplasticity may contribute to the development of depressive symptoms. The modulation of the gut microbiota has been recognized as a potential therapeutic strategy for the management of MMD. In this regard, physical exercise has been shown to positively change microbiota composition and diversity, and this can underlie, at least in part, its antidepressant effects. Given this, the present review will explore the relationship between physical exercise, gut microbiota and depression, with an emphasis on the potential of physical exercise as a non-invasive strategy for modulating the gut microbiota and, through this, regulating the gut-brain axis and alleviating MDD-related symptoms.

Association of exercise, brain-derived neurotrophic factor, and cognition among older women: A systematic review and meta-analysis

This systematic review and meta-analysis explored the effects of structured exercise regimens on brain-derived neurotrophic factor (BDNF) levels, a proxy for cognitive function, in older women. In this study, we collated evidence from the available clinical trials that reported BDNF levels and other outcomes following structured exercise regimens. Adhering to PRISMA Statement 2020 guidelines. PubMed/MEDLINE, Scopus, CINAHL Plus, and Cochrane were systematically searched using a combination of the following keywords: brain-derived neurotrophic factor, women, exercise, older, cognition, and/or cognitive. A random-effects model was applied; the statistical analysis was conducted in RevMan 5.4 (Cochrane). The risk of bias in the included trials was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Across 12 trials, 994 older women were included that were enrolled in different exercise regimens globally. Exercise regimens were categorized as aerobic, resistance/power training, aquatic, taekwondo, and multimodal and ranging from 30 to 60 min, 1-5 times per week across 5-24 weeks. Moderate improvement (Cohen's d: 0.44, 95% CI: 0.04-0.84, p = 0.03) was found in BDNF levels across all trials. There was a small yet insignificant improvement in mini-mental state examination (MMSE) scores (Cohen's d: 0.17, 95% CI: -0.79-1.13, p = 0.73). Aerobic exercise, aquatic exercise, and multimodal regimens showed significant association with improved BDNF levels but the sample size for individual exercise regimens was small A main limitation was the inclusion of 114 (10.3%) males in the data, introducing gender bias. This study provides novel insight into the association between various exercise regimens and BDNF levels among older women.

Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review

BACKGROUND

This narrative review aims to provide a comprehensive overview of the current prehabilitation and rehabilitation strategies for thyroid cancer survivors to optimize functional outcomes and enhance their quality of life.

METHODS

The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus.

RESULTS

The review emphasizes the role of a comprehensive rehabilitation approach in targeting the different domains that generate disability in thyroid cancer patients. In this context, physical activity, range of motion exercises, myofascial release, joint mobilization, and postural exercises are crucial for improving functional outcomes and reducing treatment-related discomfort and disability. Moreover, tailored rehabilitative management addressing dysphonia and dysphagia might have a positive impact on the quality of life of these patients. Despite these considerations, several barriers still affect the implementation of a multimodal rehabilitative approach in common clinical practice. Thus, sustainable and effective strategies like digital innovation and patient-centered approaches are strongly needed in order to implement the rehabilitative treatment framework of these subjects.

CONCLUSIONS

This narrative review provides valuable insights into the current prehabilitation and rehabilitation strategies to treat thyroid cancer survivors, addressing physical, psychological, and vocational needs to optimize functional outcomes and enhance their quality of life.

Sports Therapy for Schizophrenia Psychoses: from the Idea to the Guideline

Schizophrenia psychoses can be treated much better today due to the introduction of antipsychotics about 70 years ago in conjunction with the implementation of specific psychotherapies. However, current treatment options are still limited in the area of negative symptoms and disease-associated cognitive deficits. In the last 15 years, randomised controlled trials (RCTs) have been able to show that physical training and especially endurance training could represent a comprehensive complementary treatment approach and could lead to a significant improvement in positive, but especially also in negative symptoms and cognitive deficits. As a result, sports therapy for schizophrenia psychoses has found its way not only into the national treatment guidelines of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology (DGPPN), but also into European recommendations such as those of the European Psychiatric Association (EPA). With the introduction of the "Living guideline" format (here an update takes place at least once a year), a broader implementation in health care will be easier in the future. Based on a narrative review, this paper describes the process of implementing sports therapy for schizophrenia psychoses from its beginnings to its incorporation into guidelines and can be applied analogously to other forms of therapy.

Autonomic responses to aerobic and resistance exercise in patients with chronic musculoskeletal pain: A systematic review

BACKGROUND

It is unknown whether patients with chronic musculoskeletal pain (CMP) show autonomic dysregulation after exercise, and the interventional effects of exercise on the autonomic dysregulation have not been elucidated. The objectives of this study were to reveal acute autonomic responses after aerobic and resistance exercises and the interventional effects of both exercises on autonomic dysregulation in patients with CMP.

METHODS

A systematic search using nine electronic databases was performed based on three key search terms: "chronic musculoskeletal pain," "autonomic nervous system," and "exercise." Data were extracted from measurements of the autonomic nervous system and pain.

RESULTS

We found a total of 1170 articles; 17 were finally included, incorporating 12 observational and five interventional studies. Although a comparator has not been specified, healthy controls were compared to patients with CMP in observational studies. Three of five interventional studies were pre-post study with healthy controls as a comparator or no controls. The other two interventional studies were randomized controlled trial with a different treatment e.g., stretching. There were four good, 10 fair, and three poor-quality articles. The total number of participants was 617, of which 551 were female. There was high heterogeneity among the five disease conditions and nine outcome measures. Following one-time exposure to aerobic and resistance exercises, abnormal autonomic responses (sympathetic activation and parasympathetic withdrawal), which were absent in healthy controls, were observed in patients with CMP. The effects of aerobic and resistance exercise as long-term interventions were unclear since we identified both positive effects and no change in the autonomic activities in patients with CMP.

CONCLUSIONS

This study indicates dysfunctional autonomic responses following one-time exposure to exercise and inconsistent interventional effects in the autonomic activities in patients with CMP. Appropriate therapeutic dose is necessary for studying the management of autonomic regulation and pain after exercise.

The effectiveness of different aerobic exercises to improve pain intensity and disability in chronic low back pain patients: a systematic review

Background: Physical activity, including aerobic exercise, is highly recommended for chronic low back pain (CLBP) patients to improve pain intensity and functional disability. Objectives: To assess the effectiveness of different aerobic exercises to reduce pain intensity and functional disability in patients with CLBP. Methods: A computer-aided search was performed to find Randomised Controlled Trials (RCTs) that evaluated the effectiveness of different aerobic exercises in CLBP. Articles published between January 2007 to December 2020 were included in the review. Quality assessment using the PEDro scale, extraction of relevant information, and evaluation of outcomes were done by two reviewers independently. Results: A total of 17 studies were included that involved 1146 participants. Outcomes suggested that aerobic exercise combined with other interventions was more effective than aerobic exercise alone. Aerobic exercise with higher frequency (≥ 5 days/week) and longer duration (≥ 12 weeks) were effective to gain clinically significant (≥ 30%) improvements. Environment and using pedometer did not seem to influence the outcomes. Conclusions: Pain intensity and functional disability in CLBP patients can be minimized by prescribing aerobic exercise. However, to get better improvements, aerobic exercise should be done in combination with other interventions and at optimum frequency and duration. Further studies should emphasize examining the optimal doses and duration of different aerobic exercises.

A systematic review of the effect of structured exercise on inflammation and body composition in inflammatory bowel disease

PURPOSE

Given the substantial risk of treatment failure in inflammatory bowel disease (IBD), adjuvant therapies may play a role in disease management. We aim to carry out a systematic review to examine the effects of structured exercise on the inflammatory response in patients with IBD. Our secondary aim is to examine the effect of structured exercise programmes on body composition given both an increase in visceral obesity and the presence of sarcopenia have deleterious effects on outcomes in IBD.

METHODS

A systematic review was carried out following the Methodological Expectations of Cochrane Intervention Reviews (MECIR) manual and the Cochrane Handbook for Systematic Reviews of Interventions. Title/Abstract and MeSH Terms were used to search for relevant studies.

RESULTS

In total, 1516 records were screened for eligibility, and 148 records were reviewed for eligibility, of which 16 were included and a further 7 studies were identified from hand searching references. Four studies included body composition outcomes, and 14 studies reviewed the inflammatory response to exercise.

CONCLUSION

Further studies of adequate duration are required to include patients with more active disease to demonstrate an inflammatory response to exercise. Body composition measurements including muscle mass and visceral adiposity may play a key role in response to medical therapy in IBD and should be included as exploratory outcomes in future studies. A meta-analysis was not carried out due to the significant heterogeneity amongst studies.

Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis

INTRODUCTION

Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults.

MATERIAL AND METHODS

We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity.

RESULTS

We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions).

CONCLUSIONS

There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories.

PROSPERO REGISTRATION

CRD42020194258.

Examining the Relation Between Exercise and Word Learning in Preschool-Age Children

PURPOSE

There is evidence suggesting that aerobic exercise immediately after vocabulary training can improve word recall in school-age children. This work examined whether the previously identified word-learning benefits associated with exercise can be extended to preschoolers. Additionally, we evaluated whether the effects of physical activity on vocabulary learning may be influenced by existing language skills that the child possesses.

METHOD

Children ages 3-6 years completed the study (N = 42). Data were collected via a virtual testing session in which participants completed a word-learning task that included two experimental conditions (exercise and resting). In the resting measure, children were taught names of novel objects and then sat down and colored for 3 min before being tested on their ability to identify the trained words. The exercise condition was identical, except that participants engaged in 3 min of guided aerobic exercise before testing. Additionally, at the end of the visit, participants completed the Quick Interactive Language Screener (QUILS), which measured general language skills.

RESULTS

Accuracy of word recognition was significantly higher after the exercise condition compared to the resting condition. Furthermore, this pattern of results was not related to children's existing language skills, as measured by the QUILS.

CONCLUSIONS

This study is one of the first to closely examine the relation between physical activity and word-learning abilities in children as young as 3-6 years of age. Results align with previous findings stating that aerobic exercise can boost vocabulary learning and suggest that this is the case regardless of existing language skills.

Effects of Aerobic Training in Patients with Subacute COVID-19: A Randomized Controlled Feasibility Trial

Many clinical practice recommendations indicate rehabilitation as essential for patients with sequelae of severe or critical COVID-19 and suggest the prompt initiation of a multicomponent rehabilitation program focused on aerobic and endurance training. However, randomized controlled trials (RCTs) regarding aerobic exercise are lacking. Therefore, we aimed to assess the feasibility and effectiveness of the addition of aerobic training to standard rehabilitation in subjects with subacute COVID-19. Participants were 32/214 patients with the sequelae of severe or critical COVID-19 in the acute phase who were eligible and agreed to participate in the study (eligibility = 15%, recruitment = 100%). After randomization and assessment with functional and strength tests, all the participants underwent an inpatient-tailored rehabilitation program (50 min/day, 5 days/week, 10 sessions); in addition, the experimental group performed a low- to moderate-intensity aerobic exercise (30 min/day, 10 sessions). No dropouts or severe adverse events were reported, with an attendance rate of 95.6%. Most of the secondary outcomes significantly improved in both groups, but the improvement in the Functional Independence Measure and Cumulated Ambulation Score-Italian version was significantly greater in the experimental group (at least, p < 0.05). This RCT showed that aerobic exercise is feasible and safe in subacute COVID-19. Moreover, it appears to be beneficial and useful in improving patients' independence and mobility.

Investigating External and Internal Loads in Male Older Adult Basketball Players during Official Games

This study aimed at assessing the external [Player Load (PL), acceleration (ACC), changes of direction (COD), JUMP, and their relative values (PL/min; ACC/min; COD/min and JUMP/min)] and internal [percentage of the peak heart rate (%HRpeak) and the training load calculated with the session rating of perceived exertion (sRPE) method (sRPE-load)] loads of masters (senior citizen) basketball players during official games. Thirteen male basketball masters players (age: 66.6 ± 2.1 years; body mass: 89.9 ± 8.7 kg; stature: 183.7 ± 4.6 cm) were monitored during an official Lietuvos Krepsinio Veteranu Lyga (LKVL) 65-year game. Beside descriptive analysis, a chi-square goodness of fit test was adopted to assess the differences in the distribution within JUMP, ACC and COD classes of intensities (i.e., low, medium and high). The results revealed PL = 269.9 ± 83.3 AU and PL/min = 6.54 ± 1.29 AU/min. Moreover, significant differences (p < 0.001) in the distribution of the intensity classes were found for JUMP, ACC, and COD, with the lowest intensities as the most frequent. Finally, HRpeak = 81.7 ± 8.1% and sRPE-load = 148.9 ± 69.7 AU were found, with sRPE = ~3 AU. In conclusion, a low external load during an official basketball game was found compared to other basketball populations. Moreover, a high objective internal load did not correspond to a low perceived demand, which might increase the training adherence and motivation during long-term studies.

Research on the Recognition of Various Muscle Fatigue States in Resistance Strength Training

Instantly and accurately identifying the state of dynamic muscle fatigue in resistance training can help fitness trainers to build a more scientific and reasonable training program. By investigating the isokinetic flexion and extension strength training of the knee joint, this paper tried to extract surface electromyogram (sEMG) features and establish recognition models to classify muscle states of the target muscles in the isokinetic strength training of the knee joint. First, an experiment was carried out to collect the sEMG signals of the target muscles. Second, two nonlinear dynamic indexes, wavelet packet entropy (WPE) and power spectrum entropy (PSE), were extracted from the obtained sEMG signals to verify the feasibility of characterizing muscle fatigue. Third, a convolutional neural network (CNN) recognition model was constructed and trained with the obtained sEMG experimental data to enable the extraction and recognition of EMG deep features. Finally, the CNN recognition model was compared with multiple support vector machines (Multi-SVM) and multiple linear discriminant analysis (Multi-LDA). The results showed that the CNN model had a better classification accuracy. The overall recognition accuracy of the CNN model applied to the test data (91.38%) was higher than that of the other two models, which verified that the CNN dynamic fatigue recognition model based on subjective and objective information feedback had better recognition performance. Furthermore, training on a larger dataset could further improve the recognition accuracy of the CNN recognition model.

Prognostic Potential of the Body Composition Indices in Predicting Positive Changes in Resting Blood Pressure after High-Intensity Interval Training in Adolescents

This study aimed to investigate the prognostic potential of body composition indices in predicting the improvement in resting blood pressure after 10 weeks of high-intensity interval training (HIIT) implemented in physical education lessons. The participants were 141 adolescents aged 16 years. Independent variables were body mass index (BMI), fat mass index (FMI), muscle mass index (SMI), and mass to fat ratio (MFR); dependent variables were systolic and diastolic blood pressure (SBP, DBP) and its indices: pulse pressure (PP), mid-blood pressure (MBP), and mean arterial pressure (MAP). The receiver operating curve (ROC) method was employed. SMI and MFR are body composition indices with prognostic potential to predict positive changes in SBP in males (SMI: AUC = 0.82; p < 0.001, MFR = 0.70; p = 0.039) and MFR in females (AUC = 0.72; p = 0.035). The respective cut-off point values used to classify participants as a beneficiary of HIIT intervention concerning SBP were SMI = 7.84 and MFR = 2.43 in males, and for SMI = 10.12 and MFR = 1.94 in females. Body composition indices based on skeletal muscle (SMI, MFR) were more likely to predict positive changes in SBP after HIIT intervention in adolescents. PP, MBP, and MAP did not reflect the detecting power of SMI and MFR. However, these thresholds' utility is limited to adolescents of 16 years of age.

Alzheimer's disease genes and proteins associated with resistance and aerobic training: An in silico analysis

BACKGROUND

Exercise appears to be a viable intervention for maintaining cognitive function and regaining functional autonomy, and perhaps even contributing to a slower progression of Alzheimer's Disease (AD).

OBJECTIVE

To explore different neuroplasticity pathways modulated by aerobic and strength training, determine whether signaling pathways overlapped for each specific training method (aerobic and strength training), and evaluate whether there is a functional relationship between APOE and APP gene expression with aerobic training modulated by BDNF; and strength training modulated by IGF-1.

METHODS

An in silico analysis was performed to analyze the connection between exercise types and neuroplasticity as a protective factor in AD. The platform provides a protein-protein interaction network translated into known and predicted interactions. A score > 0.70 was determined as high confidence and the network was considered significant when the Protein-Protein Interaction Enrichment was <0.01.

RESULTS

Multiple functional associations considered significant between the analyzed proteins. The results of our gene network model support that exercise, both aerobic and strength, can modulate genes that affect hippocampal neuroplasticity and neurogenesis, which may delay cognitive decline and Alzheimer's related symptoms.

CONCLUSION

The investigation about the functional association of aerobic training via BDNF in the modulation of APP, APOE, and MAPT genes in the hippocampus seems to be established, while strength training seems to induce the production of IGF-1 and IGF-1R, modulating AKT1.

Rehabilitation interventions for cognitive deficits in stroke survivors: A systematic review of randomized controlled trials

Cognitive deficits are one of the most common impairments after stroke. It negatively affects physical and social functioning. Rehabilitation interventions for cognitive deficits post-stroke have taken less consideration. The present study aimed to provide an overview of the effects of various rehabilitation interventions on cognitive functions in patients with stroke. PUBMED, SCOPUS, PEDro, EMBASE, MEDLINE, and REHABDATA were searched for randomized controlled trials (RCTs) investigating the effects of rehabilitation interventions on cognitive domains poststroke until August 2021. The methodological quality of the selected studies was evaluated using the Cochrane Collaboration tool, and the effect sizes were calculated. Forty-four studies met the inclusion criteria. A total of 3561 individuals with stroke, 57.60% of whom were males. The mean age for all participants was 65.48 years. Eighteen RCTs were high, moderate (n = 17), and low methodological quality (n = 9). The results showed evidence for the beneficial effects of many rehabilitation interventions on cognition in individuals with stroke. Rehabilitation plays a crucial role in improving cognitive functions in stroke patients with mild cognitive deficits. Virtual reality (VR), computer-based cognitive rehabilitation (CBCR), and non-aerobic exercises may promote cognitive functions in patients with stroke.

The most effective exercise to prevent obesity: A longitudinal study of 33,731 Taiwan biobank participants

Regular physical exercise is recommended to reduce the risk of obesity. However, it remains unclear which activities are more effective in preventing obesity. In this study, five obesity indices and lifestyle factors of 33,731 Taiwan Biobank adults were measured/collected twice with a mean time interval of 4.06 years. A linear mixed effects model was fitted to assess the associations of exercises with obesity indices, in which a random intercept term was used to account for individual differences. The five obesity indices included body mass index (BMI), body fat percentage (BFP), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR). Among 23 exercises, jogging and yoga were consistently the most effective choices across all five obesity indices. One more weekly hour to jog was associated with a 0.093 kg/m2 decrease in BMI (p = 4.2E-20), a 0.297% decrease in BFP (p = 3.8E-36), a 0.398 cm decrease in WC (p = 1.6E-21), and a 2.9E-3 decrease in WHR (p = 1.3E-17). One more weekly hour to perform yoga was associated with a 0.225 cm decrease in HC (p = 6.4E-14). Jogging is an exercise for the entire body. Arms swing, waist turn, legs and feet run, and shoulders and abdomen are also involved in this act. By contrast, many yoga poses use muscles around the hips and pelvis, and therefore yoga is the most effective exercise to reduce HC.

Physical activity to reduce PCSK9 levels

The amount of physical activity (PA) people practice everyday has been reducing in the last decades. Sedentary subjects tend to have an impaired lipid plasma profile with a higher risk of atherosclerosis and related cardio- and cerebrovascular events. Regular PA helps in both primary and secondary cardiovascular prevention because of its beneficial effect on the whole metabolism. Several studies reported lower levels of plasma lipids in trained subjects, but the precise mechanisms by which PA modulates lipoproteins remain only partially described. Thereupon, proprotein convertase subtilisin/kexin type 9 (PCSK9) is a serin protease whose main function is to reduce the amount of low-density lipoprotein cholesterol (LDL-C) receptors, with the direct consequence of reducing LDL-C uptake by the liver and increasing its circulating pool. Accordingly, recently developed PCSK9 inhibitors improved cardiovascular prevention and are increasingly used to reach LDL-C goals in patients at high CV risk. Whether PA can modulate the levels of PCSK9 remains partially explored. Recent studies suggest PA as a negative modulator of such a deleterious CV mediator. Yet the level of evidence is limited. The aim of this review is to summarize the recent reports concerning the regulatory role of PA on PCSK9 plasma levels, highlighting the beneficial role of regular exercise on the prevention of atherosclerosis and overall CV health.

Bioinformatics Analysis of Exercise-Related Biomarkers in Diabetes

Background

Exercise is a regular behavioral activity that not only helps to lose weight but also reduces the risk of cardiovascular and cerebrovascular diseases. Diabetes is a common disease that plagues human health. It is shown that regular exercise can improve the insulin sensitivity of diabetic patients and have an important function in adjuvant therapy.

Methods

We downloaded the GSE101931 dataset from the Gene Expression Omnibus (GEO) database, 10 samples were obtained from the GSE101931 dataset, including 5 before exercise and 5 postexercise samples, and GEO2R was used to screen the differentially expressed genes (DEGs) exhibited by a heat map. Then, the enrichment analysis of DEGs in Gene Ontology (GO) function was analyzed by Metascape, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway of DEGs was also analyzed by gene set enrichment analysis (GSEA). Next, the protein-protein interaction (PPI) network maps were drawn, and the hub genes were identified through Metascape. Finally, the expressions of the hub genes in the dataset were analyzed.

Results

Totally, 116 upregulated DEGs and 1017 downregulated DEGs were identified from these data. These DEGs were mainly enriched in the platelet-derived growth factor receptor signaling pathway and mRNA processing. Then, the GSEA analysis showed that 6 KEGG pathways were associated with postexercise prediabetic samples, namely, ABC transporters, focal adhesion, MAPK signaling pathway, prion diseases, melanogenesis, and gap junction. Afterward, three hub genes (HSPA8, STIP1, and HSPH1) were highly expressed after exercise through the box plot analysis.

Conclusion

A myriad of research results confirms that there is a certain connection between exercise and diabetes, which provides a favorable basis for emerging exercise into the treatment of diabetic patients.

Enhancing Mental Health, Well-Being and Active Lifestyles of University Students by Means of Physical Activity and Exercise Research Programs

Mental disorders (e.g., depression) and sedentary behavior are increasing, also among emerging adults. One particular target group of emerging adults with high sitting times and vulnerability to mental disorders are university students. In particular, anxiety and depressive symptoms as well as stress symptoms are very common among university students. The present manuscript discusses whether physical activity and exercise interventions can help to promote the mental health of emerging adults such as university students. The manuscript will summarize current scientific evidence and based on this evidence, introduce an university-based scientific research project that investigates if physical activity, exercise interventions and acute bouts of exercise of low- to moderate intensity can buffer perceived stress, alleviate mental health symptoms and strengthen well-being (psychologically and physiologically) among university students by positively influencing depressive and anxiety symptoms, perceived stress and emotion perception, body awareness and subjective well-being including overall quality of life. The research project, its concept, multimethod approach, and first results from available studies are discussed in relation to current scientific evidence, health care needs and future developments. The results from the studies conducted within the research project so far and that are briefly summarized in this manuscript suggest that physical activity, mental health and well-being are positively related, also in university students as an important group of emerging adults. The results further suggest that exercise interventions comprising aerobic exercises of low- to moderate intensity may work best to improve mental health (alleviate depressive symptoms and perceived stress) among university students after a few weeks of intervention. In addition, acute bouts of certain types of exercises (yoga in particular) seem to be particularly effective in changing perception of bodily signals, cardiac activity and emotion processing immediately after the exercise. The results underscore the importance of systematic investigations of the combined examination of psychological and physiological factors that promote an active lifestyle and that strengthen mental health and well-being (psychologically and physiologically) among emerging adults such as university students.

Type, Intensity, and Duration of Exercise as Regulator of Gut Microbiome Profile

ABSTRACT

Gut microbiome profile is related to individual health. In metabolic syndrome, there is a change in the gut microbiome profile, indicated by an increase in the ratio of Firmicutes to Bacteroidetes. Many studies have been conducted to determine the effect of exercise on modifying the gut microbiome profile. The effectiveness of exercise is influenced by its type, intensity, and duration. Aerobic training decreases splanchnic blood flow and shortens intestinal transit time. High-intensity exercise improves mitochondrial function and increases the essential bacteria in lactate metabolism and urease production. Meanwhile, exercise duration affects the hypothalamic-pituitary-adrenal axis. All of these mechanisms are related to each other in producing the effect of exercise on the gut microbiome profile.

Considerations in the Care of Athletes With Type 1 Diabetes Mellitus

Type 1 diabetes mellitus is an autoimmune disease caused by affected individuals’ autoimmune response to their own pancreatic beta-cell. It affects millions of people worldwide. Exercise has numerous health and social benefits for patients with type 1 diabetes mellitus; however, careful management of blood glucose is crucial to minimize the risk of hypoglycemia and hyperglycemia. Anaerobic and aerobic exercises cause different glycemic responses during and after exercise, each of which will affect athletes’ ability to reach their target blood glucose ranges. The optimization of the patient’s macronutrient consumption, especially carbohydrates, the dosage of basal and short-acting insulin, and the frequent monitoring of blood glucose, will enable athletes to perform at peak levels while reducing their risk of dysglycemia. Despite best efforts, hypoglycemia can occur. Recognition of symptoms and rapid treatment with either fast-acting carbohydrates or glucagon is important. Continuous glucose monitoring devices have become more widely used in preventing hypoglycemia.

Effects of physical activity as an adjunct treatment on healing outcomes and recurrence of venous leg ulcers: A scoping review

Healing time is protracted and ulcer recurrence is common in patients with venous leg ulcers. Although compression is the mainstay treatment, many patients do not heal timely. Physical activity may be a clinically effective adjunct treatment to compression to improve healing outcomes. This scoping review provides a broad overview of the effect of physical activity as an adjunct treatment to compression on wound healing and recurrence. We followed the six-step framework developed by Arksey and O'Malley. We searched electronic databases and trial registration websites for relevant studies and ongoing trials. Two authors independently screened and selected articles. Findings were presented in a descriptive statistical narrative summary. We consulted and presented our findings to the wound consumer group to ensure the relevance of our study. Physical activity interventions in 12 out of the 16 eligible studies consisted of only one component, eight studies were resistance exercises, three studies reported ankle and/or foot range of motion exercises, and one study reported aerobic/walking exercises. The remaining four studies involved multicomponent exercise interventions. Resistance exercise combined with ankle and/or foot range of motion exercise minimised ulcer size on day 12 (intervention group: 4.55 ± 1.14 cm² vs. control group: 7.43 ± 0.56 cm² ) and improved calf muscle pump performance on day 8 (ejection fraction: 40%-65%; residual volume fraction: 56%-40%). We identified one study that reported ulcer recurrence rate with no clinical difference in the intervention group versus the control group (i.e., 12% in intervention vs. 5% in control). Our review identified that resistance exercise was the most common type of physical activity intervention trialled in the published literature. Resistance exercise combined with ankle and/or foot range of motion exercise appears to be effective adjunct treatments; however, the overall evidence is still relatively weak as most programmes had a short intervention period which limited clinical outcomes.

Does aerobic exercise effect pain sensitisation in individuals with musculoskeletal pain? A systematic review

Background

Pain sensitisation plays a major role in musculoskeletal pain. However, effective treatments are limited, and although there is growing evidence that exercise may improve pain sensitisation, the amount and type of exercise remains unclear. This systematic review examines the evidence for an effect of aerobic exercise on pain sensitisation in musculoskeletal conditions.

Methods

Systematic searches of six electronic databases were conducted. Studies were included if they examined the relationship between aerobic physical activity and pain sensitisation in individuals with chronic musculoskeletal pain, but excluding specific patient subgroups such as fibromyalgia. Risk of bias was assessed using Cochrane methods and a qualitative analysis was conducted.

Results

Eleven studies (seven repeated measures studies and four clinical trials) of 590 participants were included. Eight studies had low to moderate risk of bias. All 11 studies found that aerobic exercise increased pressure pain thresholds or decreased pain ratings in those with musculoskeletal pain [median (minimum, maximum) improvement in pain sensitisation: 10.6% (2.2%, 24.1%)]. In these studies, the aerobic exercise involved walking or cycling, performed at a submaximal intensity but with incremental increases, for a 4-60 min duration. Improvement in pain sensitisation occurred after one session in the observational studies and after 2-12 weeks in the clinical trials.

Conclusions

These findings provide evidence that aerobic exercise reduces pain sensitisation in individuals with musculoskeletal pain. Further work is needed to determine whether this translates to improved patient outcomes, including reduced disability and greater quality of life.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-022-05047-9.

Effects of Long-Term Regular Continuous and Intermittent Walking on Oxidative Stress, Metabolic Profile, Heart Rate Variability, and Blood Pressure in Older Adults with Hypertension

It is documented that regular exercise is beneficial for improving the antioxidant system, metabolic system, cardiac autonomic function, and blood pressure in those with hypertension. In this regard, low-intensity exercise is recommended for older adults, particularly those with chronic diseases. This study aimed to compare the effects of long-term regular continuous walking with intermittent walking on oxidative stress, metabolic profile, heart rate variability, and blood pressure in older adults with hypertension. Forty-three participants with hypertension aged 60–80 years were randomly divided into the continuous or intermittent walking (CON or INT) groups. Participants in the CON group walked for 30 min, 3 days/week for 12 weeks. Participants in the INT group split 30 min walking into 3 identical sessions punctuated by a 1 min rest after each session, 3 days/week for 12 weeks. Antioxidant and oxidative stress markers, metabolic markers, heart rate variability, and blood pressure were evaluated before and after the exercise program. Glutathione (GSH), GSH to GSH disulfide (GSSG) ratio, and total GSH increased significantly, and GSSG and malondialdehyde decreased significantly in both groups ( $p<0.05$ ) without significant differences between groups. Triglycerides, ratio of total cholesterol to high-density lipoprotein cholesterol, and atherosclerogenic index were significantly lower in the CON group than those in the INT group ( $p<0.05$ ). The standard deviation of the NN intervals and root mean square of the successive differences were significantly higher, and low-frequency power was significantly lower in the INT group than that in the CON group ( $p<0.05$ ). No significant changes in blood pressure were noted in both groups, and nor were there any significant differences between groups. Long-term regular continuous and intermittent walking may comparably increase antioxidants, reduce oxidative stress, and be beneficial for improving important blood pressure-related outcomes, including metabolic profile or cardiac autonomic function in older adults with hypertension.

Does aerobic exercise reduce NASH and liver fibrosis in patients with non-alcoholic fatty liver disease? A systematic literature review and meta-analysis

BACKGROUND

Exercise is an effective strategy for the prevention and regression of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD), but it is unclear whether it can reduce advanced stages of NAFLD, i.e., steatohepatitis and liver fibrosis. Furthermore, it is not evident which modality of exercise is optimal to improve/attenuate NAFLD.

OBJECTIVES

The aim is to systematically review evidence for the effect of aerobic exercise (AE) on NAFLD, in particular non-alcoholic steatohepatitis (NASH) and liver fibrosis.

METHODS

A systematic literature search was conducted in Medline and Embase. Studies were screened and included according to predefined criteria, data were extracted, and the quality was assessed by Cochrane risk of bias tools by two researchers independently according to the protocol registered in the PROSPERO database (CRD42021270059). Meta-analyses were performed using a bivariate random-effects model when there were at least three randomized intervention studies (RCTs) with similar intervention modalities and outcome.

RESULTS

The systematic review process resulted in an inclusion a total of 24 studies, 18 RCTs and six non-RCTs, encompassing 1014 patients with NAFLD diagnosed by histological or radiological findings. Studies were grouped based on the type of AE: moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT). A total of twelve meta-analyses were conducted. Compared to controls, MICT resulted in a mean difference (MD) in the NAFLD biomarkers alanine transaminase (ALT) and aspartate aminotransferase (AST) of -3.59 (CI: -5.60, -1.59, p<0.001) and -4.05 (CI: -6.39, -1.71, p<0.001), respectively. HIIT resulted in a MD of -4.31 (95% CI: -9.03, 0.41, p=0.07) and 1.02 (95% CI: -6.91, 8.94, p=0.8) for ALT and AST, respectively. Moreover, both AE types compared to controls showed a significantly lower magnetic resonance spectroscopy (MRS) determined liver fat with a MD of -5.19 (95% CI: -7.33, -3.04, p<0.001) and -3.41 (95% CI: -4.74, -2.08, p<0.001), for MICT and HIIT respectively. MICT compared to controls resulted in a significantly higher cardiorespiratory fitness (MD: 4.43, 95% CI: 0.31, 8.55, p=0.03).

CONCLUSION

Liver fat is decreased by AE with a concomitant decrease of liver enzymes. AE improved cardiorespiratory fitness. Further studies are needed to elucidate the impact of different types of AE on hepatic inflammation and fibrosis.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier (CRD42021270059).

A Summary of Current Findings on Quality of Life Domains and a Proposal for Their Inclusion in Clinical Interventions

Whilst the assessment of quality of life (QoL) and well-being has burgeoned in the past 50 years, there still remains relatively little research into its treatment in psychology, in spite of the launching of such approaches as positive psychology to widen the ambit of interventions to promote well-being. We posit that there are a number of outstanding QoL areas that could be integrated into standard therapeutic procedures, and that this would this result in an increase in well-being as a therapeutic outcome. To investigate this an exploratory search of the literature was undertaken of associations between improvements in a life domain and increased well-being or QoL. Ten domains (relationships, work, money, health, and leisure, mindfulness, self-esteem, resolution of past life events, mental style and life management skills) were identified. In view of the substantial evidence of the cumulative impact of these domains upon well-being, it is proposed that conducting a unidimensional clinical intervention that focuses only on the presenting issue is not sufficient. Implications and possible therapeutic pathways are discussed and it is recommended that practitioners include such QoL domains in their assessment, case formulation, and intervention planning.

Exercise mimetics: harnessing the therapeutic effects of physical activity

Exercise mimetics are a proposed class of therapeutics that specifically mimic or enhance the therapeutic effects of exercise. Increased physical activity has demonstrated positive effects in preventing and ameliorating a wide range of diseases, including brain disorders such as Alzheimer disease and dementia, cancer, diabetes and cardiovascular disease. This article discusses the molecular mechanisms and signalling pathways associated with the beneficial effects of physical activity, focusing on effects on brain function and cognitive enhancement. Emerging therapeutic targets and strategies for the development of exercise mimetics, particularly in the field of central nervous system disorders, as well as the associated opportunities and challenges, are discussed.

Comparison of Telomere Length in Young and Master Endurance Runners and Sprinters

It is unclear how running modality influences telomere length (TL). This single laboratory visit study compared the TL of master sprinters and endurance runners with their young counterparts. The correlation between leukocyte and buccal cell TL in athletes was also explored. Participants consisted of 11 young controls, 11 young sprinters, 12 young endurance runners, 12 middle-aged controls, 11 master sprinters, and 12 master endurance runners. Blood and buccal samples were collected and randomized for analysis of TL by quantitative polymerase chain reaction. Young endurance runners displayed longer telomeres than master athletes (p < .05); however, these differences were not significant when controlled for covariates (p > .05). A positive correlation existed between leukocyte and buccal cell TL in athletes (r = .567, p < .001). In conclusion, young endurance runners possess longer telomeres than master endurance runners and sprinters, a consequence of lower body mass index and visceral fat.

Sex-Specific Impacts of Exercise on Cardiovascular Remodeling

Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field.

Prevention and Reversal of Morbidity in Today's Cardiovascular Patient: Role of Lifestyle Modification and Nutrition in the Current Era

PURPOSE OF REVIEW

The prevalence of cardiovascular disease despite good medical therapy is on the rise, driven by risk factors such as hypertension, diabetes, hypercholesterolemia, and obesity. As healthcare providers, we must seek to better advise patients on preventative strategies through lifestyle changes.

RECENT FINDINGS

Guideline recommendations have been published by professional societies on the prevention of heart disease through lifestyle changes; however, limited education and experience with these lifestyle-modifying methods hinders appropriate counseling and treatment of patients. Robust data support the use of lifestyle medicine to reduce cardiovascular morbidity and risk. These include, a more plant-based whole food diet, regular exercise, stress relief, connectedness, and other lifestyle approaches. This review will help further the understanding of the front-line clinician in cardiovascular prevention.

Assessment of cancer prevention effect of exercise

There are many documents about benefits of exercise on human health. However, evidences indicate to positive effect of exercise on disease prevention, understanding of many aspects of this mechanism need more investigations. Determination of critical genes which effect human health.GSE156249 including 12 gene expression profiles of healthy individual biopsy from vastus lateralis muscle before and after 12-week combined exercise training intervention were extracted from gene expression omnibus (GEO) database. The significant DEGs were included in interactome unit by Cytoscape software and STRING database. The network was analyzed to find the central nodes subnetwork clusters. The nodes of prominent cluster were assessed via gene ontology by using ClueGO. Number of 8 significant DEGs and 100 first neighbors analyzed via network analysis. The network includes 2 clusters and COL3A1, BGN, and LOX were determined as central DEGs. The critical DEGs were involved in cancer prevention process.

Changes in health promoting behavior during COVID-19 physical distancing: Utilizing wearable technology to examine trends in sleep, activity, and cardiovascular indicators of health

The COVID-19 pandemic incited unprecedented restrictions on the behavior of society. The aims of this study were to quantify changes to sleep/wake behavior and exercise behavior, as well as changes in physiological markers of health during COVID-19 physical distancing. A retrospective analysis of 5,436 US-based subscribers to the WHOOP platform (mean age = 40.25 ± 11.33; 1,536 females, 3,900 males) was conducted covering the period from January 1st, 2020 through May 15th, 2020. This time period was separated into a 68-day baseline period and a 67-day physical distancing period. To provide context and allow for potential confounders (e.g., change of season), data were also extracted from the corresponding time periods in 2019. As compared to baseline, during physical distancing, all subjects fell asleep earlier (-0.15 hours), woke up later (0.29 hours), obtained more sleep (+0.21 hours) and reduced social jet lag (-0.13 hours). Contrasting sleep behavior was seen in 2019, with subjects falling asleep and waking up at a similar time (-0.01 hours; -0.03 hours), obtaining less sleep (-0.14 hours) and maintaining social jet lag (+0.06 hours) in corresponding periods. Individuals exercised more intensely during physical distancing by increasing the time spent in high heart rate zones. In 2020, resting heart rate decreased (-0.90 beats per minute) and heart rate variability increased (+0.98 milliseconds) during physical distancing when compared to baseline. However, similar changes were seen in 2019 for RHR (-0.51 beats per minute) and HRV (+2.97 milliseconds), suggesting the variation may not be related to the introduction of physical distancing mandates. The findings suggest that individuals improved health related behavior (i.e., increased exercise intensity and longer sleep duration) during physical distancing restrictions. While positive changes were seen to cardiovascular indicators of health, it is unclear whether these changes were a direct consequence of behavior change.