Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review

Hormone therapy following surgery reduces the risk of breast cancer (BC) recurrence and progression of hormone-sensitive BC, especially in postmenopausal women. Despite the antitumor efficacy of hormone therapy, particularly of aromatase inhibitors, they cause long-term side effects, mainly bone density reduction. Exercise can slow the rate of bone loss, which reduces the risk of fractures from osteoporosis, and could be an integrative treatment able to mitigate the BC treatment side effects positively impacting bone health. This narrative review aims to discuss studies on the effect of exercise on bone health in BC women undergoing aromatase inhibitors, highlighting the possible role of exercise as complementary to conventional therapies. Additionally, according to the literature revision, exercise practical applications to improve bone health in these patients are summarized.

The effects of pre-task music on choice visual reaction time in elite taekwondo athletes

OBJECTIVES

The effects of music on sport performance mainly involved endurance or resistance exercises overlooking possible effects on reaction time, which is deemed essential in martial arts for a proficient performance. Therefore, the aim of this study was to investigate the effects of the exposure to pre-task music on choice visual reaction time in elite taekwondo athletes.

DESIGN

Repeated measure study design.

METHODS

Reaction time and mean Heart Rate (HRmean) were recorded in twenty young taekwondo athletes (17.5 ± 2.5 years old) while performing a roundhouse kick in response to different visual stimuli after three warmup conditions: listening to self-selected music (SM), research-selected music (RM) or no music (CC). Moreover, Feeling Scale (FS), Felt Arousal Scale (FAS) were recorded before (T0) and after warmup (T1) in each testing session.

RESULTS

SM and RM elicited significantly faster reaction times compared to CC (-3.3 % and -5.2 %, respectively). No significant difference in reaction time was observed between SM and RM. The FS and FAS scores were significantly higher at T1 compared to T0 in the SM and RM conditions, whereas no difference between T0 and T1 was observed in the CC condition. No difference was observed for HRmean between SM, RM and CC conditions.

CONCLUSIONS

Listening to SM and RM during the warmup improved choice visual reaction times in elite taekwondo athletes. These results suggest the use of music as a performance-enhancing strategy prior to combat competition or training in martial arts.

Shoulder brace has no detrimental effect on basic spatio-temporal gait parameters and functional mobility after arthroscopic rotator cuff repair

BACKGROUND

The risk of falls in patients undergoing orthopedic procedures is significant in terms of health and socioeconomic effects.

RESEARCH QUESTION

Is there an influence of the shoulder abduction brace (SAB) on gait parameters in patients undergoing arthroscopic rotator cuff repair (ARCR)?

METHODS

Thirty-five patients undergoing ARCR, who used a 15° SAB in the postoperative period, were included in a prospective study. Participants underwent gait analysis preoperatively (T0), 24 h after surgery (T1), 1 week (T2), and 4 weeks after surgery (1 week after SAB removal) (T3) by using a wearable inertial sensor (BTS G-Walk sensor). Gait Parameters (cadence, speed, right (R) and left (L) step length, gait and propulsion-R and L symmetry indices) and functional mobility (agility and balance) were assessed using the 10-meter test (10MWT) and the Timed Up and Go (TUG) test, respectively.

RESULTS

There were 22 men and 13 women with a median age of 56 (IQR 48.0-61.0) years. The right upper limb was involved in 83% of cases. Regarding the 10MWT, speed was significantly higher at T0 than at T1 (p < 0.01) and significantly lower at T1 than at T3 (p < 0.05). Cadence was significantly lower at T1 than at T3 (p < 0.05). Propulsion-R was significantly higher at T3 than at T1 (p < 0.01), whereas propulsion-L was significantly lower at T1 than at T0 (p < 0.05) and significantly higher at T2 and T3 than T1 (p < 0.01 for all). No significant differences were found for R and L step lengths as well as for symmetry index (p > 0.05). Regarding TUG test, the final turning phase was significantly higher at T2 than at T3 (p < 0.01).

SIGNIFICANCE

The results demonstrated that the use of the SAB affected gait speed and propulsion only 24 h after ARCR, but no effects were reported at long-term observations.

Effects of self-selected versus motivational music on lower limb muscle strength and affective state in middle-aged adults

Background

Strength training plays a crucial role in promoting healthy ageing and music might affect how individuals perform and perceive strength exercises. This study aimed to investigate the effects of self-selected music (SSM) on muscle strength and affective states during maximal isometric contractions on a customized leg extension.

Methods

Twenty-six healthy middle-aged males (50.8 ± 8.4 years) performed maximal and endurance isometric strength tests under three different conditions: SSM, motivational music (MM), and control condition (CC). Peak force and Rate of Force Development (RFD) were assessed during the maximal isometric strength test. The isometric endurance test evaluated the mean force and a fatigue index. Moreover, Felt Arousal Scale (FAS) was administered before the strength protocol, whereas the Rate of Perceived Exertion (RPE) and Feeling Scale (FS) at the end of it.

Results

Mean force was significantly higher in the SSM (507.3 ± 132.2 N) than MM (476.3 ± 122.4 N, p < 0.01) and CC (484.6 ± 119.2 N, p = 0.03). FAS was significantly higher in the SSM (4.0 [1.3] than MM (3.0 [2.3], p < 0.01) and CC (3.0 [1.3], p < 0.01) conditions. FS was significantly higher in the SSM (4.0 [2.0] than MM (3.0 [1.3], p < 0.01) and CC (3.0 [1.3], p < 0.01) conditions. No significant differences were found for peak force, RFD, fatigue index, and RPE.

Conclusions

Listening to SSM seems to influence isometric endurance strength performance in middle-aged adults positively. Moreover, listening to SSM might improve individuals' affective states without affecting the level of perceived exertion.

The Beneficial Role of Physical Exercise on Anthracyclines Induced Cardiotoxicity in Breast Cancer Patients

The increase in breast cancer (BC) survival has determined a growing survivor population that seems to develop several comorbidities and, specifically, treatment-induced cardiovascular disease (CVD), especially those patients treated with anthracyclines. Indeed, it is known that these compounds act through the induction of supraphysiological production of reactive oxygen species (ROS), which appear to be central mediators of numerous direct and indirect cardiac adverse consequences. Evidence suggests that physical exercise (PE) practised before, during or after BC treatments could represent a viable non-pharmacological strategy as it increases heart tolerance against many cardiotoxic agents, and therefore improves several functional, subclinical, and clinical parameters. At molecular level, the cardioprotective effects are mainly associated with an exercise-induced increase of stress response proteins (HSP60 and HSP70) and antioxidant (SOD activity, GSH), as well as a decrease in lipid peroxidation, and pro-apoptotic proteins such as Bax, Bax-to-Bcl-2 ratio. Moreover, this protection can potentially be explained by a preservation of myosin heavy chain (MHC) isoform distribution. Despite this knowledge, it is not clear which type of exercise should be suggested in BC patient undergoing anthracycline treatment. This highlights the lack of special guidelines on how affected patients should be managed more efficiently. This review offers a general framework for the role of anthracyclines in the physio-pathological mechanisms of cardiotoxicity and the potential protective role of PE. Finally, potential exercise-based strategies are discussed on the basis of scientific findings.

The effects of music on cardiorespiratory endurance and muscular fitness in recreationally active individuals: a narrative review

Music is made up of several features (e.g., melody and rhythm) and it accompanies our life in different daily activities. During the last years, there was a growing interest in research about the music-related effects in the exercise domain. Music stimuli could act as an ergogenic effect leading to improvements in health-related and physical fitness components like cardiorespiratory endurance and muscular fitness. Moreover, listening to music may positively affect individuals' psychological state which could lead to increased exercise adherence. Conflicting data exist regarding the effects of music on cardiorespiratory and muscle-strengthening exercises indicating that music's characteristics (i.e., rhythm and musicality), studied samples (i.e., athletes and amateur) and methodology (i.e., self-selected music and research-selected music) might influence the results. Listening to music while exercising is becoming more frequent also in recreationally active individuals. While literature mainly focused on the effects of music in elite and amateur athletes, little data are available regarding recreationally active participants. Therefore, this review aims to summarize evidence regarding the effects of music on health-related physical fitness components in recreationally active individuals, specifically referring to cardiorespiratory endurance and muscular fitness. These outcomes will be helpful to all recreationally active participants to optimize the exercise protocol with the use of music.

Male hypogonadism: therapeutic choices and pharmacological management

Male hypogonadism, defined as an inadequate testosterone production, recognizes a testicular (primary hypogonadism) or a hypothalamic-pituitary dysfunction (central hypogonadism), although combined forms can also occur. Moreover, it has been known that intensive exercise training might be a cause of functional hypogonadism. Many therapeutic choices are currently available, depending on the timing of hypogonadism onset and fertility issue. The aim of this review was to comprehensively supply therapeutic options and schemes currently available for male hypogonadism, including pharmacological management of primary and central forms. Evidence on testosterone formulations, human chorionic gonadotropin, selective estrogen receptor modulators and aromatase inhibitors will be provided.

Exercise as a drug for glucose management and prevention in type 2 diabetes mellitus

Physical inactivity and sedentary behavior are risk factors for type 2 diabetes mellitus (T2DM). Therefore, physical exercise (PE) together with medical treatment might be considered as a key strategy to counteract T2DM. Glycemic control is a central objective in the prevention and management of T2DM, and PE might be able to substantially affect the processes that determine it. Just like a drug, exercise can be dosed based on the characteristics of the individual to increase its benefits and reduce side effects. In this brief review, the mechanisms underlying the effects of PE on glucose metabolism in muscle are illustrated, and the effects of modulation of the parameters characterizing this atypical "drug" on glucose homeostasis are described.

Initial validation of the Italian version of the Volition in Exercise Questionnaire (VEQ-I)

The purpose of this study was to validate the Volition in Exercise Questionnaire in Italian language (VEQ-I). The translation and cultural adaptation of the VEQ-I was conducted using the forward-backward translation method. VEQ-I eighteen items correspond to the six-factors structure of the original version. The construct validity was verified by the confirmatory factor analysis (CFA) (CFI = 0.960; TLI = 0.943; RMSEA = 0.039; and SRMR = 0.040). The eighteen items were well distributed in six subscales and the six-factors structure of the questionnaire was supported. Internal Consistency value of the questionnaire was investigated for each subscale of the VEQ-I. Cronbach’s alpha and Omega values of the Reasons, Postponing Training, Unrelated Thoughts, Self-Confidence, Approval from Others and Coping with Failure subscales were 0.76 (α) and 0.76 (ω), 0.76 (α) and 0.76 (ω), 0.87 (α) and 0.88 (ω), 0.85 (α) and 0.85 (ω), 0.70 (α) and 0.72 (ω) and 0.74 (α) and 0.74 (ω), respectively. They were acceptable in all the six subscales. The concurrent validity was assessed using the correlation among the subscales of VEQ-I measures and those contained in two questionnaires: Psychobiosocial States in Physical Education (PBS-SPE) and Exercise Motivations Inventory (EMI-2).

Effects of Ballroom Dance on Physical Fitness and Reaction Time in Experienced Middle-Aged Adults of Both Genders

Ballroom dance practice might play a pivotal role for successful aging, but its effects could differ depending on dancers' experience level. The aim of this study was to investigate the effects of six months of ballroom dance (three times/w) on physical fitness and reaction time (RT) in 24 middle-aged adults who are experienced dancers (age: 59.4 ± 11.6 years). Body composition, handgrip test (HG), standing long-jump test (SLJ), step test (ST), one-legged stance balance test (OLSB), and RT were assessed before (T₀) and after six months (T₆) of dance practice. RT was re-evaluated four months later (T₁₀). RT was significantly (p < 0.05) lower at T₆ (221.2 ± 20.3 ms) and T₁₀ (212.0 ± 21.9 ms) than T₀ (239.1 ± 40,7 ms); no significant differences were found between T₆ and T₁₀. No significant differences were observed for all the other parameters between T₀ and T₆: weight and muscle mass were significantly lower (p < 0.01) in females than in males, and percentage of fat mass was significantly higher (p < 0.01) in females than in males. HG was significantly higher in males than females (p < 0.01). Results suggest that in experienced middle-aged adults of both genders, ballroom dance may positively influence RT, and this result could be maintained for four months.

Prediction equation for estimating cognitive function using physical fitness parameters in older adults

Ageing is associated with declines in cognitive functions and physical fitness (PF). Physical exercise training and physical activity (PA) have been shown to have positive effects on cognitive functions and brain plasticity. This study aims to establish a practical equation for evaluating cognitive functions using PF parameters in healthy older adults. One-hundred and two older subjects were physically and clinically evaluated. Participants performed the Short Physical Performance Battery (SPPB) and handgrip test (HG); general cognitive functions were examined using the Mini Mental State Examination (MMSE). For all of them, a multiple regression analysis was used to predict MMSE from age, SPPB and HG variables. The new equation was cross validated to determine its prediction accuracy. Considering that SPPB and MMSE reference score are not different between genders, only one equation was developed for females and males. Age, SPPB and HG correlated significantly (p<0.01) with the MMSE score. The developed equation was MMSE = 19.479 + (1.548 x SPPB)-(0.130 x age) (R2 = 0.72 and root mean square errors of 3.6). The results of PF are useful for exercise specialists to achieve the best physical exercise training and PA in older adults. In conclusion, this study showed for the first time that our new equation can be used to predict subjects' cognitive functions based on SPPB results and subject age. We suggest its use when patients' cognitive functions or more appropriate clinical tests cannot be pursued.

Effects of Acute Whole-Body Vibration Practice on Maximal Fat Oxidation in Adult Obese Males: A Pilot Study

OBJECTIVE

Whole-body vibration (WBV) training has been established as a useful method to improve physical fitness in obese individuals. However, the effects of WBV exercise on maximal fat oxidation (MFO) have not been examined in obese subjects yet.

METHOD

MFO was eval-uated during a cardiopulmonary exercise test (CPET) on a treadmill in 12 adult obese males (BMI = 34.9 ± 3.3 kg/m2) after three different warm-up conditions: static half squat plus WBV (HSV), static half squat without WBV (HSWV), and rest (REST). Cortisol levels were evaluated before and after the warm-up, and 1 min (T1), 10 min (T10), and 30 min (T30) of the recovery phase.

RESULTS

MFO was significantly higher in HSV (p = 0.013; 569.4 ± 117.9 mg/min) and HSWV (p = 0.033; 563.8 ± 142.9 mg/min) than REST (445.5 ± 117.9 mg/min). Cortisol concentrations at T1 were significantly higher in HSV (p = 0.023) and HSWV (p = 0.015) than REST. Moreover, cortisol concentrations were significantly lower at T30 than T1 in HSWV (p = 0.04). No differences were found between T30 and T1 in HSV.

CONCLUSIONS

Active warm-up increases MFO; however, vibration stimulus during half squatting does not increase MFO during a CPET in obese subjects. The lack of significant differences of cortisol concentrations in HSV during the recovery phase might suggest a long-term effect of WBV on the endocrine system.

Characterization of the Effects of a Six-Month Dancing as Approach for Successful Aging

Aging is accompanied by a decline in multiple domains. Positive effects of dance practice on several health issues have been evaluated in young adults, while the effects of regular social dance practice on physical fitness, sexual health, and cognitive functions have not been studied yet in older experienced dancers. Thus, the aim of this study has been to investigate whether a 6-month social dance practice might influence fitness performance, sexual health, and specific cognitive functions and/or mood characteristics in older experienced dancers. Thirty experienced dancers (age: 71.2±5.1 years, 18 females/12 males) were enrolled from the dance school "NonSoloLiscio" of Catanzaro. Body composition, physical fitness, sexual health, and cognitive functions were assessed before (T0) and after (T6) intervention. After 6 months of dance practice, percent of fat mass (%FM) significantly decreased (p<0.01), while fat-free mass (FFM) significantly increased (p<0.01) in both genders. Moreover, significant main effects of time on physical fitness tests, such as chair stand test (CST) (p<0.01), gait speed (p<0.05), and timed up and go (p<0.05), were found. Sexual health was significantly higher in males than in females at T0 and no significant effects of dance on subjects' sexual health were found. Interestingly, trait of anxiety significant decreased (p<0.05) and perception of retrospective memory significantly increased (p=0.05) after training independently of gender. Our preliminary results suggest that, even in older intermediate-level dancer, the practice of social dance might positively influence body composition and also increase fitness performance, memory functions, and anxiety. In contrast, no effects on sexual health were observed after 6 months of dancing.

Gender difference and correlation between sexuality, thyroid hormones, cognitive, and physical functions in elderly fit

PURPOSE

Sexuality in the elderly is related to psycho-physical well-being. Aim of this study was to analyze the correlation between sexual health, thyroid hormones, cognitive functions, and physical fitness in elderly population.

METHODS

Fifty-one fit adults were recruited (age: 71.9 ± 5.3 years, 26 females and 25 males). Sexuality was evaluated using the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14) and the Sexual Attitude Scale (SAS). Thyroid function was assessed by measuring serum TSH, FT3, and FT4. Cognitive functions and depressive symptoms were evaluated by the Mini Mental State Examination (MMSE) test and Geriatric Depression Scale (GDS) scores. Subjects' physical fitness was evaluated using the following tests: Short Physical Performance Battery (SPPB), Handgrip test (HG), Timed Up and Go test (TUG), and 2-Minute step test (ST).

RESULTS

CSFQ-14 positively correlated with MMSE (p < 0.05) and negatively with GDS (p < 0.05), while thyroid function was not correlated with sexuality, in both genders. A negative relationship between FT4 vs. weight, FT3 vs. HG and FT3/FT4 ratio vs. ST were found (p = 0.05) in females, while in males, it occurred for TSH vs. TUG (p < 0.05); a positive relationship existed in females between FT4 vs. ST (p < 0.05). Finally, CSFQ-14 was significantly correlated with SPPB (p < 0.05), CST, TUG, and ST (p < 0.01), in both genders.

CONCLUSION

We demonstrated a strict relationship between active sexuality, preserved cognitive function and appropriate physical fitness in elderly subjects, independently from gender. Our preliminary data suggest that in elderly fit population, peripheral thyroxin deiodination may be a useful predictor of better physical performance and more successful aging.

Relationship between individual ventilatory threshold and maximal fat oxidation (MFO) over different obesity classes in women

Objective

The use of the Individual Ventilatory Threshold (IVT), as parameter to prescribe exercise intensity in individuals with obesity, has become more frequent during the last years. This study aimed to evaluate the relationship between IVT and Maximal Fat Oxidation (MFO) in women with obesity.

Methods

Fifty-two obese female adults (age = 43.6±10.9 years; BMI = 38.5±5.2 kg/m²) were included in this study. According to the BMI classification, subjects were divided into three groups: Obese Class I (OBI, n = 16); Obese Class II (OBII, n = 20) and Obese Class III (OBIII, n = 16). All subjects performed an incremental graded exercise test to evaluate peak oxygen uptake (VO_2peak), IVT and MFO. MFO was evaluated using a stoichiometric equation. Fat max zone was determined for each subject within 10% of fat oxidation rates at MFO. For each HR, %HR_max, VO₂ and %VO_2peak variable, Pearson’s correlation test was done between IVT and MFO exercise intensity. When statistical correlation was found we used a comparative statistical analysis to assess differences between IVT and MFO. Statistical significance was set at P ≤ 0.05.

Results

For each HR, %HR_max, VO₂ and %VO_2peak variable there was a positive significant correlation (P<0.01) between IVT and MFO. No significant differences were found for HR, %HR_max, and VO₂ between IVT and MFO. %VO_2peak was significantly higher at IVT than at MFO (P = 0.03).

MFO rates were significantly higher in OBIII women than in women of the other two classes. In all subjects, IVT was within the fat max zone.

Conclusion

The use of HR and VO₂ corresponding to IVT could be a useful parameter not only to improve cardiorespiratory fitness but also to prescribe physical activity that maximize fat oxidation in obese subjects.

Validity, reliability and minimum detectable change of COSMED K5 portable gas exchange system in breath-by-breath mode

PURPOSE

This study aimed to examine the validity, reliability and minimum detectable change (MDC) of the Cosmed K5 in breath by breath (BxB) mode, against VacuMed metabolic simulator. Intra and inter-units reliability was also assessed.

METHODS

Fourteen metabolic rates (from 0.9 to 4 L.min-1) were reproduced by a VacuMed system and pulmonary ventilation (VE), oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured by two different K5 units. Validity was assessed by ordinary least products (OLP) regression analysis, Bland-Altman plots, intraclass correlation coefficients (ICC), mean percentage differences, technical errors (TE) and MDC for VE, VO2, and VCO2. Intra- and inter-K5 reliability was evaluated by absolute percentage differences between measurements (MAPE), ICCs, TE, and MDC.

RESULTS

Validity analysis from OLP regression data and Bland- Altman plots indicated high agreement between K5 and simulator. ICC values were excellent for all variables (>0.99). Mean percentage differences in VE (-0.50%, p = 0.11), VO2 (-0.04%, p = 0.80), and VCO2 (-1.03%, p = 0.09) showed no significant bias. The technical error (TE) ranged from 0.73% to 1.34% (VE and VCO2 respectively). MDC were lower than 4% (VE = 2.0%, VO2 = 3.8%, VCO2 = 3.7%). The intra and inter K5 reliability assessment reveled excellent ICCs (>0.99), MAPE <2% (no significant differences between trials), TE < or around 1%, MDC <or around 3%.

CONCLUSIONS

K5 in BxB mode is a valid and reliable system for metabolic measurements. This is the first study assessing the MDC accounting only for technical variability reporting intra- and inter-units MDCs <3.3%.

Lifestyle and fertility: the influence of stress and quality of life on male fertility

BACKGROUND

Male infertility is a widespread condition among couples. In about 50% of cases, couple infertility is attributable to the male partner, mainly due to a failure in spermatogenesis. In recent times, the crucial role that modifiable lifestyle factors play in the development of infertility have generated a growing interest in this field of study, i.e. aging, psychological stress, nutrition, physical activity, caffeine, high scrotal temperature, hot water, mobile telephone use. Several studies have investigated associations between semen quality and the presence of lifestyle stressors i.e. occupational, life events (war, earthquake, etc.) or couple infertility; overall, these studies provide evidence that semen quality is impaired by psychological stress. In this review, we will discuss the impact of quality of life (modifiable lifestyle factors) and psychological stress on male fertility. In addition, the role that increased scrotal temperature along with inappropriate nutritional and physical exercise attitudes exert on male fertility will be presented.

CONCLUSION

The decline of male fertility, particularly associated with advancing age, incorrect lifestyles and environmental factors plays an important role on natality, and its consequences on the future on human population makes this an important public health issue in this century. Thus, modification of lifestyle through a structured program of educational, environmental, nutritional/physical exercise and psychological support, combined with the use of nutraceutical antioxidants can prevent infertility and therefore, may help couples to obtain better quality of life and improved possibility to conceive spontaneously or optimize their chances of conception.

Effects of body weight loss program on parameters of muscle performance in female obese adults

BACKGROUND

Body weight loss program may lead to a decrease in lean body mass affecting negatively muscle performance in obese subjects. Thus, the aim of this study was to examine the effect of weight loss on muscle performance in female obese subjects.

METHODS

Eighty obese female adults were enrolled for a 2-month unsupervised aerobic training (UAT) plus nutritional program. In the pre- and postintervention body composition was evaluated by hand-to-foot bioelectrical impedance method, body strength using handgrip test, and lower muscle power was assessed by a 5-repetition chair stand test (CST) and 30-s chair stand test (30sCST) wearing a dynamometer.

RESULTS

Thirty-six subjects completed the protocol, 39% had high compliance (HC), while 61% had low compliance (LC) to exercise prescription. HC group showed a significant decreased body weight, percent of fat mass and lean muscle mass after training. Both groups significantly increased CST performance while only HC significantly increased 30sCST. No differences were found in CST muscle power in both groups between pre- and post-training. However, evaluation of muscle power during 30sCST showed significantly higher value in HC group than LC group after training.

CONCLUSIONS

The results of our study show that although total lean muscle mass decreased after UAT, lower body muscle efficiency increased while muscle power did not change suggesting that in obese patients UAT can help to optimize weight loss and body efficiency. The data might be helpful for exercise professionals to evaluate correctly the muscle performance in obese adults after weight loss programs.

Effects of an individualized home-based unsupervised aerobic training on body composition and physiological parameters in obese adults are independent of gender

PURPOSE

Evaluation of the effects of an individualized home-based unsupervised aerobic training on body composition, physical and physiological parameters in female and male obese adults.

METHODS

Two hundred and twenty obese adults (age 47.9 ± 12.4 years; BMI 38.0 ± 7.2 kg/m²) entered the 4-month training program. Body composition, physiological and functional capacities were assessed pre- and post-intervention. All subjects were requested to perform unsupervised aerobic training with the intensity based on heart rate, walking speed and OMNI-RPE score corresponding to the individual ventilatory threshold for at least 5 days/week.

RESULTS

After 4-month study period, 40% of patients completed the protocol, 24% had high compliance (HC) (exercise ≥ 3 days/week), while 16% had low compliance (LC) to exercise prescription (exercise < than 3 days/week). In HC group, a significant improvement of body composition variables after training was performed. Moreover, oxygen uptake and metabolic equivalent at peak significantly increased after training. Six-minute walking test (6MWT) distance significantly increased while heart rate during 6MWT was significantly lower after training. No significant differences were found in LC group between pre- and post-intervention in all variables. Interestingly, gender does not influence the effects of training.

CONCLUSIONS

Our results indicate that subjects, independent of gender, with high compliance to the aerobic training based on a new individualized method can achieve a significant reduction in weight loss and also an improvement in physical and physiological parameters. This innovative personalized prescription could be a valuable tool for exercise physiologist, endocrinologists, and nutritionists to approach and correct life style of obese subjects.

Physical activity and hypocaloric diet recovers osteoblasts homeostasis in women affected by abdominal obesity

Obesity is a multifactorial disease linked to metabolic chronic disorders such as diabetes, and hypertension. Also, it has recently been associated with skeletal alterations and low bone mineral density. We previously demonstrated that exposure of osteoblasts to sera of sedentary subjects affected by obesity alters cell homeostasis in vitro, leading to disruption of intracellular differentiation pathways and cellular activity. Thus, the purpose of the present study has been to evaluate whether sera of sedentary obese women, subjected to physical activity and hypocaloric diet, could recover osteoblast homeostasis in vitro as compared to the sera of same patients before intervention protocol. To this aim, obese women were evaluated at time 0 and after 4, 6, and 12 months of individualized prescribed physical activity and hypocaloric diet. Dual-energy-X-ray absorptiometry measurements were performed at each time point, as well as blood was collected at the same points. Cells were incubated with sera of subjects before and after physical activity as described: obese at baseline and after for 4, 6, and 12 months of physical activity and nutritional protocol intervention. Osteoblasts exposed to sera of patients, who displayed increased lean and decreased fat mass (from 55.5 ± 6.5 to 57.1 ± 5.6% p ≤ 0.05; from 44.5 ± 1.1 to 40.9 ± 2.6% p ≤ 0.01 respectively), showed a time-dependent increase of Wnt/β-catenin signaling, versus cells exposed to sera of obese patients before intervention protocol, suggesting recovery of osteoblast homeostasis upon improvement of body composition. An increase in β-catenin nuclear accumulation and nuclear translocation was also observed, accompanied by an increase in Adiponectin receptor 1 protein expression, suggesting positive effect on cell differentiation program. Furthermore, a decrease in sclerostin amount and an increase of type 1 procollagen amino-terminal-propeptide were depicted as compared to baseline, proportionally to the time of physical activity, suggesting a recovery of bone remodeling modulation and an increase of osteoblast activity induced by improvement of body composition. In conclusion, our results show for the first time that sera of obese sedentary women who increased lean mass and decreased fat mass, by physical activity and hypocaloric diet, rescue osteoblasts differentiation and activity likely due to a reactivation of Wnt/β-catenin-pathway, suggesting that a correct life style can improve skeletal metabolic alteration induced by obesity.

Effects of different physical education programmes on children's skill- and health-related outcomes: a pilot randomised controlled trial

Aim of this study was to evaluate the effectiveness of two different 5-month physical education (PE) interventions conducted by a specialist PE teacher on primary school children's skill- and health-related outcomes. About 230 children were randomly assigned to one of three intervention groups: experimental_1 group, experimental_2 group or control group (school curriculum given by the generalist teacher). Pre- and post-intervention tests assessed pupils' fitness (pacer, curl-up, push-up, trunk lift, sit and reach tests) and gross motor coordination (shifting platforms, balance beam, jumping laterally, hopping on one leg over an obstacle tests). Both experimental groups significantly improved some fitness and coordinative tests after the intervention period when compared with control group. However, no differential changes on coordinative development were observed between the 2 experimental groups. Results of this study demonstrated that children benefitted from a well-structured PE intervention conducted and supervised by a specialist PE teacher improving their motor skills and fitness.

Effects of combined physical education and nutritional programs on schoolchildren's healthy habits

Background. A multidisciplinary approach seems to be effective in creating healthy habits in children. The aim of this study was to evaluate the efficacy of three 5-month combined physical education (PE) and nutritional interventions on body composition, physical activity (PA) level, sedentary time and eating habits of schoolchildren. Methods. Anthropometric data, weekly PA level, sedentary time and eating habits of 230 healthy students were analysed using a repeated-measures ANOVA with Group (experimental group 1 vs experimental group 2 vs control group), Adiposity Status (under fat vs normal fat vs obese), and Time (pre vs post) as factors. Results. Body fat mass percentage increased after intervention (18.92 ± 8.61% vs 19.40 ± 8.51%) in all groups. The weekly PA level significantly increased after intervention in both experimental groups. Sedentary time significantly decreased after the intervention period (565.70 ± 252.93 vs 492.10 ± 230.97 min/week, p < 0.0001). Moreover, obese children were more sedentary than under fat and normal fat children. Children significantly changed the consumption of some specific foods after intervention. Discussion. This study revealed the effectiveness of a combined PE and nutritional intervention to improve children's healthful dietary practices and to encourage an active lifestyle. However, it needs a further appropriate development to establish patterns of healthful dietary practices that encourage an active lifestyle with which to maintain healthy habits through life.

Differences in Ventilatory Threshold for Exercise Prescription in Outpatient Diabetic and Sarcopenic Obese Subjects

Aim of the study was to examine cardiorespiratory parameters at individual ventilatory threshold (IVT) and peak exercise capacity ([Formula: see text]) in outpatient diabetic and sarcopenic obese subjects. Seventeen obese subjects (BMI: 36.6 ± 4.1 kg·m(-1)) and sixteen SO subjects (BMI: 37.0 ± 7.3 kg·m(-1)) were compared with sixteen T2DM subjects (BMI: 37.7 ± 5.6 kg·m(-1)). All groups performed an incremental exercise test on a treadmill according to their physical ability. [Formula: see text], %HRmax, and maximal metabolic equivalent (METmax) were evaluated at maximal effort. Moreover, [Formula: see text], %[Formula: see text], %HRmax, %HRR, ΔHR, and METivt were assessed at IVT. No significant differences were found in any physiological parameters at maximal effort ([Formula: see text], %HRmax, and METmax) in all groups. On the contrary, [Formula: see text], %[Formula: see text], %HRmax, %HRR, ΔHR, and METivt were significantly lower in T2DM subjects as compared to OB and SO subjects at IVT (p < 0.05). Our results show that while at maximal effort there are no differences among groups, at IVT the physiological parameters are lower in T2DM subjects than in OB and SO subjects. Therefore, due to the differences observed in the groups, we suggest usng the IVT as a useful parameter to prescribe aerobic exercise in obese with sarcopenia or diabetes mellitus conditions.

PSYCHOPHYSICAL BENEFITS OF ROCK-CLIMBING ACTIVITY

The aim of the study was to compare the psychophysical effects of rock climbing with a supervised fitness training in adults. Thirty-three healthy participants (M age=32 yr., SD=7) participated in rock climbing or in fitness training. The participants' functional fitness, anxiety, and mood states were tested before and after 3 mo. of training. There was significant improvement of physical fitness in both groups after the intervention period. Anxiety significantly decreased after each single training session at the end of both courses. Differential effects in the rock-climbing group, as compared to the fitness group, emerged only on Vigor. Specifically, the rock-climbing group showed a decreasing trend in Vigor while the fitness group showed an increasing trend of Vigor after the intervention.

Impacts of coordinative training on normal weight and overweight/obese children's attentional performance

This study investigated the efficacy of a physical activity (PA) program to improve the attention span in normal weight vs. overweight/obese children. The study was designed as a cluster-randomized controlled intervention. One hundred fifty-seven normal weight and overweight/obese primary school children were randomly divided in three cohorts: Traditional PA, Coordinative PA and a Control group (not attending any PA). Before and after 5 months of intervention, children were administered the d2-R test of attention. Results showed that participants’ attentional performances were significantly affected by Time (pre vs. post; P < 0.01) and by Time × Group interaction (traditional vs. coordinative vs. control; P < 0.001), revealing significant different effects of intervention/exercise modality on children’s attentional performance, independently of their weight status. These data suggest that a 5-month school-based PA intervention can improve the cognitive performance in children. Further, the Coordinative PA intervention resulted in the most significant improvement in children’s attention.

Psychophysiological responses to Salsa dance

Speculation exists whether dance provides physiological stimuli adequate to promote health and fitness benefits. Unfortunately, research to date has not addressed the affective and exertional responses to dance. These responses are of interest as positive affective and exertional responses experienced during physical activity may play an important role in predicting adherence. The present study aims to examine the psychophysiological responses of different Salsa dance styles. Ten pairs of dancers performed two different structured lessons of Salsa dance, including Typical Salsa and Rueda de Casino lessons, and a non-structured Salsa dance at a night club. Physiological responses (i.e., percent of heart rate reserve; %HRR) were continuously assessed and perceived exertion and affective valence were rated every 15 min throughout the trials. %HRR responses differed between the Salsa dance styles (%HRR from 41.3 to 51.9%), and participants were dancing at intensities near their ventilatory threshold. Specifically, Typical Salsa lesson elicited lower %HRR responses than Rueda de Casino lesson (p < 0.05), but similar %HRR responses to Salsa dance at a night club condition (p > 0.05). Surprisingly, exertional (from 8 to 11) and affective (from +3 to +5) responses were unaffected by Salsa dance styles (p > 0.05). These data support that different Salsa dance styles provide physiological stimuli adequate to promote health and fitness benefits, and perhaps more importantly, produce pleasurable experiences, which in turn might lead to an increase in adherence to Salsa dancing which likely provides exercise-like health benefits.

Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes

In obese diabetic subjects, a correct life style, including diet and physical activity, is part of a correct intervention protocol. Thus, the aim of this study was to evaluate the effects of aerobic training intervention, based on heart rate at aerobic gas exchange threshold (AerTge), on clinical and physiological parameters in obese elderly subjects with type 2 diabetes (OT2DM). Thirty OT2DM subjects were randomly assigned to an intervention (IG) or control group (CG). The IG performed a supervised aerobic exercise training based on heart rate at AerTge whereas CG maintained their usual lifestyle. Anthropometric measures, blood analysis, peak oxygen consumption ([Formula: see text]), metabolic equivalent (METpeak), work rate (WRpeak), and WRAerTge were assessed at baseline and after intervention. After training, patients enrolled in the IG had significantly higher (P < 0.001) [Formula: see text], METpeak, WRpeak, and WRAerTge and significantly lower (P < 0.005) weight, BMI, %FM, and waist circumference than before intervention. Both IG and CG subjects had lower glycated haemoglobin levels after intervention period. No significant differences were found for all the other parameters between pre- and posttraining and between groups. Aerobic exercise prescription based upon HR at AerTge could be a valuable physical intervention tool to improve the fitness level and metabolic equilibrium in OT2DM patients.

Acute effects of two different tennis sessions on dorsal and lumbar spine of adult players

The aim of the study was to evaluate the dorsal and lumbar spine of expert and recreational tennis players before (pre) and after (post) two different training sessions. The sample consisted of 17 male tennis players, nine expert and eight recreational males (age 21.2 ± 1.6 years). We assessed the back surface by rasterstereography pre and post two different training sessions both lasting 1.5 h: a standard training and a specific over-shoulder shots training session, respectively. Lordotic and kyphotic angle, length, imbalance, inclination for trunk, pelvic torsion, left and right lateral deviation and surface rotation were measured. Tennis expertise (expert versus recreational) significantly affected the surface rotation and right lateral deviation (P < 0.05). Trunk length was affected by intervention (pre versus post) (P < 0.05). Left lateral deviation differed both for type of session (session 1 versus session 2) and intervention (P < 0.001, P < 0.05). Expert tennis players had higher values on surface rotation and right lateral deviation, around or just above physiological values (0-5° and 0-5 mm, respectively). Type of session significantly affected left lateral deviation, indicating that over-shoulder shots lead to a higher stress for the spine; the workload produced by both single sessions led to a shortening effect on trunk length. A single training session can induce acute modifications in some parameters of dorsal and lumbar spine of players.

Abdominal Fat and Sarcopenia in Women Significantly Alter Osteoblasts Homeostasis In Vitro by a WNT/ β -Catenin Dependent Mechanism

Obesity and sarcopenia have been associated with mineral metabolism derangement and low bone mineral density (BMD). We investigated whether imbalance of serum factors in obese or obese sarcopenic patients could affect bone cell activity in vitro. To evaluate and characterize potential cellular and molecular changes of human osteoblasts, cells were exposed to sera of four groups of patients: (1) affected by obesity with normal BMD (O), (2) affected by obesity with low BMD (OO), (3) affected by obesity and sarcopenia (OS), and (4) affected by obesity, sarcopenia, and low BMD (OOS) as compared to subjects with normal body weight and normal BMD (CTL). Patients were previously investigated and characterized for body composition, biochemical and bone turnover markers. Then, sera of different groups of patients were used to incubate human osteoblasts and evaluate potential alterations in cell homeostasis. Exposure to OO, OS, and OOS sera significantly reduced alkaline phosphatase, osteopontin, and BMP4 expression compared to cells exposed to O and CTL, indicating a detrimental effect on osteoblast differentiation. Interestingly, sera of all groups of patients induced intracellular alteration in Wnt/ β -catenin molecular pathway, as demonstrated by the significant alteration of specific target genes expression and by altered β -catenin cellular compartmentalization and GSK3 β phosphorylation. In conclusion our results show for the first time that sera of obese subjects with low bone mineral density and sarcopenia significantly alter osteoblasts homeostasis in vitro, indicating potential detrimental effects of trunk fat on bone formation and skeletal homeostasis.

Acute exercise modulates BDNF and pro-BDNF protein content in immune cells

PURPOSE

Although several studies have shown that immune cells stimulated by in vitro stress are capable to produce neurotrophins, there is still no evidence whether physiological stress, such as exercise, can modulate the in vivo levels of brain-derived neurotrophic factor (BDNF) in peripheral blood mononuclear cells (PBMCs).

METHODS

This work investigated whether acute exercise modulates the expression of BDNF, pro-BDNF, and p75(NTR) in the PBMCs of 10 healthy young men who performed a cycling incremental test to exhaustion (MAX) or exercised at individual anaerobic threshold (IAT). The PBMC expression of stress response proteins and the level of circulating BDNF, vascular endothelial growth growth factor, platelet-derived growth factor subunit B, basic fibroblast growth factor pro-inflammatory, and anti-inflammatory cytokines were analyzed as well.

RESULTS

A major finding is that both sessions of acute exercise regulated the content of BDNF isoforms within PBMCs in a manner related to the physiological stress exerted. Although the pro-BDNF increased after both MAX and IAT protocols, BDNF showed a kinetics dependent on exercise type: MAX induced a 54% protein increase immediately after exercise, followed by a significant drop 60 min after its conclusion (38% lower than the baseline). Differently, in the IAT, BDNF increased significantly up to 75% from the baseline throughout the recovery phase. All physiological parameters, as well as the p75(NTR) receptor and the stress-inducible proteins, were also differently regulated by the two exercise conditions.

CONCLUSIONS

These data supported the hypothesis that PBMCs might produce and secrete BDNF isoforms, as well as modulate the proteins p75(NTR) , Bcl-xL, hsp90, hsp27, and αB-crystallin, as part of the physiological stress response induced by acute exercise, offering a novel example of bidirectional interaction between nervous and immune systems.

Exercise intensity and gender difference of 3 different salsa dancing conditions

The aims of this study were to estimate the difference in exercise intensity (METs), energy cost (EE) and gender difference between a typical salsa lesson (TSL), rueda de casino lesson (RCL), and salsa dancing at a night club (SDN). Subjects performed 1 pre-testing session and 3 testing conditions. During the pre-testing session height, weight and V˙O2max were assessed. During the testing conditions all subjects performed 3 different kinds of salsa dance. Heart rate was assessed during each dance condition. The exercise intensity of the 3 salsa dancing conditions was moderate ranging from 3.9 to 5.5 METs. A significant difference between genders for HRpeak (P=0.01), max%HRR (P=0.006) and mean EE (P=0.02) were observed. Significant gender×condition interactions for HRpeak (P=0.03), mean %HRR (P=0.02), mean METs (P=0.02) and mean EE (P=0.02) were found. In addition, a significant main effect for each condition was found in all variables (P<0.01). Our results showed that the exercise intensities of all 3 salsa dancing conditions were moderate. Findings showed some significant differences in exercise intensity between males and females and within conditions. Salsa dancing could be useful in achieving a significant training effect in people who have a low level of fitness.

Basketball ability testing and category for players with mental retardation: 8-month training effect

Although sport for athletes with mental retardation (MR) is achieving an important role, the literature concerning basketball tests and training is still poor. The aims of this study were to verify whether the basketball test battery could be an appropriate modality to classify the players in the Promotion (Pro) category, to assess basketball abilities before (PRE) and after (POST) an 8-month training in players with MR in relation to Competitive (Comp) and Pro categories, to analyze the variation of specific basketball abilities based on subjects' MR diagnosis. Forty-one male basketball players with MR (17 Comp and 24 Pro; age range 18-45 years; MR: 15% mild, 54% moderate, 29% severe, and 2% profound) were assessed PRE and POST training through the basketball test battery, which assessed 4 ability levels of increasing difficulty (from I to IV), each one characterized by the analysis of fundamental areas (ball handling, reception, passing, and shooting). Level I was significantly changed after the intervention period regardless of the Category, whereas shooting was affected by the interaction between Category and Intervention. The results showed significant differences between categories in the scores of individual global, level I, level II, level III, and in all fundamental areas. Individual global score in both categories significantly increased. The players of Comp significantly improved in level III, in ball handling, reception, passing, and shooting scores. The players of Pro improved significantly in level II, in ball handling, reception, and passing scores. Individual global, ability levels I-III, and fundamental area scores were negatively correlated to the MR level indicating that the players with a lower MR obtained higher ability scores. In conclusion, it was found that the basketball test battery could be useful for improving and monitoring training in both Comp and Pro players.

The phosphodiesterases type 5 inhibitor tadalafil reduces the activation of the hypothalamus-pituitary-adrenal axis in men during cycle ergometric exercise

Phosphodiesterase type 5 inhibitors may influence human physiology, health, and performance by also modulating endocrine pathways. We evaluated the effects of a 2-day tadalafil administration on adenohypophyseal and adrenal hormone adaptation to exercise in humans. Fourteen healthy males were included in a double-blind crossover trial. Each volunteer randomly received two tablets of placebo or tadalafil (20 mg/day with a 36-h interval) before a maximal exercise was performed. After a 2-wk washout, the volunteers were crossed over. Blood samples were collected at -30 and -15 min and immediately before exercise, immediately after, and during recovery (+15, +30, +60, and +90 min) for adrenocorticotropin (ACTH), β-endorphin, growth hormone (GH), prolactin, cortisol (C), corticosterone, dehydroepiandrosterone-sulfate (DHEAS), and cortisol binding globulin (CBG) assays. C-to-CBG (free cortisol index, FCI) and DHEAS-to-C ratios were calculated. Exercise intensity, perceived exertion rate, O₂ consumption, and CO₂ and blood lactate concentration were evaluated. ACTH, GH, C, corticosterone, and CBG absolute concentrations and/or areas under the curve (AUC) increased after exercise after both placebo and tadalafil. Exercise increased DHEAS only after placebo. Compared with placebo, tadalafil administration reduced the ACTH, C, corticosterone, and FCI responses to exercise and was associated with higher β-endorphin AUC and DHEAS-to-C ratio during recovery, without influencing cardiorespiratory and performance parameters. Tadalafil reduced the activation of the hypothalamus-pituitary-adrenal axis during exercise by probably influencing the brain's nitric oxide- and cGMP-mediated pathways. Further studies are necessary to confirm our results and to identify the involved mechanisms, possible health risks, and potential clinical uses.

Postural control after a prolonged treadmill run at individual ventilatory and anaerobic threshold

The objective of the study was to verify whether young males' balance was affected by 30min prolonged treadmill running (TR) at individual ventilatory (IVT) and anaerobic (IAT) thresholds in recovery time. The VO2max, IAT and IVT during an incremental TR were determined. Mean displacement amplitude (Acp) and velocity (Vcp) of center of pressure were recorded before (pre) and after (0min post; 5min post; and 10min post) prolonged TR at IAT and IVT, through posturographic trials performed with eyes open (EO) and closed (EC). Significant differences between IVT and IAT for Vcp, between EO and EC for Acp and Vcp, were observed. The IAT induced higher destabilizing effect when postural trials were performed with EC. The IVT intensity produced also a destabilizing effect on postural control immediately after exercise. An impairment of postural control after prolonged treadmill running exercise at IVT and IAT intensity was showed. However, destabilizing effect on postural control disappeared within 10min after IAT intensity and within 5min after IVT intensity. Key pointsTo verify whether young males' balance was affected by 30min prolonged treadmill running at individual ventilatory and anaerobic thresholds in recovery time.Mean displacement amplitude and velocity of foot pressure center were recorded before and after prolonged treadmill running at individual ventilatory and anaerobic thresholds, through posturographic trials performed with eyes open and closed.Destabilizing effect on postural control disappeared within 10min post individual anaerobic threshold, and within 5min post individual ventilatory threshold.

Could sport specialization influence fitness and health of adults with mental retardation?

Although several studies showed the positive effects of exercise and physical activity on health and well-being for individuals with ID, there is a lack of information about the influence of sport specialization on fitness and health components. Therefore, the aims of this study were to assess: (a) physical fitness of athletes with intellectual disability (ID) compared with individuals included in recreational and leisure activity programs (non-athletic people); (b) contribution of sport specialization on athletes' fitness; and c) correlation of each fitness variable with subjects' ID levels. Twenty-two track and field, 19 basketball, and 23 non-athletic adults were recruited. Before and after a 9-month period, all participants performed fitness tests assessing body composition, flexibility (SR), arm muscular strength (HG), lower and upper-body muscular strength and endurance (SUP and PUP), explosive leg power (SLJ), cardiovascular endurance (ST), balance ability (FT), motor coordination (TUGT). The results showed that participants' weight, BMI and FT were significantly affected by time; SLJ by activity; ST, HG, PUP, SUP, and TUGT by both time and activity. Only track and field athletes increased significantly ST. All athletes improved significantly HG, PUP and SUP, instead non-athletic people decreased significantly SUP (p<0.01). TUGT improved significantly in track and field athletes (p<0.05), and decreased significantly in non-athletic people. ID level was positively correlated to TUGT. Findings of this study showed that physical activity improved fitness in adult athletes with ID, decreasing health risks. Athletes with lower ID obtained higher performance scores in motor coordination test.

Using basketball test battery to monitor players with mental retardation across 2 sports seasons

Although sport for athletes with mental retardation (MR) is achieving an important role, literature concerning basketball test and training is still poor. The aims of this study were to assess basketball ability before (PRE) and after (POST) a 6-month training in athletes with MR across 2 sports seasons (ss) and to analyze the variation of basketball abilities by subjects' MR level. Fifteen trained basketball players with MR participated (11 men and 4 women; age range 19-43 years; MR: 3 Mild, 8 Moderate, 3 Severe, and 1 Profound). Athletes were tested PRE and POST a 6-month training during 2 following sports seasons (ss1 and ss2). The tests assessed 4 ability levels, each one characterized by the analysis of 4 fundamental areas (ball handling, reception, passing, and shooting), divided into 5 specific components. The athletes' global score improved after training in both ss1 (41.5 +/- 12.0 vs. 48.6 +/- 15.4; p < 0.01) and ss2 (41.7 +/- 12.4 vs. 50.8 +/- 16.2; p < 0.01). Levels II, III, and IV showed an increase both after each ss and the 2 following ss (p < 0.01). No significant difference was found between POST-ss1 and POST-ss2 due to score decrease during the resting period between the 2 ss. In both ss, global and level scores were negatively correlated to MR level indicating that athletes with a lower MR obtained higher ability scores. In conclusion, a 6-month training caused a general improvement, especially evident in levels II and III in both ss. Global and level scores were negatively correlated to MR level (p < 0.05) indicating that athletes with a lower MR obtained higher scores. Therefore, the basketball test battery could be useful for improving and monitoring training.