Resistance Training Reduces Blood Pressure Putative Molecular Mechanisms

Arterial hypertension is a multifactorial clinical condition characterized by higher blood pressure levels. The main treatment for controlling high blood pressure consists of drug therapy, but the scientific literature has been pointing to the efficiency of aerobic and resistance exercises acting in a therapeutic and/or preventive way to reduce and control the blood pressure levels. Resistance training is characterized by sets and repetitions on a given muscle segment that uses overload, such as machine weights, bars, and dumbbells. As it successfully affects a number of variables associated to practitioners' functional and physiological features as well as emotional and social variables, resistance training has been a crucial part of physical exercise programs. Several reports highlight the various adaptive responses it provides, with a focus on the improvement in strength, balance, and muscular endurance that enables a more active and healthy lifestyle. Resistance training programs that are acute, sub-chronic, or chronic can help people with varying ages, conditions, and pathologies reduce their arterial hypertension. However, molecular mechanisms associated with resistance training to reduce blood pressure still need to be better understood. Thus, we aimed to understand the main effects of resistance training on blood pressure as well as the associated molecular mechanisms.

Effects of exercise programs on cardiovascular responses in individuals with down syndrome: A systematic review and meta-analysis

The purpose of this study is to conduct a systematic review and meta-analysis of exercise interventions designed to improve cardiovascular responses in individuals with DS. A search for relevant articles was conducted on seven electronic databases: PubMed, PEDro, Google Scholar, Scopus, WOS, MEDLINE, and SPORT Discus. An electronic search was conducted on October 15, 2022, without applying any year constraints. The studies were chosen based on a predetermined set of inclusion and exclusion criteria. The methodology of the study was evaluated using the PEDro scale, and data analyses were conducted using the CMA v3 random effects model. In total, 625 articles were reviewed, and data from 10 randomized controlled trials (RCTs) involving DS were used in this meta-analysis. The results showed that exercise programs were effective in increasing VO2peak (ml. kg -1min-1) (ES: 0.69; 95 % confidence interval [CI], 0.27-1.12; P: 0.001), time to exhaustion (ES: 0.83; CI, 0.31-1.35, P: 0.001), and VEpeak (ES: 0.76; CI, 0.32-1.20; P: 0.001). No changes were found for HRpeak (ES: 0.3; CI, -0.02-0.63, P: 0.07), VO2peak (ml·min-1) (ES: 0.45; CI, -0.01-0.92; P: 0.06), or RER (ES: 0.45; CI, -0.09-0.98, P: 0.10). No adverse effects were reported in any of the studies. In this meta-analysis and comprehensive review, exercise interventions may improve cardiovascular responses in DS; however, the association wasn't consistent across trials. RCTs with precise intervention criteria, large sample sizes, and long-term follow-up are needed in the future to demonstrate the benefits of exercise on cardiovascular responses in people with DS.

Combined Physical Training Strategies Improve Physical Fitness, Behavior, and Social Skills of Autistic Children

The present study aimed to investigate the effects of combined physical training (CPT) on social skills and physical fitness (PF) in children with ASD. Sixteen children with autism (age 6-10 years) were randomly assigned into two groups: CPT and control. The CPT group participated in a program involving ball game, rhythmic movements, and resistance training for eight weeks (three sessions per week). PF and behavior profile were assessed before and after training. CPT program had a significant effect on indicators of social skills such as stereotypic behavior and communication, as well as PF such as handgrip strength, upper and lower body power, flexibility, balance, and agility (P < 0.05). CPT in autistic children can improve indicators of social skills and PF.

Exercise-based training programs for patients with chronic Chagas cardiomyopathy: A systematic review and meta-analysis

Background

We assessed the effects of exercise-based training programs (EBTP) in patients with chronic Chagas cardiomyopathy (CCC) through a systematic review and meta-analysis.

Methods

We conducted a search in Pubmed/Medline, Embase, Scopus, Web of Science, Cochrane Library, Virtual Health Library, and SciELO until January 2023. Randomized controlled trials (RCTs) and non-randomized intervention studies (NRIS) investigating the effects of EBTP in CCC patients were included. The primary outcomes were all-cause mortality, cardiovascular mortality, and health-related quality of life (HRQoL), and the secondary outcomes were exercise capacity by peak VO2, heart failure-related hospital admissions (HFRHA), and left ventricular ejection fraction (LVEF).

Results

The search strategy yielded 3617 studies. After removing duplicates and screening, eight studies (3 RCTs and 5 NRIS) involving 222 patients were included. Seven studies were conducted in Brazil. The age range was from 30 to 71 years, and 47.1% were male. Data on mortality, HRQoL, LVEF, and HFRHA were scarcely reported. The meta-analysis pooling four studies showed that the peak VO2 was significantly higher (mean difference 4.45, 95% confidence interval 3.50 to 5.39 mL/kg/min, I2 = 0%) in the EBTP group compared to the control group.

Conclusion

The evidence available was limited and heterogeneous. While EBTP has shown to improve HRQoL and exercise capacity, there is no conclusive information about the other proposed outcomes. These positive effects present an opportunity to provide treatment to CCC patients in low- and middle-income countries. Further studies are needed to ascertain the effects of EBTP on hard outcomes in this population.Registration number: CRD42022334060.

[Nonpharmacological treatment measures, rehabilitation services and membership in patient support groups in axial spondylarthritis (The ATTENTUS axSpA study)]

BACKGROUND

The treatment of axial spondylarthritis (axSpA) includes pharmacological treatment measures (PTM) and nonpharmacological treatment measures (NPTM) as well as supporting resources, such as rehabilitation services (RS) and membership in patient support groups (PSG). Nevertheless, there are significant participation restrictions in patients with axSpA in Germany.

OBJECTIVE

Investigation of functional deficits, participation restrictions and utilization of PTM, NPTM, RS and PSG membership in patients with axSpA.

MATERIAL AND METHODS

Multicentric, observational study of 770 axSpA patients in Germany (ATTENTUS-axSpA).

RESULTS

Substantial functional deficits and participation restrictions were observed in axSpA patients. Of the patients 39% did not receive treatment with biological disease-modifying antirheumatic drugs (bDMARD). In the NPTM 54% received physiotherapy less than once per week and 29% once per week. Physical activities were regularly performed by 86% of patients, mainly in the form of home exercises. Training in a gym (14%) or sports club (7%) was carried out much less frequently. Of the patients 54% received RS, one third had the last rehabilitation more than 5 years ago and 13% of the patients were members in a PSG. A significantly higher utilization of NPTM and rehabilitation was found in this group.

CONCLUSION

Treatment options and resources were often utilized to a small extent and/or in low intensity by axSpA patients, which could be a possible explanation for persisting restrictions of participation. Membership in a PSG was associated with an increased utilization of NPTM and RS.

Effect of Exercise Training on Functional Capacity Head and Neck Cancer Patients Receiving Various Anticancer Therapies: An Interventional Study

BACKGROUND

Anticancer therapies causes decreased respiratory function, quality of life and functional capacity in head and neck cancer patients. Patients receiving these cancer therapies suffer from fatigue which causes decrease in functional capacity and quality of life. The objective of this present study was to determine and compare the effect of exercise training on fatigue, functional capacity and quality of life in head and neck cancer patients receiving various anticancer therapies.

METHOD

A total of 45 subjects were included based on inclusion and exclusion criteria. 6-minute walk test, brief fatigue inventory (BFI) and functional assessment of cancer therapy- general (FACT-G) was used to measure the functional capacity, fatigue and quality of life respectively at baseline and post intervention. Participants received exercise intervention for six weeks (three days a week) for 40 min. Exercise intervention is delivered by a qualified physiotherapist from the Department of Physiotherapy.

RESULTS

The result of this study shows that there was highly significant improvement in six-minute walk distance pre and post intervention in chemotherapy (33.75+21.55, p=0.000), radiation therapy (39.69+25.46, p=0.000) and chemoradiotherapy (32.06+16.49, p=0.000) within the group. Similarly, significant improvement was also seen in quality of life within the groups, chemotherapy (2.92+2.43, p=0.002), radiation therapy (6.06+3.13, p=0.000) and chemo radiotherapy (5.65+6.93, p=0.004). There was significant reduction in fatigue in chemotherapy (6.92+11.07, p=0.045), radiation   therapy (12.38+7.28, p=0.000)   and   chemo   radiotherapy (11.47+8.89, p=0.000). No significant improvement was noted between the groups for six- minute walk distance (p=0.784), quality of life (p= 0.058) and reduction in fatigue (p=0.065).

CONCLUSION

This study concluded that exercise training is effective in improving functional capacity, quality of life and reducing fatigue in head and neck cancer patients receiving various anticancer therapies.

Exercise training and BDNF injections alter APP processing enzymes and improve cognition

Exercise reduces cognitive aging, neurodegeneration, and Alzheimer's disease (AD) risk. Acute exercise reduces the activity of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), the rate limiting enzyme in the production of Aβ. However, mechanisms mediating these effects remain largely unknown. Work has implicated brain-derived neurotrophic factor (BDNF) in the processing of amyloid precursor protein (APP). BDNF is an exercise-induced neurotrophin known for its role in synaptic plasticity, neurite growth, and neuronal survival. Previously, our lab has shown using an ex vivo model that treatment of the prefrontal cortex with BDNF reduced BACE1 activity, highlighting a BDNF to BACE1 link. The purpose of this research was to examine whether BDNF treatments resulted in similar biochemical adaptations to APP processing as exercise training. Male C57BL6/J mice were assigned into one of four groups (n=12/group): 1) control; 2) exercise training (progressive treadmill training 5 days/week); 3) BDNF (0.5 mg/kg body mass subcutaneous injection 5 days/week); or 4) endurance training and BDNF, for an 8-week intervention. Recognition memory was measured with a novel object recognition test. Serum, the prefrontal cortex, and hippocampus were collected. BDNF improved recognition memory to a similar extent as endurance training. BDNF and exercise decreased BACE1 activity and increased ADAM10 activity in the prefrontal cortex, indicating a shift in APP processing. Our novel results indicate that BDNF exerts similar beneficial effects on cognition and APP processing as exercise. Future evidence-based preventative or therapeutic interventions that increase BDNF and reduce BACE1 will be valuable for populations at risk of AD.

Interaction of exercise training with taurine attenuates infarct size and cardiac dysfunction via Akt-Foxo3a-Caspase-8 signaling pathway

This research aimed to investigate the synergistic protective effect of exercise training and taurine on Akt-Foxo3a-Caspase-8 signaling related to infarct size and cardiac dysfunction. Therefore, 25 male Wistar rats with MI were divided into five groups: sham (Sh), control-MI(C-MI), exercise training-MI(Exe-MI), taurine supplementation-MI(Supp-MI), and exercise training + taurine-MI(Exe + Supp-MI). The taurine groups were given a 200 mg/kg/day dose of taurine by drinking water. Exercise training was conducted for 8 weeks (5 days/week), each session alternated 2 min with 25-30% VO2peak and 4 min with 55-60% VO2peak for 10 alternations. Then, the left ventricle tissue samples were taken from all groups. Exercise training and taurine activated Akt and decreased Foxo3a. Expression of the caspase-8 gene was increased in cardiac necrosis after MI, While, after 12 weeks of intervention decreased. Results exhibited that exercise training combined with taurine has a greater effect than either alone on activating the Akt-Foxo3a-caspase signaling pathway (P < 0.001). MI-induced myocardial injury leads to increase collagen deposition (P < 0.001) and infarct size and results in cardiac dysfunction via reduced stroke volume, ejection fraction, and fractional shortening (P < 0.001). Exercise training and taurine improved cardiac functional parameters (SV, EF, FS) and infarct size (P < 0.001) after 8 weeks of intervention in rats with MI. Also, the interaction of exercise training and taurine has a greater effect than alone on these variables. Interaction of exercise training with taurine supplementation induces a general amelioration of the cardiac histopathological profiles and improves cardiac remodeling via activating Akt-Foxo3a-Caspase-8 signaling with protective effects against MI.

Obesity and exercise training alter inflammatory pathway skeletal muscle small extracellular vesicle miRNAs

New Findings

What is the central question of this study?

Is 1 week of exercise training sufficient to reduce local and systemic inflammation?

Do obesity and short‐term concurrent aerobic and resistance exercise training alter skeletal muscle extracellular vesicle (EV) contents?

What is the main finding and its importance?

Obesity alters skeletal muscle small EV microRNAs targeting inflammatory and growth pathways. Exercise training alters skeletal muscle small EV microRNAs targeting inflammatory pathways, indicative of reduced inflammation. Our findings provide support for the hypotheses that EVs play a vital role in intercellular communication during health and disease and that EVs mediate many of the beneficial effects of exercise.

Abstract

Obesity is associated with chronic inflammation characterized by increased levels of inflammatory cytokines, whereas exercise training reduces inflammation. Small extracellular vesicles (EVs; 30–150 nm) participate in cell‐to‐cell communication in part through microRNA (miRNA) post‐transcriptional regulation of mRNA. We examined whether obesity and concurrent aerobic and resistance exercise training alter skeletal muscle EV miRNA content and inflammatory signalling. Vastus lateralis biopsies were obtained from sedentary individuals with (OB) and without obesity (LN). Before and after 7 days of concurrent aerobic and resistance training, muscle‐derived small EV miRNAs and whole‐muscle mRNAs were measured. Pathway analysis revealed that obesity alters small EV miRNAs that target inflammatory (SERPINF1, death receptor and Gα_i) and growth pathways (Wnt/β‐catenin, PTEN, PI3K/AKT and IGF‐1). In addition, exercise training alters small EV miRNAs in an anti‐inflammatory manner, targeting the IL‐10, IL‐8, Toll‐like receptor and nuclear factor‐κB signalling pathways. In whole muscle, IL‐8 mRNA was reduced by 50% and Jun mRNA by 25% after exercise training, consistent with the anti‐inflammatory effects of exercise on skeletal muscle. Obesity and 7 days of concurrent exercise training differentially alter skeletal muscle‐derived small EV miRNA contents targeting inflammatory and anabolic pathways.

Pharmacy and Exercise as Complimentary Partners for Successful Cardiovascular Ageing

Diseases of the cardiovascular system have been the biggest cause of mortality for the majority of the last century, currently contributing to almost a third of deaths every year globally. Ageing associates with changes to the structure and function of the heart and vascular system that progressively increase the incidence of abnormalities, morbidity, and cardiovascular disease. The burden of ageing and its relationship to cardiovascular disease risk highlights the need for more research into the underlying mechanisms involved and how they may be treated and/or prevented. Factors influencing adrenergic dysfunction may explain a significant part of the age-related deterioration in health and responsiveness of the cardiovascular system. Increased sympathetic activity in old age overstimulates adrenergic receptors and causes detrimental changes within the associated signalling mechanisms including a reduction in receptor number and downstream effector efficiency. Pharmacological agents such as metformin, resveratrol, beta-blockers, and angiotensin converting enzyme (ACE) inhibitors have been identified as potential anti-ageing therapies with cardiovascular effects, which may be beneficial in treating the decline in cardiovascular function with old age. Regular exercise has also shown promise in the prevention and treatment of harmful age-related effects on the cardiovascular system. This review will investigate age-associated vascular and cardiac remodelling, and the link between adrenergic dysfunction and vascular and cardiac control. This review will also consider whether pharmacological or non-pharmacological therapies are most effective, or indeed complimentary to potentially optimise ageing of the cardiovascular system and improve quality of life in the elderly.

The COVID-19 pandemic and physical activity during intermittent fasting, is it safe? A call for action

Intermittent fasting (IF) has recently gained popularity, and has been used for centuries in many religious practices. The Ramadan fasting is a mandatory form of IF practiced by millions of healthy adult Muslims globally for a whole lunar month every year. In Islam, the "Sunna" also encourages Muslims to practice IF all along the year (e.g.; two days a week). The 2019-Coronavirus disease (COVID-19) pandemic in the context of Ramadan has raised the question whether fasting is safe practice during the COVID-19 pandemic health crisis, and what would be the healthy lifestyle behaviors while fasting that would minimize the risk of infection. As COVID-19 lacks a specific therapy, IF and physical activity could help promote human immunity and be part of holistic preventive strategy against COVID-19. In this commentary, the authors focus on this dilemma and provide recommendations to the fasting communities for safely practicing physical activity in time of COVID-19 pandemic.

Effects of Neuromuscular Electrical Stimulation on Quadriceps Muscle Strength and Mass in Healthy Young and Older Adults: A Scoping Review

OBJECTIVE

Although neuromuscular electrical stimulation (NMES) has been used as a safe and relevant complement to voluntary resistance training, its effectiveness in increasing quadriceps femoris muscle strength and mass in healthy young and older adults has not been determined. The aim of this scoping review was to assess the effects of NMES on quadriceps muscle strength and mass in healthy young and older adults.

METHODS

CENTRAL, Pedro, MEDLINE, and PubMed were searched from inception to September 2019. Randomized controlled trials (RCTs) that compared NMES with control group or voluntary resistance training for healthy young and older adults were included. Study characteristics, primary and secondary outcome parameters, and details of the NMES intervention were extracted by 2 reviewers. Only studies for which full text was available in English were included.

RESULTS

Thirty-two RCTs including 796 healthy participants were identified as being eligible for young adults, and 5 RCTs including 123 healthy participants were identified as being eligible for older adults. The available evidence strongly suggests that NMES improves quadriceps muscle strength compared with a control group in young adults, but its efficacy seems lower than that of voluntary resistance training. The available limited evidence regarding the effects of NMES on quadriceps muscle mass compared with control in young adults is inconclusive, with 3 RCTs showing positive effects and 3 RCTs not showing positive effects. The very limited available evidence from 5 RCTs in older adults suggests that NMES might be beneficial for increasing quadriceps muscle strength and mass.

CONCLUSION

Overall, the evidence indicates that NMES is an efficacious method for increasing quadriceps muscle strength in young adults, whereas its impact on muscle mass requires further investigations. In addition, the effectiveness of NMES needs to be confirmed in older adults on the basis of more high-quality RCTs with larger sample sizes.

IMPACT

This scoping review of 37 RCTs including 919 people is the first study, to the authors' knowledge, to show that the use of NMES increases quadriceps muscle strength in young adults and might improve quadriceps muscle strength compared with control interventions in older adults. In both young and older adults, the effects of NMES on quadriceps muscle mass are still unclear.

The Effect of Aerobic Training and Green Tea Supplementation on Cardio Metabolic Risk Factors in Overweight and Obese Females: A Randomized Trial

BACKGROUND

The use of exercise along with green tea supplements has been shown to have beneficial effects on obesity and its complications.

OBJECTIVES

This study aimed at exploring the effect of aerobic training (AT) and green tea (GT) supplementation on body composition, blood lipids, blood glucose, and cardiovascular risk factors in overweight and obese females.

METHODS

Thirty-nine healthy non-athlete overweight and obese females with an average age of 28.11 ± 6.50 years were sampled and randomly assigned to control (n = 13), AT (n = 13), and AT + GT (n = 13). Participants of the latter group received 33 mg of green tea after each main meal every day, and in addition, they were subjected to AT for eight weeks, including three 90-minute training sessions that were progressive, reaching 80% of the target heart rate (THR). Blood samples were taken from participants one week before the initiation of the study and 48 hours after the last training session.

RESULTS

Compared to the control group, body weight, body fat percentage, body mass index (BMI), triglyceride, low-density lipoprotein, blood pressure, and heart rate (HR) significantly decreased in the groups treated with AT and AT + GT (P < 0.05). However, no significant changes occurred in FBS, HDL, TC, and WHR (P > 0.05).

CONCLUSIONS

AT was effective in modifying cardiovascular risk factors, e.g. hypertension, heart rate (HR), triglyceride, and low-density lipoprotein (LDL). However, GT addition was not effective. Considering Iranians' high tendency towards the consumption of plant materials, this finding needs further investigation.

Is Cardiorespiratory Fitness Related to Cardiometabolic Health and All-Cause Mortality Risk in Patients with Coronary Heart Disease? A CARE CR Study

Background

Higher cardiorespiratory fitness (CRF) is associated with lower morbidity and mortality in patients with coronary heart disease (CHD). The mechanisms for this are not fully understood. A more favourable cardiometabolic risk factor profile may be responsible; however, few studies have comprehensively evaluated cardiometabolic risk factors in relation to CRF amongst patients with CHD. We aimed to explore differences in cardiometabolic risk and 5-year all-cause mortality risk in patients with CHD who have low, moderate, and high levels of CRF.

Methods

Patients with CHD underwent maximal cardiopulmonary exercise testing, echocardiogram, carotid intima-media thickness measurement, spirometry, and dual X-ray absorptiometry assessment. Full blood count, biochemical lipid profiles, high-sensitivity (hs) C-reactive protein, and NT-proBNP were analysed. Patients were defined as having low, moderate, or high CRF based on established prognostic thresholds.

Results

Seventy patients with CHD (age 63.1 ± 10.0 years, 86% male) were recruited. Patients with low CRF had a lower ventilatory anaerobic threshold, peak oxygen pulse, post-exercise heart rate recovery, and poor ventilatory efficiency. The low CRF group also had higher NT pro-BNP, hs-CRP, non-fasting glucose concentrations, and lower haemoglobin and haematocrit. Five-year mortality risk (CALIBER risk score) was also greatest in the lowest CRF group (14.9%).

Conclusions

Practitioners should interpret low CRF as an important clinical risk factor associated with adverse cardiometabolic health and poor prognosis, study registry; www.researchregistry.com.

Cardiac systolic regional function and synchrony in endurance trained and untrained females

Background

Most studies on cardiac function in athletes describe overall heart function in predominately male participants. We aimed to compare segmental, regional and overall myocardial function and synchrony in female endurance athletes (ATH) and in age-matched sedentary females (CON).

Methods

In 46 ATH and 48 CON, echocardiography was used to measure peak longitudinal systolic strain and myocardial velocities in 12 left ventricular (LV) and 2 right ventricular (RV) segments. Regional and overall systolic function were calculated together with four indices of dyssynchrony.

Results

There were no differences in regional or overall LV systolic function between groups, or in any of the four dyssynchrony indices. Peak systolic velocity (s′) was higher in the RV of ATH than in CON (9.7±1.5 vs 8.7±1.5 cm/s, p=0.004), but not after indexing by cardiac length (p=0.331). Strain was similar in ATH and CON in 8 of 12 LV myocardial segments. In septum and anteroseptum, basal and mid-ventricular s′ was 6–7% and 17–19% higher in ATH than in CON (p<0.05), respectively, while s′ was 12% higher in CON in the basal LV lateral wall (p=0.013). After indexing by cardiac length, s′ was only higher in ATH in the mid-ventricular septum (p=0.041).

Conclusions

We found differences between trained and untrained females in segmental systolic myocardial function, but not in global measures of systolic function, including cardiac synchrony. These findings give new insights into cardiac adaptation to endurance training and could also be of use for sports cardiologists evaluating female athletes.

IS EXERCISE CORTISOL RESPONSE OF ENDURANCE ATHLETES SIMILAR TO LEVELS OF CUSHING'S SYNDROME?

Several theories exist as to the mechanism causing the development of the Overtraining Syndrome in athletes. One theory proposes hypercortisolemic states (e.g., "pseudo" Cushing's Syndrome type-condition) brought on by intensive exercise training and the stress of sporting competitions results in neuroendocrine dysfunctions and subsequent physiological compromise. We wondered whether stressful exercise could provoke changes in cortisol to the magnitude of that seen in Cushing's Syndrome patients. Therefore we conducted a study to determine if the cortisol levels in highly trained endurance athletes in response to a stressful exercise bout compared to that found in Cushing Syndrome patients. Cortisol levels were examined in physically active men at rest, and after intensive, prolonged exercise (~85 min at 75% VO2max) and compared to that of Cushing's patients at rest. Results showed exercise does significantly (p<0.001) and substantially elevate cortisol to near Cushing's Syndrome levels. However, the cortisol response to exercise in athletes is highly transient and abates rapidly. The present findings support that cortisol responses to exercise such as what endurance athletes might encounter in their sporting competition (or during an intensive exercise training session) can elevate cortisol to the levels seen in Cushing Syndrome patients (i.e., for only a short period of time).