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Purpose: We examined the effects of aerobic exercise and detraining on adiponectin, resistin, tumor necrosis factor alpha (TNF-α), white blood cell, and pubertal signs (uterine length, ovarian volume, luteinizing hormone [LH], and follicle-stimulating hormone [FSH]) in girls with central precocious puberty (CPP). Methods: Thirty girls with CPP (7–9 yr old) were randomly divided into CPP and CPP + Exercise (EX) groups. Fifteen healthy age-matched girls without precocious puberty participated for comparison with CPP. Subjects in the CPP + EX group attended 12 wk of aerobic exercise protocol three sessions a week. In the baseline, after completing the exercise protocol and after 4 wk of detraining, all the parameters were measured. In the CPP and healthy groups, all the parameters were measured in all three stages. To measure adiponectin, resistin, and TNF-α, the ELISA method was used. LH and FSH were measured by electrochemiluminescence immunoassay. White blood cell counts were analyzed by an automated blood cell counter. Repeated-measures ANOVA was used to analyze the results. Results: CPP girls have lower adiponectin (P = 0.01) and higher TNF-α levels (P = 0.001) than healthy girls. In the CPP + EX group, after 12 wk, body weight and fat mass decreased, and adiponectin increased significantly (P = 0.02). Resistin (P = 0.02), TNF-α (P = 0.02), neutrophils (P = 0.01), and signs of puberty significantly (P < 0.05) decreased. After detraining, no significant change was observed except TNF-α, which increased significantly (P = 0.03). In the CPP group, no significant change was observed in any of the parameters; only LH (P = 0.0001) and uterine length and ovarian volume (P = 0.003, P = 0.001) decreased after 12 and 16 wk, respectively. Conclusions: Aerobic exercise can have a positive effect on the state of inflammation and pubertal signs. Positive effects remain after 4 wk of detraining. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the effects of a 2-yr-long maintenance training (MT) exergaming and detraining (DT) on clinical–motor symptoms in subacute ischemic patients with stroke (PwST). The hypothesis was that MT motor rehabilitation program would further increase the effects of the initial rehabilitation. Methods: After high-intensity and high-frequency exergaming twice or once a day, 5 times per week for 5 wk (EX2: 50 sessions; EX1: 25 sessions, results reported previously), 558 PwST were randomized to EX2-MT, EX2-DT, EX1-MT, and EX1-DT. MT exergaming consisted of once a day, 3 times per week for 2 yr, and DT did not train. Outcomes were measured at 6, 12, 18, and 24 months. The data were analyzed using longitudinal linear mixed-effects models and general linear hypotheses testing. Results: Modified Rankin Score (primary outcome), body mass, Mini-Mental State Examination score, Beck Depression Inventory, measures of quality of life, Berg Balance Scale, 6-min walk test, and four measures of center of pressure path tended to retain the initial rehabilitation-induced gains in the MT patients in selected outcomes (especially walking capacity). The scores tended to mildly worsen after DT, partially supporting the hypothesis. Conclusions: MT successfully maintained, but only in selected variables did it further increase the initial exergaming rehabilitation-induced robust improvements. DT modestly reduced the initial exergaming rehabilitation-induced improvements. MT programs might be needed after initial stroke rehabilitation to reduce subsequent losses of quality of life and further improve clinical–motor symptoms. [ABSTRACT FROM AUTHOR]

Introduction: High-intensity interval training is an effective tool to improve cardiovascular fitness and maximal anaerobic power. Different methods of high-intensity interval training have been studied but the effects of repeated maximal effort cycling with very short exercise time (i.e. 4 s) and short recovery time (15-30 s) might suit individuals with limited time to exercise. Purpose: We examined the effects of training at near maximal anaerobic power during cycling (PC) on maximal anaerobic power, peak oxygen consumption (V[spacing dot above]O2peak), and total blood volume in 11 young healthy individuals (age: 21.3 +/- 0.5 yr) (six men, five women). Methods : Participants trained three times a week for 8 wk performing a PC program consisting of 30 bouts of 4 s at an all-out intensity (i.e. 2 min of exercise per session). The cardiovascular stress progressively increased over the weeks by decreasing the recovery time between sprints (30-24 s to 15 s), and thus, total session time decreased from 17 to <10 min. Results : Power cycling elicited a 13.2% increase in V[spacing dot above]O2peak (Pre: 2.86 +/- 0.18 L[middle dot]min-1, Post: 3.24 +/- 0.21 L[middle dot]min-1; P = 0.003) and a 7.6% increase in total blood volume (Pre: 5139 +/- 199 mL, Post: 5529 +/- 342 mL; P < 0.05). Concurrently, maximal anaerobic power increased by 17.2% (Pre: 860 +/- 53 W, Post: 1,009 +/- 71 W; P < 0.001). Conclusions: A PC training program employing 30 bouts of 4 s duration for a total of 2 min of exercise, resulting in a total session time of less than 10 min in the last weeks, is effective for improving total blood volume, V[spacing dot above]O2peak and maximal anaerobic power in young healthy individuals over 8 wk. These observations require reconsideration of the minimal amount of exercise needed to significantly increase both maximal aerobic and anaerobic power. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Purpose: Chronic obstructive pulmonary disease (COPD) is associated with altered metabolism and body composition that accompany poor outcomes. We aimed to determine whether metabolic derangements in COPD are associated with skeletal muscle deconditioning and/or physical inactivity, independent of pulmonary obstruction. Methods: We characterized serum metabolites associated with muscle oxidative capacity or physical activity in 44 COPD patients (forced expiratory volume in 1 s [FEV1] = 61% ± 4% predicted) and 63 current and former smokers with normal spirometry (CON) (FEV1 = 93% ± 2% predicted). Medial gastrocnemius oxidative capacity was assessed at rest from the recovery rate constant (k) of muscle oxygen consumption using near-infrared spectroscopy. Step counts and physical activity (average vector magnitude units [VMU] per minute) were measured over 5–7 d using triaxial accelerometry. Untargeted prime and lipid metabolites were measured using liquid chromatography and mass spectrometry. Results: Muscle k (1.12 ± 0.05 vs 1.68 ± 0.06 min−1, P < 0.0001, d = 1.58) and VMU per minute (170 ± 26 vs 450 ± 50 VMU per minute, P = 0.004, d = 1.04) were lower in severe COPD (FEV1 < 50% predicted, n = 14–16) compared with CON (n = 56–60). A total of 129 prime metabolites and 470 lipids with known identity were quantified. Using sex as a covariate, lipidomics revealed 24 differentially expressed lipids (19 sphingomyelins) in COPD, consequent to a diminished sex difference of sphingomyelins in COPD (false discovery rate [FDR] < 0.05, n = 44). Total, and some individual, fatty acid concentrations were greater in severe COPD than CON (FDR < 0.05, n = 16, d = 0.56–1.02). After adjusting for FEV1% predicted, we observed that grouped diacylglycerides (ρ = −0.745, FDR = 0.03) and triacylglycerides (ρ = −0.811, FDR = 0.01) were negatively associated with muscle oxidative capacity, but not physical activity, in severe COPD (n = 14). Conclusion: Strong negative associations relate impaired mitochondrial function to the accumulation of serum aclyglycerides in severe COPD. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is an immune-mediated, neurological disease that results in physiological deconditioning with increasing disability. High-intensity interval training (HIIT) exercise has induced significant improvements in physiological conditioning in healthy and clinical populations and might be appropriate for persons with MS who have mobility disability. The feasibility and acute effects of HIIT using recumbent stepping in persons with MS who have mobility disability are relatively unknown. Methods: The physiological effects of single sessions of HIIT and continuous (CON), steady-state aerobic exercise using recumbent stepping were compared in 20 persons with MS with mobility disability (i.e., Expanded Disability Status Scale of 4.0–6.5). The HIIT bout included 10 cycles of 1-min intervals at the work rate associated with 90% peak aerobic capacity (V˙O2peak) followed by 1-min recovery intervals at 15 W, totaling 20 min in length. The CON bout consisted of 20 min at the work rate associated with 50% to 60% V˙O2peak. Physiological (i.e., power output, oxygen consumption, carbon dioxide expiration, respiratory exchange ratio, ventilation, HR, and core temperature) and perceptual (i.e., ratings of perceived exertion) measures were collected across the acute sessions. Results: There were statistically significant condition–time interactions for all physiological measures and ratings of perceived exertion expressing differential patterns of change over time for HIIT versus CON (P < 0.05). The main effect of condition was significant for all physiological outcomes, except core temperature, with the HIIT condition inducing significantly higher values than CON (P < 0.05). Conclusions: High-intensity interval training exercise taxes the cardiorespiratory system significantly more than CON, yet without deleterious effects on core temperature in persons with MS. This has important implications for informing an evidence-based exercise prescription that is appropriate for improving physiological conditioning in persons with MS who have mobility disabilities. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Introduction: This study investigated the safety and effectiveness of a new integrated aerobic and resistance exercise training prescription (SPRINT) using two different sets of exercise equipment: a suite of large International Space Station–like exercise equipment similar to what is found on the International Space Station and a single device with aerobic and resistance exercise capability in the spaceflight analog of bed rest (BR). Methods: Subjects (n = 34) completed 70 d of 6° head down tilt BR: 9 were randomized to remain sedentary (CONT), 9 to exercise training using traditional equipment (EX), 8 to exercise using traditional equipment and low-dose testosterone supplementation (ExT), and 8 to exercise using a combined resistance and aerobic flywheel device. Peak aerobic capacity, ventilatory threshold, cardiac morphology and function (echocardiography), muscle mass (magnetic resonance imaging) and strength/power (isokinetic, leg press, and vertical jump), and bone health (bone mineral density, blood and urine bone markers) were assessed before and after BR. Results: The SPRINT protocol mitigated BR-induced muscle and cardiac deconditioning regardless of the exercise device used. Molecular markers of bone did not change in the CONT or EX groups. Peak aerobic capacity was maintained from pre- to post-BR in all exercise groups similarly, whereas significant declines were observed in the CONT group (~10%). Significant interaction effects between the CONT group and all EX groups were observed for muscle performance including leg press total work, isokinetic upper and lower leg strength, vertical jump power, and maximal jump height as well as muscle size. Conclusions: This is the first trial to evaluate multisystem deconditioning and the role of an integrated exercise countermeasure. These findings have important implications for the design and implementation of exercise-based countermeasures on future long-duration spaceflight missions. [ABSTRACT FROM AUTHOR]

Purpose: Spinal cord injury (SCI) creates a complex pathology, characterized by low levels of habitual physical activity and an increased risk of cardiometabolic disease. This study aimed to assess the effect of a moderate-intensity upper-body exercise training intervention on biomarkers of cardiometabolic component risks, adipose tissue metabolism, and cardiorespiratory fitness in persons with SCI. Methods: Twenty-one inactive men and women with chronic (>1 yr) SCI (all paraplegic injuries) 47 T 8 yr of age (mean T SD) were randomly allocated to either a 6-wk prescribed home-based exercise intervention (INT; n = 13) or control group (CON; n = 8). Participants assigned to the exercise group completed 4 x 45-min moderate-intensity (60%-65% peak oxygen uptake (...O2peak)) arm-crank exercise sessions per week. At baseline and follow-up, fasted and postload blood samples (collected during oral glucose tolerance tests) were obtained to measure metabolic regulation and bio- markers of cardiovascular disease. Abdominal subcutaneous adipose tissue biopsies were also obtained, and cardiorespiratory fitness was assessed. Results: Compared with CON, INT significantly decreased (P = 0.04) serum fasting insulin (Δ, 3.1 ± 10.7 pmol⋅L-1 for CON and -12.7 ± 18.7 pmol⋅L-1 for INT) and homeostasis model assessment of insulin resistance (HOMA2-IR; Δ, 0.06 ± 0.20 for CON and -0.23 ± 0.36 for INT). The exercise group also increased ...O2peak (Δ, 3.4 mL⋅kg-1⋅min-1 P ≤ 0.001). Adipose tissue metabolism, composite insulin sensitivity index (C-ISIMatsuda), and other cardiovascular disease risk biomarkers were not different between groups. Conclusions: Moderate- intensity upper-body exercise improved aspects of metabolic regulation and cardiorespiratory fitness. Changes in fasting insulin and HOMA2-IR, but not C-ISIMatsuda, suggest improved hepatic but not peripheral insulin sensitivity after 6 wk of exercise training in persons with chronic paraplegia. [ABSTRACT FROM AUTHOR]

Purpose: Oral contraceptive (OC) use reduces peak aerobic capacity (...O2peak); however, whether it also influences adaptations to training has yet to be determined. This study aimed to examine the influence of OC use on peak performance (peak power output [PPO]) and physiological adaptations (...O2peak and peak cardiac output [...peak]) after sprint interval training (SIT) in recreationally active women. Methods: Women taking an OC (n = 25) or experiencing natural regular menstrual cycles (MC; n = 16) completed an incremental exercise test to assess ...O2peak, PPO, and ...peak before, immediately after, and 4 wk after 12 sessions of SIT. The SIT consisted ten 1-min efforts at 100% to 120% PPO in a 1:2 work-rest ratio. Results: Though ...O2peak increased in both groups after SIT (both P < 0.001), the MC group showed greater improvement (OC, +8.5%; MC, +13.0%; P = 0.010). Similarly, ...peak increased in both groups, with greater improvement in the MC group (OC, +4.0%; MC, +16.1%; P = 0.013). PPO increased in both groups (OC, +13.1%; MC, +13.8%; NS). All parameters decreased 4 wk after SIT cessation, but remained elevated from pretraining levels; the OC group showed more sustained training effects in ...O2peak (OC, -4.0%; MC, -7.7%; P = 0.010). Conclusion: SIT improved peak exercise responses in recreationally active women. However, OC use dampened ...O2peak and ...peak adaptation. A follow-up period indicated that OC users had spared ...O2peak adaptations, suggesting that OC use may influence the time course of physiological training adaptations. Therefore, OC use should be verified, controlled for, and considered when interpreting physiological adaptations to exercise training in women. [ABSTRACT FROM AUTHOR]

Purpose: Long-term exercise training is associated with characteristic cardiac adaptation, termed athlete's heart. Our research group previously characterized in vivo left ventricular (LV) function of exercise-induced cardiac hypertrophy in detail in a rat model; however, the effect of detraining on LV function is still unclear. We aimed at evaluating the reversibility of functional alterations of athlete's heart after detraining. Methods: Rats (n = 16) were divided into detrained exercised (DEx) and detrained control (DCo) groups. Trained rats swam 200 min⋅d-1 for 12 wk, and control rats were taken into water for 5 min⋅d-1. After the training period, both groups remained sedentary for 8 wk. We performed echocardiography at weeks 12 and 20 to investigate the development and regression of exercise-induced structural changes. LV pressure-volume analysis was performed to calculate cardiac functional parameters. LV samples were harvested for histological examination. Results: Echocardiography showed robust LV hypertrophy after completing the training protocol (LV mass index = 2.61 ± 0.08 DEx vs 2.04 ± 0.04 g⋅kg-1 DCo, P < 0.05). This adaptation regressed after detraining (LV mass index = 2.01 ± 0.03 vs 1.97 ± 0.05 g ⋅kg-1, n.s.), which was confirmed by postmortem measured heart weight and histological morphometry. After the 8-wk-long detraining period, a regression of the previously described exercise-induced cardiac functional alterations was observed (DEx vs DCo): stroke volume (SV; 144.8 ± 9.0 vs 143.9 ± 9.6 µL, P = 0.949), active relaxation (τ =11.5 ± 0.3 vs 11.3 ± 0.4 ms, P = 0.760), contractility (preload recruitable stroke work = 69.5 ±2.7 vs 70.9 ± 2.4 mm Hg, P = 0.709), and mechanoenergetic (mechanical efficiency = 68.7 ± 1.2 vs 69.4 ± 1.8, P = 0.742) enhancement reverted completely to control values. Myocardial stiffness remained unchanged; moreover, no fibrosis was observed after the detraining period. Conclusion: Functional consequences of exercise-induced physiological LV hypertrophy completely regressed after 8 wk of deconditioning. [ABSTRACT FROM AUTHOR]

Introduction: Slow gait predicts many adverse clinical outcomes in old adults, but the mechanisms of how power training can minimize the age-related loss of gait velocity is unclear. We examined the effects of 10 wk of lower extremity power training and detraining on healthy old adults' lower extremity muscle power and gait kinematics. Methods: As part of the Potsdam Gait Study, participants started with 10 wk of power training followed by 10 wk of detraining (n = 16), and participants started with a 10-wk control period followed by 10 wk of power training (n = 16). We measured gait kinematics (stride characteristic and joint kinematics) and isokinetic power of the ankle plantarflexor (20°⋅s-1, 40°⋅s-1, and 60°⋅s-1) and knee extensor and flexor (60°⋅s-1,120°⋅s-1, and 180°⋅s-1) muscles at weeks 0,10, and 20. Results: Power training improved isokinetic muscle power by ~30% (P < 0.001) and fast (5.9%, P < 0.05) but not habitual gait velocity. Ankle plantarflexor velocity measured during gait at fast pace decreased by 7.9% (P < 0.05). The changes isokinetic muscle power and joint kinematics did not correlate with increases in fast gait velocity. The mechanisms that increased fast gait velocity involved higher cadence (r = 0.86, P < 0.001) rather than longer strides (r = 0.49, P = 0.066). Detraining did not reverse the training-induced increases in muscle power and fast gait velocity. Conclusion: Because increases in muscle power and modifications in joint kinematics did not correlate with increases in fast gait velocity, kinematic mechanisms seem to play a minor role in improving healthy old adults' fast gait velocity after power training. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer-related lymphedema is a common and debilitating side effect of cancer treatment. This randomized trial compared the effect of progressive resistance- or aerobic-based exercise on breast cancer-related lymphedema extent and severity, as well as participants_ muscular strength and endurance, aerobic fitness, body composition, upper-body function, and quality of life.Methods:Women with a clinical diagnosis of stable unilateral, upper-limb lymphedema secondary to breast cancer were randomly allocated to a resistance-based (n = 21) or aerobic- based (n = 20) exercise group (12-wk intervention).Women were assessed preintervention, postintervention, and 12 wk postintervention, with generalized estimating equation models used to compare over time changes in each groups lymphedema (two-tailed P < 0.05). Results: Lymphedema remained stable in both groups (as measured by bioimpedance spectroscopy and circumferences), with no significant differences between groups noted in lymphedema status. There was a significant (P < 0.01) time-group effect for upper-body strength (assessed using four to six repetition maximum bench press), with the resistance-based exercise group increasing strength by 4.2 kg (95% confidence interval [CI] = 3.2-5.2) postintervention compared with 1.2 kg (95% CI =j0.1 to 2.5) in the aerobic-based exercise group. Although not supported statistically, the aerobic-based exercise group reported a clinically relevant decline in number of symptoms postintervention (-1.5, 95% CI = -2.6 to -0.3), and women in both exercise groups experienced clinically meaningful improvements in lower-body endurance, aerobic fitness, and quality of life by 12-wk follow-up. Discussion: Participating in resistance- or aerobic-based exercise did not change lymphedema status but led to clinically relevant improvements in function and quality of life, with findings suggesting that neither mode is superior with respect to lymphedema effect. As such, personal preferences, survivorship concerns, and functional needs are important and relevant considerations when prescribing exercise mode to those with secondary lymphedema. [ABSTRACT FROM AUTHOR]

Purpose: Early life processes, through influence on fetal stem cells, affect postnatal and adult health outcomes. This study examines the effects of physical activity before and during pregnancy on stem cell counts in umbilical cord blood. Methods: We isolated mononuclear cells from umbilical cord blood samples from 373 singleton full-term pregnancies and quantified hematopoietic (CD34+, CD34+CD38-, and CD34+ c-kit+), endothelial (CD34+CD133+, CD34+CD133+VEGFR2+, CD34+VEGFR2+, and CD133+VEGFR2+), and putative breast (EpCAM+, EpCAM+CD49f+, EpCAM+CD49f+CD117+, CD49f+CD24+, CD24+CD29+, and CD24+CD29+CD49f+) stem/progenitor cell subpopulations by flow cytometry. Information on physical activities before and during pregnancy was obtained from questionnaires. Weekly energy expenditure was estimated based on metabolic equivalent task values. Results: Prepregnancy vigorous exercise was associated positively with levels of endothelial CD34+CD133+, CD34+CD133+VEGFR2+, CD34+VEGFR2+, and CD133+VEGFR2+ progenitor cell populations (P = 0.02, P = 0.01, P = 0.001, and P = 0.003, respectively); positive associations were observed in samples from the first births and those from the second or later births. Prepregnancy moderate and light exercises and light exercise during the first trimester were not significantly associated with any stem/ progenitor cell population. Light exercise during the second trimester was positively associated with CD34+VEGFR2+ endothelial progenitor cells (P = 0.03). In addition, levels of EpCAM+CD49f+ and CD49f+CD24+ breast stem cells were significantly lower among pregnant women who engaged in vigorous/moderate exercise during pregnancy (P = 0.05 and P = 0.02, respectively). Conclusions: Vigorous exercise before pregnancy increases the number of endothelial progenitor cells in umbilical cord blood and thus could potentially enhance endothelial function and improve cardiovascular fitness in the offspring. Findings of lower levels of putative breast stem cell subpopulations could have implications on exercise and breast cancer prevention. Prenatal effects of exercise on fetal stem cells warrant further studies. [ABSTRACT FROM AUTHOR]

Purpose: Low-load voluntary exercise can induce muscle hypertrophy and strength gain in working muscles when combined with blood flow restriction (BFR). However, it is unknown whether such hypertrophy and strength gain can be induced by involuntary muscle contractions triggered via low-intensity neuromuscular electrical stimulation (NMES) combined with BFR. The purpose of this article was to investigate whether low-intensity NMES combined with BFR (NMES-BFR) could elicit muscle hypertrophy and strength gain in the quadriceps. Methods: Eight untrained young male participants (mean ± SE; age, 26.2 ± 0.7yr; height, 1.74 ± 0.02 m; body weight, 71.4 ± 4.8 kg) were subjected to 23 min of unilateral low-intensity (5%--10% of maximal voluntary contraction) NMES twice per day (5 d⋅wk-1) for 2 wk: one leg received NMES-BFR and the other leg received NMES alone. Quadriceps muscle thickness and isometric and isokinetic strength were measured before and every week throughout the training and detraining periods. Results: In NMES-BFR legs, muscle thickness increased after 2 wk of training (+3.9%) and decreased after 2 wk of detraining (-3.0%). NMES-BFR training also increased maximal knee extension strength in isometric (+14.2%) and isokinetic (+7.0% at 90°⋅s-1 and +8.3% at 180°⋅s-1) voluntary contractions. In addition, maximal isometric strength decreased (-6.8%), whereas no large fall ( -1.9% at 90°⋅s-1 and -0.6% at 180°⋅s-1) in isokinetic maximal strength was evident after 2 wk of detraining. In legs that received NMES alone, no prominent change was observed; there was a negligible effect on isometric strength. Conclusion: Low-intensity NMES-BFR induces muscle hypertrophy and strength gain in untrained young male participants. [ABSTRACT FROM AUTHOR]

INTRODUCTION: High cardiorespiratory fitness (CRF) is strongly associated with longer life among older adults. CRF can be assessed by exercise-based methods, which are not feasible in most clinical settings. Thus, nonexercise algorithms to estimate CRF have been developed, but whether they predict mortality in older adults is uncertain. METHODS: A cohort of 1470 men and 1460 women, representative of the Spanish population age ≥60 yr, was established in 2000/2001 and followed up prospectively through 2011. At baseline, nonexercise CRF was estimated with the sex-specific algorithms developed by Jackson et al. Analyses were performed with Cox regression and adjusted for the main confounders. RESULTS: During an average follow-up of 9.4 yr, 570 (38.8%) deaths occurred in men and 295 (20.2%) in women. Among men, no association was observed between nonexercise CRF and all-cause mortality. Compared with women in the lowest quartile of CRF, the hazard ratio (95% confidence interval) for all-cause death was 0.81 (0.62-1.06) in the second quartile, 0.68 (0.48-0.95) in the third quartile, and 0.56 (0.36-0.87) in the highest quartile (P for trend = 0.004). Results held regardless of age, body mass index, waist circumference, HR, subjective health, functional limitations, and disease status. CONCLUSIONS: Higher nonexercise CRF was related to lower risk of death in older women but not in men. Because previous research does not support clear sex-specific association, further research is required to assess whether nonexercise CRF predicts mortality in older adults or new algorithms should be developed for this population, with special attention to older men. [ABSTRACT FROM AUTHOR]

Purpose: To accurately assess exercise interventions and to evaluate acute and chronic cardiovascular effects in patients with early-stage cancer, consistently reliable functional outcome measures must be obtained. An incremental cardiopulmonary exercise test (CPET) with gas exchange measurement to assess peak oxygen consumption (VO2peak) provides the gold standard outcome of cardiorespiratory fitness. Methods: In the context of a randomized controlled trial, 40 patients with prostate cancer (mean age, 59 ± 7 yr) after radical prostatectomy performed two maximal CPET within 5.6 ± 5.5 d of each other. Incremental treadmill tests were performed in the morning under identical laboratory conditions. Reliability and within-subject variability from test 1 to test 2 for peak and submaximal variables were assessed by correlation coefficients, intraclass correlations (ICC), Bland-Altman plots, coefficient of variation, and paired r-tests. Results: There was high reliability between CPET for VO2peak (r = 0.92; P < 0.001; ICC, 0.900), ventilatory threshold (r = 0.88; P < 0.001; ICC, 0.927), minute ventilation-carbon dioxide production relation (VE/VCO2) (r = 0.86; P < 0.001; ICC, 0.850), and peak heart rate (r = 0.95; P < 0.001; ICC, 0.944). However, high within-subject variability was observed for all CPET parameters (mean coefficient of variation, 4.7%). Compared with those for test 1, significantly higher mean values were observed for VO2peak (27.0 ± 5.6 vs 28.1 ± 5.3 mL•kg-1•min-1, P < 0.05), ventilatory threshold (1.91 ± 0.5 vs 1.97 ± 0.4 L•min-1, P < 0.05), and VE/VCO2 (31.3 ± 5.8 vs 32.8 ± 3.4, P < 0.05) in test 2. Conclusions: These findings indicate the presence of significant, and potentially clinically important, variability in CPET procedures in men with clinically localized prostate cancer and have important implications for the application and use of CPET to evaluate the efficacy of interventions to improve aerobic capacity in the oncology setting. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the effects resistance training and detraining had on glucose and insulin responses to an oral glucose load, muscle fiber type, and muscular performance in the offspring of those with type 2 diabetes (familial insulin resistant (FIR). Researchers evaluated six FIR patients and 10 control subjects. They found that FIR appeared to have exaggerated responses to resistance training and detraining, with a greater reduction in insulin release with glucose ingestion after training and increase when training ceases. They concluded that resistance training has a significant effect on insulin responses and may reduce future risk of type 2 diabetes mellitus among FIR.

The article provides information on the investigation whether the voluntary wheel running in mice modulates cholesterol and bile acid metabolism. It states that the male mice were randomly assigned to have accessed to a voluntary running wheel for 2 wk (RUN group) or remained sedentary (SED group). It shows that the RUN group ran an average of 10 km.d-1 and displayed lower plasma cholesterol compared with SED (P=0.030). It concludes that the voluntary wheel running increased cholesterol turnover in healthy mice owing to an increased fecal bile acid excretion and a decreased intestinal cholesterol absorption. It emphasizes that enhanced cholesterol turnover may contribute to the established reduction of cardiovascular risk induced by regular exercise.

Cardiovascular deceases are the leading cause of death worldwide in older adults and exercise is one method that can bring benefits against their risk factors, such hypertension and high cholesterol. Exercise can be applied in older adults through different methods, like multicomponent training and can promote lifestyle changes. PURPOSE: Can multicomponent training (MT) and detraining (DT) promote different effects in blood pressure (BP), total cholesterol (TCHOL) and cardiorespiratory capacity of older women with or without hypertension and high cholesterol (HT and HCHOL)? METHODS: Sixteen older women without HT and HCHOL (CG: n = 16, 65.4 ± 1.8 years), and fifteen older women with HT and HCHOL (EG: n = 15, 67.7 ± 4.2 years) followed a six-month multicomponent exercise program before a three-month detraining period. Cardiorespiratory capacity was assessed through 6-min walk test (6MWT), Systolic (SBP) and diastolic (DBP) blood pressure through a Omron Digital Blood Pressure Monitor HEM-907, and total cholesterol (TCHOL) blood sample were assessed in accordance with the procedures of Diabetes Atlas Committee. All assessments were conducted before and after the exercise program and after three months of detraining. RESULTS: MT resulted in declines in SBP (EG: -4.00%, p < 0.01; CG: -2.38%, p < 0.01), DBP (EG: -7.07%, p < 0.01; CG: -7.73%, p < 0.01), TCHOL (EG: -13,29%, p < 0.01; CG: -5.26%, p < 0.01) and improvements in 6MWT (EG: 7.49%, p < 0.01; CG: 4.49%, p < 0.01). DT led to negative effects in SBP (EG: 2.69%, p < 0.01; CG: 3.04%, p < 0.01), DBP (EG: 7,54%, p < 0.01; CG: 7.46%, p < 0.01), TCHOL (EG: 6,26%, p < 0.01; CG: -3.16%, p < 0.01) and 6MWT (EG: -8.70%, p < 0.01; CG: -3.19%, p < 0.01). CONCLUSIONS: Besides the benefits of MT the DT period was enough to reverse the benefits of exercise in BP, TCHOL and cardiorespiratory fitness of booth groups. MT in older adults with hypertension and HCHOL group promoted greater improvements in HCHOL and cardiorespiratory fitness than in the CG. [ABSTRACT FROM AUTHOR]

HISTORY: A 19 year-old female division 1 NCAA cross country athlete presented for campus pre-participation physicals during the summer of her sophomore year 2020. She reported subjective chest tightness and exercise intolerance. Patient reported symptoms consistent with a COVID-19 viral infection in February 2020 including her initial symptoms were cough, congestion, fevers, and myalgias. She subsequently developed significant dyspnea on exertion, and was unable to tolerate even minimal exertion. Patient reported initial symptoms lasted for 2 weeks, and was seen by her PCP in March 2020. She was then tested for COVID-19 IgG antibodies, which were positive. She continued to have exertional dyspnea that progressed to night time cough. Patient has a medical history of anxiety and mild intermittent asthma, requiring her albuterol inhaler once a month. At onset of symptoms, she began using her albuterol more frequently, and progressed to daily inhaled corticosteroid. Due to her continued symptoms, further medical testing was ordered. PHYSICAL EXAMINATION: Patient was resting comfortably. Heart regular rate and rhythm without murmur. Lungs clear to auscultation bilaterally. Pulses 2/4 in upper and lower extremities. DIFFERENTIAL DIAGNOSIS: 1. Progression of mild intermittent asthma 2. Cardiomyopathy3. Deconditioning TEST AND RESULTS: EKG: - NSR at 64 BPM Chest XR: -No acute findings, mild hyperinflation Labs:-Troponin <0.01, Hgb 13.0 Pulmonary Function Testing:-Normal without signs of obstruction or restriction Transthoracic echocardiogram: - Normal atrium and ventricles. Normal left ventricular function Cardiopulmonary Exercise Testing: - Low VO2 max, depressed maximum heart rate, EKG with new inferior wall changes Cardiac MRI: - Normal cardiac anatomy, normal ventricular function, no evidence of scar of infiltration. FINAL WORKING DIAGNOSIS: - Post COVID-19 syndrome TREATMENT AND OUTCOMES: 1. Received clearance for return to athletic participation after full cardiac workup. 2. Symptoms due to cardiopulmonary deconditioning secondary to viral syndrome. 3. Gradual increase in exercise as tolerated. 4. Patient's symptoms slowly improving [ABSTRACT FROM AUTHOR]

The article presents a study which summarizes the findings of studies being conducted in relation to the topic of whether prolonged exercise can lead to transient depression in left ventricular (LV) functions. It presents several research studies which utilized various techniques as evidences including echocardiographic technology, tissue Doppler imaging (TDI) and assessment on myocardial strain rate. In conclusion, it notes the growing evidence which indicates that extended exercise may cause reduction in both systolic and diastolic LV functions.

The article presents a study which discusses the clinical significance of functional changes and cardiac changes in the left ventricular function after prolonged exercise. It relates that there is a need to understand the clinical issues of the changes that occurred and resolving issues such as whether extended exercise can produce cardiac stress and the need to educate people responsible for the medical care of athletes about the occurrence of the disease. In addition, it states that further studies are needed to support the notion that upper limit of exercise can cause cardiac problems.

The article presents a study which provides an overview of exercise-associated alterations of cardiac biomarkers such as ischemia-modified albumin, troponin T and I as well as B-type natriuretic peptide (BNP). According to the article, these biomarkers are said to be elevated in patients with myocardial infection and heart failure although it is still unclear if whether an increase in cardiac biomarkers among healthy athletes can generate difficulties that can result to unfitting consequences. In addition, it concludes that troponin increases only in mild and short duration while it decreases on healthy athletes within 24 hours after the exercise.

The article presents the study which aims to analyze the relationship of physical activity and its changes to the prevalence of metabolic syndrome (MetS) between young adults enrolled in the Cardiovascular Risk in Young Finns Study. According to the article, among the methods being used include the recording of leisure-time physical activity (LTPA), the summing up of LTPA which forms the physical activity index (PAI). In addition, it concludes that a physically active lifestyle can reduce or delay the onset of metabolic syndrome among adults.

The article presents a study which aims to review available literature that suggests that prolonged strenuous exercise (PSE) can cause transient reduction in the right (RV) and left ventricular (LV) functions. It provides analysis on major mechanisms that are associated with the changes in the systolic and diastolic functions after having PSE, which include myocardial damage, cardiac autonomic modulation, changes in LV pressure gradients as well as alterations in the myocardial relaxation. In addition, it concludes that exercise-induced cardiac fatigue after PSE can reduce both systolic and diastolic functions of the LV.

The article presents a study which aims to determine whether a moderate dosage of caffeine could augment resting ventilatory responsiveness, exercise ventilation (VE), end-tidal O2 partial pressure, and arterial oxyhemoglobin saturation (HbSaO2) in athletes with exercise-induced hypoxemia. The study assessed the ventilatory responsiveness at rest of via the isocapnic hypoxic response (HVR) and hyperoxic hypercapnic ventilatory response (HCVR). Results shows that the failure of HbSaO2 to increase at VO2max despite an increased VE suggests that the mechanisms influencing HbSaO2 other than an inadequate hyperventilatory response may operate to different degrees across individuals as VO2max is approached.

The article presents the study which examines the ability of cardiopulmonary exercise testing (CPX) variables to reflect resting hemodynamics in patients with nonobstructive hypertrophic cardiomyopathy (NHCM). Researchers performed CPX and right heart catheterization on 83 subjects with NHCM and compared the peak oxygen consumption and minute ventilation/carbon dioxide ration at peak exercise to resting hemodynamics. Results showed that CPX can accurately identify abnormal resting hemodynamics in patients with NHCM.

The article presents the study which sought to examine the effects of exercise preconditioning on acute doxorubicin (DOX)-induced cardiotoxicity and determine whether any observed cardioprotection was associated with myosin heavy chain (MHC) isoform alterations. Researchers used male Sprague-Dawley rats in which they were trained on a motorized treadmill, had access to voluntary wheels, or remained sedentary for 10 week prior to being injected with either saline or DOX. Moreover, left ventricular function was analyzed in vivo using transthoraic echocardiography and ex vivo using the isolated working heart at 5 and 10 d after injection. Results showed that DOX treatment had promoted significant in vivo and ex vivo cardiac dysfunction at 5 and 10 d after injection in sedentary animal.

The article focuses on the research study related to heart rate recovery (HRR) whether it is predictive of all-cause mortality, cardiovascular mortality and cardiovascular events in asymptomatic patients with type 2 diabetes mellitus. According to the author, survival analysis has been used to test the association of 1- and 2-minutes HRR with all-cause mortality, cardiovascular mortality and cardiovascular events. He emphasized that information beyond traditional cardiovascular risk factors that can aid in clinical risk stratification with T2DM has been provided by the HRR.

The article offers information on the study of the difference between thermoregulatory and cardiovascular responses and the endurance performance between prepubertal boys and adult males during a steady-load cycling in a moderately hot and cool ambient conditions with moderate humidity. According to the author, to identify the difference of each response, eight prepubertal boys and eight adult men performed the steady-load cycling to exhaustion at an intensity equivalent to approximately 65% with fluid intake ad libitum. He emphasized that the study failed to show the differences in exercise tolerance, thermoregulatory adaptation or cardiovascular response to exercise in the heat between euhydrated prepubertal boys and adult men.

The article offers information on a study concerning the quantification of plantar pressure variable changes observed during five cardiovascular exercises. Ten young men and ten middle-aged men were asked to participate on the mentioned study. The plantar pressure data were recorded during running, stair climbing, walking, and recumbent biking, and during elliptical training after the familiarization of the equipment. several differences in pressure variables during the exercises and between the age group under the arch, heel, and the forefoot were identified using a separate one-way analyses of variance with repeated measures.

The article investigates the time-course changes of several commonly used makers of oxidative stress by performing serial measurements during a 24-hour period after an acute bout of strenuous cardiovascular exercise. The results of the study indicate that there is no best time point applying to all makers for collecting blood samples after aerobic exercise. The optimum postexercise time points for blood collection in untrained individuals are immediately after exercise for catalase, 1 hour for thiobarbituric acid-reactive substances, 2 hours for total antioxidant capacity, reduced glutathione and oxidized glutathione while 4 hours after exercise for protein carbonyls.

The article presents a study which shows the effects of exercise in overweight Japanese with multiple cardiovascular risk factors in a randomized controlled trial. The participants of the study, who should have two of the risk factors such as hypertension, hyperlipidemia, or glucose intolerance, will receive a standard health exam with counseling followed by randomization. A marginal significance between-group difference in changes in systolic blood pressure is among the primary outcome measures. Moreover, it was concluded that exercising an average of 2.6 times per week for six months, produces a significant improvement in cardiovascular risk profile without adverse effects.

The article examines the potential cardiovascular complications of exercise. It is stated that habitual physical activity reduces coronary heart disease cases but forceful exercises can also lead to the increase risk of sudden cardiac death and acute myocardial infraction. According to a study, the rate of exercise-related cardiac death varies with the prevalence of the disease. Here, the authors suggest several strategies to reduce the said incidence including screening the patient before participating in an exercise activity, training fitness personnel for emergencies and encouraging an individual to avoid engaging in high-risk activities.

The article presents a study which examines the effect of high-impact exercise on the physical performance and cardiovascular risk factors. A 12-month population-based randomized controlled trial was performed to 120 women ages 35-40 who are divided into the exercise group and the controlled group. The exercise regimen composed of a supervised, progressive and high-impact physical activities for two to three times per week as well as an added home program. The changes in the physical function were determined and the exercises given were recorded using an accelerometer-based approach. Results showed that the moderate to intensity exercise regimen initially improved cardiorespiratory fitness, speed-strength and lipid profiles.

The article focuses on a study which aims to determine the aerobic fitness' role on central neuromuscular activation and maximal voluntary contractile force with 37 men from aerobic fitness and training history placed in a 35 degrees centigrade environment using liquid garment . The study shows that in production, there was a passive heating attenuated force, decrease in voluntary activation, and moderate increased in cardiovascular strain. In addition, the study concludes that low aerobic fitness and activity level are associated with a decreased tolerance to passive hyperthermia. Furthermore, voluntary and maximum activation during high body temperatures were afflicted regardless of training status to an equal level.

The article presents a study which investigated whether the way children and adolescents travel to school is associated with level of cardiovascular fitness in Denmark. The participants were recruited via proportional, two-stage cluster sample of schools as part of the European Heart Youth Study. Results showed that children and adolescents who cycled to school were more fit than those who walked or traveled by motorized transport and were nearly five times as likely to be in the top quartile of fitness. In conclusion, cycling to school can contribute a higher cardiovascular fitness in young people.

The article cites a study on the physiological response, reliability and validity of Yo-Yo intermittent recovery level two test (Yo-Yo IR2) in soccer players. Thirteen males carried four Yo-Yo IR2 tests, an incremental treadmill test and various sprint tests. Subjects' muscle biopsies, blood samples and heart rate were measured before, during and after the tests. One-hundred ninety-nine Scandinavian elite soccer players carried out Yo-Yo IR2 test in two or four occasions. The study analyzed that Yo-Yo IR2 test was reproducible and evaluates athletes' ability to perform aerobic or anaerobic exercises. It is concluded that Yo-Yo IR2 test is sensitive tool to differentiate intermittent exercise performance of soccer players.

The article cites the study which evaluates the accuracy of accelerometer-type pedometers used by elderly with slow walking speeds with or without gait disorders. Eighteen subjects walked with cane and 31 subjects walked without cane. Researchers monitored the number of steps by pedometer (PM), also by visually counting the actual number of steps (RM) and the triaxial acceleration signals. Fourier transform (FFT) was used to calculate the direction of power spectrum of accelerometer. Results showed that PM was less than RM and an error of PM was also determined. Based on the results on the subjects, researchers concluded that the FFT method was suitable for estimating number of steps during walking.

The article cites the study on the effect of esophageal acid and prophylactic rabeprazole on performance in runners. The researchers aimed to determine the effect of esophageal acid perfusion during exercise on pulmonary function and exercise activity and to determine whether acid suppression with rabeprazole increases performance. The study was divided into two-phases, 24 conditioned runners had completed phase one and 16 runners with heartburn completed phase 2. Results showed that total energy expenditure during exercises was less in each acid-perfusion. Moreover, cardiopulmonary changes were not affected by decrease in exercise performance during acid perfusion.

The article cites the study which focuses on the effects of exercise heat-induced two percent dehydration (DEH) and euhydration (EUH) with six percent carbohydrate-electrolyte solution (CES) compared with placebo (P EUH) on 15 skilled basketball players ages 12 to 16 years old. Subjects had undergone three separate heat exposure exercises for two hours with limited fluid intake in two percent DEH, six percent CES, EUH with flavored water as placebo. After which, subjects performed continual basketball drills. A conclusion was made that deterioration in performing basketball accompanies two percent dehydration in 12 to 15 years old players. EUH with six percent CES significantly improves shooting performance and on-count sprinting over EUH with water.

The article cites the study which found that swimming performance correlates to both power and torque and fluctuations in neuromuscular function in athletes during taper is lacking. The study focuses on time course of changes in maximal mechanical power (Pmax), torque at power maximum (T), velocity at power maximum (V) and performance of 24 male swimmers during a taper. Arm ergometer with inertial loading were attached to the subjects one week before taper, during the second and third week and during the peek of competition. Results showed that biphasic response was common among individual swimmers. In conclusion, maximal arm power measured using inertial load ergometry increased largely in first and third week after training volume was tapered for peek swimming performance.

The article cites a study regarding the use of accelerometers in assessing physical activity (PA). The article notes that accelerometers were known to be used in public health research but their accuracy were limited in data-processing techniques. Quadratic discriminant analysis (QDA) was performed when six subjects were made to perform four activities: walking, uphill walking, vacuuming and working with a computer. Mean percentage (SE) of time points from 70.9 percent of QDA was identified. Computer works were correctly recognized more frequently having 100 percent SE, vacuuming at 67.5 percent, uphill walking 58.2 percent while walking 53.6 percent. A conclusion was drawn that the novel approach may be more accurate in estimating activity mode.

The article cites a study on the comparability of the prevalence physical activity estimates from the Behavioral Risk Factor Surveillance System (BRFSS) and the International Physical Activity Questionnaire (IPAQ). Both systems were used in studies determining the prevalence of physical activity among U.S. adults aged 18-99 years old that were listed in the National Physical Activity and Weight Loss Survey. Through telephone survey, data were analyzed from 9,945 adults who completed BRFSS and IPAQ questions. Results showed differences in physical activity categories for sex, age, income, education, and body mass index. Due to different results, direct comparison of the two survey is not recommended.

The article cites a clinical study which found that resistance training (RT) of overweight eumenorrheic healthy women can improve brachial artery endothelial function. As cited, impaired endothelial function has been implicated as an initial step in the pathogenesis of atherosclerosis that predisposes cardiovascular disease. The study aims to examine the before- and after-effects of one year RT on vascular structure and function of 30 women subjects ages 24-44 years old. After one year of RT, results showed significant mean improvement and increase in lean body mass of the RT group compared to the control group. No RT-associated changes in blood pressure, fasting blood lipids and glucose or insulin levels were found.

The article presents a study which investigated whether manipulation of cardiovascular drift by changing exercise duration or by fluid ingestion is associated with altered peak oxygen uptake (OU). OU was measured in several trained men after exercise in relative humidity. Stroke volume, heart rate, and related measures were also assessed. It was concluded that the progressive decline in stroke volume during prolonged, constant-rate submaximal exercise in a warm environment, reflective of increased cardiovascular strain associated with hyperthermia, dehydration , and other changes that occur over time, reduces OU.

The article presents a study which focuses on several common polymorphisms of the β2 adregenic (ADRB2) have been described including a Glycine (Gly) for arginine (Arg) substitution at amino acid 16. In vivo studies have attributed phenotypic differences in the Arg16Gly polymorphism of the ADRB2 to differences in agonist-mediated desensitization. ADRB2 density has been measured on isolated lymphocytes in healthy subjects matched for age, cardiovascular fitness, body mass index, and gender. Subjects had lower receptor density as well as lower resting cardiac output due to reduced stroke volume. It has been concluded that the resulting data suggest that Arg16Gly polymorphism of the ADRB2 influences receptor density.