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The aim of this study was to assess the anti-inflammatory effects of local cryotherapy in human non-septic knee arthritis. In the phase I of the study, patients were randomized to receive either ice (30 min; N= 16) or cold CO2(2 min; N= 16) applied twice during 1 day at an 8-h interval on the arthritic knee. In phase II, 16 other ice-treated arthritic knees according to the same protocol were compared to the contralateral non-treated arthritic knees (N= 16). The synovial fluid was analyzed just before the first cold application, then 24 h later. IL-6, IL-1β, TNF-α, IL-17A, VEGF, NF-kB-p65 protein, and PG-E2 levels were measured in the synovial fluid and compared before/after the two cold applications. Forty-seven patients were included (17 gouts, 11 calcium pyrophosphate deposition diseases, 13 rheumatoid arthritides, 6 spondyloarthritides). Local ice cryotherapy significantly reduced the IL-6, IL-1β, VEGF, NF-kB-p65, and PG-E2 synovial levels, especially in the microcrystal-induced arthritis subgroup, while only phosphorylated NF-kB-p65 significantly decreased in rheumatoid arthritis and spondyloarthritis patients. Cold CO2only reduced the synovial VEGF levels. In the phase II of the study, the synovial PG-E2 was significantly reduced in ice-treated knees, while it significantly increased in the corresponding contralateral non-treated arthritic knees, with a significant inter-class effect size (mean difference − 1329 [− 2232; − 426] pg/mL; N= 12). These results suggest that local ice cryotherapy reduces IL-6, IL-1β, and VEGF synovial protein levels, mainly in microcrystal-induced arthritis, and potentially through NF-kB and PG-E2-dependent mechanisms. Clinicaltrials.gov, NCT03850392—registered February 20, 2019—retrospectively registered

Background: The first (VT1) and second (VT2) ventilatory thresholds are landmarks to tailor exercise rehabilitation in coronary artery disease (CAD) or chronic heart failure (CHF). Methods allowing VT1 and VT2 determination based on heart rate variability (HRV) have been proposed but not yet evaluated in these patients.Design: To determine the heart rate (HR) associated with VT1 and VT2 by three methods of HRV analyses.Methods: Fourteen CHF and 24 CAD patients performed an exercise test on a cycle ergometer (10 -W every minute until exhaustion). VT1 and VT2 were determined with the ‘respiratory equivalent’ method. HR at VT1 was determined with the standard deviation (SD) of R⊟R intervals (VTSD) and of the instantaneous beat-to-beat variability of the Poincaré plot method (VTPoincaré). HR at VT1 and VT2 was determined through a time-varying HRV analysis method (VTTV1and VTTV2, respectively).Results: HR at VTSDwas significantly higher than HR at VT1. No significant differences were observed between HR at VTPoincaré, VTTV1, and at VT1, nor between HR at VTTV2and VT2. HR at VTSD, VTPoincaré, and VT1 were significantly correlated, but with a low r2value and a large mean HR difference. With the time-varying method, the mean HR difference was lower than 5% and the correlation coefficients were higher (especially for VTTV2).Conclusions: SD and Poincaré plot methods lead to substantial inaccuracy in HR estimates. The time-varying HRV analysis led to strong correlation coefficients and low limits of agreement. Therefore, this method may be a promising, low-cost tool for non-invasive assessment of the ventilatory thresholds in cardiac disease.

The purpose of the present study was to examine both the specific and the transfer effects of a Square Wave Endurance Exercise Test (SWEET) and to investigate the determining factors of transfer effect. A control group (CG, n = 5) and 2 experimental groups were studied. Experimental groups completed 3 days/week a 45 min SWEET over 6 weeks, either with the arms using a wheelchair ergometer (AG, n = 5) or with the legs using a cycling ergometer (LG, n = 5). All subjects performed before and after training two maximal progressive tests: the first one with the arms and the second with the legs. During those tests oxygen uptake (V˙O2) and cardiorespiratory parameters were continuously measured. Specific effects (changes between the tests performed with trained limbs) were observed: the peak power output (W˙p) and V˙O2 were significantly increased by both arm (+ 66 %, + 35 %) and leg (+ 17 %, + 14 %) training. At ventilatory threshold (VT), power output (W˙) and V˙O2 were significantly increased with arm (+ 145 % and + 51 %) and leg (+ 53 % and + 46 %) training. Transfer effects (changes between pre and post tests performed with untrained limbs) were observed: W˙p and V˙O2 were not increased in AG while W˙p was increased in LG (+ 11 %). At VT, W˙ and V˙O2 were increased with arm (+ 19 % and + 23 %) and leg (+ 33 % and + 46 %) training. For AG and LG the V˙O2 expressed in percent of the V˙O2 peak was increased (+ 19 % and + 33 %, respectively) and the O2p was also increased (+ 30 %) for LG. These results show that SWEET training induced specific and transfer effects. Moreover, the initial level of the subjects, the type and the intensity of the training seem to be the major factors for effective observable transfer effects.

Chez les patients atteints d’une BPCO modérée à sévère, l’adaptation de la ventilation (V′E) lors de l’exercice physique concentrique (CONC) est limitée par une contrainte portant sur l’augmentation du volume courant (Vt). Du fait de son faible coût cardiorespiratoire, l’exercice excentrique (EXC) pourrait être une alternative au CONC chez ces patients. L’objectif de ce travail était de comparer l’adaptation ventilatoire a l’effort entre exercices de pédalage CONC et EXC.Méthodes Treize patients atteints de BPCO modérée a sévère (VEMS : 1,27±0,31L ; 44,5±10,7 %Pred) ont effectué une épreuve d’effort incrémentale CONC maximale et 4 séances de 30minutes de pédalage EXC. Le V′E maximal observé en EXC a été déterminé, et le V′E correspondant en CONC a été obtenu par interpolation linéaire. Plusieurs paramètres (Vt, fréquence respiratoire [FR], consommation d’oxygène [V′O2], quotient respiratoire [QR], fréquence cardiaque [FC], score de dyspnée [Borg]) ont été comparés a iso-V′E en CONC et en EXC.Résultats Le V′E maximum en EXC et le V′E correspondant en CONC étaient respectivement de 26,1±7,9 et 26,1±8,0L.min−1, soit 60,6±21,2 % de la VMM calculée (35×VEMS). Le Vt est plus faible d’environ 12 % en EXC qu’en CONC (981±221 vs. 1098±315mL, respectivement ; p<0,001) et la FR était 18 % plus élevée (27,8±5,2 vs. 23,8±4,0min−1). En revanche, la V′O2, la FC et le score de Borg étaient similaires dans les conditions EXC et CONC (respectivement, 0,81±0,23 vs. 0,83±0,27L ; 97±11 vs. 97±14min−1 et 2,5±2,5 vs. 1,8±1,0).Conclusion Pour la V’E maximale observée lors de l’exercice EXC chez des patients avec une BPCO modérée a sévère, le Vt est plus faible et la FR plus élevée qu’en CONC, comme observé a iso-V′O2/V′E par Lechauve et al. [1]chez des sujets sains. Même si cela ne se traduit pas par un niveau de dyspnée différent, les conséquences de cette hyperpnée lors d’un entraînement EXC dans la BPCO méritent d’être étudiées.