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22 ABSTRACT 23 Study design Experimental study 24 Objectives To compare lipid metabolism in individuals with a cervical spinal cord injury (SCIC) 25 and able-bodied (AB) persons in response to mild cold stress. 26 Settings Laboratory of Wakayama Medical University, Japan. 27 Methods Nine males with SCIC and 11 AB wore a water-perfusion suit in a supine position. 28 Following 30-min rest thermoneutrality, the whole body was cooled by perfusing 25°C water 29 through the suit for 15-20 minutes (CS). Blood samples were collected before, immediately, and 60 30 (post-CS60) and 120 minutes after CS (post-CS120). Concentrations of serum free fatty acid 31 ([FFA]s), total ketone bodies ([tKB]s), insulin ([Ins]s) and plasma adrenaline ([Ad]p), noradrenaline 32 ([NA]p) and glucose ([Glc]p) were assessed. 33 Results [Ad]p in SCIC were lower than AB throughout the study (p=0.0002) and remained largely 34 unchanged in both groups. [NA]p increased after cold stress in AB only (p

Objectives To evaluate acute changes in serum brain-derived neurotrophic factor (BDNF) concentration following combined endurance exercise and heat stress through head-out water immersion (HOI). Setting Observational study with crossover design. Methods Ten healthy young male participants performed HOI at 40 °C (40 °C HOI) or continuous cycling at 60% of maximal oxygen uptake while immersed in 40 °C (40 °C HOI-ex) or 23 °C water (23 °C HOI-ex) for 15 min. Serum BDNF, cortisol and lactate concentrations, and core temperature (Tcore) were measured pre, immediately post, and 15 and 30 min post-immersion. Results BDNF concentration increased immediately and 15 min after 40 °C HOI-ex, but not after 40 °C or 23 °C HOI-ex. No changes in Tcore concentration were observed during 23 °C HOI-ex (Pre; 37.3 °C ± 0.3 °C, Post; 37.8 °C ± 0.2 °C, Post 15; 37.4 °C ± 0.3 °C, Post 30; 37.2 °C ± 0.2 °C). Tcore increased significantly post, post 15, and post 30 min of 40 °C HOI (Pre; 37.1 °C ± 0.4 °C, Post; 38.8 °C ± 0.5 °C, Post 15; 37.9 °C ± 0.4 °C, Post 30; 37.9 °C ± 0.2 °C) and 40 °C HOI-ex (Pre; 37.2 °C ± 0.2 °C, Post; 40.2 °C ± 0.7 °C, Post 15; 38.9 °C ± 0.5 °C, Post 30; 38.3 °C ± 0.5 °C). Tcore was higher in 40 °C HOI-ex compared with 40 °C HOI and 23 °C HOI-ex immediately post and post 15 min. Plasma lactate and cortisol were significantly higher in 40 °C HOI-ex compared with 40 °C HOI and 23 °C HOI-ex after immersion (p = 0.001). Conclusion While 15 min HOI alone or thermoneutral exercise do not increase BDNF concentration, both combined may form a time-efficient strategy to acutely elevate BDNF.

Prospective cardiovascular adjustment occurs before starting voluntary exercise, increasing heart rate and arterial pressure followed by muscle vasodilation; however, the precise mechanisms and significance for this vasodilation remain unknown. We found that during the countdown before starting exercise cerebral blood flow velocity increased, followed by increases in heart rate and arterial pressure, which suppressed MSNA through baroreflex, resulting in thigh muscle vasodilation to increase oxygen consumption rate, which might make it easier to start exercise.

Brain-derived neurotrophic factor (BDNF) plays a key role in neuronal adaptations. While previous studies suggest that whole-body heating can elevate circulating BDNF concentration, this is not known for local heating protocols. This study investigated the acute effects of whole-body versus local passive heating on serum and plasma BDNF concentration. Using a water-perfused suit, ten recreationally active males underwent three 90 min experimental protocols: heating of the legs with upper-body cooling (LBH), whole-body heating (WBH) and a control condition (CON). Blood samples were collected before, immediately after and 1 h post-heating for the determination of serum and plasma BDNF concentration, platelet count as well as the BDNF release per platelet. Rectal temperature, cardiac output and femoral artery shear rate were assessed at regular intervals. Serum and plasma BDNF concentration were elevated after WBH (serum: 19.1±5.0 to 25.9±11.3 ng/ml, plasma: 2.74±0.9 to 4.58±2.0; pp>0.126), when compared with CON (serum: 18.6±6.4 to 16.8±3.4 ng/ml, plasma: 2.49±0.69 to 2.82±0.89 ng/ml); accompanied by an increase in platelet count (pp = 0.392). All physiological measures were elevated to a larger extent after WBH compared with LBH (pp

Early mobilization decreases the likelihood of negative outcomes for acute-phase inpatients. Adverse events occurring during intensive care unit rehabilitation have previously been reported; however, no study has reported the incidence rates for adverse events during the acute rehabilitation phase. This study aimed to investigate the incidence of severe adverse events during acute-phase rehabilitation and evaluate them in detail.Reports of adverse events occurring during acute-phase rehabilitation in a university hospital from April 1, 2011 to March 31, 2018 were retrospectively assessed.Nine severe adverse events occurred during this period (incidence rate, 0.032%), comprising 2 cardiopulmonary arrests, 2 pulseless electrical activity events, 2 deterioration in consciousness events, 1 deterioration in consciousness event due to cerebral infarction, 1 fracture due to a fall, and 1 event involving removal of a ventricular drain. Pulmonary thromboembolism was implicated in 1 adverse event involving pulseless electrical activity and 1 deterioration in consciousness event. The causes for the 6 other adverse events could not be identified. The mean days from admission and the onset of rehabilitation to adverse event occurrence were 22.0 ± 18.2 and 17.9 ± 13.5 days (mean ± standard deviation), respectively. Four of 9 patients died, and 5 patients were discharged home or transferred to other stepdown facilities. When assessed retrospectively, there were no conflicts between patient conditions and the cancellation criteria of rehabilitation by the Japanese Association of Rehabilitation Medicine.The occurrences of severe adverse event may not be related to early mobilization (or onset time of rehabilitation) and compliance status of cancellation criteria.

We aimed to investigate whether out-patient rehabilitation with the same concept as physiatrist and registered therapist operating rehabilitation (PROr) would improve activities of daily living in out-patients with chronic cerebrovascular disorder and whether the improvements were related to the frequency and/or time of therapy.Out-patients with chronic cerebrovascular disorder, who visited a clinic affiliated with a university hospital for at least a month between April 2010-September 2020, were retrospectively selected. Changes in the functional independence measure (FIM) from the first visit to the 12Initially, 174 patients were selected and 125 were excluded based on the exclusion criteria. Three patients terminated rehabilitation because of improvements. In 18 of 49 patients, FIM improved at the 12Approximately 40% of the patients displayed improved FIM even during the chronic phase, and the improved out-patients took PROr for at least 108 min/day and twice a week. A longer rehabilitation time would be reinforced by patients' motivation.

Previous research indicates a better improvement of functional independence measure (FIM) at discharge in acute-stroke patients who received physiatrist and registered therapist operating rehabilitation (PROr) within 24 hrs compared with those who received after 24 hrs was reported. The aim of this prospective cohort study was to determine whether PROr provided within 24 hrs for new-onset stroke patients affects home-discharge rate at 6 months later.Acute new-onset stroke patients admitted to our hospital and received PROr (A total of 139 patients [VEM (Starting PROr within 24 hrs of new-onset stroke may help to increase home-discharge rates at 6-month follow-up, simultaneously with a higher FIM. Very early mobilization in our hospital did not increase the risks of recurrence or death.

Objective: To determine the relationship between physical findings, wheelchair sitting time, and interface pressure on ischial region in subjects with spinal cord injury (SCI). Design: Cross-sectional study. Setting: Rehabilitation center in Japan. Participants: Manual wheelchair users with chronic SCI (n = 45). Interventions: Pressure ulcers (PU) were diagnosed by inspection, palpation, and ultrasonography. Self-reports were obtained on wheelchair sitting time and pressure mapping was recorded while the subject was seated on the wheelchair. Outcome measures: Subjects were divided into those with ultrasonographically low-echoic lesions (PU-positive group, n = 11) and no such lesions (PU-negative group, n = 34). Outcome measures included wheelchair sitting time and interface pressure at bilateral ischial regions. Results: Using ultrasonography, 13 low-echoic lesions were identified in 11 subjects of the PU-positive group. The pressure duration was longer and interface pressure was significantly higher in subjects of the PU-positive group compared with those of the PU-negative group (P

Acute experimental study.To investigate the acute response of markers of lipid metabolism and interleukin (IL)-6 to dopamine infusion in people with a cervical spinal cord injury (CSCI).Laboratory of Wakayama Medical University, Japan.Ten participants, four with CSCI and six AB individuals, underwent 50 min of dopamine infusion. Blood samples were collected prior to, immediately after and 1 h following cessation of dopamine infusion for the determination of circulating catecholamine, lipid, ketone body and IL-6 concentrations.The adrenaline concentration following dopamine infusion was increased by 59 ± 7% in CSCI (p = 0.038, Cohen's d effect size (ES): 1.47), while this was not changed in AB (p = 0.223). Triglycerides and acetoacetic acid concentration were increased in both groups, immediately after and 1 h post-infusion (triglycerides p ≤ 0.042, ES CSCI: 1.00, ES AB: 1.12; acetoacetic acid p ≤ 0.030; ES CSCI: 1.72, ES AB: 1.31). 3-Hydroxybutyric acid concentration was increased in CSCI only (48 ± 15%, p = 0.039, ES: 1.44; AB p = 0.115). Dopamine infusion did not affect plasma IL-6 concentration in either group (p ≥ 0.368).Dopamine infusion induced a sustained increase in triglyceride and ketone body concentrations in persons with CSCI. In contrast, cytokine concentrations were not affected by dopamine infusion. These findings suggest that circulating catecholamines can stimulate metabolism in people with CSCI despite the presence of autonomic dysfunction.

Blood pressure response to head-up tilt (HUT) in 7 healthy subjects and 9 patients before and after coronary artery bypass grafting (CABG) was measured during supine and 15-min 60° HUT. Stroke volume (SV) and ejection fraction (EF) were assessed by echocardiography. Baseline mean arterial pressure (MAP) and heart rate (HR) in patients before CABG were similar to healthy subjects. MAP in patients decreased by 6 (4–9) mmHg [median (1st–3rd quartiles)] during 7–12 mmHg of HUT with decreased cardiac output (CO = SV × HR) while HR remained unchanged. MAP in healthy subjects remained unchanged during HUT with increased HR. Body weight decreased by 3.5 (2.5–3.7) kg and MAP decreased by 6 (2–13) mmHg during the last 3-min HUT while HR increased after CABG. Decreases in SV and CO during HUT disappeared after CABG. Blood pressure decreased during HUT in patients before and after CABG regardless of HR response.

Study design: Experimental study. Objectives: To characterize static and dynamic cerebral autoregulation (CA) of individuals with cervical spinal cord injury (SCI) compared to able-bodied controls in response to moderate increases in mean arterial pressure (MAP) caused by mild whole-body cold stress. Setting: Japan Methods: Five men with complete autonomic cervical SCI (sustained>5y) and six age-matched able-bodied men participated in hemodynamic, temperature, catecholamine and respiratory measurements for 60 min during three consecutive stages: baseline (10 min; 330C water through a thin-tubed whole-body suit), mild cold stress (20 min; 250C water) and post-cold recovery (30 min; 330C water). Static CA was determined as the ratio between mean changes in middle cerebral artery blood velocity and MAP, dynamic CA as transfer function coherence, gain and phase between spontaneous changes in MAP to middle cerebral artery blood velocity. Results: MAP increased in both groups during cold and post-cold recovery (mean differences: 5 to 10 mm Hg; main effect of time: p=0.001). Static CA was not different between the able-bodied vs the cervical SCI group (mean [95% CI] of between-group difference: -4 [-11 to 3] and -2 [-5 to 1] cm/s/mmHg for cold (p=0.22) and post-cold (p=0.24), respectively). At baseline, transfer function phase was shorter in the cervical SCI group (mean [95% CI] of between-group difference: 0.6 [0.2 to 1.0] rad; p=0.006), while between-group differences in changes in phase were not different in response to the cold stress (interaction term: p=0.06). Conclusions: This pilot study suggests that static CA is similar between individuals with cervical SCI and able-bodied controls in response to moderate increases in MAP, while dynamic CA may be impaired in cervical SCI due to disturbed sympathetic control.

This study investigates the relationship between autonomic function and the inflammatory response to a wheelchair half-marathon in people with a spinal cord injury (SCI). Seventeen wheelchair athletes with a cervical SCI (CSCI, N = 7) and without CSCI (NON-CSCI, N = 10) participated in a wheelchair half-marathon. Blood was taken prior, post and 1 h post-race to determine the concentrations of adrenaline, noradrenaline, extracellular heat shock protein 72 (eHsp72) and interleukin-6 (IL-6). A sit-up tilt test was performed to assess autonomic function at rest. CSCI showed a lower supine ratio of the low and high frequency power of the variability in RR intervals (LF/HF RRI

Our aim was to determine differences in thermal comfort during simulated one-day parcel home delivery between summer and winter. Six young healthy males performed experiments in summer (up to 31°C) and winter (up to 8°C). After baseline measurement in a chamber, subjects drove a truck to a prespecified location for outside measurements. They performed 4 sets of 100-m walk with carrying 5-kg plate during the first 50-m walk at 100 m/min, separated by 7-min driving in each of the morning and the afternoon. Subjects could ingest water ad libitum in outside and set the cockpit temperature by themselves during driving. Thermal sensation and comfort were recorded using a subjective scale at the first and the last sets of each morning and afternoon session, while esophageal temperature (Tes) was monitored (thermocouples). Body weight was measured before and the end of experiment. We found that 1) whole-body comfort decreased in summer and the decrease was greater than winter with higher Tes and 2) changes in body weight were 0.7 and 0.3 kg through whole day in summer and winter, respectively. In summary, thermal comfort during working worsened in summer, possibly related with higher core temperature and greater decrease in body weight.

In Japan, the incidence of heat illness in older people has rapidly increased during midsummer in the last decade, and we suggested that whey-protein+carbohydrate supplementation during aerobic training would increased plasma volume (PV) to enhance thermoregulatory adaptation in older men ( J Appl Physiol 107: 725-733, 2009); however, >60% of people age 65 and older suffer from hypertension, and the symptoms may be worsened by hypervolemia. To examine this, we randomly divided 21 older men (∼69 yr) with ∼160 mmHg for systolic and ∼90 mmHg for diastolic blood pressure at rest into two groups: Glc ( n = 11) consuming glucose alone (25 g) and Pro-Glc ( n = 10) consuming whey protein (10 g) + glucose (15 g), immediately after cycling exercise at 60–75% of peak aerobic capacity (V̇o2 peak) for 60 min/day, 3 days/wk, for 8 wk. Before and after training, we measured PV (dye dilution), baroreflex sensitivity (BRS) of heart rate (Valsalva maneuver), and carotid arterial compliance (CAC) from carotid arterial diameter (ultrasound imaging) responses to pulsatile arterial pressure change (photoplethysmography) at rest. Additionally, we measured esophageal temperature (Tes) and forearm skin blood flow (plethysmography) during exercise at 60% pretraining V̇o2 peak for 20 min in a warm environment. We found that the forearm skin vascular conductance response to increased Tes was enhanced in Pro-Glc with increased PV, but this was not found in Glc; however, despite the increased PV, arterial blood pressures rather decreased with increased CAC and BRS in Pro-Glc. Thus, the prescription was applicable to older men with hypertension to prevent heat illness during exercise.

A reduction in exercise efficiency with aging limits daily living activities. We examined whether 5-aminolevulinic acid (ALA) with sodium ferrous citrate (SFC) increased exercise efficiency and voluntary achievement of interval walking training (IWT) in older women. Ten women [65 ± 3(SD) yr] who had performed IWT for >12 mo and were currently performing IWT participated in this study. The study was conducted in a placebo-controlled, double-blind crossover design. All subjects underwent two trials for 7 days each in which they performed IWT with ALA+SFC (100 and 115 mg/day, respectively) or placebo supplement intake (CNT), intermittently with a 2-wk washout period. Before and after each trial, subjects underwent a graded cycling test at 27.0°C atmospheric temperature and 50% relative humidity, and oxygen consumption rate, carbon dioxide production rate, and lactate concentration in plasma were measured. Furthermore, for the first 6 days of each trial, exercise intensity for IWT was measured by accelerometry. We found that, in the ALA+SFC trial, oxygen consumption rate and carbon dioxide production rate during graded cycling decreased by 12% ( P < 0.001) and 11% ( P = 0.001) at every workload, respectively, accompanied by a 16% reduction in lactate concentration in plasma ( P < 0.001), although all remained unchanged in the CNT trial ( P > 0.2). All of the reductions were significantly greater in the ALA+SFC than the CNT trial ( P < 0.05). Furthermore, the training days, impulse, and time at fast walking were 42% ( P = 0.028), 102% ( P = 0.027), and 69% ( P = 0.039) higher during the ALA+SFC than the CNT intake period, respectively. Thus ALA+SFC supplementation augmented exercise efficiency and thereby improved IWT achievement in older women.

BackgroundUlnar neuropathy at the elbow is an entrapment neuropathy, while ulnar nerve dislocation might also be involved in its incidence and severity. Wheelchair marathon athletes may be at an increased risk for Ulnar Neuropathy. However, there is a paucity of research into the prevalence of Ulnar Neuropathy and ulnar nerve dislocation in this population.ObjectiveTo investigate the prevalence of ulnar neuropathy at the elbow and ulnar nerve dislocation in wheelchair marathon athletes.ParticipantsWheelchair marathon athletes (N = 38) who participated in the 2017, 2018, and 2019 Oita International Wheelchair Marathon. 2 athletes participated only one time, 36 athletes repeatedly. Data from athletes`latest assessment were used.MethodsThe day before the race, questionnaires, physical examinations, and ultrasonography were conducted to screen for Ulnar Neuropathy in both upper limbs. Ulnar nerve dislocation was confirmed by physical examination and ultrasonography.Results11 (29%) athletes were diagnosed with Ulnar Neuropathy. There were no significant differences in age, height, weight, Body Mass Index, or history of primary illness between athletes with and without Ulnar Neuropathy. In the group without Ulnar Neuropathy, 44% of athletes reported to have been engaging in other wheelchair sports, compared to 9% in the group with Ulnar Neuropathy (p = 0.037). Ulnar nerve dislocation was diagnosed in 15 (39%) athletes by ultrasonography. Out of the 14 elbows of 11 athletes diagnosed with Ulnar Neuropathy, 9 (64%) elbows had ulnar nerve dislocation.ConclusionThe prevalence of Ulnar Neuropathy in wheelchair marathon athletes was higher than previously reported in able-bodied, non-athlete individuals and lower than in non-athletes with lower limb dysfunction. Therefore, while wheelchair sports may provide some protection against Ulnar Neuropathy, this study further supports the importance of screening for Ulnar Neuropathy, as well as for ulnar nerve dislocation as a potential risk factor for the development of Ulnar Neuropathy.

Experimental study. Individuals with spinal cord injuries (SCI) may present with impaired sympathetic control over thermoregulatory responses to environmental and exercise stressors, which can impact regional core temperature (Tcore) measurement. The purpose of this study was to investigate whether regional differences in Tcore responses exist during exercise in individuals with SCI. Rehabilitation centre in Wakayama, Japan. We recruited 12 men with motor-complete SCI (7 tetraplegia, 5 paraplegia) and 5 able-bodied controls to complete a 30-min bout of arm-cycling exercise at 50% VO2 peak reserve. Tcore was estimated using telemetric pills (intestinal temperature; Tint) and esophageal probes (Teso). Heat storage was calculated from baseline to 15 and 30 min of exercise. At 15 min of exercise, elevations in Teso (Δ0.39 ± 0.22 °C; P

Humans are unique in their ability to control body temperature with a large amount of skin blood flow and sweat rate while exercising in an upright position. However, cutaneous vasodilation in the body reduces total peripheral resistance and blood pooling in cutaneous veins decreases venous return to the heart and cardiac filling pressure. In addition, hypovolemia by sweating accelerates the reduction in cardiac filling pressure. These may threaten the maintenance of blood pressure if they are not compensated for. To prevent this, cutaneous vasodilation and sweat rate are suppressed by baroreflexes or hyperosmolality with dehydration. These mechanisms suppress heat dissipation, accelerate the increase in body temperature, and sometimes cause heat stroke. As a countermeasure to prevent this, we have recommended glucose electrolyte solutions but recently found that aerobic training with carbohydrate + whey protein supplementation markedly improves heat dissipation mechanisms by plasma volume expansion. In this article, we will discuss the importance of improving body fluid homeostasis for thermoregulation under heat stress in humans and the strategy to attain this.

KEY POINTS: In hyperthermia, plasma hyperosmolality suppresses both cutaneous vasodilatation and sweating responses and this suppression is removed by oropharyngeal stimulation such as drinking. Hypovolaemia suppresses only cutaneous vasodilatation, which is enhanced by rapid infusion in hyperthermia. Our recent studies suggested that skin sympathetic nerve activity (SSNA) involves components synchronized and non‐synchronized with the cardiac cycle, which are associated with an active vasodilator and a sudomotor, respectively. In the present study, plasma hyperosmolality suppressed both components; drinking removed the hyperosmolality‐induced suppressions, simultaneously with increases in cutaneous vasodilatation and sweating, while not altering plasma volume and osmolality. Furthermore, a rapid saline infusion increased the synchronized component and cutaneous vasodilatation in hypovolaemic and hyperthermic humans. The results support our idea that SSNA involves an active cutaneous vasodilator and a sudomotor, and that a site where osmolality signals are projected to control thermoregulation is located more superior than the medulla where signals from baroreceptors are projected. ABSTRACT: We reported that skin sympathetic nerve activity (SSNA) involved components synchronized and non‐synchronized with the cardiac cycle; both components increased in hyperthermia and our results suggested that the components are associated with an active vasodilator and a sudomotor, respectively. In the present study, we examined whether the increases in the components in hyperthermia would be suppressed by plasma hyperosmolality simultaneously with suppression of cutaneous vasodilatation and sweating and whether this suppression was released by oropharyngeal stimulation (drinking). Also, effects of a rapid saline infusion on both components and responses of cutaneous vasodilatation and sweating were tested in hypovolaemic and hyperthermic subjects. We found that (1) plasma hyperosmolality suppressed both components in hyperthermia, (2) the suppression was released by drinking 200 mL of water simultaneously with enhanced cutaneous vasodilatation and sweating responses, and (3) a rapid infusion at 1.0 and 0.2 ml min(−1) kg(−1) for the first 10 min and the following 20 min, respectively, increased the synchronized component and cutaneous vasodilatation in diuretic‐induced hypovolaemia greater than those in a time control; at 0.1 ml min(−1) kg(−1) for 30 min no greater increases in the non‐synchronized component and sweating responses were observed during rapid infusion than in the time control. The results support the idea that SSNA involves components synchronized and non‐synchronized with the cardiac cycle, associated with the active cutaneous vasodilator and sudomotor, and a site of osmolality‐induced modulation for thermoregulation is located superior to the medulla where signals from baroreceptors are projected.

Depressive patients often experience difficulty in performing exercise due to physical and psychological barriers. We examined the effects of 5-aminolevulinic acid (ALA) with sodium ferrous citrate (SFC) supplementation during home-based walking training in middle-aged depressive women. Nine outpatients [53 ± 8 (SD) yr] with major depressive disorder participated in the pilot study with randomized, placebo-controlled, double-blind crossover design. They underwent two trials for 7 days, each performing interval walking training (IWT) with ALA + SFC (ALA + SFC) or placebo supplement intake (PLC) intermittently with >a 10-day washout period. For the first 6 days of each trial, exercise intensity for IWT was measured by accelerometry. Before and after each trial, subjects underwent a graded cycling test, and lactate concentration in plasma ([Lac−]p), oxygen consumption rate ($${\dot{{\bf{V}}}{\bf{O}}}_{{\bf{2}}}$$ V ˙ O 2 ), and carbon dioxide production rate ($${\dot{{\bf{V}}}{\bf{\text{CO}}}}_{{\bf{2}}}$$ V ˙ CO 2 ) were measured with depression severity by the Montgomery–Åsberg Depression Rating Scale (MADRS). We found that the increases in [Lac−]p, $${\dot{{\bf{V}}}{\bf{O}}}_{{\bf{2}}}$$ V ˙ O 2 and $${\dot{{\bf{V}}}{\bf{\text{CO}}}}_{{\bf{2}}}$$ V ˙ CO 2 during the test were attenuated only in ALA + SFC ([before vs. after] × workload; all, P

Aerobic training-induced plasma volume (PV) expansion improves thermoregulation, and carbohydrate (CHO) + whey protein supplementation enhanced the effects in older people; however, these were suggested by studies on gym-based cycling training but not on home-based interval walking training (IWT). Moreover, long-term walking training effects on PV remain unknown.Seventeen male and 10 female subjects (~69 yr), having performed IWT for ≥24 months before the study, were used. After pre-intervention measurement (PRE) of PV, plasma albumin content (Albcont), fasting glucose concentration ([Glc]f), and HbA1c, the subjects were randomly divided into two groups: CHO and Pro-CHO, either consuming CHO (22.5 g) alone or CHO (15 g) + whey protein (10 g), respectively, during additional 5-month IWT from May to November, 2009. After the additional IWT, we measured the same variables again (postintervention measurement).The baseline PV and Albcont were significantly correlated with the number of IWT days for the 12 months preceding PRE (r = 0.716, P0.001 and r = 0.671, P0.001, respectively). In postintervention, PV and Albcont marginally decreased in CHO from the baselines (P = 0.081 and P = 0.130, respectively) with increased HbA1c (P0.001) after correction for the baseline [Glc]f by ANCOVA, but these values remained unchanged in Pro-CHO (both, P0.74), with significant differences in the changes between groups (P = 0.020, P = 0.041, and P = 0.018 respectively).PV was proportional to the number of IWT days for 12 months and a CHO + whey protein supplementation during the 5-month IWT prevented PV reduction for the period of no supplementation, which might be partially linked with blood glucose control mechanisms.

Objective Clinical evidence suggests that early mobilization of patients with acute stroke improves activity of daily living (ADL). The purpose of this study was to compare the utility of the physiatrist and registered therapist operating acute rehabilitation (PROr) applied early or late after acute stroke. Subjects and methods This study was prospective cohort study, assessment design. Patients with acute stroke (n = 227) admitted between June 2014 and April 2015 were divided into three groups based on the time of start of PROr: within 24 hours (VEM, n = 47), 24–48 hours (EM, n = 77), and more than 48 hours (OM, n = 103) from stroke onset. All groups were assessed for the number of deaths during hospitalization, and changes in the Glasgow Coma Scale (GCS), National Institute of Health Stroke Scale (NIHSS), and Functional Independence Measure (FIM) at hospital discharge. Interventions All patients were assessed by physiatrists, who evaluated the specific needs for rehabilitation, and then referred them to registered physical therapists and occupational therapists to provide early mobilization (longer than one hour per day per patient). Results The number of deaths encountered during the PROr period was 13 (out of 227, 5.7%), including 2 (4.3%) in the VEM group. GCS improved significantly during the hospital stay in all three groups, but the improvement on discharge was significantly better in the VEM group compared with the EM and OM groups. FIM improved significantly in the three groups, and the gains in total FIM and motor subscale were significantly greater in the VEM than the other groups. Conclusions PROr seems safe and beneficial rehabilitation to improve ADL in patients with acute stroke.

The purpose of this study was to determine the effect of aerobic training under noninvasive positive pressure ventilation (NPPV) on maximal oxygen uptake ([Formula: see text]).Ten healthy young male volunteers participated in the study. Before the training, stroke volume (SV) and cardiac output (CO) were measured in all subjects under 0, 4, 8, and 12 cmH2O NPPV at rest. Then, the subjects exercised on a cycle ergometer at 60% of pre-training [Formula: see text] for 30 min daily for 5 consecutive days with/without NPPV. The 5-day exercise protocol was repeated after a three-week washout period without/with NPPV. The primary endpoint was changes in [Formula: see text]. The secondary endpoints were changes in SV, CO, maximum heart rate (HRmax), maximum respiratory rate (RRmax), maximum expiratory minute volume (VEmax) and the percent change in plasma volume (PV).NPPV at 12 cmH2O significantly reduced SV and CO at rest. [Formula: see text] significantly increased after 5 days training with and without NPPV, but the magnitude of increase in [Formula: see text] after training under 12 cmH2O NPPV was significantly higher than after training without NPPV. VEmax significantly increased after training under NPPV, but not after training without NPPV. HRmax and RRmax did not change during training irrespective of NPPV. The percent change in PV was similar between training with and without NPPV. The 5-day training program with NPPV resulted in greater improvement in [Formula: see text] than without NPPV.Aerobic training under NPPV has add-on effects on [Formula: see text] and exercise-related health benefits in healthy young men.

Cognitive performances may improve after acute moderate exercise, but not after prolonged and/or heavy exercise. The present study aimed to investigate the effects of environmental temperature during exercise on human cognitive processing. Fifteen healthy males performed four bouts of a 15‐min cycling exercise with a 10‐min rest between each bout, and event‐related potentials (ERPs) were recorded in five sessions during somatosensory Go/No‐go paradigms (i.e., Pre, post‐first exercise bout, post‐second exercise bout, post‐third exercise bout, and post‐fourth exercise bout) in an environmental chamber with temperature controlled at 20°C (Temperate) and 35°C (Hot). Increases in external canal temperature and heart rate were greater under the 35°C condition than under the 20°C condition. Regardless of thermal conditions, reaction times (RT) and error rates were not affected by the repetition of moderate exercise, whereas the peak amplitude of the N140 component, which is mainly related to somatosensory processing, was significantly reduced with the repetition of the exercise. However the peak amplitude of P300, which is linked to cognitive processes of context updating, context closure, and event‐categorization, was significantly smaller in post‐third and post‐fourth exercise bouts under the 35°C condition than under the 20°C condition, and this decrease was more prominent in No‐go trials under the 35°C condition. These results suggest that executive function, which is based on RTs and error rates, is not affected by prolonged exercise and different thermal conditions, whereas the exercise in a hot environment impairs human cognitive processing, particularly response inhibition.

Humans are unique in controlling body temperature in a hot environment by a large amount of skin blood flow; however, the decrease in total peripheral resistance due to systemic cutaneous vasodilatation and the reduction of venous return to the heart due to blood pooling in the cutaneous vein threatens blood pressure maintenance in the upright position, and occasionally causes heat syncope. Against this condition, cutaneous vasodilatation is reportedly suppressed to maintain arterial pressure; however, the nerve activity responsible for this phenomenon has not been identified. In the present study, we found that the skin sympathetic nerve activity component that was synchronised with the cardiac cycle increased in hyperthermia, but the increase was suppressed when the posture was changed from supine to head-up tilt. The profile of the component agreed with that of cutaneous vasodilatation. Thus, the component might contribute to the prevention of heat syncope in humans.In humans, the cutaneous vasodilatation response to hyperthermia has been suggested to be suppressed by baroreflexes to maintain arterial pressure when the posture is changed from supine to upright, and if the reflexes do not function sufficiently, it can cause heat syncope. However, the efferent signals of the reflexes have not been identified. To identify the signals, we continuously measured skin sympathetic nerve activity (SSNA; microneurography), right atrial volume (RAV; echocardiography, the baroreceptors for the reflexes are reportedly located in the right atrium), cutaneous vascular conductance on the chest (CVC

We examined whether enhanced cardiovascular and thermoregulatory responses during exercise after short-term aerobic training in a warm environment were reversed when plasma volume (PV) expansion was reversed by acute isotonic hypohydration. Seven young men performed aerobic training at the 70% peak oxygen consumption rate (V̇o2peak) at 30°C atmospheric temperature and 50% relative humidity, 30 min/day for 5 days. Before and after training, we performed the thermoregulatory response test while measuring esophageal temperature (Tes), forearm skin vascular conductance, sweat rate (SR), and PV during 30 min exercise at the metabolic rate equivalent to pretraining 65% V̇o2peak in euhydration under the same environment as during training in four trials (euhydration and hypohydration, respectively). Hypohydration targeting 3% body mass was attained by combined treatment with low-salt meals to subjects from ∼48 h before the test and administration of a diuretic ∼4 h before the test. After training, the Tes thresholds for cutaneous vasodilation and sweating decreased by 0.3 and 0.2°C ( P = 0.008 and 0.012, respectively) when PV increased by ∼10%. When PV before and after training was reduced to a similar level, ∼10% reduction from that in euhydration before training, the training-induced reduction in the threshold for cutaneous vasodilation increased to a level similar to hypohydration before training ( P = 0.093) while that for sweating remained significantly lower than that before training ( P = 0.004). Thus the enhanced cutaneous vasodilation response after aerobic training in a warm environment was reversed when PV expansion was reversed while the enhanced SR response remained partially.

To determine the target intensity for fast walking during interval walking training (IWT) in water for middle-aged and older people to enhance physical fitness. Thirty-one women [59±5 (SD) years old] were randomly divided into two groups: IWT on land (LG, N = 15) and in water (WG, N = 16). All subjects were instructed to perform ≥6 sets of fast and slow walking for 3 min each in a day, ≥4 days week−1, for 8 weeks, at an intensity 35 % higher than the oxygen consumption rate at the gas exchange threshold ( $$\dot{V}$$ O2GET), with a subjective feeling of 16–18 points of the Borg scale during fast walking in each condition. Before and after IWT, we measured $$\dot{V}$$ O2GET, peak aerobic capacity ( $$\dot{V}$$ O2peak) by graded walking and cycling tests on land and isometric knee extension (F EXT) and flexion (F FLX) forces. Before IWT, the $$\dot{V}$$ O2GET for walking in water was 14 % higher and the heart rate (HR) at a given $$\dot{V}$$ O2 was ~10 beats min−1 lower (P=0.001) than on land. During IWT, subjects in both groups performed IWT for ~4 days week−1 (P > 0.9) with a 14 % higher fast walking intensity in WG than in LG (P

While non-noxious local cooling is widely used in physical medicine, its effect on muscle sympathetic nerve activity (MSNA) and cardiovascular regulation are not clear. The purpose of the present study was to assess the responses of MSNA, blood pressure (BP), heart rate (HR) and local blood flow during non-noxious local cooling. The study included two protocols. Both protocols consisted of 10-min rest in supine position, followed by 15-min local cooling (15 °C) of the shin and anterior foot, and 20-min recovery. MSNA of the right common peroneal nerve, BP, HR, and shin skin temperature (TSK) were recorded in eight men in the first protocol, while leg blood flow (LBF) was measured in the same subjects by strain-gauge plethysmography in the second protocol. TSK gradually decreased from 31.5 ± 0.02 to 16.0 ± 1.01 °C (mean ± SEM) during local cooling, and gradually increased after the end of local cooling. No subject complained of pain, and BP and HR remained constant. The MSNA burst rate increased significantly (p

The purposes of this review are to show pathophysiological mechanisms for heat illness during working in a hot environment and accordingly provide some preventive considerations from a viewpoint of body fluid homeostasis. The incidence of the heat illness is closely associated with body temperature regulation, which is much affected by body fluid state in humans. Heat generated by contracting muscles during working increases body temperature, which, in a feedback manner, drives heat-dissipation mechanisms of skin blood flow and sweating to prevent a rise in body temperature. However, the impairment of heat-dissipation mechanisms caused by hard work in hot, humid, and dehydrated conditions accelerates the increase in body temperature, and, if not properly treated, leads to heat illness. First, we overviewed thermoregulation during working (exercising) in a hot environment, describe the effects of dehydration on skin blood flow and sweating, and then explained how they contributes to the progression toward heat illness. Second, we described the advantageous effects of blood volume expansion after heat acclimatization on temperature regulation during exercise as well as those of restitution from dehydration by supplementation of carbohydrate-electrolyte solution. Finally, we described that the deteriorated thermoregulation in the elderly is closely associated with the impaired body fluid regulation and that blood volume expansion by exercise training with protein supplementation improves thermoregulation.

Plasma volume (PV) expansion by endurance training and/or heat acclimatization is known to increase aerobic and thermoregulatory capacities in humans. Also, higher erythrocyte volume (EV) fractions in blood are known to improve these capacities. We tested the hypothesis that training in a hypobaric hypoxic and warm environment would increase peak aerobic power (V˙o 2 peak) and forearm skin vascular conductance (FVC) response to increased esophageal temperature (Tes) more than training in either environment alone, by increasing both PV and EV. Twenty men were divided into four training regimens ( n = 5 each): low-altitude cool (610-m altitude, 20°C ambient temperature, 50% relative humidity), high-altitude cool (2,000 m, 20°C), low-altitude warm (610 m, 30°C), and high-altitude warm (HW; 2,000 m, 30°C). They exercised on a cycle ergometer at 60%V˙o 2 peak for 1 h/day for 10 days in a climate chamber. After training, PV increased in all trials, but EV increased in only high-altitude trials (both P < 0.05). V˙o 2 peak increased in all trials ( P < 0.05) but without any significant differences among trials. FVC response to increased Tes was measured during exercise at 60% of the pretrainingV˙o 2 peak at 610 m and 30°C. After the training, Tes threshold for increasing FVC decreased in warm trials ( P < 0.05) but not in cool trials and was significantly lower in HW than in cool trials ( P < 0.05). The slope of FVC increase/Tes increase increased in all trials ( P < 0.05) except for high-altitude cool ( P > 0.4) and was significantly higher in HW than in cool trials ( P < 0.05). Thus, against our hypothesis, the V˙o 2 peak for HW did not increase more than in other trials. Moreover, slope of FVC increase/Tes increase in HW increased most, despite the similar increase in blood volume, suggesting that factors other than blood volume were involved in the highest FVC response in HW.

This study assessed the hypothesis that increasing cardiac filling pressure (CFP) would enhance contracting muscle blood flow (MBF) by stretching cardiopulmonary baroreceptors and attenuate the increase in plasma lactate concentration ([Lac−]p) during dynamic exercise. Continuous negative-pressure breathing (CNPB) (−15 cmH2O) was used to increase the CFP by accelerating the venous return to the heart. In the first series of experiments, 10 men performed a graded exercise seated on a cycle ergometer with (N1) and without CNPB (C1). The increase in [Lac−]p for N1 was attenuated at 60%, 90%, and 100% of maximal exercise intensity compared with that in C1 ( P < 0.001). Also, the increases in mean arterial pressure (MAP) and plasma catecholamine concentrations were attenuated in N1 compared with those in C1 throughout the graded exercise ( P < 0.05). However, heart rate and pulse pressure were not significantly influenced by CNPB. Second, we studied the impact of CNPB on forearm MBF during a rhythmic handgrip exercise in 5 of the 10 subjects. Forearm MBF was measured immediately after cessation of the exercise by venous occlusion plethysmography at rest, 30%, 50%, and 70% of maximal work load (WLmax) with (N2) and without CNPB (C2). Forearm MBF and vascular conductance for both trials increased with the increase in intensity, but forearm skin blood flow measured by laser-Doppler flowmetry remained unchanged. MBF and vascular conductance in N2, however, increased more than in C2 at every intensity ( P < 0.01) except for MBF at 70% WLmax, whereas the increase in MAP for N2 was attenuated compared with that in C2 ( P < 0.05). Thus augmented active muscle vasodilation occurred in N2 with a lower increase in MAP compared with that in C2. These findings suggest that the stretch of intrathoracic baroreceptors, such as cardiopulmonary mechanoreceptors, by CNPB increased MBF by suppressing sympathetic nerve activity. The attenuation of the increase in [Lac−]p might be caused, at least partially, by the increased MBF.

We examined whether carbohydrate in beverages accelerated fluid retention during recovery from thermal and exercise-induced dehydration and whether it was caused in part by an enhanced renal Na+reabsorption rate due to insulin secretion. After dehydrating by ∼2.3% body weight by exercise in a hot environment, seven young men underwent high-carbohydrate, low-carbohydrate, or control rehydration trials by drinking one of three beverages with 3.4 g glucose + 3.1 g fructose, 1.7 g glucose + 1.6 g fructose, or 0.0 g glucose + 0.0 g fructose per deciliter, respectively, in a common composition of electrolyte solution: 21 meq/l [Na+], 5 meq/l [K+], 16.5 meq/l [Cl−], 10 meq/l [citrate−3]. They drank the same amount of beverage as total body weight loss within 30 min. During the 60 min before the start of drinking and the following 180 min, we measured plasma volume (PV), plasma glucose ([Glc]p), serum insulin ([Ins]s), plasma Na+concentrations, and the renal clearances of inulin, lithium, and Na+with plasma vasopressin ([AVP]p) and aldosterone concentrations ([Ald]p) every 30 min. After dehydration, PV decreased by ∼5% and plasma osmolality increased by ∼6 mosmol/kgH2O in all trials with no significant differences among them. We found in the high-carbohydrate trial that 1) PV increased faster than in the control trial and remained at the higher level than other trials for the last 60 min ( P < 0.05); 2) accumulated urine volume was smallest after 90 min ( P < 0.05); 3) the renal Na+reabsorption rate was greatest for the first 120 min ( P < 0.05); 4) during which period [AVP]pand [Ald]pwere not significantly different from other trials (both, P > 0.9); and 5) [Glc]pand [Ins]swere highest from 45 to 105 min ( P < 0.05) during rehydration. Thus carbohydrate in beverages enhances renal Na+reabsorption, and insulin is possibly involved in this enhancement.

We examined whether protein and carbohydrate (CHO) supplementation during 5-day training enhanced plasma volume (PV) expansion and thermoregulatory and cardiovascular adaptations in young men. Eighteen men [age 23 ± 4 (SD) yr] were divided into two groups according to supplements: placebo (CNT: 0.93 kcal/kg, 0.00 g protein/kg, n = 9) and protein and CHO (Pro-CHO: 3.6 kcal/kg, 0.36 protein/kg, n = 9). Subjects in both groups performed a cycling exercise at 70% peak oxygen consumption rate (V̇o2peak), 30 min/day, for 5 consecutive days at 30°C ambient temperature and 50% relative humidity and took either a placebo or Pro-CHO within 10 min after exercise for each day. Before and after training, PV at rest, heart rate (HR), and esophageal temperature (Tes) during 30-min exercise at 65% of pretraining V̇o2peak in the same condition as training were determined. Also, the sensitivity of the chest sweat rate (ΔSR/ΔTes) and forearm vascular conductance (ΔFVC/ΔTes) in response to increased Tes were determined. After training, PV and cardiac stroke volume (SV) at rest increased in both groups ( P < 0.001) but the increases were twofold higher in Pro-CHO than CNT ( P = 0.007 and P = 0.078, respectively). The increases in HR from 5 to 30 min and Tes from 0 to 30 min of exercise were attenuated after training in both groups with greater attenuation in Pro-CHO than CNT ( P = 0.002 and P = 0.072, respectively). ΔSR/ΔTes increased in CNT ( P = 0.052) and Pro-CHO ( P < 0.001) and the increases were higher in Pro-CHO than CNT ( P = 0.018). ΔFVC/ΔTes increased in Pro-CHO ( P < 0.001), whereas not in CNT ( P = 0.16). Thus protein-CHO supplementation during 5-day training enhanced PV expansion and thermoregulatory adaptation and, thereby, the reduction in heat and cardiovascular strain in young men.

To examine whether the biased estimation of oxygen consumption rate (VO2, mL x kg(-1) x min(-1)) by accelerometry during incline walking can be improved by the addition of altitude changes as measured by barometry.We measured VO2 by respiratory gas analysis and vector magnitude (VM, G) from triaxial accelerations in 42 healthy people (mean +/- SD age = 63 +/- 7 yr) during graded walking on a treadmill while the incline was varied from -15% to +15%. They walked at subjectively slow, moderate, and fast speeds on level and uphill inclines and, in addition to these, at their fastest speed at 0% incline. They then walked at approximately 3, 4, and 5 km x h(-1) on downhill inclines for 3 min each. We determined a regression equation to estimate VO2 from VM and theoretical vertical upward (Hu, m x min(-1)) and downward speeds (Hd, m x min(-1)) for the last 1 min of each trial. To validate the precision of the equation, we measured VM and altitude changes with a portable device equipped with a triaxial accelerometer and a barometer in 11 of the 42 subjects walking on an outdoor hill and compared the estimated VO2 with the value simultaneously measured by respiratory gas analysis.VO2 above resting was estimated from VO2 = 0.044 VM + 1.365 Hu + 0.553 Hd (r = 0.93, P0.001) and the estimated V O2(y) was almost identical to the measured VO2(x) (y = 0.97x, r = 0.88, P0.001) with a mean difference of -0.20 +/- 3.47 (mean +/- SD) by Bland-Altman analysis in the range of 2.0-33.0 mL x kg(-1) x min(-1).VO2 during walking on various inclines can be precisely estimated by using the device equipped with a triaxial accelerometer and a barometer.

Whether increasing peak aerobic capacity for walking (VO(2peak)) by interval walking training (IWT) is closely linked with decreasing the indices of lifestyle-related diseases (LSDs) in middle-aged and older people were examined.For 4 months from April to September 2005 or 2006, 246 males and 580 females (∼65 years) performed IWT consisting of ≥5 sets of fast walking at ≥70% VO(2peak) for 3 min followed by slow walking at ≤40% VO(2peak) for 3 min ≥4 days/week. Before and after IWT, we measured VO(2peak), body mass index (BMI), %body fat, arterial blood pressure, thigh muscle strength and blood parameters. We analysed 198 males and 468 females who had undergone all the measurements both before and after IWT. To examine the hypothesis, we divided the subjects equally into three groups according to their pretraining VO(2peak): low, middle and high groups for each sex.Before training, it was found that thigh muscle strength and blood high-density lipoprotein cholesterol concentration were lower, whereas body weight, BMI, %body fat, arterial blood pressure and blood glucose were higher in the low group than the high group (all, p0.05). After training, although VO(2peak) and thigh muscle strength increased and body weight, BMI, %body fat, blood pressure and blood glucose concentration decreased in all groups (all, p0.05), the changes were greatest in the low group for both sexes.VO(2peak) at baseline and changes in response to training were closely linked with indices of LSDs.

Jaw muscle contraction, such as mastication and biting (BT), is known to evoke pressor responses. We examined whether the responses were evoked by somatosensory receptors in periodontal tissue and, moreover, whether they were accompanied by altered arterial baroreflex sensitivity. In the first experiment, we measured mean arterial pressure, heart rate, and muscle sympathetic nerve activity from the peroneal nerve during 2-min isometric BT at 50% maximal voluntary contraction before [control (CNT)] and after pharmacological alveolar nerve block (BLK) in eight young men, while monitoring finger cutaneous vascular conductance, gingival vascular conductance (GVC), surface electromyogram of masseter muscle, and BT force. In the second experiment, cardiac and sympathetic baroreflex sensitivities were successfully determined in eight and five of the subjects, respectively, by the modified Oxford method during 5-min BT at 30% maximal voluntary contraction and also during resting without BT in CNT and BLK, respectively. In the first experiment, although BT in CNT and BLK significantly increased mean arterial pressure, heart rate, and total muscle sympathetic nerve activity (burst amplitude × burst incidence), and decreased finger cutaneous vascular conductance and GVC ( P < 0.05), all changes except GVC were markedly attenuated in BLK ( P < 0.05). There were no significant differences in integrated electromyogram and BT force among any trials. In the second experiment, although BT in CNT significantly decreased cardiac and sympathetic baroreflex sensitivities (both, P < 0.05), these changes disappeared in BLK. These results suggest that somatosensory receptors in periodontal tissue were involved in pressor responses to isometric BT, which was accompanied by decreased arterial baroreflex sensitivity.

Purpose: We tested the suitability of triaxial accelerometry to evaluate walking efficiency in older subjects. Methods: First, we verified the accuracy to estimate the oxygen consumption rate (VO 2 , mL.min -1 ) from the total impulse (I total , N.min -1 ), the square root of summed accelerations of each direction, during graded walking on a flat ground in 13 male and 27 female older subjects (61 ± 6 yr, mean ± SD). Second, to examine the effects of endurance/resistance training on walking efficiency, we assessed the relations of maximal isometric knee extension force (F max , N.m), maximal walking velocity (V max , m.min -1 ), and three-dimensional impulses (I x , anterior-posterior; I y , mediolateral; I z , vertical) in 13 male and 40 female older subjects (62 ± 7 yr) before and after 6 and 9 months of training. Results: The following analyses were performed in all the data from the male and female groups. First, VO 2 was highly correlated with I total (r = 0.958, P < 0.0001) over the range of 250-2200 mL.min -1 . Second, F max and V max increased by 48 ± 7% (P < 0.001) and 21 ± 2% (P < 0.001), respectively, after 9 months of training. I x /I total and I y /I total increased by 18 ± 2% (P < 0.001) and 10 ± 2%, respectively, after 9 months of training (P < 0.001), whereas I z /I total decreased by 14 ± 2% (P < 0.001). V max was negatively correlated with I z /I total (r = -0.522, P < 0.0001) while positively correlated with I x /I total (r = 0.561, P < 0.0001) and I y /I total in the pooled data from before, after 6 and 9 months of training. Similarly, the product of V max and body weight was positively correlated with F max (r = 0.633, P < 0.0001). Conclusions: These results suggest that increased F max improved walking efficiency by increasing energy utilization in the anterior-posterior/mediolateral directions while decreasing energy loss in the vertical direction.

We assessed the effects of aerobic and/or resistance training on thermoregulatory responses in older men and analyzed the results in relation to the changes in peak oxygen consumption rate (V˙o 2 peak) and blood volume (BV). Twenty-three older men [age, 64 ± 1 (SE) yr; V˙o 2 peak, 32.7 ± 1.1 ml · kg−1 · min−1] were divided into three training regimens for 18 wk: control (C; n = 7), aerobic training (AT; n = 8), and resistance training (RT; n = 8). Subjects in C were allowed to perform walking of ∼10,000 steps/day, 6–7 days/wk. Subjects in AT exercised on a cycle ergometer at 50–80%V˙o 2 peak for 60 min/day, 3 days/wk, in addition to the walking. Subjects in RT performed a resistance exercise, including knee extension and flexion at 60–80% of one repetition maximum, two to three sets of eight repetitions per day, 3 days/wk, in addition to the walking. After 18 wk of training,V˙o 2 peak increased by 5.2 ± 3.4% in C ( P > 0.07), 20.0 ± 2.5% in AT ( P < 0.0001), and 9.7 ± 5.1% in RT ( P < 0.003), but BV remained unchanged in all trials. In addition, the esophageal temperature (Tes) thresholds for forearm skin vasodilation and sweating, determined during 30-min exercise of 60% V˙o 2 peak at 30°C, decreased in AT ( P < 0.02) and RT ( P< 0.02) but not in C ( P > 0.2). In contrast, the slopes of forearm skin vascular conductance/Tes and sweat rate/Tes remained unchanged in all trials, but both increased in subjects with increased BV irrespective of trials with significant correlations between the changes in the slopes and BV ( P < 0.005 and P < 0.0005, respectively). Thus aerobic and/or resistance training in older men increased V˙o 2 peak and lowered Tes thresholds for forearm skin vasodilation and sweating but did not increase BV. Furthermore, the sensitivity of the increase in skin vasodilation and sweating at a given increase in Tes was more associated with BV than withV˙o 2 peak.