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Clinical Scenario: As of 2020, the lifetime prevalence of at least one self-reported concussion is 24.6%. Athletic trainers in all settings work with patients who are at risk of sustaining a concussion or mild traumatic brain injury (mTBI) and developing persistent postconcussive symptoms. Aerobic exercise is emerging as an intervention for decreasing symptoms in patients who have sustained mTBI; however, the majority of research has been performed on pediatric patients. It is of interest whether aerobic exercise is an effective intervention for adult patients with mTBI. Focused Clinical Question: In adults who have sustained mTBI, does traditional therapy decrease symptoms more than aerobic exercise? Summary of Search: A systematic search of 4 databases was performed to answer this question. Three randomized controlled trials were identified that compared aerobic exercise to traditional therapy, which consists of physical and cognitive rest. Two studies found no significant differences in symptoms between the 2 groups while 1 study found decreased symptoms in the aerobic exercise group. Clinical Bottom Line: The current evidence is clear that there is no decrease in mTBI symptoms with traditional therapy as compared with aerobic exercise, with 1 study showing decreased symptoms with aerobic exercise. Strength of Evidence: Based on the Center for Evidence-Based Medicine grades of evidence, the clinical bottom line is based on grade A evidence. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease threatens the health of older adults, particularly by disrupting executive and memory functions, and many studies have shown that aerobic exercise prevents and improves the symptoms associated with the disease. Objective: The objective was to systematically review the effects of aerobic exercise on executive and memory functions in patients with Alzheimer's disease and to determine the effect factors and mechanisms of the design of aerobic exercise intervention programs. Method: Relevant literature was searched in three databases (PubMed, Web of Science, and EBSCO) from January 1, 2014 to March 1, 2023, using a subject-word search method. Data on 10 items, including author and country, were extracted from the literature after screening. The quality of the literature was evaluated using the Physiotherapy Evidence Database scale, and a systematic review was performed. Results: Twelve papers from seven countries were ultimately included, embodying 11 randomized controlled trials and one study with a repeated-measures design. The overall quality of the studies was good as 657 study participants, aged 45 years and older who had varying degrees of Alzheimer's disease and significant symptoms, were included. Aerobic exercise was found to have a significant positive impact on executive and memory functions in people with Alzheimer's disease. Conclusion: The effects of aerobic exercise on aspects of executive function were mainly characterized by improvements in inhibitory control, working memory, and cognitive flexibility, whereas the effects on aspects of memory function were mainly characterized by improvements in logical memory, situational memory, and short-term memory. [ABSTRACT FROM AUTHOR]

Purpose: Continuous glucose monitors (CGMs) are becoming increasingly popular among endurance athletes despite unconfirmed accuracy. We assessed the concurrent validity of the FreeStyle Libre 2 worn on 2 different sites at rest, during steady-state running, and postprandial. Methods: Thirteen nondiabetic, well-trained recreational runners (age = 40 [8] y, maximal aerobic oxygen consumption = 46.1 [6.4] mL·kg–1·min–1) wore a CGM on the upper arm and chest while treadmill running for 30, 60, and 90 minutes at intensities corresponding to 50%, 60%, and 70% of maximal aerobic oxygen consumption, respectively. Glucose was measured by manually scanning CGMs and obtaining a finger-prick capillary blood glucose sample. Mean absolute relative difference, time in range, and continuous glucose Clarke error grid analysis were used to compare paired CGM and blood glucose readings. Results: Across all intensities of steady-state running, we found a mean absolute relative difference of 13.8 (10.9) for the arm and 11.4 (9.0) for the chest. The coefficient of variation exceeded 70%. Approximately 47% of arm and 50% of chest paired glucose measurements had an absolute difference ≤10%. Continuous glucose Clarke error grid analysis indicated 99.8% (arm) and 99.6% (chest) CGM data fell in clinically acceptable zones A and B. Time-in-range analysis showed reduced accuracy at lower glucose levels. However, CGMs accurately detected trends in mean glucose readings over time. Conclusions: CGMs are not valid for point glucose monitoring but appear to be valid for monitoring glucose trends during steady-state exercise. Accuracy is similar for arm and chest. Further research is needed to determine whether CGMs can detect important events such as hypoglycemia during exercise. [ABSTRACT FROM AUTHOR]

Background: Repeated exposure to heat (ie, plasma volume expansion) or altitude (ie, increase in total hemoglobin mass), in conjunction with exercise, induces hematological adaptations that enhance endurance performance in each respective environment. Recently, combining heat and altitude training has become increasingly common for athletes preparing to compete in temperate, sea-level conditions. Purpose: To review the physiological adaptations to training interventions combining thermal and hypoxic stimuli and summarize the implications for temperate, sea-level performance. Current Evidence: To date, research on combining heat and hypoxia has employed 2 main approaches: simultaneously combining the stressors during training or concurrently training in the heat and sleeping at altitude, sometimes with additional training in hypoxia. When environmental stimuli are combined in a training session, improvements in aerobic fitness and time-trial performance in temperate, sea-level conditions are generally similar in magnitude to those observed with heat, or altitude, training alone. Similarly, training in the heat and sleeping at altitude does not appear to provide any additional hematological or nonhematological benefits for temperate; sea-level performance relative to training in hot, hypoxic, or control conditions. Conclusions: Current research regarding combined heat and altitude interventions does not seem to indicate that it enhances temperate, sea-level performance to a greater extent than "traditional" (heat or hypoxia alone) training approaches. A major challenge in implementing combined-stressor approaches lies in the uncertainty surrounding the prescription of dosing regimens (ie, exercise and environmental stress). The potential benefits of conducting heat and altitude exposure sequentially (ie, one after the other) warrants further investigation. [ABSTRACT FROM AUTHOR]

Purpose: Fran is one of the most popular CrossFit benchmark workouts used to control CrossFitters' improvements. Detailed physiological characterization of Fran is needed for a more specific evaluation of CrossFitters' training performance improvements. The aim of the study was to analyze the oxygen uptake ( V ˙ O 2 ) kinetics and characterize the energy system contributions and the degree of postexercise fatigue of the unbroken Fran. Methods: Twenty trained CrossFitters performed Fran at maximal exertion. V ˙ O 2 and heart-rate kinetics were assessed at baseline and during and post-Fran. Blood lactate and glucose concentrations and muscular fatigue were measured at baseline and in the recovery period. Results: A marked increase in V ˙ O 2 kinetics was observed at the beginning of Fran, remaining elevated until the end (V ˙ O 2 peak : 49.2 [3.7] mL·kg−1·min−1, V ˙ O 2 amplitude: 35.8 [5.2] mL·kg−1·min−1, time delay: 4.7 [2.5] s and time constant: 23.7 [11.1] s; mean [SD]). Aerobic, anaerobic lactic, and alactic pathways accounted for 62% (4%), 26% (4%), and 12% (2%) of energy contribution. Reduction in muscle function in jumping ability (jump height: 8% [6%], peak force: 6% [4%], and maximum velocity: 4% [2%]) and plank prone test (46% [20%]) was observed in the recovery period. Conclusions: The Fran unbroken workout is a high-intensity effort associated with an elevated metabolic response. This pattern of energy response highlights the primary contribution of aerobic energy metabolism, even during short and very intense CrossFit workouts, and that recovery can take >24 hours due to cumulative fatigue. [ABSTRACT FROM AUTHOR]

Purpose: Although running traditionally relies on critical speed (CS) as an indicator of critical intensity, portable inertial measurement units offer a potential solution for estimating running mechanical power to assess critical power (CP) in runners. The purpose of this study was to determine whether CS and CP differ when assessed using the Stryd device, a portable inertial measurement unit, and if 2 running bouts are sufficient to determine CS and CP. Methods: On an outdoor running track, 10 trained runners ( V ˙ O 2 max , 59.0 [4.2] mL·kg−1·min−1) performed 3 running time trials (TT) between 1200 and 4400 m on separate days. CS and CP were derived from 2-parameter hyperbolic speed–time and power–time models, respectively, using 2 (CS2TT and CP2TT) and 3 (CS3TT and CP3TT) TTs. Subsequently, runners performed constant-intensity running for 800 m at their calculated CS3TT and CP3TT. Results: Running at the calculated CS3TT speed (3.88 [0.44] m·s−1) elicited an average Stryd running power (271 [28] W) not different from the calculated CP3TT (270 [28]; P =.940; d = 0.02), with excellent agreement between the 2 values (intraclass correlation coefficient =.980). The CS2TT (3.97 [0.42] m·s−1) was not higher than CS3TT (3.89 [0.44] m·s−1; P =.178; d = 0.46); however, CP2TT (278 [29] W) was greater than CP3TT (P =.041; d = 0.75). Conclusion: The running intensities at CS and CP were similar, supporting the use of running power (Stryd) as a metric of aerobic fitness and exercise prescription, and 2 trials provided a reasonable, albeit higher, estimate of CS and CP. [ABSTRACT FROM AUTHOR]

Purpose: Interval-training sets may be applied in a different sequence within a swimming training session. The aim of this study was to investigate the effect of different set sequences on performance and physiological responses in a training session. Methods: Twelve highly trained male swimmers performed 4 sessions in randomized order. Each session included a different combination of 2 training sets: set A–set C, set C–set A, set B–set C, or set C–set B. Set A consisted of 8 × 200 m at speed corresponding to lactate threshold (30-s recovery), set B included 8 × 100 m at maximum aerobic speed (30-s recovery), and set C included 4 × 50-m all-out swimming (2-min recovery). Performance and physiological responses (lactate concentration, pH, base excess, bicarbonate, heart rate, and heart-rate variability) were measured. Results: Performance in each set was similar between sessions irrespective of set sequence. Blood lactate, heart rate, and acid–base responses during set C were similar in all sessions, but blood lactate was higher in sets A and B during C–A and C–B sessions (P =.01). The overall blood lactate and acid–base response was higher in C–A and C–B sessions compared with A–C and B–C sessions, respectively (P =.01). Heart-rate variability in each set, separately as well as the overall session effect, did not differ and was thus independent to the set sequence applied. Conclusions: Training sessions including all-out swimming as a first set increase the magnitude of metabolic responses to the subsequent aerobic-dominated training set. [ABSTRACT FROM AUTHOR]

Background: Exercise with blood-flow restriction (BFR) is being increasingly used by practitioners working with athletic and clinical populations alike. Most early research combined BFR with low-load resistance training and consistently reported increased muscle size and strength without requiring the heavier loads that are traditionally used for unrestricted resistance training. However, this field has evolved with several different active and passive BFR methods emerging in recent research. Purpose: This commentary aims to synthesize the evolving BFR methods for cohorts ranging from healthy athletes to clinical or load-compromised populations. In addition, real-world considerations for practitioners are highlighted, along with areas requiring further research. Conclusions: The BFR literature now incorporates several active and passive methods, reflecting a growing implementation of BFR in sport and allied health fields. In addition to low-load resistance training, BFR is being combined with high-load resistance exercise, aerobic and anaerobic energy systems training of varying intensities, and sport-specific activities. BFR is also being applied passively in the absence of physical activity during periods of muscle disuse or rehabilitation or prior to exercise as a preconditioning or performance-enhancement technique. These various methods have been reported to improve muscular development; cardiorespiratory fitness; functional capacities; tendon, bone, and vascular adaptations; and physical and sport-specific performance and to reduce pain sensations. However, in emerging BFR fields, many unanswered questions remain to refine best practice. [ABSTRACT FROM AUTHOR]

Purpose: Ice hockey is a team invasion sport characterized by repeated high-intensity skating efforts, technical and tactical skill, physical contact, and collisions requiring considerable levels of muscular strength. The purpose of this study was to evaluate the relationships between lower-body vertical force–time metrics and skating qualities in subelite female ice hockey players. Methods: A cross-sectional cohort design was employed utilizing 14 athletes (body mass = 66.7 [1.8] kg; height = 171.6 [6.2] cm; age = 21.1 [1.7] y). The relationships between metrics of lower-body strength collected from a drop jump, squat jump, countermovement jump, loaded countermovement jump, and an isometric squat and 4 skating qualities collected from a linear sprint, repeated sprint test, and a multistage aerobic test were evaluated. Results: The regression models revealed a positive relationship between relative peak force in the isometric squat and skating multistage aerobic test performance (r2 =.388; P =.017) and a positive relationship between repeated-sprint ability and eccentric mean force during the loaded countermovement jump (r2 =.595; P =.001). No significant relationships were observed between strength metrics and skating acceleration or maximal velocity. Conclusions: These data suggest that skating ability is most affected by relative isometric strength in female ice hockey players. It is recommended that practitioners focus training on tasks that improve relative force output. It is also recommended that isometric relative peak force be used as a monitoring metric for this cohort. [ABSTRACT FROM AUTHOR]

Background: Children with inflammatory bowel disease (IBD) experience extraintestinal side effects including altered body composition, impaired muscle strength, and aerobic capacity. Exercise training may remedy these issues. Purpose: To assess the feasibility, safety, participant satisfaction, and efficacy of a training program for youth with IBD. Methods: Children with IBD completed 16 weeks of training (2 supervised + 1 home sessions per week). Feasibility was assessed by tracking recruitment, adherence, and compliance rates. Safety was assessed by tracking symptoms and adverse events. Posttraining interviews gauged satisfaction. Circulating inflammatory markers, body composition, muscle strength, aerobic fitness, and habitual physical activity were measured at baseline, midtraining (8 wk), and posttraining. Results: Eleven youth were recruited and 10 completed the study. Participants adhered to 28 (1) of 32 prescribed supervised sessions and 8 (4) of 16 prescribed home sessions. There were no adverse events, and overall feedback on training was positive. Posttraining, we observed an increase in lean mass (+2.4 [1.1] kg), bone density (+0.0124 [0.015] g·cm−2), aerobic fitness (+2.8 [5.7] mL·kg LM−1· min−1), and vigorous physical activity levels (+13.09 [8.95] min·h−1) but no change in inflammation or muscle strength. Conclusion: Supervised exercise training is feasible, safe, and effective for youth with IBD and should be encouraged. [ABSTRACT FROM AUTHOR]

This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed. [ABSTRACT FROM AUTHOR]

Background: The osteoclastogenesis RANKL gene plays a key role in bone remodeling. The hypomethylation of its promoter region may cause osteoporosis. The present study aimed to elucidate the influence of physical activity on DNA methylation changes of RANKL promoter cytosine-phosphate-guanine (CpG)-rich region in active and sedentary adults and to assess the effect of aerobic and strength training on RANKL DNA methylation changes among Tunisian-North African adults. Methods: A total of 104 participants including 52 adults (58% males and 42% females) and 52 adults (31% males and 69% females) were recruited for the observational and interventional part of the study, respectively. The intervention consisted of 12 weeks of aerobic training (30 min/session) followed by 10 minutes of strengthening exercises. All participants completed the International Physical Activity Questionnaire and provided blood samples for quantitative methylation-specific polymerase chain reaction (PCR) analysis. Results: The study revealed a significant difference (P = 6 × 10−10) in the methylation level of the RANKL promoter region between active and sedentary adults, with a 6.68-fold increase observed in the active group. After the intervention, both the trained (P = 41 × 10−5) and untrained (P =.002) groups displayed high methylation levels in the RANKL promoter region. In addition, the trained group exhibited significant improvements in heart rate (P = 2.2 × 10−16), blood pressure (P = 39 × 10−3), maximal oxygen uptake (P = 1.5 × 10−7), and fat mass (P = 7 × 10−4). Conclusion: Exploring epigenetic modifications in the RANKL promoter region may contribute to a more comprehensive understanding of the complexity of osteoporosis. This suggests that aerobic/strength training could potentially improve the bone system, reducing its vulnerability to osteoporosis by increasing RANKL DNA methylation. [ABSTRACT FROM AUTHOR]

Mitochondrial dysfunction is a well‐established hallmark of Alzheimer's disease (AD). Despite recent documentation of transcellular mitochondrial transfer, its role in the pathogenesis of AD remains unclear. In this study, we report an impairment of mitochondrial quality within the astrocytes and neurons of adult 5 × FAD mice. Following treatment with mitochondria isolated from aged astrocytes induced by exposure to amyloid protein or extended cultivation, cultured neurons exhibited an excessive generation of reactive oxygen species and underwent neurite atrophy. Notably, aerobic exercise enhanced mitochondrial quality by upregulating CD38 within hippocampal astrocytes of 5 × FAD mice. Conversely, the knockdown of CD38 diminished astrocytic–neuronal mitochondrial transfer, thereby abolishing the ameliorative effects of aerobic exercise on neuronal oxidative stress, β‐amyloid plaque deposition, and cognitive dysfunction in 5 × FAD mice. These findings unveil an unexpected mechanism through which aerobic exercise facilitates the transference of healthy mitochondria from astrocytes to neurons, thus countering the AD‐like progression. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is rapidly becoming one of the most expensive, burdening, and deadly diseases of this century. Up to now, there is still a lack of pharmacotherapy with substantial efficacy, and physical exercise is a promising and low‐cost way to aid in delaying the process of AD. The aim of this review is to summarise the efficacy of different physical exercise approaches and doses in the management of AD, including aerobic exercise, resistance exercise and multicomponent exercise. A literature search using MeSH terms for each topic is undertaken using PubMed and the Web of Science Core Collection database, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesised, and summarised. This review shows that aerobic exercise has been almost unanimously recognised for the improvement of cognition, neuropsychiatric symptoms and activities of daily living. Resistance exercise also shows a good prospect in the above aspects and has a unique advantage in enhancing muscle strength, while multicomponent physical activity does not seen to significantly improve cognitive function. Each type of exercise has a dose effect, but for individuals with AD, the most appropriate exercise dose is still controversial. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATION1) to develop two maximum heart rate (HRmax) prediction equations for individuals after stroke; 2) to investigate its validity.The HRmax was obtained by a Cardiopulmonary Exercise Test (CPET). Participants also completed the Six-minute Walking Test (6MWT) and the Incremental Shuttle Walking Test (ISWT).60 individuals (54(12) years; 64(69) months after stroke) were included. Twenty individuals (58(10) years; 67(61) months after stroke) were included in the cross-validation group. For the first model, the following equation was generated (equation-1): HRmax= 87.655 + 0.726 (HRpeak in the 6MWT) − 0.386 (age in years), (R2=0.53; Standard Error of the Estimate (SEE)= 15.35; p < 0.0001). For the second model, the following equation was generated (equation-2): HRmax= 96.523 + 0.681 (HRpeak in the ISWT) − 0.039 (walking distance in meters in the ISWT) − 0.400 (age in years), (R2=0.53; SEE = 15.51; p < 0.0001). Significant and high magnitude agreement was found between the HRmax obtained by the CPET and the predicted HRmax by equation-1 (ICC= 0.85; 95% CI= 0.63 − 0.94) and equation-2 (ICC= 0.72; 95% CI= 0.29 − 0.89).Two HRmax prediction equations have been developed and showed adequate validity. Professionals will have the option of choosing one of the two equations to use.Two maximum heart rate prediction equations, with clinical applicability and adequate validity, were provided for individuals after strokeTo apply the equations, it is necessary to perform the Six-Minute Walking Test or the Incremental Shuttle Walking Test.Both equations are valid and suitable for use in this population for the prescription of aerobic exercise intensity in clinical practice.Two maximum heart rate prediction equations, with clinical applicability and adequate validity, were provided for individuals after strokeTo apply the equations, it is necessary to perform the Six-Minute Walking Test or the Incremental Shuttle Walking Test.Both equations are valid and suitable for use in this population for the prescription of aerobic exercise intensity in clinical practice. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions As the prevalence of chemotherapy‐related cognitive impairment rises, investigation into treatment options is critical. The objectives of this study were to test the effects of an aerobic exercise intervention initiated during chemotherapy compared to usual care (wait list control condition) on (1) objectively measured cognitive function and self‐reported cognitive function, as well as on (2) the impact of cognitive impairment on quality of life (QOL) postintervention (commensurate with chemotherapy completion).The Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE) trial was a two‐arm, two‐center randomized controlled trial conducted in Ottawa and Vancouver (Canada). Fifty‐seven women (Mage, 48.8 ± 10 years) diagnosed with stage I–III breast cancer and awaiting chemotherapy were randomized to aerobic exercise initiated with chemotherapy (nEX = 28) or usual care during chemotherapy with aerobic exercise after chemotherapy completion (nUC = 29). The intervention lasted 12–24 weeks and consisted of supervised aerobic training and at‐home exercise. The primary outcome was objective cognitive function measured via 13 neuropsychological tests (standardized to M ± SD, 0 ± 1); secondary outcomes of self‐reported cognitive function and its impact on QOL were assessed via questionnaires. Data collected pre‐ and postintervention (the primary end point) were analyzed.Although no significant differences between groups were found for objective cognitive function outcomes postintervention after accounting for multiple testing, four of six self‐reported cognitive function outcomes showed significant differences favoring the aerobic exercise group.Among women initiating chemotherapy for breast cancer, aerobic exercise did not result in significant differences in objective cognitive function postintervention after chemotherapy completion; however, the results do support the use of this intervention for improving self‐reported cognitive function and its impact on QOL. [ABSTRACT FROM AUTHOR]

Background: To explore the effects of different dose of aerobic exercise on motor function, balance, mobility, and quality of life in Parkinson's disease patients, aiming to provide insights into determining the optimal aerobic exercise dose for treating PD. Methods: Searching was conducted in four databases: PubMed, Embase, Web of Science, and Cochrane. The dose of aerobic exercise intervention was evaluated based on the recommendations of the American College of Sports Medicine regarding the development and maintenance of cardiorespiratory health, muscle strength, and functional mobility in patients with PD. The exercise intervention dose of the included studies were first classified into high ACSM compliance and low ACSM compliance based on meeting 4/6 of the ACSM recommendations. The reliability of the results was then validated using the criterion of meeting 5/6 of the ACSM recommendations. Comparisons of the effects of aerobic exercise dose on Motor function, Balance, Mobility, and QOL in PD patients using standardized mean difference with 95% confidence intervals. Results: When using the 4/6 ACSM compliance criterion, 17 studies were categorized as high ACSM compliance and 12 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (-0.79: -0.18), BBS (0.60: 0.05), TUG (-0.60: -0.60), and QOL (-1.05: -0.15). When using the 5/6 ACSM compliance criterion, 11 studies were categorized as high ACSM compliance and 19 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (-0.95: -0.38), BBS (0.48: 0.37), TUG (-0.71: -0.55), and QOL (-0.7: 0.04). Conclusion: This study provides preliminary support for the potential of aerobic exercise to improve certain clinical symptoms in patients with PD. Furthermore, the results indicate that compliance to higher doses of aerobic exercise, as per ACSM standards, may contribute to improvements in motor function, balance, mobility, and quality of life for patients with PD. However, due to the heterogeneity in the studies and the influence of factors that have not yet been fully explored, these conclusions should be interpreted with caution. More high-quality randomized controlled trials are needed in the future to further verify and clarify the effects of aerobic exercise. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate the effects of blood flowrestrictive resistance training (BFR-RT) on improving metabolic abnormalities, blood pressure (BP), obesity, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in middle-aged patients with type 2 diabetes mellitus (T2DM). Method: We conducted a parallel-group, single blind randomized controlled trial. Participants who met the inclusion criteria were randomly divided into control group, BFR-RT group and aerobic exercise (AE) group. Control group received health education and follow-up; Two exercise groups received supervised collective training for a period of six months, three times per week. AE group trained at moderate-intensity for 60 minutes each time, while BFR-RT group trained at low-intensity for 40 minutes each time. The primary outcomes were change in 10-year ASCVD risk index and level, and the secondary outcomes included changes in fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), blood lipids, BP, and obesity level within and across the three groups at baseline, the third and sixth months of intervention. Result: Among 93 individuals (control group, n=31; AE, n=30; BFR-RT, n=32) were analyzed. At baseline, there were no significant differences in various indicators among the three groups (p>0.05). After intervention, the 10-year ASCVD risk index and risk level of both exercise groups significantly decreased compared to the control group and baseline (p<0.05), and the risk reduction became more pronounced over time. In the sixth month of intervention, the 10-year ASCVD risk index in the AE group decreased by 27.40%, and that in the BFRRT group decreased by 26.78%. Meanwhile, apart from lipoprotein (a) and diastolic blood pressure, both exercise groups showed significant improvements in FPG, HbA1c, dyslipidemia, systolic blood pressure, and obesity indicators compared to the control group and baseline (p<0.05). There was no significant difference in various indicators between the two exercise groups (p>0.05). Conclusion: BFR-RT could reduce the 10-year ASCVD risk in middle-aged T2DM patients for by improving metabolic abnormalities, BP and obesity, and its effect was similar to that of moderate-intensity AE. [ABSTRACT FROM AUTHOR]

Objective: This study was to investigate the developmental characteristics of executive function (EF) in obese adolescents and the time-course effects of a 14-week exercise intervention combining aerobic exercise and resistance training on EF in this population. Methods: The experimental group of 28 obese junior high school students participated in the exercise intervention combining aerobic exercise and resistance training, while the control group of 24 healthy weight junior high school students engaged in the regular recess exercise. EF, including inhibition, working memory, and cognitive flexibility, was assessed 1 week prior to the exercise intervention and at 12 and 14 weeks post-intervention. Changes in EF sub-functions in both groups at different time points during the exercise intervention were analyzed. Results: The findings revealed that obese junior high school students exhibited lower levels of inhibition (p = 0.003, Cohen's d = 0.848) and cognitive flexibility (p = 0.013, Cohen's d = 0.706) compared to their healthy weight peers. The exercise intervention combining aerobic exercise and resistance training led to significant improvements in EF among obese junior high school students, with inhibition (p < 0.01, Cohen's d = 0.713; p = 0.003, Cohen's d = 0.683) and cognitive flexibility (p = 0.001, Cohen's d = 0.797; p < 0.01, Cohen's d = 0.890) showing significant improvement at 12 and 14 weeks post-intervention, and working memory demonstrating significant improvement at 14 weeks (p = 0.004, Cohen's d = 0.710). No significant differences were observed in EF over time in healthy weight junior high school students. Conclusion: Obese adolescents had impaired EF, as evidenced by low levels of the inhibition and cognitive flexibility compared to healthy weight adolescents. The exercise intervention combining aerobic exercise and resistance training had a positive effect on EF of obese adolescents. The time-course effects of the intervention on improvements in inhibition, working memory, and cognitive flexibility varied with intervention duration in obese adolescents, with significant changes in inhibition and cognitive flexibility observed at 12 weeks and significant changes in working memory at 14 weeks. [ABSTRACT FROM AUTHOR]

Aims: High non-fasting triglycerides (TG) concentration is linked to the development of atherosclerosis, and physical activity is commonly recommended to reduce postprandial TG concentration and cardiovascular diseases. Previous studies have demonstrated that acute whole-body (walking and running) or lower-body (leg cycling) aerobic exercise reduces postprandial TG. However, it is unclear whether upper-body exercise (i.e. arm-cranking) with sufficient energy expenditure lowers postprandial TG. Therefore, this study aimed to evaluate the effects of energy-matched upper- and lowerbody exercises on postprandial TG concentrations the next day in healthy young men. Method and Materials: Fifteen healthy young men (age 22.5 ± 1.7 years, height 173.8 ± 5.7 cm, body mass 68.2 ± 8.5 kg, peak oxygen uptake 48.0 ± 5.5 mL/min/kg and physically active) participated in a three-arm crossover trials: 1) arm-cranking, 2) leg-cycling exercise at 70% of mode-specific peak oxygen uptake to induce a net energy expenditure of 1,255 kJ, or 3) rested between 16:00 and 17:00 h on day 1 and consumed two standardised meals for breakfast (10:00 h) and lunch (13:00 h) on day 2. The mean macronutrient content of the breakfast was 44.9 ± 5.6 g fat, 104.8 ± 13.0 g carbohydrate, and 29.4 ± 3.6 g protein, which provided 3.95 ± 0.49 MJ energy (43% fat, 45% carbohydrate, and 12% protein), and that of the lunch was 45.2 ± 5.6 g fat, 106.7 ± 13.2 g carbohydrate, and 33.9 ± 4.2 g protein, which provided 4.06 ± 0.50 MJ energy (42% fat, 44% carbohydrate, and 14% protein). Results: Time-averaged postprandial serum TG concentrations over 8 h differed among trials (main effect of trial p < 0.001) and were lower in the upper- and lower-body exercise trials than in the control trial (1.46 ± 0.54 vs. 1.50 ± 0.69 vs. 1.79 ± 0.83 mmol/L, respectively). The incremental TG area under the curve (AUC) (main effect of trial, p = 0.012) was 39% and 37% higher in the control trial than in the upper- and lower-body exercise trials (p = 0.025 and p = 0.033, respectively). There were no significant differences in incremental TG AUC between the upper- and lower-body exercise trials. Conclusion: An acute bout of energy-matched upper- and lower-body exercises similarly lowered postprandial TG concentrations the following day in healthy young men. Trial registration number: UMIN000045449. Date of registration: 10 September 2021. [ABSTRACT FROM AUTHOR]

Background: Sleep, sedentary behaviour, and physical activity are essential components within the 24-hour time frame. Existing questionnaires used to measure these behaviours have insufficient measurement properties and are unsuitable for assessing compliance with the WHO Physical Activity and 24-hour Movement Guidelines. To describe the development process of the 24-hour Movement Questionnaire (QMov24h) and its testing. The QMov24h was developed to gather detailed information on sleep, sedentary behaviour, and physical activity. Methods: The sample comprised 117 participants (58% women), aged 30.95 ± 13.56 years. The development process of the QMov24h followed the COSMIN guidelines: (i) Construction of items; (ii) Face validity with end-users; (iii) Content validity with experts; (iv) Criterion validity against accelerometry and convergent validity against diary assessments; and (v) 7-day test-retest reliability. Results: The QMov24h presented adequate content and face validity. The QMov24h showed moderate criterion validity for sleep (rho=0.343;p<0.001), light physical activity (rho=0.31;p=0.002) and total aerobic physical activity (rho=0.343;p<0.001), as well as strong criterion validity for sedentary behaviour (rho=0.428;p<0.001) and aerobic moderate-to-vigorous physical activity (rho=0.534;p<0.001). Reliability varied from poor to excellent (ICC from 0.38 to 0.962;p<0.001) for all questionnaire variables. Regarding compliance of the 24-hour movement guidelines, the questionnaire also showed a strong to almost perfect percentage of agreement with accelerometry (from 69% to 94.3%), and minimal to strong reliability (k from 0.38 to 0.87) between the first and second administrations of the QMov24h. Conclusions: The QMov24h questionnaire is a valid and reliable tool for assessing levels of movement behaviours and compliance with guidelines in adults. Its measurement properties are comparable to, or even better than, those of existing questionnaires, while posing a similar burden to participants. The QMov24h is useful for research, clinical practice, and public health surveillance. The QMov24h has strong psychometric properties, making it suitable for translation, cultural adaptation, and testing in diverse populations for broader international use. [ABSTRACT FROM AUTHOR]

Background: Higher prevalence rates of diabetes and its complications have been reported among individuals with poor physical activity and a sedentary lifestyle. This study explored the influence of six months of moderate-intensity supervised aerobic training on the serum lipid profile, hs-CRP level, and variable-related correlations in prediabetic and type 2 diabetes patients (T2DM). Design: The study was based on a two-arm parallel group pretest‒posttest comparative design. Methods: A total of 50 subjects who were diagnosed with diabetes for more than five years and aged 30–70 years were included in this study. The subjects were classified into two groups on the basis of their glycated haemoglobin (HbA1c%) values: Group 1 (patients with the prediabetes; HbA1c % ≤ 6.5, n = 25) and Group 2 (patients with the T2DM; HbA1c % ≥ 6.5, n = 25). Blood sugar, HbA1c %, insulin, lipid profile, and highly sensitive CRP (hs-CRP) were measured via colorimetric and immunoassay techniques at baseline and six months postintervention with moderate aerobic exercise. Results: The results revealed that participation in moderate aerobic training interventions for six months resulted in a significant reduction in BMI, fasting blood sugar, glycosylated haemoglobin, hs-CRP, and lipid profile parameters such as T-Cholest, TG, and LDL-C as well as significant improvement in the level of insulin with a reduction in the values of HOMA-IR towards normal values in the patients with prediabetes (P < 0.01) in group 1 and patients with diabetes in group 2 (P < 0.001). The change in VO2max with good physical fitness significantly improved with the exercise program after six months. The reduced levels of hs-CRP, HOMA-IR, and lipid profile and improved levels of insulin were significantly positively correlated with the levels of glycated haemoglobin (HbA1c%) in the patients with prediabetes (P < 0.01) and those with diabetes (P < 0.001) following six months of moderate aerobic training interventions. Moreover, hs-CRP was positively correlated with T-Cholest, TG, and LDL-C (p = 0.01) and negatively correlated with HDL-C. The data revealed improved glycemic control factors, lipid profiles, and hs-CRP levels as cardio-predictive markers in patients with both prediabetes and diabetes as well. These findings suggest that the anti-inflammatory effect of physical activity gained from moderate exercise training for six months may counteract increased cardiovascular complications associated with increased CRP levels and lipid profiles in prediabetes and T2DM patients. Conclusions: Moderate aerobic training for six months favourably affects glycemic parameters, lipid profiles, and inflammatory hs-CRP indicators and improves VO2max, an indicator of physical fitness, in prediabetic and diabetic patients. The data obtained suggest the positive effect of moderate exercise training as a protective modulator of cardiovascular disorders, including the dyslipidaemic profile, glycaemic control, and hs-CRP inflammatory markers, in prediabetes and T2DM patients. Thus, regular exercise, owing to its anti-inflammatory effects and ability to improve cardiorespiratory fitness, lipid profiles, blood glucose levels, and insulin resistance, may help reduce the severity of cardiovascular diseases in prediabetes and T2DM patients and healthy controls. Trial registration: Retrospectively registered with ClinicalTrials.gov PRS under trial identifier ID: NCT06246435 dated 30/01/2024. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions This trial analyzes the effects of home‐based isometric handgrip training (IHT) and aerobic exercise training (AET) on ambulatory and office blood pressure (BP) in older adults with high normal to established hypertension.This randomized controlled trial included 84 participants (46 women, 71.1 ± 3.6 years, systolic BP [SBP] 137.1 ± 13.8 mmHg, diastolic BP [DBP] 80.8 ± 8.3 mmHg). Participants were randomized into IHT (n = 28), AET (n = 28), or usual medical care plus lifestyle advice (UC, n = 28). Participants performed IHT or AET three times/week for 8 weeks. IHT consisted of 4 × 45 s bilateral contractions at 50% of maximum voluntary contraction with 1‐min rest between sets. AET consisted of walking 30 min at 50%–70% of estimated maximum oxygen consumption. UC received standardized medical care including lifestyle advice.Seventy‐six participants completed the intervention: 27 in IHT, 26 in AET, and 23 in UC. At baseline, BP values were similar among groups. No differences were observed in 24‐h ambulatory, daytime, and nighttime SBP and DBP in any group (p > 0.05). IHT and AET reduced office SBP (−8.0 ± 13.4 mmHg; p = 0.004; −5.6 ± 12.2 mmHg; p = 0.027, respectively). IHT reduced office DBP (−3.3 ± 7.4 mmHg; p = 0.024), but AET did not. No differences occurred in office BP in UC. There was no difference in office BP among groups (p > 0.05).An 8‐week home‐based IHT and AET failed to reduce ambulatory SBP, while office SBP was reduced by 8/5 mmHg. Only IHT reduced office DBP by 3 mmHg. Thus, IHT and AET may be effective for lowering office BP in older adults with high normal to established hypertension. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionIntegrating aerobic exercise (AE) into rehabilitation programs for post-stroke individuals could enhance motor recovery and cardiovascular health by increasing brain-derived neurotrophic factor (BDNF) and the myokine irisin. Chronic stroke survivors typically exhibit elevated matrix metalloproteinase-9 (MMP-9) activity, which is negatively correlated with steps and time in medium cadence, although the impact of AE on this biomarker remains unclear.To evaluate the effect of high-intensity AE training prior to modified constraint-induced movement therapy (mCIMT) on BDNF and irisin concentration, and on MMP-2 and MMP-9 activity in chronic post-stroke individuals and to associate these results with functional improvements.Nine participants received AE combined with mCIMT for two weeks, while the control group (n = 7) received mCIMT alone. Manual dexterity and functional capacity were assessed before and after the intervention. Serum samples were analyzed for BDNF, irisin, MMP-2 and MMP-9.There were no significant main effects of assessment, group or interaction on molecular biomarkers. However, the AE group had a significant increase in MMP-9 activity post-intervention (p = .033; d = 0.67). For the Box and Block Test, there were significant main effects of assessment (F [1, 14] = 33.27, p = .000, ηp2 = 0.70) and group (F [1, 14] = 5.43, p = .035, ηp2 = .28). No correlations were found between biomarkers and clinical assessments.AE prior to mCIMT did not influence circulating BDNF and irisin levels but did induce an acute rise in MMP-9 activity, suggesting potential effects on cardiovascular remodeling in this population. [ABSTRACT FROM AUTHOR]

Background: Beyond being a pulmonary disease, chronic obstructive pulmonary disease (COPD) presents with extrapulmonary manifestations including reduced cognitive, cardiovascular, and muscle function. While exercise training is the cornerstone in the non-pharmacological treatment of COPD, there is a need for new exercise training methods due to suboptimal adaptations when following traditional exercise guidelines, often applying moderate-intensity continuous training (MICT). In people with COPD, short-duration high-intensity interval training (HIIT) holds the potential to induce a more optimal stimulus for training adaptations while circumventing the ventilatory burden often associated with MICT in people with COPD. We aim to determine the effects of supramaximal HIIT and MICT on extrapulmonary manifestations in people with COPD compared to matched healthy controls. Methods: COPD-HIIT is a prospective, multi-centre, randomized, controlled trial with blinded assessors and data analysts, employing a parallel-group designed trial. In phase 1, we will investigate the effects and mechanisms of a 12-week intervention of supramaximal HIIT compared to MICT in people with COPD (n = 92) and matched healthy controls (n = 70). Participants will perform watt-based cycling two to three times weekly. In phase 2, we will determine how exercise training and inflammation impact the trajectories of neurodegeneration, in people with COPD, over 24 months. In addition to the 92 participants with COPD performing HIIT or MICT, a usual care group (n = 46) is included in phase 2. In both phases, the primary outcomes are a change from baseline in cognitive function, cardiorespiratory fitness, and muscle power. Key secondary outcomes include change from baseline exercise tolerance, brain structure, and function measured by MRI, neuroinflammation measured by PET/CT, systemic inflammation, and intramuscular adaptations. Feasibility of the interventions will be comprehensively investigated. Discussion: The COPD-HIIT trial will determine the effects of supramaximal HIIT compared to MICT in people with COPD and healthy controls. We will provide evidence for a novel exercise modality that might overcome the barriers associated with MICT in people with COPD. We will also shed light on the impact of exercise at different intensities to reduce neurodegeneration. The goal of the COPD-HIIT trial is to improve the treatment of extrapulmonary manifestations of the disease. Trial registration: Clinicaltrials.gov: NCT06068322. Prospectively registered on 2023-09-28. [ABSTRACT FROM AUTHOR]

Background: Depression is a leading cause of disability worldwide, and treatments could be more effective. Identifying methods to improve treatment success has the potential to reduce disease burden dramatically. Preparing or "priming" someone to respond more effectively to psychotherapy (e.g., cognitive behavioral therapy [CBT]) by preceding sessions with aerobic exercise, a powerful neurobiological activator, could enhance the success of the subsequently performed therapy. However, the success of this priming approach for increasing engagement of working mechanisms of psychotherapy (e.g., increased working alliance and behavioral activation) has yet to be formally tested. Methods: The CBT + trial will be a parallel-arm randomized controlled trial that will recruit 40 adult participants with DSM-5 diagnosed depression (verified with clinical interview) via referrals, mass emails, local flyers, and social media posts. Participants will be randomized to an ActiveCBT or CalmCBT condition. The ActiveCBT group will receive an 8-week CBT intervention primed with 30 min of moderate-intensity aerobic exercise (cycling on a stationary bike at a 13 rating of perceived exertion). The CalmCBT group will receive the same 8-week CBT intervention while resting for 30 min before CBT (i.e., cycling vs no cycling is the only difference). The primary outcome measures will be mean working alliance (assessed with the client version of the Working Alliance Inventory—Short Revised) and mean behavioral activation (self-reported Behavioral Activation for Depression Scale) recorded at each of the 8 therapy sessions. Secondary outcomes include evaluation of state anhedonia and serum brain-derived neurotrophic factor before the active/calm conditions, between the condition and therapy, and after the therapy. Additional exploratory analyses will evaluate group differences in algorithm-generated ratings of therapist-participant interactions via the Lyssn platform. Discussion: The novel approach of priming CBT with moderate-intensity aerobic exercise evaluated in a randomized controlled trial (CBT + trial) has the potential to demonstrate the usefulness of exercise as an augmentation strategy that improves working mechanisms of therapy and overall treatment outcomes for adults with depression. Trial registration: ClinicalTrials.gov NCT06001346. Registered on August 21, 2023. [ABSTRACT FROM AUTHOR]

Objective: Research evidence suggests that exercise is a potent therapeutic strategy for non-alcoholic fatty liver disease (NAFLD). Many investigations have delved into the curative potential of diverse exercise regimens on NAFLD. This investigation synthesizes findings from randomized controlled trials via a network meta-analysis to evaluate the efficacy of exercise-based interventions on NAFLD. Methods: We conducted a search across five electronic databases (Web of Science, EMBASE, PubMed, SCOPUS, and CNKI)to identify randomized controlled trials (RCTs) comparing the effects of different exercise modalities on metabolic profiles and liver functions in patients with NAFLD. The literature search was comprehensive up to 15, December 2023. The selected studies were subjected to a rigorous quality appraisal and risk of bias analysis in accordance with the Cochrane Handbook's guidelines, version 5.1.0. We employed Stata/MP 17 for the network meta-analysis, presenting effect sizes as standardized mean differences (SMD). Results: This study aggregated results from 28 studies, involving a total of 1,606 participants. The network meta-analysis revealed that aerobic exercise was the most effective intervention for improving BMI in patients with NAFLD, demonstrating a significant decrease in BMI (-0.72, 95%CI: -0.98 to -0.46; p < 0.05; Surface Under the Cumulative Ranking (SUCRA) = 79.8%). HIIT was the top intervention for enhancing HDL-C (0.12, 95% CI: 0.04 to 0.20; p < 0.05; SUCRA = 76.1%). Resistance exercise was the most effective for reducing LDL-C (-0.20, 95% CI: -0.33 to -0.06; p < 0.05; SUCRA = 69.7%). Mind-body exercise showed superior effectiveness in improving TC (-0.67, 95% CI: -1.10 to -0.24; p < 0.05; SUCRA = 89.7%), TG = -0.67, 95% CI: -1.10 to -0.24; p < 0.05; SUCRA = 99.6%), AST (-8.07, 95% CI: -12.88 to -3.25; p < 0.05; SUCRA = 76.1%), ALT (-12.56, 95% CI: -17.54 to -7.58; p < 0.05; SUCRA = 99.5%), and GGT (-13.77, 95% CI: -22.00 to -5.54; p < 0.05; SUCRA = 81.8%). Conclusion: This network meta-analysis demonstrates that exercise interventions positively affect various metabolic profiles and liver functions in NAFLD patients. Mind-body exercises are particularly effective, surpassing other exercise forms in improving metabolic profiles and liver functions. [ABSTRACT FROM AUTHOR]

An increasing body of evidence confirms the effectiveness of physical exercise (PE) in promoting brain health by preventing age-related cognitive decline and reducing the risk of neurodegenerative diseases. The benefits of PE are attributed to neuroplasticity processes which have been reported to enhance cerebral health. However, moderate to high-intensity PE is necessary to induce these responses and these intensities cannot always be achieved especially by people with physical limitations. As a countermeasure, electrical stimulation (ES) offers several benefits, particularly for improving physical functions, for various neurological diseases. This review aims to provide an overview of key mechanisms that could contribute to the enhancement in brain health in response to ES-induced exercise, including increases in cerebral blood flow, neuronal activity, and humoral pathways. This narrative review also focuses on the effects of ES protocols, applied to both humans and animals, on cognition. Despite a certain paucity of research when compared to the more classical aerobic exercise, it seems that ES could be of interest for improving cerebral health, particularly in people who have difficulty engaging in voluntary exercise. [ABSTRACT FROM AUTHOR]

Background: Individuals with type 2 diabetes mellitus (T2DM) are prone to musculoskeletal complications, particularly in the upper extremities (UE), which can significantly impair their grip strength and UE muscle strength. This review will provide valuable insights for developing optimized exercise interventions aimed at enhancing upper limb functionality and improving patient outcomes. Aim: To determine the effect of different exercise training on grip strength & UE muscle strength in patients suffering from T2DM. Methodology: A comprehensive search from electronic databases was performed based on the selection criteria and 13 randomized controlled trials (RCT's) were included in the study. Mean changes in grip strength and UE muscle strength were the primary outcome measures. Included studies ranked high on the PEDro rating scale and eta‐analysis was performed by Rev Man 5.4 software. Results: Meta‐analysis results indicated that there was a statistically significant improvement in UE muscle strength of experimental group when compared to control group (mean differences [MD] = 2.91, 95% confidence interval = 0.12, 5.71; p = 0.04) with moderate heterogeneity (I2 = 49%, p < 0.07). Grip strength improved significantly in the experimental group when compared to the control group with (MD = 2.93, 95% CL = −0.00, 5.86; p = 0.05) and moderate heterogeneity (I2 = 66%, p < 0.08). Conclusion: This review indicated a positive role of supervised resistance & aerobic exercises on UE muscle strength in patients with T2DM. Due to lack of RCT's, grip strength needs to be explored by further investigations in these patients. [ABSTRACT FROM AUTHOR]

Acute exercise is a promising non‐pharmacological therapy for alleviating anxiety. However, the effects of different types of acute exercise on anxiety in adolescents and young adults remain unclear. Therefore, our study aims to conduct a network meta‐analysis to compare the effectiveness of various exercise interventions in improving anxiety in adolescents and young adults. We conducted an online literature search in five databases: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO. The search was conducted from inception to March 1, 2023, and was limited to English‐language publications. Pairwise and network meta‐analyses were performed using random‐effects models. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was applied to rate the certainty of evidence. A total of 33 studies involving 1121 participants were included. The network meta‐analysis results revealed that mind–body exercise was the most effective intervention for reducing anxiety in adolescents and young adults (SMD = −0.36, 95% CI: −0.70, −0.03, moderate certainty). Additionally, aerobic exercise (SMD = −0.16, 95% CI: −0.28, −0.03, high certainty) showed significant reduction in anxiety, while resistance exercise (SMD = −0.09, 95% CI: −0.33, 0.14, moderate certainty) and multicomponent exercise (SMD = −0.01, 95% CI: −0.59, 0.57, moderate certainty) did not show significant reduction in anxiety. Moderate certainty evidence suggests that acute mind–body exercise may be the most effective type of exercise for reducing anxiety in adolescents and young adults. Future research should focus on conducting more multi‐arm randomized controlled trials to provide more direct evidence on the relative effectiveness of different exercise interventions. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the influence of the CYP1A2 c.-163 A > C (rs762551) polymorphism on the effect of oral caffeine intake on fat oxidation during exercise. Methods: Using a pilot randomized, double-blind, crossover, placebo-controlled trial, 32 young and healthy individuals (women = 14, men = 18) performed an incremental test on a cycle ergometer with 3-min stages at workloads from 30 to 70% of maximal oxygen uptake (VO2max). Participants performed this test after the ingestion of (a) placebo; (b) 3 mg/kg of caffeine; (c) 6 mg/kg of caffeine. Fat oxidation rate during exercise was measured by indirect calorimetry. The influence of the CYP1A2 c.-163 A > C polymorphism in the effect of caffeine on fat oxidation rates during exercise was established with a three-way ANOVA (substance × genotype × intensity). Results: Eight participants were genotyped as AA, 18 participants were CA heterozygotes, and 6 participants were CC. There was a main effect of substance (F = 3.348, p = 0.050) on fat oxidation rates during exercise with no genotype effect (F = 0.158, p = 0.959). The post hoc analysis revealed that, in comparison to the placebo, 3 and 6 mg/kg of caffeine increased fat oxidation at 40–50% VO2max in AA (all p < 0.050) and 50–60% VO2max in CA and CC participants (all p < 0.050). Conclusion: Oral intake of 3 and 6 mg/kg of caffeine increased fat oxidation rate during aerobic exercise in individuals with AA, CA and CC genotypes. This suggests that the effect of caffeine to enhance fat oxidation during exercise is not influenced by the CYP1A2 c.-163 A > C polymorphism. Trial registration: The study was registered on clinicaltrials.gov with ID: NCT05975489. [ABSTRACT FROM AUTHOR]

Background • Diabetes, a chronic disease metabolic disorder, commonly affects people. It is well-documented that aerobic exercise significantly reduces blood glucose in diabetic conditions. This study aimed to demonstrate the role of aerobic exercise on T2DM patients and cognitive impairment. Methods • We selected studies that published random controlled trials (RCTs) on the effects of aerobic exercise on cognitive function in patients with T2DM. However, the animal trials were we excluded in this study. We retrieved the data of random controlled trials from 8 databases based on the influences of aerobic exercise on cognitive function in patients with type 2 diabetes mellitus (T2DM). We utilized RevMan 5.3 software to analyze the data after evaluating the literature. Results • We selected 685 studies based on the information in the abstract and title after deleting the duplicate references. Then, we investigated the full text of 15. After full-text evaluation,we selected 10 random controlled trials to perform this comprehensive meta-analysis. We found that 10 studies derived the information of cognitive function between the test and the control groups and the cognitive function is significantly higher in the experimental group (SMD: 1.88; 95% Cl: 0.91,2.84; P < .01) than the control group. Moreover, the experimental group showed significantly higher minimum mental state examination (MMSE) (SMD: 2.06; 95% Cl: 0.96,3.14; P < .01) and Montreal Cognitive Assessment (MoCA) (SMD:1.62; 95% Cl: 0.54, 2.69; P < .01) than the normal group. Conclusion • Our findings demonstrated that aerobic exercise is crucially potent in T2DM patients and cognitive impairment, as evidenced by total cognitive function, MMSE, and MoCA. The above results should be warranted to verify with sophisticated clinical trials. In the future, aerobic exercise is suggested to guide patients’srecovery. [ABSTRACT FROM AUTHOR]

(1) Background: Exploring the relationship between spontaneous breathing patterns and aerobic and anerobic running exercise performance can greatly improve our understanding of optimizing physical fitness. Spontaneous breathing patterns refer to how the rhythm and depth of breathing affect performance and physical adaptation during exercise. (2) Methods: This study aimed to investigate this relationship by enrolling 240 college students (120 males and 120 females, aged 18–22). We evaluated their resting respiratory rate (RR), the combined total of abdominal and thoracic movements (AM+TM), the proportion of abdominal movement to the overall respiratory movement (AM/(AM+TM)), and the inhalation to exhalation ratio (I/E ratio). Additionally, their performance in a 50 m sprint (measuring anerobic capability), an 800- or 1000 m run (assessing mixed aerobic and anerobic capacity), and a 12 min distance run (evaluating aerobic capacity) was recorded. (3) Results: Our findings, through both correlational and comparative analyses, indicate that a larger AM+TM is predictive of a greater distance covered in the 12 min run, suggesting enhanced aerobic capacity. Interestingly, among female participants, a lower body mass index (BMI) coupled with a higher proportion of abdominal movement (AM/(AM+TM)) was linked to better performance in the 800 m run, indicative of superior mixed aerobic and anerobic capacities. These results imply that women with a larger tidal volume and those with a lower BMI but higher abdominal contribution to breathing at rest may exhibit better aerobic and mixed exercise capacities, respectively. (4) Conclusions: Based on these findings, we recommend that healthcare professionals and physical education instructors incorporate respiratory pattern assessments into their practices to potentially improve the physical health of their clients and students, with a particular emphasis on female populations. This study underscores the importance of understanding the intricate relationship between spontaneous respiratory patterns and exercise capabilities in enhancing overall physical fitness and health. [ABSTRACT FROM AUTHOR]

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014–2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86–3.07), and those with lower education (OR: 1.56; 95% CI: 1.33–1.82), rural residence (OR: 1.89; 95% CI: 1.49–2.38), low household income, (OR: 1.45; 95% CI: 1.13–1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46–1.94), current smoking (OR: 1.70; 95% CI: 1.26–2.29), and diabetes (OR: 1.28; 95% CI: 1.09–1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults. [ABSTRACT FROM AUTHOR]

The editorial "Clinical Insights into Physical Activity, Fitness, and Cardiovascular Health" highlights the positive impact of increased physical activity on cardiovascular health, supported by various studies. It emphasizes the importance of exercise testing, particularly the cardiopulmonary exercise test (CPET), in evaluating physical capacity, fitness, and cardiovascular function. The editorial also discusses the role of physical activity in primary and secondary prevention of cardiovascular diseases, underscoring the need for lifestyle interventions and exercise prescription tailored to individual needs and capabilities. Additionally, it explores the emerging field of sports cardiology and the potential benefits of integrating strength training into remote cardiac rehabilitation programs. [Extracted from the article]

Background/Objectives: Physical exercise (PE) has been shown to have positive effects on the symptoms associated with autism spectrum disorder (ASD). However, there is still no consensus on the most appropriate PE intervention model. With this in mind, we developed a program with the aim of determining the effects of PE on physical fitness, with a view to applying it as a potential treatment. Methods: Using an experimental methodology, this research work will recruit 18 institutionalized young people and adults who will be allocated to one of two groups, namely (i) the youth training group and (ii) the adult training group, using low-cost materials. Both intervention groups will perform 90 min of training per session, twice a week, for 12 weeks. Evaluations will be carried out at baseline and month 3. The impact of the exercise program will be assessed based on the variables of anthropometry, body composition, cardiovascular response, and cardiorespiratory fitness. Results: The results of this study will contribute to the development of more effective strategies, prescription recommendations, and interventions as a guarantee in future programs of better and greater adherence to PE by institutionalized individuals with ASD. Conclusions: In addition, we intend to make the PE program available if it promotes positive effects in the target population. [ABSTRACT FROM AUTHOR]

Though the mechanisms are not fully understood, tryptophan (Trp) and physical exercise seem to regulate mechanical hypersensitivity in fibromyalgia. Here, we tested the impact of Trp supplementation and continuous low-intensity aerobic exercise on the modulation of mechanical hypersensitivity in a fibromyalgia-like model induced by acid saline in female rats. Twelve-month-old female Wistar rats were randomly divided into groups: [control (n = 6); acid saline (n = 6); acid saline + exercise (n = 6); acid saline + Trp (n = 6); and acid saline + exercise + Trp (n = 6)]. Hypersensitivity was caused using two intramuscular jabs of acid saline (20 μL; pH 4.0; right gastrocnemius), 3 days apart. The tryptophan-supplemented diet contained 7.6 g/hg of Trp. The three-week exercise consisted of progressive (30–45 min) treadmill running at 50 to 60% intensity, five times (Monday to Friday) per week. We found that acid saline induced contralateral mechanical hypersensitivity without changing the levels of Trp, serotonin (5-HT), and kynurenine (KYN) in the brain. Hypersensitivity was reduced by exercise (~150%), Trp (~67%), and its combination (~160%). The Trp supplementation increased the levels of Trp and KYN in the brain, and the activity of indoleamine 2,3-dioxygenase (IDO), and decreased the ratio 5-HT:KYN. Exercise did not impact the assessed metabolites. Combining the treatments reduced neither hypersensitivity nor the levels of serotonin and Trp in the brain. In conclusion, mechanical hypersensitivity induced by acid saline in a fibromyalgia-like model in female rats is modulated by Trp supplementation, which increases IDO activity and leads to improved Trp metabolism via the KYN pathway. In contrast, physical exercise does not affect mechanical hypersensitivity through brain Trp metabolism via either the KYN or serotonin pathways. Because this is a short study, generalizing its findings warrants caution. [ABSTRACT FROM AUTHOR]

Simple Summary: Research continues to show that exercising at recommended levels is associated with lower mortality rates and decreased risk of recurrence in breast cancer survivors (BCS). Moreover, those BCS exercising at levels meeting guidelines have higher self-reported health-related quality of life (HR-QOL) than those that do not. This includes lowered levels of perceived global stress. However, which modalities of exercise are most effective has yet to be determined. Our study investigates changes in stress experienced by breast cancer survivors participating in one of three different exercise modalities conducted over six months, as indicated by self-report and salivary cortisol measures. The revealed improvement in constructs of Health Related-Quality of Life (HR-QOL) suggest that engagement in exercise had a greater impact on outcomes than any particular modality. Background/Objectives: Extensive evidence suggests that exercise is physically and mentally beneficial for cancer survivors. This study reports on changes in self-reported stress, physiological biomarkers for stress (salivary cortisol), and HR-QOL constructs for fifty breast cancer survivors participating in one of three different exercise programs over 6 months. Methods: Fifty post-treatment breast cancer survivors were randomized to either therapeutic yoga-based exercise (YE), comprehensive exercise (CE) (aerobic, resistance, flexibility), or choosing (C) their own exercise activities. Participants completed the Perceived Stress Scale (PSS), Medical Outcomes Short-Form 36® (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Five samples of salivary cortisol were collected on two consecutive days. The 10 samples were used to calculate the diurnal rhythm slope. Outcome measures were repeated after six months. Results: All groups improved in HR-QOL measures of PSS; PSQI sleep quality components of latency and daytime functioning; and five of the ten SF-36 scales (Mental Component Scale, Social Functioning subscale, Mental Health subscale, Physical Component Scale, Physical Functioning subscale). Although the CE group observed the most favorable change in cortisol (−0.183), where cortisol slope changes approached significance (p = 0.057), but no significant decrease in cortisol between groups were noted. Conclusions: Our results suggest that it is the engagement of, rather than the specific type of exercise, which is associated with improved HR-QOL. However, longer-term studies with better adherence monitoring and larger sample sizes are needed to better determine clinical impact. [ABSTRACT FROM AUTHOR]

Background: Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications. Objective: We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes. Methods: A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose–response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels. Results: A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = − 0.78% [− 8.50 mmol/mol]; 95% CrI: − 1.04, − 0.51), followed by combined aerobic and resistance exercise (CE) (MD = − 0.54% [− 5.90 mmol/mol]; 95% CrI: − 0.69, − 0.40), yoga (MD = − 0.45% [− 4.92 mmol/mol]; 95% CrI: − 0.77, − 0.13), and continuous aerobic exercise (CAE) (MD = − 0.42% [− 4.58 mmol/mol]; 95% CrI: − 0.54, − 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week. Conclusions: There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose–response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription. [ABSTRACT FROM AUTHOR]

Aim: Research has demonstrated that participation in aerobic exercise can have significant beneficial effects across both physical and mental health domains for individuals who are in the early phase of schizophrenia. Despite these notable benefits of exercise, deficits in motivation and a lack of methods to increase engagement are significant barriers for exercise participation, limiting these potentially positive effects. Fortunately, digital health tools have the potential to improve adherence to an exercise program. The present study examined the role of motivation for exercise and the effects of an automated digital text messaging program on participation in an aerobic exercise program. Methods: A total of 46 first‐episode psychosis participants from an ongoing 12‐month randomized clinical trial (Enhancing Cognitive Training through Exercise Following a First Schizophrenia Episode (CT&E‐RCT)) were included in an analysis to examine the efficacy of motivational text messaging. Personalized motivational text message reminders were sent to participants with the aim of increasing engagement in the exercise program. Results: We found that participants with higher levels of intrinsic motivation to participate in a text messaging program and in an exercise intervention completed a higher proportion of individual, at‐home exercise sessions. In a between groups analysis, participants who received motivational text messages, compared to those who did not, completed a higher proportion of at‐home exercise sessions. Conclusion: These results indicate the importance of considering a person's level of motivation for exercise and the potential utility of using individualized and interactive mobile text messaging reminders to increase engagement in aerobic exercise in the early phase of psychosis. We emphasize the need for understanding how individualized patient preferences and needs interplay between intrinsic motivation and digital health interventions for young adults. [ABSTRACT FROM AUTHOR]

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Obesity often exacerbates the clinical manifestations of PCOS, contributing to insulin resistance, metabolic disturbances, and reproductive issues. This study aims to evaluate the effect of a period of aerobic exercises on sexual hormones and appetite in obese women with Polycystic Ovary Syndrome (PCOS). Methods: This semi-experimental study involved 30 obese women with PCOS, divided into an aerobic exercise group and a control group (15 participants each). The exercise group underwent a supervised 12-week aerobic training program, consisting of three 60-minute sessions per week. Hormonal levels (prolactin, luteinizing hormone [LH], follicle-stimulating hormone [FSH], total testosterone, hydroxyprogesterone, LH/FSH ratio) and appetite scores were measured before and after the intervention. Statistical analyses were performed using ANCOVA to assess the impact of the exercise intervention, adjusting for pre-test scores. Results: Significant improvements were observed in the experimental group postintervention. Prolactin levels decreased from 20.95 ± 2.63 ng/mL to 18.50 ± 1.82 ng/mL (P < 0.001), LH levels from 9.47 ± 2.35 mIU/mL to 6.02 ± 1.45 mIU/mL (P < 0.001), FSH levels from 5.21 ±1.09 mIU/mL to 4.21 ±1.22 mIU/mL (p < 0.001), total testosterone levels from 59.19 ± 20.20 g/mL to 40.62 ± 14.81 g/mL (P < 0.001), and hydroxyprogesterone levels from 4.83 ± 1.65 Mol/L to 3.98 ± 0.95 Mol/L (P < 0.001). The LH/FSH ratio improved from 1.87 ± 0.54 to 1.52 ± 0.47 (p = 0.025), and appetite scores decreased from 7.53 ± 1.50 to 6.33 ± 1.18 (P< 0.001). Conclusion: Aerobic exercise significantly improves hormonal profiles and reduces appetite in obese women with PCOS, highlighting its potential as an effective therapeutic intervention. Regular aerobic training can address both reproductive and metabolic aspects of PCOS, enhancing overall health and quality of life. [ABSTRACT FROM AUTHOR]

A study published in the Journal of the American Geriatrics Society examines the relationship between exercise and dementia prevention. The study finds that physical activity initiated during midlife significantly reduces the risk of dementia and cognitive impairment, particularly in women. However, there are limitations to the study, such as the use of self-reported physical activity and potential confounding variables. The article emphasizes the need for further research and public policy interventions to promote physical activity. [Extracted from the article]

Exercise training is a conventional treatment strategy throughout the entire treatment process for patients with spinal cord injury (SCI). Currently, exercise modalities for SCI patients primarily include aerobic exercise, endurance training, strength training, high-intensity interval training, and mind–body exercises. These exercises play a positive role in enhancing skeletal muscle function, inducing neuroprotection and regeneration, thereby influencing neural plasticity, reducing limb spasticity, and improving motor function and daily living abilities in SCI patients. However, the mechanism by which exercise training promotes functional recovery after SCI is still unclear, and there is no consensus on a unified and standardized exercise treatment plan. Different exercise methods may bring different benefits. After SCI, patients' physical activity levels decrease significantly due to factors such as motor dysfunction, which may be a key factor affecting changes in exerkines. The changes in exerkines of SCI patients caused by exercise training are an important and highly relevant and visual evaluation index, which may provide a new research direction for revealing the intrinsic mechanism by which exercise promotes functional recovery after SCI. Therefore, this article summarizes the changes in the expression of common exerkines (neurotrophic factors, inflammatory factors, myokines, bioactive peptides) after SCI, and intends to analyze the impact and role of different exercise methods on functional recovery after SCI from the perspective of exerkines mechanism. We hope to provide theoretical basis and data support for scientific exercise treatment programs after SCI. [ABSTRACT FROM AUTHOR]

Absrtact: Objective: To evaluate the effects of various non-pharmacological interventions on patients with cognitive impairment by systematic search and network meta-analysis, and to rank the effects of the included non-pharmacological interventions. Methods: The databases of PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, WANFANG, and SinoMed were searched by computer. All randomized controlled trials (RCTs) of non-pharmacological interventions for people with cognitive frailty were collected. The search was conducted from 2000 to February 2024. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias of the included studies, and then used Stata15 and R4.3.1 software to conduct network meta-analysis, with physical function and cognitive function as the main outcome indicators. Results: A total of 19 randomized controlled trials involving 1738 patients were included. The results of network meta-analysis showed that among the non-pharmacological interventions, nutritional support had the best effect on improving frailty scores and cognitive function scores in patients with cognitive frailty. Aerobic training combined with resistance training is best for improving grip strength. For improving the patient's motor status, cognitive training had the best effect on improving TUG test scores. High-speed resistance training is best for improving walking speed. Conclusion: This review analyses the current study of non-pharmacological interventions to improve physical performance in patients with cognitive frailty. Current evidence suggests that nutritional support is most effective at improving physical frailty and cognitive decline in patients with cognitive frailty, and that exercise and cognitive training interventions significantly improve grip strength and motor ability. Trial registration: This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42023486881). [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus is the most common medical condition in pregnancy, disproportionately affecting overweight or obese women and those from non-White populations. The lack of standardised screening and diagnostic consensus contributes to varying prevalence. Conventional risk factor-based screening can leave women undiagnosed, leading to increased risk of harm. If diet and lifestyle modifications fail to achieve glycaemic targets, prompt treatment should be initiated to manage glucose levels. A planned birth is crucial to ensure the best outcomes. Postpartum, women need screening for type 2 diabetes and other cardiometabolic risk factors, enrollment in diabetes prevention programmes, and counselling on the increased risk of future cardiometabolic disease for themselves and their offspring, highlighting the importance of ongoing prevention and management strategies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to determine the effect of moderately strenuous aerobic exercise training on heart rate variability (HRV) and heart rate turbulence (HRT) in patients with an implantable cardioverter defibrillator (ICD). Methods: Patients were randomized to a 24-week home-based aerobic exercise (EX) training program (n = 84) or to usual care (UC) (n = 76). All subjects underwent 24-h Holter monitoring at baseline, 8 and 24 weeks. Generalized estimating equations were used to test the effects of exercise on HRV and HRT outcomes. Results: The study group was comprised of n = 160 patients (124 M, 36 F, age 54.9 ± 12.2 years) with an ICD for primary (43%) or secondary prevention (57%). Compared to UC, EX was associated with a significant improvement in parasympathetic HRV for root mean square of successive differences (rMSSD; p =.05) at 8 weeks and global HRV for standard deviation of all normal (N-N) intervals (SDNN; p =.05) and standard deviation of 5-min averages N-N intervals (SDANN; p =.03) at 24 weeks. When stratified by adherence, those who were ≥80% adherent (minutes/week) had significant improvements in parasympathetic HRV (rMSSD, pNN50) and global HRV (SDNN, SDANN) at 8 weeks, and a further significant improvement in global HRV (SDNN, SDANN, SDNN index) at 24 weeks. Neither HRT nor ventricular ectopy changed with exercise training. Conclusion: Moderately strenuous aerobic exercise improved parasympathetic and global HRV indices following an ICD, with greater adherence associated with greater improvements. Clinical trial registration: Clinicaltrials.gov: NCT 00522340. [ABSTRACT FROM AUTHOR]

Aerobic exercise (AE) has attracted considerable research attention as a non-invasive therapeutic tool in recent years. Accumulating evidence has revealed its protective role against a wide range of diseases. In this study, we aimed to establish whether AE could inhibit apoptosis in infarcted cardiomyocytes and protect the heart. AE in post-myocardial infarction (post-MI) mice improved their cardiac and physical functions. Transmission electron microscopy of myocardial tissue and adenosine 5'-triphosphate (ATP) assay findings revealed an increased mitochondrial number but decreased ATP content in the post-MI mice. Notably, this change was significantly reversed by AE. Immunofluorescence/ TUNEL staining assay results showed that AE inhibited cardiomyocyte apoptosis. Using immunoblotting of myocardial tissues, we found that AE increased the level of the anti-apoptotic protein Bcl-2/Bax, significantly decreased the expression of the pro-apoptotic protein caspase-3, and activated the AMPK/PGC-1α signaling pathway. Our findings provide evidence that AE activates the AMPK/PGC-1α signaling pathway, improves mitochondrial energy supply capacity, and effectively inhibits apoptosis in cardiomyocytes. Therefore, AE can be considered a promising post-infarction therapeutic intervention. [ABSTRACT FROM AUTHOR]

Deep water running (DWR) is an exercise model often used for health promotion purposes. This study standardized an aerobic capacity evaluation protocol specific for attached DWR in young healthy adults and monitored a DWR session with normobaric hypoxia exposure addition. In study 1, nine young healthy adults, seven male and two female (22.88 ± 3.14 years old; 72.44 ± 11.38 kg; 174.88 ± 9 cm; 23.58 ± 2.33 kg m−2), were subjected to two DWR incremental tests with a 48-hour interval between them, and in study 2, six healthy males were subjected to three (hypoxia, normoxia, and inter-effort recovery hypoxia) attached DWR exercise sessions involving normobaric hypoxia. Data are expressed as average ± standard deviation. Friedman's test was used to compare the groups with a significance level of P < 0.05. In study 1, no significant statistical differences were observed for the physiological variables analyzed. In study 2, there was no difference in strength and lactate between conditions; values of rates of perceived exertion were higher in the hypoxic session, compared to inter-effort recovery hypoxia, in efforts 1 and 5, respectively, while heart rate was lower in effort 1 in normoxia. In hypoxia, effort 1 was lower than effort 3, with no alteration in recovery hypoxia. This aerobic capacity evaluation protocol is valid, sensitive, and replicable, and there were no important differences in the physiological variables from high-intensity exercise sessions monitoring in hypoxia, normoxia, and inter-effort recovery hypoxia conditions. [ABSTRACT FROM AUTHOR]

The mechanisms leading to a predominantly hypertrophied phenotype versus a predominantly oxidative phenotype, the hallmarks of resistance training (RT) or aerobic training (AT), respectively, are being unraveled. In humans, exposure of naïve persons to either AT or RT results in their skeletal muscle exhibiting generic 'exercise stress-related' signaling, transcription, and translation responses. However, with increasing engagement in AT or RT, the responses become refined, and the phenotype typically associated with each form of exercise emerges. Here, we review some of the mechanisms underpinning the adaptations of how muscles become, through AT, 'fit' and RT, 'mighty.' Much of our understanding of molecular exercise physiology has arisen from targeted analysis of post-translational modifications and measures of protein synthesis. Phosphorylation of specific residue sites has been a dominant focus, with canonical signaling pathways (AMPK and mTOR) studied extensively in the context of AT and RT, respectively. These alone, along with protein synthesis, have only begun to elucidate key differences in AT and RT signaling. Still, key yet uncharacterized differences exist in signaling and regulation of protein synthesis that drive unique adaptation to AT and RT. Omic studies are required to better understand the divergent relationship between exercise and phenotypic outcomes of training. [Display omitted] • Skeletal muscle phenotype is underpinned by constituent proteins' activity/function. • Targeted analyses demarcate few differences between exercise modes. • Unknown unique signaling between aerobic/resistance exercise underpin phenotypes. • Multi-timepoint and unbiased omic methods will characterize exercise adaptation. [ABSTRACT FROM AUTHOR]

We investigated the effects of exercise training on bone mineral density (BMD) in people living with Human Immunodeficiency Virus (PLHIV). Pubmed, Scopus, Cochrane Library, and ScienceDirect databases were searched for trials investigating exercise training-induced changes in BMD of PLHIV at baseline vs. post-intervention assessed by dual-energy X-ray absorptiometry (DXA). Hedge effect sizes (ES) were calculated incorporating fixed effects for BMD variation assumptions. Disaggregated comparisons were performed for trials with more than one intervention or BMD site assessment. Seven trials included 210 PLHIV and 35 non-HIV-infected controls. Methodological quality evaluated using the Physiotherapy Evidence Database (PEDro) scale ranged from poor to moderate. Interventions applied isolated resistance, combined aerobic and resistance, and multimodal exercise protocols performed 3 d/wk for 12-to 104 week. One controlled and another uncontrolled trial presented significant effects, reporting improvements at the femoral neck and total (ES 2.14 and 0.49, respectively). Magnitude of those specific ES influenced the overall effect (controlled and uncontrolled trials), which was small but significant (k = 12, ES 0.277, 95% confidence interval 0.120-0.434). Resistance training may promote favorable adaptations in BMD of PLHIV, particularly in femur. Future research should elucidate the optimal dose-response relationship and physiological mechanisms underlying exercise-induced adaptations on the BMD of PLHIV. [ABSTRACT FROM AUTHOR]