Search

Chronic venous disease (CVD), comprising impaired lower limb venous return, will lead to chronic distal venous pressure overload manifested by various clinical signs and symptoms and resulting in diminished quality of life. The CEAP (Clinical, Etiology, Anatomy, and Pathophysiology) classification of CVD distinguishes six stages (C0-C6) using clinical, etiologic, anatomic, and pathophysiologic parameters. In the present study, we analyzed the effects of adapted physical activity (APA) and patient-oriented therapeutic education (PTE) programs on the clinical signs, symptoms, and quality of life of patients with CVD.Our analysis, in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) recommendations, included a search of PubMed, CINAHL and LiSSa databases, using a single search equation.A total of 21 studies were selected for analysis. The analysis revealed first, that patients at stage C0 to C5 had had access to an APA program. This therapy alleviated the clinical signs and symptoms and improved the patients' quality of life. The beneficial effects of APA were greater in the programs that had included aquatic activities than in the program that were exclusively dry-land programs. Second, patients at stage C6 had predominantly followed a PTE program. This therapy showed beneficial effects on the clinical signs and symptoms. However, the quality of life had rarely been assessed.At present, APA and PTE programs comprise useful and complementary therapeutic options for the care of patients with CVD. Two of the studies included in our review had evaluated the effects of combining these two approaches, notably in the context of balneotherapy, and reported promising results.

International audience; Background: Pediatric obesity is closely associated with obstructive sleep apnea (OSA) and short sleep duration. While multidisciplinary weight loss interventions are recommended for pediatric obesity management, the evidence for their effects on OSA severity and overall sleep in youth have not been systematically examined.Objectives: To conduct a systematic review and meta-analysis investigating the effects of multidisciplinary weight loss interventions on OSA severity and prevalence, and on overall sleep health in youth with obesity.Methods: A systematic search of interventional studies (participants age range: 10-19 yrs) was performed using PubMed, CENTRAL and Embase, from inception to May 2019. The quality of the evidence was assessed using the Cochrane risk of bias tool.Results: Ten studies were included by the end of the screening process. Ninety percent of the included studies reported a decrease in OSA prevalence post-intervention, and OSA was normalized for 46.2-79.7% of the youth. The meta-analysis comprising seven longitudinal studies revealed significant reductions in apnea-hypopnea index (effect size: -0.51, 95%CI -0.94 to -0.08, p = 0.019), and oxygen desaturation index (effect size: -0.28, 95%CI = -0.50 to -0.05, p = 0.016). Seventy-five percent of the studies reported improved sleep duration in youth with OSA.Conclusions: Evidence suggests that multidisciplinary weight loss interventions result in improvements in OSA severity and sleep duration in youth with obesity. Future randomized controlled trials are warranted to better assess and understand the independent implications of weight loss, fat mass decrease and chronic exercise on OSA and sleep health in this population.

BACKGROUND Despite growing interest in athletes' sleep, few studies have focused on professional athletes, especially in individual sports. Moreover, limited investigations included female athletes. This study aims to evaluate sleep chronotype, as well as objective and subjective sleep characteristics in male and female professional cross-country mountain bikers. METHODS Thirteen athletes (7 males and 6 females) of the French national team took part in this study. The Chronotype was assessed by the Horne and Ostberg Morningness-Eveningness Questionnaire and sleep by actigraphy for one month, by ambulatory polysomnography (PSG) for one night and by the Pittsburgh Sleep Quality Index. RESULTS Most athletes (77 %) are classified as moderately morning type and a minority of athletes (23 %) are intermediate type. Athletes sleep on average 8 hours per night and during the night recorded by PSG, N3 and REM sleep stages represented 21.2 ± 3.4 % and 20.9 ± 3.1 % of the total sleep time, respectively. These good sleep parameters were confirmed by subjective data with 77 % good sleepers. Except the poorer subjective sleep quality in female athletes (5.7 ± 1.6) compared to male athletes (2.6 ± 1.7, p < 0.05), no significant sex difference was found for all characteristics evaluated. CONCLUSIONS The professional status of these athletes and the organization of mountain bike calendar may explain their good sleep characteristics.

Garbellotto, L, Petit, E, Brunet, E, Guirronnet, S, Clolus, Y, Gillet, V, Bourdin, H, and Mougin, F. Gradual advance of sleep-wake schedules before an eastward flight and phase adjustment after flight in elite cross-country mountain bikers: effects on sleep and performance. J Strength Cond Res XX(X): 000-000, 2022-Strategies, for alleviating jet lag, specifically targeted to competitive athletes have never been studied, in ecological conditions. This study aimed to assess the effects of a phase advance before a 7-hour eastward flight followed by a strategy of resynchronization at destination on sleep and physical performance in professional mountain bikers. Six athletes participated in this study divided into 4 periods: (i) baseline (usual sleep-wake rhythm); (ii) phase advance (advance sleep-wake schedules of 3 hours for 6 days); (iii) travel (flight: Paris-Tokyo); and (iv) phase adjustment (resynchronization of sleep-wake schedules). Melatonin pills and light therapy were administrated during the phase advance and phase adjustment. Sleep was recorded by polysomnography and actigraphy, core body temperature (CBT) rhythm was assessed by ingestible capsules, and physical performances were tested by the Wingate and 5-minute maximal exercise tests. Results showed that bedtime was advanced by 2.9 hours at the end of the phase advance (p ≤ 0.01) with a batyphase of CBT advanced by 2.5 hours (p = 0.07). Bedtime was similar at destination compared with baseline. Total sleep time and sleep composition were unchanged at the end of the phase advance or at destination, compared with baseline. Physical performances were maintained after phase advance and at destination. The phase advance enabled to preshift part of the time zones without disturbing sleep and physical performances and contributed to preserving them once at destination. A phase advance before eastward travel represents an effective strategy to counter harmful effects of jet lag.

International audience; Objectives: Pediatric obesity and sleep-disordered breathing (SDB) are strongly associated, and both promote metabolic impairments. However, the effects of a lifestyle intervention on the overall metabolic syndrome (MetS) are unknown. The objectives were i) to evaluate the effects of a lifestyle intervention on cardiometabolic risk (CMR), assessed with a dichotomous (MetS) and a continuous (MetScoreFM) instrument, in obese adolescents with and without SDB and ii) to compare the post-intervention cardiometabolic responses between adolescents with persistent (apnea-hypopnea index; AHI≥2) or normalized-SDB (AHI

Early adiposity rebound (EAR) predicts paediatric overweight/obesity, but current approaches do not consider both the starting point of EAR and the BMI trajectory. We compared the clinical characteristics at birth, age 3–5 and 6–8 years of children, according to the EAR and to its type (type A/type B-EAR). We assessed the childrenʼs odds of being classified as overweight/obese at age 6–8 years, according to the type of EAR as defined at age 3–5 years. As part of this two-wave observational study, 1055 children were recruited and examined at age 3–5 years. Antenatal and postnatal information was collected through interviews with parents, and weight and height from the health records. Type A and type B-EAR were defined in wave 1 according to the BMI nadir and the variation of BMIz-score between the starting point of the adiposity rebound and the last point on the curve. At 6–8 years (wave 2), 867 children were followed up; 426 (40·4 %) children demonstrated EAR. Among them, 172 had type A-EAR, higher rates of parental obesity (P< 0·05) and greater birth weight compared with other children (P< 0·001). Odds for overweight/obesity at 6–8 years, when adjusting for antenatal and postnatal factors, was 21·35 (95 % CI 10·94, 41·66) in type A-EAR children and not significant in type B-EAR children (OR 1·76; 95 % CI 0·84, 3·68) compared with children without EAR. Classification of EAR into two subtypes provides physicians with a reliable approach to identify children at risk for overweight/obesity before the age of 5 years.

International audience; Background and aims: Pediatric obesity and sleep-disordered breathing (SDB) are associated with cardiometabolic risk (CMR), but the degree of severity at which SDB affects cardiometabolic health is unknown. We assessed the relationship between the CMR and the apnea-hypopnea index (AHI), to identify a threshold of AHI from which an increase in the CMR is observed, in adolescents with obesity. We also compared the clinical, cardiometabolic and sleep characteristics between adolescents presenting a high (CMR+) and low CMR (CMR-), according to the threshold of AHI.Methods and results: 114 adolescents with obesity were recruited from three institutions specialized in obesity management. Sleep and SDB as assessed by polysomnography, anthropometric parameters, fat mass (FM), glucose and lipid profiles, and blood pressure (BP) were measured at admission. Continuous (MetScoreFM) and dichotomous (metabolic syndrome, MetS) CMR were determined. Associations between MetScoreFM and AHI adjusted for BMI, sex and age were assessed by multivariable analyses. Data of 82 adolescents were analyzed. Multivariable analyses enabled us to identify a threshold of AHI = 2 above which we observed a strong and significant association between CMR and AHI (Cohen's d effect-size = 0.57 [0.11; 1.02] p = 0.02). Adolescents with CMR+ exhibited higher MetScoreFM (p < 0.05), insulin resistance (p < 0.05), systolic BP (p < 0.001), sleep fragmentation (p < 0.01) and intermittent hypoxia than CMR- group (p < 0.0001). MetS was found in 90.9% of adolescents with CMR+, versus 69.4% in the CMR- group (p < 0.05).Conclusions: The identification of a threshold of AHI ≥ 2 corresponding to the cardiometabolic alterations highlights the need for the early management of SDB and obesity in adolescents, to prevent cardiometabolic diseases.

Breast cancer, the most common in women, is a cancer of good prognosis. During this last decade, the improvement of cancer screening and treatment has significantly increased disease-free and overall survival. However, the chemotherapy, especially based on anthracyclines, and targeted therapies like trastuzumab have a toxicity to the cardiovascular system. If physical exercise is recognized as beneficial in tertiary prevention, especially by reducing fatigue, improving the physiological capacities of exercise, muscle strength and ultimately quality of life, conversely, few data are available on the effects of exercise on treatment-induced cardiotoxicity. This review, based on the PubMed database, presents the results of preclinical and clinical studies showing that physical exercise, by its cardioprotective role, increases the antioxidant capacity, reduces oxidative stress, maintains the left ventricular ejection fraction at a normal value and improves diastolic functions during and after treatment. Regular physical exercise should be an integral part of supportive care in oncology but it is necessary, in future studies, to determine its modalities for a better prevention of the cardiotoxicity of the treatments.

De par la modification du mode de vie, le rythme veille-sommeil est négligé, et le manque de sommeil est devenu aujourdʼhui une préoccupation majeure de santé publique. Chez les jeunes, lʼutilisation inadaptée des écrans le soir et la nuit chez les jeunes est à lʼorigine dʼun retard de phase et dʼune restriction de sommeil. Bien que la relation réciproque entre obésité et privation de sommeil soit déjà reconnue, il est important de comprendre les mécanismes (comportementaux, endocriniens…) conduisant lʼadolescent à une augmentation de la masse corporelle. Par ailleurs, lʼobésité est associée à une modification de lʼarchitecture du sommeil et au développement du syndrome dʼapnées obstructives du sommeil. Lʼobjectif de cette revue est de faire un état des lieux, des causes et conséquences dʼune privation de sommeil sur la santé et le sommeil de lʼadolescent obèse, et dʼidentifier le rôle des activités physiques adaptées dans la prévention et le traitement de lʼobésité et du syndrome dʼapnées obstructives du sommeil.

Aim To evaluate the impact of an aerobic fitness program on disease activity, defined by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and on C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in case of axial spondyloarthritis. Methods A systematic review of the literature, following the Prisma recommendations, was performed by two reviewers on the PubMed and Embase databases. Controlled trials assessing the efficacy of aerobic exercises compared to physiotherapy on axial spondyloarthritis disease activity were included. The diagnosis of axial spondyloarthritis was meeting the New York criteria and/or the Assessment in Axial Spondyloarthritis International Working Group criteria. Aerobic fitness was defined as an exercise performed at 50%-90% of the maximal heart rate or between 50% and 80% oxygen consumption (VO2 ) peak. Results Five hundred and twenty abstracts were identified and 93 abstracts were analyzed. Eight studies met the selection criteria and 6 were finally included in this study because of the presence of a control group. Both groups were similar in terms of age, sex ratio, disease duration. Aerobic exercise provided a positive impact on the BASDAI in the intervention group (148 patients) (weighted mean difference [WMD]: -0.52 [95% CI: -0.9 to -0.13]) (I2 : 10.3%, P = 0.35). However, when compared to a control group (152 patients), the improvement of BASDAI didn't reach significance (WMD: -0.25 [95% CI: -0.83 to 0.32]) (I2 : 0%, P = 0.41). Aerobic exercise did not improve BASFI, CRP or ESR. Conclusion Aerobic exercise did not provide beneficial effects either on disease activity or on physical function and biological parameters when compared to a control group in axial spondyloarthritis.

Physical exercise and lifestyle modification are recognized as adjunct therapy for obstructive sleep apnea (OSA) in overweight adults. The objectives of this study were to investigate the effects of long-term physical exercise combined with a balanced diet on sleep architecture, sleep duration, and OSA in adolescents with severe obesity.This interventional study was conducted in a nursing institution. Participants were aged 14.6 ± 1.2 years with obesity (body mass index (BMI) = 40.2 ± 6.5 kg/mTwenty-four subjects completed the study. Analyses were performed on the whole population and on a subgroup of subjects with OSA (OSA-subgroup). OSA, defined as obstructive apnea-hypopnea index (OAHI) ≥ 2 events/h, was diagnosed in 58.3% of the population. OAHI was only associated with fat mass in males (A combination of supervised aerobic exercise and a balanced diet led to weight loss, improved aerobic capacity, and modified sleep architecture without changes in OSA.A commentary on this article appears in this issue on page 907.Registry: ClinicalTrials.gov, Title: Exercise and Venous Compression on Upper Airway Resistance in Obese Teenagers With OSA (OBESOMAC), URL: https://clinicaltrials.gov/ct2/show/NCT02588469, Identifier: NCT02588469.

Post-lunch sleepiness belongs to biological rhythms. Athletes take a nap to counteract afternoon circadian nadir, in prevision of disturbed sleep. This study examined the effects of brief post-lunch nap on vigilance in young and healthy athletes. The P300 components, physiological and cognitive performances were assessed either after nap or rest, following a night of normal sleep (NSC) or simulated jet lag condition (5-h advance-JLC). P300 wave is the positive deflection at about 300 ms in response to a rare stimulus, representing higher information processing. P300 amplitude reflects the amount of attention allocated whereas P300 latency reflects time spent on stimulus classification. P300 amplitude was significantly increased (Fz:11.14±3.0vs9.05±3.2 µV; p

International audience

The objectives of this study were to assess the relationship between inflammation and obstructive sleep apnea (OSA) and determine whether the lifestyle program’s effects on inflammatory markers are associated with changes in anthropometric parameters, cardiorespiratory fitness, sleep duration, and OSA severity in severely obese adolescents. Participants were aged 14.6 (SD 1.2) yr, with a body mass index (BMI) of 40.2 (SD 6.5) kg/m2. Sleep, anthropometric parameters, glucose metabolism, inflammatory profile, and cardiorespiratory fitness [V̇o2peakrelative to body weight (V̇o2peakBW) and fat-free mass (V̇o2peakFFM)] were assessed at admission and at the end of a 9-mo lifestyle intervention program (LIP). Associations between C-reactive protein (CRP) concentrations and BMI, sex, oxygen desaturation index (ODI), sleep fragmentation, total sleep time (TST), and V̇o2peakwere assessed via ANCOVA. Twenty-three subjects completed the study. OSA subjects ( n = 13) exhibited higher CRP concentrations and a trend for higher BMI than non-OSA subjects ( P = 0.09) at admission. After intervention, OSA was normalized in six subjects, and CRP significantly decreased in the OSA group and in the whole population. In both groups, leptin levels significantly decreased, whereas adiponectin concentrations increased. At admission, BMI adjusted for sex, arousal index, ODI, TST, and V̇o2peakBWwas associated with CRP levels (adjusted r2 = 0.32, P < 0.05). The decrease in CRP concentrations postintervention was associated with enhanced V̇o2peakFFMadjusted for sex, weight loss, and changed sleep parameters (adjusted r2 = 0.75, P < 0.05). Despite higher amounts of CRP in OSA subjects, obesity severity outweighs the proinflammatory effects of OSA, short sleep duration, and low cardiorespiratory fitness. However, enhanced cardiorespiratory fitness is associated with the decrease of inflammation after controlling for the same parameters.

Introduction Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease and is associated with an excess risk of cardiovascular disease. For the general population, the World Health Organization has issued detailed recommendations on the type of physical activity appropriate for decreasing the cardiovascular risk. The objective of this work is to review available data on the effects of physical activity in patients with RA. Results RA is responsible for a marked decrease in physical activity. Physical activity significantly diminishes both the cardiovascular risk and the DAS 28. Vascular benefits from physical activity include improved endothelial function and slowing of the atherosclerotic process. Physical activity also has favorable effects on bone, slowing radiographic disease progression in small joints and increasing bone mineral density at the femoral neck, although these effects are not statistically significant. Finally, engaging in physical activity increases self-esteem, alleviates symptoms of depression, improves sleep quality, and decreases pain perception. Aerobic exercise is the most commonly advocated type of physical activity. Most interventions were of short duration (4 weeks) and involved aerobic activity (running or cycling) for 60 minutes a day 5 days a week. Resistance training has been shown to decrease systemic inflammation and increase muscle strength. The main obstacles to physical activity in patients with RA are related to both the patients, who lack both motivation and knowledge, and the rheumatologists, who also lack knowledge and place insufficient emphasis on promoting physical activity. Conclusion Physical activity provides many benefits in patients with RA and should be widely performed. Promoting physical activity should be among the objectives of therapeutic patient education for RA.

Resume Introduction La polyarthrite rhumatoide (PR) est le rhumatisme inflammatoire le plus frequent caracterise par un sur-risque cardiovasculaire. Dans la population generale, l’OMS propose des recommandations precises sur le type d’activite physique (AP) a realiser dans le cadre de ce risque cardiovasculaire. L’objectif de ce travail est de rapporter les donnees disponibles quant aux effets de l’AP en cas de PR. Resultats La PR est responsable d’une plus importante sedentarite. L’activite physique (AP) diminue le risque cardiovasculaire et le DAS 28 significativement. D’un point de vue vasculaire, elle ameliore la fonction endotheliale et ralentit l’atherosclerose. Concernant le tissu osseux, elle ralentit la progression radiographique des petites articulations et augmente la densite minerale osseuse au col femoral, mais de maniere non significative. Enfin, la pratique d’une AP renforce l’estime de soi, reduit les symptomes depressifs, ameliore la qualite du sommeil et diminue la perception douloureuse. Le type d’AP proposee est majoritairement une activite d’endurance. La majorite des interventions est limitee dans le temps (4 semaines) avec des activites aerobies (course, velo) de 60 minutes 5 jours dans la semaine. Des programmes d’activites en resistance montrent egalement une amelioration du syndrome inflammatoire et de la force musculaire. Le manque de motivation et de savoir des patients ainsi que le manque de promotion et de connaissances des rhumatologues a ce sujet, sont les freins principaux a sa pratique. Conclusion Les effets benefiques de l’AP sur la PR sont multiples et sa pratique devrait etre generalisee et promue dans le cadre de l’ETP.

Objectif Chez l’adolescent obese, le degre de severite a partir duquel les troubles respiratoires du sommeil (TRS) augmentent le risque cardio-metabolique (RCM) est meconnu. Nous avons : –etudie la relation entre RCM et index d’apnees-hypopnees (IAH) afin d’identifier un seuil d’IAH a partir duquel le RCM etait majore ; –compare les caracteristiques cliniques, cardio-metaboliques et du sommeil des adolescents presentant un RCM eleve (RCM + ) et faible (RCM − ). Methodes Quatre-vingt-deux sujets (âge = 15,0 ± 1,7 ans, 49 filles) ont ete inclus. Des polysomnographies, des mesures anthropometriques, des profils glucidique, lipidique et de la pression arterielle (PA) ont ete realisees. Les RCM continus (MetScore) et dichotomique (syndrome metabolique, SM) ont ete determines. Les associations entre MetScore et IAH, ajustes pour le sexe et l’âge, ont ete etudiees par analyse multivariee. Resultats Nous avons determine un seuil d’IAH = 2, a partir duquel une relation significative entre RCM et IAH etait observee (Cohen's d effect size = 0,57 [0,11 ; 1,02] p = 0,02). Les adolescents du groupe RCM+ presentaient une resistance a l’insuline (p Conclusion L’identification d’un seuil d’IAH = 2, correspondant aux alterations cardio-metaboliques, souligne la necessite d’une prise en charge precoce des TRS chez les adolescents obeses, meme consideres comme « mild », afin de prevenir les maladies cardiovasculaires.

Background The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Methods Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean ± SD, age: 10.7 ± 2.7 years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScoreBMI and MetScoreWC). Results Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScoreBMI and MetScoreWC (p Conclusions In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children.

Objectives Evaluation of cardiorespiratory fitness in obese adolescents is necessary to develop personalised retraining programmes. We aimed to measure cardiorespiratory fitness using 3 field tests, and to evaluate their validity and sensitivity compared to values obtained by laboratory tests. Design Longitudinal interventional study in obese adolescents admitted to a rehabilitation centre for a 9-month programme of obesity management. Methods A 12-min walk/run test, an adapted 20 m shuttle walk-run test (starting speed 4 km h −1 , increments of 0.5 km h −1 min −1 ) and a 4-level submaximal cycle ergometer test were performed to estimate respectively distance covered in 12 min, maximum speed and maximal aerobic power. Results Thirty adolescents aged 14.2 ± 1.6 years were included. After 9 months intervention, we observed a significant reduction in body mass index, and an increase in peak V ˙ O 2 and field test results. We observed significant correlations between pre- and post-intervention values of peak V ˙ O 2 and distance covered in 12 min ( r = 0.70 pre; r = 0.82 post), maximum speed ( r = 0.80 pre; r = 0.83 post) and maximal aerobic power ( r = 0.71 pre; r = 0.84 post). Multiple linear regression made it possible to estimate peak V ˙ O 2 based on results from the 3 field tests using prediction equations specific to a population of obese adolescents. Conclusions These field tests, including the adapted 20 m shuttle walk-run test, adequately assess cardiorespiratory fitness in obese adolescents, and are sensitive to changes over time. Predictive equations including BMI are useful in clinical practice to predict peak V ˙ O 2 in these patients.

Introduction Un tiers des cancers du sein surexprime la proteine HER2 [1] . Les traitements radio-chimiotherapique et par trastuzumab s’accompagnent de douleurs, d’une fatigue, d’une diminution de la capacite aerobie alterant la qualite de vie (QdV) [2] , [3] . La pratique d’une activite physique reguliere d’intensite moderee pendant et apres le traitement par radio-chimiotherapie diminue ces effets indesirables. Cependant, c’est la premiere etude qui evalue les effets d’un reentrainement a l’effort aerobie, individualise, intermittent, sur les aptitudes physiologiques a l’exercice et la QdV chez des patientes ayant un cancer du sein HER2+, traitees exclusivement par trastuzumab. Materiel et methodes Quarante patientes (49,3 ± 9,4 ans ; IMC : 26,5 ± 5,9 kg.m−2) ont ete randomisees en 2 groupes (entraine : GE ou controle : GC). Une epreuve d’effort avec determination des seuils ventilatoires (SV1 et SV2) a ete realisee en pre- et post-reentrainement (cycloergometre, 3 fois/semaine, 12 semaines). Avant chaque epreuve, la QdV a ete evaluee par le QLQ-C30. Resultats Apres entrainement, la puissance maximale et le VO2 pic sont augmentes dans le GE (147,5 ± 6,8 W vs 123 ± 6,5 et 27,5 ± 1,4 vs 25,4 ± 1,5 mL.min−1.kg−1). Les SV1 et SV2 sont retardes, temoin d’une amelioration de la capacite aerobie. Les scores des domaines fonctionnels sont ameliores et ceux des symptomes de la douleur et de la fatigue sont diminues. Le VO2 pic est correle positivement au domaine « fonctionnement social » (r = 0,46) et negativement a la douleur (r = −0,45). Conclusion Une amelioration des parametres d’adaptation a l’exercice sous maximal et maximal est associee a une meilleure qualite de vie des patientes. Ces resultats montrent l’interet du reentrainement a l’effort dans les soins de support en cancerologie.

Discipline Clinique. Introduction et but de l’etude Une prise en charge (PEC) associant modification des habitudes alimentaires et reentrainement a l’exercice est efficace pour traiter le syndrome d’apnees obstructives du sommeil (SAOS) du jeune obese, mais ses effets sur l’inflammation ne sont pas totalement elucides. Les objectifs de cette etude ont ete d’evaluer, chez des adolescents obeses severes, la relation entre l’inflammation et le SAOS et de determiner les facteurs expliquant une baisse de l’inflammation a l’issue d’une PEC pluridisciplinaire de 9 mois. Materiel et methodes Les 23 participants (14,6 ± 1,2 ans) presentaient un indice de masse corporelle (IMC) de 40,2 ± 6,5 kg/m2. Le sommeil, les parametres anthropometriques, le profil inflammatoire et l’endurance cardiorespiratoire ont ete mesures en pre et post PEC. La VO2pic a ete rapportee au poids (VO2picPC ; ml/min/kg) et a la masse maigre (VO2picMM ; ml/min/kgMM). Les relations entre concentrations de proteine C-reactive (CRP) et IMC, sexe, index de desaturation en oxygene (IDO), index de μ-eveils, temps de sommeil total (TST) et VO2peak ont ete etudiees par ANCOVA. Le SAOS a ete determine selon un index d’apnees-hypopnees obstructives (IAHO) ≥ 2 pour la constitution de groupes « SAOS » et « Non SAOS ». Resultats et analyse statistique A l’admission, les sujets SAOS (n = 13) presentaient des concentrations de CRP plus elevees que les sujets Non-SAOS. L’IMC, ajuste pour le sexe, l’index de μ-eveils, l’IDO, le TST et la VO2picPC, etait associe aux taux de CRP (r2 ajuste =0,32, p Conclusion Malgre des niveaux superieurs de CRP dans le groupe SAOS compares a ceux du groupe Non-SAOS, l’obesite predomine sur les effets pro-inflammatoires induits par les troubles du sommeil et la faible endurance cardiorespiratoire, a l’admission. Bien que le programme n’ait pas permis de normaliser le SAOS chez tous les sujets, les taux de CRP et des adipokines se sont ameliores, mais restent cependant alarmants. La baisse de l’inflammation systemique est expliquee par l’amelioration de l’endurance cardiorespiratoire independamment du sexe, de la perte de poids et des parametres du sommeil. Nos resultats confirment que le SAOS et l’obesite ont bien un impact sur la sante cardio-metabolique. L’exercice represente une alternative therapeutique majeure capable de reduire l’inflammation systemique deja tres elevee chez des jeunes obeses avec des troubles du sommeil associes.

Objectif Evaluer chez des adolescents obeses la relation entre inflammation et SAOS et de determiner les facteurs expliquant une baisse de l’inflammation a l’issue d’une prise en charge (PEC) pluridisciplinaire de 9 mois. Methodes Vingt-trois sujets (14,6 ± 1,2 ans, IMC = 40,2 ± 6,5 kg/m2) ont participe. Le sommeil par polysomnographie, les parametres anthropometriques, la C-reactive proteine (CRP) et l’endurance cardiorespiratoire ont ete mesures en pre et post PEC. La VO2pic a ete rapportee au poids (VO2picPC ; mL/min/kg) et a la masse maigre (VO2picMM ; mL/min/kgMM). Les relations entre CRP et IMC, sexe, index de desaturation en oxygene (IDO), index de μ-eveils (IE), temps de sommeil total (TST) et VO2peak ont ete etudiees par ANCOVA. Le SAOS a ete determine selon IAHO ≥ 2 pour la constitution de groupes « SAOS » et « Non SAOS ». Resultats A l’admission, les sujets SAOS (n = 13) presentaient des taux de CRP plus eleves que les Non-SAOS. L’IMC, ajuste pour le sexe, l’IE, l’IDO, le TST et la VO2picPC, etait associe aux concentrations de CRP (r2 ajuste =0,32, p Conclusion Le SAOS et l’obesite ont bien un impact sur la sante cardio-metabolique. L’exercice est une alternative therapeutique capable de reduire l’inflammation systemique deja tres elevee chez des jeunes obeses avec des troubles du sommeil associes.

Objective Recent findings indicated silent incipient myocardial dysfunction in juvenile obesity despite normal global cardiac function. The present study investigated whether lifestyle intervention is able to favorably impact these obesity-related myocardial abnormalities and whether improvements are related to changes in insulin resistance and cardiac remodeling. Design and Methods Twenty-eight severe obese adolescents (OB) participated in a 9 month lifestyle intervention program (LIP) based on aerobic exercise and diet. Twenty healthy adolescents (CG) served as controls. Conventional echocardiography and myocardial mechanics were obtained at baseline and follow-up along with insulin resistance. Results Insulin sensitivity improved (P < 0.001) and body weight decreased (P < 0.001) consecutive to LIP. At baseline, OB had depressed longitudinal (L) strain (CG: −18.3 ± 2.6, OB: −14.2 ± 3.6%, P < 0.001) and enhanced twist compared to controls. The LIP in OB restored L strain to normal values (−16.9 ± 3.5%, NS), whereas it did not affect twist mechanics. From stepwise multiple regression analysis, only baseline L strain and changes in BMI Z-score (r2-adjusted = 0.49, P < 0.001) emerged as independent predictors of L strain changes. Conclusions Juvenile obesity is associated with myocardial mechanic abnormalities that can be partly corrected by lifestyle intervention. Restoration of longitudinal myocardial function occurs in the absence of left ventricular remodeling changes and is not associated with insulin resistance improvements.

The development of personalised training programmes is crucial in the management of obesity. We evaluated the ability of 2 heart rate variability analyses to determine ventilatory thresholds (VT) in obese adolescents. 20 adolescents (mean age 14.3±1.6 years and body mass index z-score 4.2±0.1) performed an incremental test to exhaustion before and after a 9-month multidisciplinary management programme. The first (VT1) and second (VT2) ventilatory thresholds were identified by the reference method (gas exchanges). We recorded RR intervals to estimate VT1 and VT2 from heart rate variability using time-domain analysis and time-varying spectral-domain analysis. The coefficient correlations between thresholds were higher with spectral-domain analysis compared to time-domain analysis: Heart rate at VT1: r=0.91 vs. =0.66 and VT2: r=0.91 vs. =0.66; power at VT1: r=0.91 vs. =0.74 and VT2: r=0.93 vs. =0.78; spectral-domain vs. time-domain analysis respectively). No systematic bias in heart rate at VT1 and VT2 with standard deviations

Objectif Evaluer, chez le sportif, les effets d’une sieste subsequente a une nuit de sommeil normal (NSN) ou de decalage horaire simule (DHS), sur les processus cognitifs et les performances psychomotrices. Methodes Seize sportifs jeunes ont realise un repos sans sieste ou une sieste de 20 min, 6 h apres le reveil faisant suite a une NSN et un DHS (avance de 5 h). Immediatement et 3 h apres, les processus cognitifs ont ete evalues par le test des ERPs, la somnolence percue par une EVA et les performances psychomotrices par le TAP M. La temperature (T°) a ete enregistree par Holter en continu. Resultats Le TTS est de 449,60 ± 18,50 min apres NSN et de 365,10 ± 106,30 min apres DHS (p Conclusion Bien que le sommeil ait ete obtenu durant la sieste apres NSH ou DHS, les processus cognitifs et les performances psychomotrices ne sont ameliores qu’apres la NSN. La sieste n’est efficace que si elle a lieu a un moment chronobiologique favorable.

Resume Introduction Evaluer chez six adolescents obeses, les effets d’un reentrainement a l’effort intermittent, individualise de 30 seances, 50 minutes, trois fois par semaine sur les parametres cardiorespiratoires et metaboliques au repos et a l’exercice. Synthese A l’issue du programme, la masse grasse a diminue (10,8 %) alors que l’IMC reste inchange. Le volume de reserve expiratoire s’est ameliore (44,6 %). La puissance maximale aerobie, le pouls d’oxygene, la ventilation maximale ont augmente (12,4 % ; 16,9 % ; 17,2 % respectivement) et les seuils d’adaptation et de desadaptation ventilatoires ont ete repousses (26,1 % et 17,3 %). Conclusion Cet entrainement se revele efficace sur les fonctions cardiorespiratoires de l’adolescent obese.

Introduction L’obesite est associee a une alteration de la quantite et de la qualite du sommeil, en raison notamment d’un syndrome d’apnees obstructives du sommeil (SAOS) tandis que l’exercice physique (EP) ameliore ces parametres. Chez l’adolescent, une relation inverse entre sommeil paradoxal (SP) et exces de poids est aussi rapportee [1] . Les objectifs de cette etude sont de comparer le sommeil de l’adolescent obese (OB, IMC > 30 kg.m−2) a celui de l’adolescent sportif (SPO, EP ≥ 6 h/semaine) par polysomnographie, et d’evaluer l’impact du SAOS sur l’architecture du sommeil de l’OB. Materiel et methodes Trente-deux adolescents (22 OB : 14,9 ans, IMC = 40,2 kg.m−2 ; 12 SP : 15,7 ans, IMC = 19,4 kg.m−2) ont participe a l’etude. Une polysomnographie, avec canaux EEG, EOG, EMG du menton, ECG, oxymetrie de pouls, et parametres respiratoires, a ete realisee en ambulatoire, un jour de semaine, en periode scolaire. Le SAOS a ete diagnostique par l’indice d’apnees-hypopnees obstructives (IAHO) ≥ 2. Resultats Le temps total de sommeil (TTS) est plus court chez les OB compare a celui des SPO (451 min vs 492 min, p Conclusion Bien que le TTS soit reduit et que la prevalence du SAOS soit plus elevee chez les adolescents obeses, l’architecture du sommeil est conservee, sans doute en raison du jeune âge des sujets. Toutefois, le risque cardio-metabolique du SAOS represente, a long terme, un facteur cle a considerer dans la prise en charge pluridisciplinaire du jeune obese dans laquelle l’activite physique adaptee peut jouer un role curatif [2] .

The aim of this study was to validate a measurement scale for perceived exertion, named the Childhood Obesity Perceived Exertion Scale (COPE-10), by evaluating concurrent validity, reliability and sensitivity in obese adolescents.Thirty obese adolescents (BMI 36.2±0.8 kg.m-2), aged 14.2±0.3 years, performed two incremental exercise tests (maximal followed by submaximal) before and after a multidisciplinary obesity management program. To standardize workload, physiological variables [heart rate (HR), ventilation (E) and gas exchange (O2)] and perceived exertion (RPE) were modelized (fHR, fVE, fVO2, fRPE). At a rank of 6 on the COPE-10 Scale (RPE6) and at fixed second ventilatory threshold (VT2), we determined respectively the associated power (WPRPE6, WPVT2) and HR (HRRPE6, HRVT2).During maximal exercise, we observed significant correlations between fRPE and each of fHR (r=0.88 ; r=0.91), fVE (r=0.93 ; r=0.94) and fVO2 (r=0.87 ; r=0.89) before and after management respectively, indicating the concurrent validity of the COPE-10 Scale to estimate exercise intensity in obese adolescents. During submaximal exercise, we observed intraclass correlation coefficients of 0.77 before and 0.86 after management, showing reliability. After management, WPVT2 and WPRPE6 increased significantly (+23W and +21W ; P0.001), and there was a significant correlation between HRVT2 and HRRPE6 (r=0.90), illustrating the scale's sensitivity to change.The COPE-10 Scale is a valid tool to measure perceived exertion in obese adolescents. This inexpensive and non-invasive instrument could be widely used in rehabilitation programs for obese youths.

Soybean proteins, a rich source of isoflavones, taken immediately after an ovariectomy prevent bone loss in rats. Exercise-induced stimuli are essential for bone growth. Few studies exist about the combined effects of swim training and soybean protein supplementation on bone metabolism. So, the purpose of this study was to investigate, in 48 female Sprague-Dawley rats (12 weeks old) the effects of an 8-week swim-training regimen (1 h/day, 5 days/week) and dietary soybean proteins (200 g/kg diet) on bone metabolism. Rats were randomly assigned to four groups: (1) ovariectomized fed with a semisynthetic control diet; (2) ovariectomized fed with a soybean protein-enriched semisynthetic diet; (3) ovariectomized trained to exercise and fed with control diet; (4) ovariectomized trained to exercise and fed with a soybean protein diet. Following the treatment period, body weight gain was identical in the four groups. Soybean protein supplementation increased bone calcium content, and reduced plasma osteocalcin values, without significant modification of calcium balance and net calcium absorption. Swim training enhanced plasma and bone calcium content and calcium balance and net calcium absorption. It did not modify either plasma osteocalcin values or urinary deoxypyridinoline excretion. Both exercise and soybean protein intake increased plasma on bone calcium without modifying net calcium absorption or bone markers. In conclusion, we demonstrated, in ovariectomized rats, that swimming exercise and dietary supplementation with soy proteins do not have synergistic effects on calcium metabolism and bone markers.

International audience; The purpose of this study was to investigate the effects of a 8-week of swim training on total plasma homocysteine and cysteine levels in 16 male Sprague-Dawley rats aged 17 weeks. We also evaluated the activity of hepatic cystathionine beta-synthase (CBS), an enzyme involved in the metabolism of Hcy, the concentration of plasma glutathione, taurine, and a fraction of vitamin B6: the pyridoxal 5-phosphate (PLP). After one week of acclimatization, rats were randomly divided into two groups: 8 non-trained (NTR) and 8 trained rats (TR). Following the training period, body weight gain was lower in TR than in NTR. Plasma homocysteine did not differ among groups while significantly lower plasma cysteine and taurine levels were found in TR (157.83 +/- 8.6 micromol/L; 133.01 +/- 9.32 micromol/L; P < 0.05) compared with data of NTR (176.19 +/- 4.9 micromol/L; 162.57 +/- 8.16 micromol/L; P < 0.05). No significant changes in hepatic CBS activity were observed in TR compared with NTR. Moreover, values for plasma glutathione and PLP concentrations were not affected by training.These results indicate that training reduces plasma cysteine and taurine levels whereas it does not modify other studied parameters. Thus, physical training may regulate cysteine metabolism.

Aims: The aim of this study was to evaluate whether endurance exercise in middle-aged men induces changes in plasma total homocysteine (tHcy) and total cysteine (tCys), and whether these changes depend on the diet especially on vitamin B6, folic acid and vitamin B12 intakes. Methods: Twelve trained subjects (52.33 ± 2.4 years) and twelve untrained subjects (56.23 ± 0.9 years) volunteered for the present study. tHcy and tCys were measured with high-pressure liquid chromatography at rest in both groups and during an incremental exercise performed on a cycle ergometer until exhaustion in the trained subjects. Results: At baseline homocysteinemia and cysteinemia were lower in trained subjects (7.48 ± 0.4 and 183.45 ± 13.6 µmol/l) compared with untrained subjects (9.79 ± 0.4 µmol/l, p < 0.001; 229.01 ±14.7 µmol/l, p < 0.05, respectively). Incremental exercise also induced a decrease in tHcy and tCys concentrations. Moreover, tHcy concentration was negatively related to the folic acid and B12 intakes in untrained (r = –0.589, p < 0.05; r = –0.580, p < 0.05, respectively) as well as in trained groups (r = –0.709, p < 0.01; r = –0.731, p < 0.01, respectively) whereas no correlation between tCys and vitamin in the diet was observed. Conclusion: This study demonstrates that the combined effects of a chronic physical exercise and a high folate and vitamin B12 intake could be responsible for the reduction of plasma tHcy and tCys concentrations that might be a key for the prevention of many diseases.

Objectif Evaluer, chez des adolescents obeses (i) la relation entre troubles respiratoires du sommeil (TRS) et risques cardio-metaboliques (RCM), (ii) les effets d’une prise en charge (PEC) multidisciplinaire (5 h activite physique/semaine et modification des habitudes alimentaires) de 9 mois sur ces parametres. Methodes Vingt-neuf adolescents (14,6 ± 1,3 ans, z -score d’IMC = 4,7 ± 0,9) ont participe a l’etude. En debut et fin de PEC, ont ete realisees : (1) une PSG ambulatoire avec mesure de l’IAH et RDI, (2) une mesure des RCM par le MetScore, determine a partir des z-scores de glycemie, insulinemie, TG, HDL-C a jeun, pression arterielle et tour de taille, (3) une mesure de la CRP, (4) une evaluation de la composition corporelle par bioimpedance, (5) une epreuve d’effort avec determination du VO 2 pic. Resultats Cinq sujets ont ete perdus de vue. Deux groupes ont ete constitues : G1 IAH z -score d’IMC et le % de masse grasse diminuent dans les 2 groupes (G1 : –0,65 et –4,97 %, G2 : –0,79 et –4,95 %). Le MetScore et la CRP sont plus bas et le VO 2 pic augmente (–0,65, –4 mg/L et +5 mL/min/kg respectivement) uniquement pour le G2. Conclusion Cette etude montre que les TRS sont etroitement lies aux RCM chez le jeune obese. La perte de poids observee apres la PEC s’accompagne d’une reduction des RCM et de l’inflammation systemique dans le G2 mais reste insuffisante pour reduire les TRS. Financement Le Don Du Souffle.

Travel across time zones causes jet lag and is accompanied by deleterious effects on sleep and performance in athletes. These poor performances have been evaluated in field studies but not in laboratory conditions. The purpose of this study was to evaluate, in athletes, the impact of 5-h phase advance on the architecture of sleep and physical performances (Wingate test). In a sleep laboratory, 16 male athletes (age: 22.2 ± 1.7 years, height: 178.3 ± 5.6 cm, body mass: 73.6 ± 7.9 kg) spent 1 night in baseline condition and 2 nights, 1 week apart, in phase shift condition recorded by electroencephalography to calculate sleep architecture variables. For these last 2 nights, the clock was advanced by 5 h. Core body temperature rhythm was assessed continuously. The first night with phase advance decreased total sleep time, sleep efficiency, sleep onset latency, stage 2 of nonrapid eye movement (N2), and rapid eye movement (REM) sleep compared with baseline condition, whereas the second night decreased N2 and increased slow-wave sleep and REM, thus improving the quality of sleep. After phase advance, mean power improved, which resulted in higher lactatemia. Acrophase and bathyphase of temperature occurred earlier and amplitude decreased in phase advance but the period was not modified. These results suggest that a simulated phase shift contributed to the changes in sleep architecture, but did not significantly impair physical performances in relation with early phase adjustment of temperature to the new local time.

The aim of this study was to examine, in trained young cyclists, whether psychomotor performances were dependent on time of day and fluctuated similarly to changes in athletic performance. 14 highly trained male cyclists ( M age = 17.3 yr., SD = 1.6; M height = 179.0 cm, SD = 0.1; M body weight = 67.4 kg, SD = 4.5) voluntarily took part in 6 test sessions, at 08:30, 10:30, 12:30, 14:30, 16:30 and 18:30. Each test session comprised a maximal-intensity exercise consisting of 2 × 10-sec. sprints (all-out exercise) preceded by an attentional performance test including 4 fields of attention performed in a randomized order at different times throughout the same day, every 2 hr. between 08:30 and 18:30. The main results indicated that attentional and physical performances depended on the time of day, with an improvement in reaction times in phasic alertness, visual scanning, flexibility, Go/No-go, and an increase in maximum power throughout the day. This study shows the daily variations in physical performances and that fluctuations are reflected in psychomotor performances. These findings suggest that cyclists' training sessions cannot be programmed throughout the day without taking into consideration the effects of the time of day, with several practical applications for coaches and athletes.

Resume Objectifs.- etudier les effets d'un programme d'entrainement en endurance chez de jeunes asthmatiques legers (une crise ou moins par semaine). Methodes.- Six jeunes (trois garcons et trois filles, 14 ± 2 ans, 49 ± 12 kg, 157 ± 6 cm) ont suivi ce programme, qui consistait en la repetition trois fois par semaine d'un exercice en creneaux de 45 minutes comportant la succession de neuf creneaux de cinq minutes. Chaque creneau est constitue par une base de 4 minutes et un pic d'une minute. Les intensites sont respectivement celle du seuil d'adaptation, puis de desadaptation ventilatoire, identifies lors d'un test triangulaire prealable. Lintensite des bases et des pics etait reajustee de 10 W chaque fois que la frequence cardiaque mesuree aux 44e et 45e minutes avait baisse de huit a dix battements par minute par rapport a l'epreuve initiale. A l'issue d'un programme total de 20 seances, les effets de l'entrainement furent juges a l'aide d'un second test triangulaire compare au test initial. Resultats.- La puissance maximale supportee (195 contre 152 W, p Conclusion.- L'exercice en creneaux individualise est bien supporte cliniquement. Le rapport bien ajuste de phases de travail intense (pics) et de phases de recuperation active (bases) semble particulerement efficace, en developpant le potentiel aerobie et en augmentant la tolerance de ces jeunes asthmatique a l'hyperventilation d'exercice.

Objectif L’objectif de cette etude a ete de determiner l’impact de la severite du syndrome d’apnee obstructive du sommeil (SAOS) et du niveau d’endurance cardiovasculaire sur les parametres anthropometriques et metaboliques de jeunes obeses. Methodes Soixante-seize enfants obeses (10,84 ± 2,65 ans) ont participe a cette etude. Les mesures du poids, de la taille (T), du tour de taille (TT), le calcul de l’indice de masse corporelle (IMC), du z-score d’IMC et du rapport TT/T ont ete realises. Des prelevements sanguins a jeun ont permis de determiner les concentrations plasmatiques de glucose, d’insuline, de triglycerides, de HDL-C et de LDL-C. L’HOMA-IR a ete calcule. L’index d’apnees et hypopnees (IAH) a ete calcule lors d’un examen de polygraphie ventilatoire nocturne. Le SAOS a ete qualifie de leger si 2 ≥ IAH Resultats Seize pour cent des sujets ont un SAOS severe (n = 12), 26 % un SAOS modere (n = 20) et 36 % un SAOS leger (n = 27). Cinquante-quatre pour cent des sujets ont ete identifies comme actifs (n = 38). Quel que soit le degre de severite du SAOS, le z-score d’IMC et le TT/T sont similaires. L’insulinemie (p Conclusion L’obesite est un facteur important du developpement du SAOS sans que sa severite ne soit associee a une exageration de ce syndrome. Un SAOS et un faible niveau d’endurance cardiovasculaire augmentent le risque d’apparition de troubles metaboliques. Un depistage et une prise en charge precoces du SAOS chez le jeune obese, de surcroit deconditionne, sont importants pour prevenir l’apparition de comorbidites cardiovasculaires a l’âge adulte.

Resume Introduction Le but de ce travail a ete d'evaluer, in vivo, les effets d'un entrainement isometrique sur la fonction endotheliale de rates Sprague–Dawley ovariectomisees. Synthese Les animaux ont ete randomises en quatre groupes : 1) temoin ; 2) ovariectomise sedentaire ; 3) ovariectomise sedentaire recevant une injection quotidienne de 17β-estradiol ; 4) ovariectomise entraine. La reactivite vasculaire a ete mesuree, sur des anneaux aortiques precontractes a la noradrenaline, par des doses croissantes d'acetylcholine. La relaxation induite par l'acetylcholine est significativement augmentee dans le groupe de rates entrainees. Conclusions Ces resultats indiquent que l'entrainement isometrique ameliore la fonction endotheliale de la rate ovariectomisee.

The aim of the study was to examine the effects of a post-prandial 20 min nap on a short-term physical exercise and subsequent sleep in athletes keeping their usual sleep schedules and in 5-h phase-advance condition. Sixteen healthy young male athletes (age 22.2 ± 1.7 years, non-habitual nappers) participated in the study. After a baseline 8-h time in bed in normal and 5-h advanced sleep schedules, a standardized morning and lunch in a laboratory environment, subjects underwent either a nap (20 min of sleep elapsed from 3 epochs of stage 1 or 1 epoch of stage 2), or a rest without sleep by lying in a bed, between 13:00 and 14:00 hours in non-shifted condition or 08:00 and 09:00 hours in shifted condition, after which anaerobic exercises were performed twice 2 h apart. Core body temperature was recorded throughout the study period. The nap extended sleep onset latency from 6.72 ± 3.83 to 11.84 ± 13.44 min, after shifted condition but did not modify sleep architecture of the post-trial night among athletes, whether shifted or not. Moreover, napping did not improve physical performance but it delayed acrophase and batyphase of core body temperature rhythm parameters. Napping showed no reliable benefit on short-term performances of athletes exercising at local time or after a simulated jet lag.

Recent findings indicated silent incipient myocardial dysfunction in juvenile obesity despite normal global cardiac function. The present study investigated whether lifestyle intervention is able to favorably impact these obesity-related myocardial abnormalities and whether improvements are related to changes in insulin resistance and cardiac remodeling.Twenty-eight severe obese adolescents (OB) participated in a 9 month lifestyle intervention program (LIP) based on aerobic exercise and diet. Twenty healthy adolescents (CG) served as controls. Conventional echocardiography and myocardial mechanics were obtained at baseline and follow-up along with insulin resistance.Insulin sensitivity improved (P0.001) and body weight decreased (P0.001) consecutive to LIP. At baseline, OB had depressed longitudinal (L) strain (CG: -18.3 ± 2.6, OB: -14.2 ± 3.6%, P0.001) and enhanced twist compared to controls. The LIP in OB restored L strain to normal values (-16.9 ± 3.5%, NS), whereas it did not affect twist mechanics. From stepwise multiple regression analysis, only baseline L strain and changes in BMI Z-score (r(2) -adjusted = 0.49, P0.001) emerged as independent predictors of L strain changes.Juvenile obesity is associated with myocardial mechanic abnormalities that can be partly corrected by lifestyle intervention. Restoration of longitudinal myocardial function occurs in the absence of left ventricular remodeling changes and is not associated with insulin resistance improvements.

International audience; The prevalence of severe obesity is increasing worldwide in adolescents. Whether it is associated with functional myocardial abnormalities remains largely unknown, potentially because of its frequent association with other cardiovascular risk factors and also use of insensitive techniques to detect subclinical changes in myocardial function. We used 2D vector velocity imaging (VVI) to investigate early changes in left ventricular (LV) myocardial function in youths with isolated severe obesity. Thirty-seven asymptomatic severely obese adolescents free of diabetes and hypertension, and 24 lean controls were enrolled. LV longitudinal, basal, and apical circumferential strain, strain rate (SR), rotations, and LV twist were measured. Obese adolescents had greater LV mass and reduced systolic and early diastolic tissue Doppler imaging (TDI) velocities than lean counterparts. L strain (−24%) and systolic and early diastolic SR were also diminished in the obese, whereas no intergroup differences existed for the circumferential deformation indexes. LV twist was more pronounced in the obese (+1.7°, P < 0.01) on account of greater apical rotation only (4.1 ± 0.9 vs. 5.2 ± 1.2°, P < 0.01), potentially compensating for the loss in longitudinal function. Systolic–diastolic coupling, an important component of early filling and diastolic function, was maintained with severe obesity. No intergroup differences were reported regarding time to peak values for all VVI indexes highlighting that dynamics of strain and twist/untwist along the cardiac cycle was preserved with severe obesity. Isolated severe obesity in adolescents, at a preclinical stage, is associated with changes in myocardial deformation and torsional mechanics that could be in part related to alterations in relaxation and contractility properties of subendocardial fibers.

Evaluation of cardiorespiratory fitness in obese adolescents is necessary to develop personalised retraining programmes. We aimed to measure cardiorespiratory fitness using 3 field tests, and to evaluate their validity and sensitivity compared to values obtained by laboratory tests.Longitudinal interventional study in obese adolescents admitted to a rehabilitation centre for a 9-month programme of obesity management.A 12-min walk/run test, an adapted 20 m shuttle walk-run test (starting speed 4 km h(-1), increments of 0.5 km h(-1)min(-1)) and a 4-level submaximal cycle ergometer test were performed to estimate respectively distance covered in 12 min, maximum speed and maximal aerobic power.Thirty adolescents aged 14.2 ± 1.6 years were included. After 9 months intervention, we observed a significant reduction in body mass index, and an increase in peak VO2 and field test results. We observed significant correlations between pre- and post-intervention values of peak VO2 and distance covered in 12 min (r=0.70 pre; r=0.82 post), maximum speed (r=0.80 pre; r=0.83 post) and maximal aerobic power (r=0.71 pre; r=0.84 post). Multiple linear regression made it possible to estimate peak VO2 based on results from the 3 field tests using prediction equations specific to a population of obese adolescents.These field tests, including the adapted 20 m shuttle walk-run test, adequately assess cardiorespiratory fitness in obese adolescents, and are sensitive to changes over time. Predictive equations including BMI are useful in clinical practice to predict peak VO2 in these patients.

Adiponectin, the most abundant hormone produced by adipose tissue, circulates in 3 isoforms, including high molecular weight (HMW) adiponectin. The latter has been suggested to be a better predictor of metabolic disturbances and insulin resistance associated with obesity. This study investigated changes in total and HMW adiponectin, resistin, and homeostasis model assessment (HOMA) during a 9-month in-patient treatment program based on physical exercise and a balanced diet in 32 severely obese adolescents. Total and HMW adiponectin, resistin, and HOMA were measured at baseline (month 0) and during the program (months 3, 6, 9). In addition, a control group of 15 teenagers served as a reference for the baseline assessments. At baseline, HMW adiponectin was more markedly decreased in obese adolescents than total adiponectin, and both were lower than in controls. Conversely, resistin and HOMA were higher in obese adolescents. During the program, there was a significant change in body composition and improved insulin sensitivity among obese teenagers. In addition, HMW adiponectin and the ratio of HMW-to-total adiponectin increased throughout the study, whereas total adiponectin only increased up until the sixth month. On the contrary, resistin did not show any significant change. In obese adolescents, a long-term combination of aerobic exercise and a balanced diet, inducing change in body composition and improved insulin sensitivity, markedly increased HMW adiponectin compared with total adiponectin, without any change in resistin concentrations. Our results thus suggest that the determination of HMW adiponectin could be more useful than measurement of total adiponectin in clinical settings.