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Wrist-ankle acupuncture (WAA) is considered a useful technique in the treatment of several painful conditions, but its real effectiveness has rarely been quantified. In order to evaluate the effects of WAA on localised pain, 25 consecutive patients (17 male, 8 female; 61.8 yr. +/- 1.5 SE) with chronic shoulder pain were treated with needle insertion in acupoints Upper Four, Five and Six (retained for 24 hours) for six sessions over four weeks. Pain intensity (PI) and quality (PQ) and active shoulder motility (ASM) were evaluated during the intervention and after a three-week follow up (FU). During the course of treatment, PI decreased and ASM increased significantly (p<0.001), while PQ remained substantially unchanged, although quantitatively reduced. A significant negative correlation was found between ASM and PI in the different phases of treatment (p<0.001), indicating a substantial influence of subjective pain on functional motor limitation. At FU, a further significant increase in ASM value (p<0.001) and a decrease (not statistically significant) in PI were observed. Overall, three patients (13.6%) attained complete pain resolution, and in six (30%) a full functional recovery was achieved. All observed changes were independent of gender, age, pain localisation, clinical history and acupuncturist performing the treatment. In conclusion, WAA appears an effective treatment of chronic shoulder pain, achieving significant pain and motor impairment reduction. [ABSTRACT FROM AUTHOR]

Background: Glycogen in skeletal muscle is a major source of energy during exercise and an important determinant of endurance capacity, so that its measurement may provide a meaningful marker of athletes' preparation and a possible predictor of performance, both in humans and in equines. Gold standard of glycogen concentration measurement is the histochemical and biochemical analysis of biopsy-derived muscle tissue, an invasive and potentially injuring procedure. Recently, high-frequency ultrasound (US) technology is being exploited in human sports medicine to estimate muscle glycogen content. Therefore, aim of the present study is to evaluate the feasibility of US assessment of muscle glycogen in equines., Results: US images of gluteus medius (GL) and semitendinosus (ST) muscles were obtained on eight healthy horses (3-10 years) before and after a steady-state exercise on treadmill (velocity: 4.0-12.5 m/s; duration: 2-20 min; heart rate: 137-218 b/min). Average image greyscale intensity was significantly different between GL and ST, both before and after exercise (p < 0.001). Comparing baseline and post-exercise US images, significant increase in greyscale intensity has been observed in ST (p < 0.001), but not in GL (p = 0.129). The volume of the exercise was significantly correlated with exercise-dependent change in image intensity (R 2  = 0.891), consistent with a reduction of glycogen muscle stores resulting from aerobic activity., Conclusions: US technique evidences also in horses muscle changes possibly associated to glycogen utilisation during exercise. Present results on a small sample need to be further confirmed and provide preliminary data warranting future validation by direct glycogen measurement through biopsy technique.

Purpose: Sedentary behaviors and muscle inactivity are being growingly recognized as important risk factors for health, adjunctively and independently from a scarce physical activity (PA), although the metabolic mechanism underneath is barely clear. To explore the relation between sedentary behaviors (SBs) and metabolism, we measured the metabolic profile in fasting condition and after oral glucose overload in a group of women, along with objective monitoring of their PA/sedentary lifestyle habits., Subjects and Methods: Thirteen women (age: 32.5 ± 16.1 years; BMI: 24.0 ± 3.3 kg/m 2 ), recruited among university students and research staff, underwent indirect calorimetry to assess fat and carbohydrate contribution to energy metabolism, in fasting conditions and after a glucose-rich standard meal (about 45 g of glucose). Glucose concentration in capillary blood was determined in fasting state and 15 and 30 min after meal. Habitual PA and SBs in the previous week were continuously monitored with Actigraph accelerometers., Results: After adjustment for age, the contribution of fat oxidation to metabolic energy sources, normalized for fat-free mass, in fasting conditions was significantly correlated with time spent in sitting/lying position during wake hours ( p < 0.001), independent from PA habits, whereas capillary blood peak and change of glucose concentration after the meal were significantly and inversely correlated with average daily moderate to vigorous PA ( p = 0.025 and p = 0.019, respectively), independent from average daily sitting/lying time., Conclusions: Here, we report for the first time a direct effect of muscle inactivity on increased fat oxidation in fasting conditions, which can be hypothesized as a preliminary condition for the development of insulin resistance. We also report the direct independent effect of PA on the capacity to respond to a glycemic load, so that SBs and reduced PA appear to concur, although independently, to the increased health risk, as elsewhere observed on an epidemiological ground., (Copyright © 2020 Tabozzi, Di Santo, Franchini, Ratto, Luchi, Filiputti, Ardigò and Lafortuna.)

Background: Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of noncommunicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mobile health (mHealth) technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology., Objective: This study aimed to describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future (F4F) mHealth intervention for adolescents from different cultural backgrounds., Methods: A total of 74 adolescents aged 13 to 16 years from Spain, Italy, and the United Kingdom participated in the co-design of the PEGASO F4F technology. In 3 iterative cycles over 12 months, participants were involved in the co-design, refinement, and feasibility testing of a system consisting of diverse mobile apps with a variety of functions and facilities to encourage healthy weight-promoting behaviors. In the first iteration, participants attended a single workshop session and were presented with mock-ups or early-version prototypes of different apps for user requirements assessment and review. During the second iteration, prototypes of all apps were tested by participants for 1 week at home or school. In the third iteration, further developed prototypes were tested for 2 weeks. Participants' user experience feedback and development ideas were collected through focus groups and completion of questionnaires., Results: For the PEGASO F4F technology to be motivating and engaging, participants suggested that it should (1) allow personalization of the interface, (2) have age-appropriate and easy-to-understand language (of icons, labels, instructions, and notifications), (3) provide easily accessible tutorials on how to use the app or navigate through a game, (4) present a clear purpose and end goal, (5) have an appealing and self-explanatory reward system, (6) offer variation in gamified activities within apps and the serious game, and (7) allow to seek peer support and connect with peers for competitive activities within the technology., Conclusions: Incorporating adolescents' preferences, the PEGASO F4F technology combines the functions of a self-monitoring, entertainment, advisory, and social support tool. This was the first study demonstrating that it is possible to develop a complex mobile phone-based technological system applying the principles of co-design to mHealth technology with adolescents across 3 countries. The findings from this study informed the development of an mHealth system for healthy weight promotion to be tested in a controlled multinational pilot trial., (©Anne Martin, Maurizio Caon, Fulvio Adorni, Giuseppe Andreoni, Antonio Ascolese, Sarah Atkinson, Kim Bul, Carme Carrion, Conxa Castell, Valentina Ciociola, Laura Condon, Mireia Espallargues, Janet Hanley, Nithiya Jesuthasan, Claudio L Lafortuna, Alexandra Lang, Federica Prinelli, Elisa Puidomenech Puig, Sarah A Tabozzi, Brian McKinstry. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 02.03.2020.)

Background: Behaviour change interventions targeting physical activity, diet, sleep and sedentary behaviour of teenagers show promise when delivered through smartphones. However, to date there is no evidence of effectiveness of multicomponent smartphone-based interventions. Utilising a user-centred design approach, we developed a theory-based, multi-dimensional system, PEGASO Fit For Future (PEGASO F4F), which exploits sophisticated game mechanics involving smartphone applications, a smartphone game and activity sensors to motivate teenagers to take an active role in adopting and maintaining a healthy lifestyle. This paper describes the study protocol to assess the feasibility, usability and effectiveness (knowledge/awareness and behavioural change in lifestyle) of the PEGASO system., Methods: We are conducting a quasi-experimental controlled cluster trial in 4 sites in Spain, Italy, and UK (England, Scotland) over 6 months. We plan to recruit 525, in a 2:1 basis, teenagers aged 13-16 years from secondary schools. The intervention group is provided with the PEGASO system whereas the comparison group continues their usual educational routine. Outcomes include feasibility, acceptance, and usability of the PEGASO system as well as between and within group changes in motivation, self-reported diet, physical activity, sedentary and sleeping behaviour, anthropometric measures and knowledge about a healthy lifestyle., Discussion: PEGASO F4F will provide evidence into the cross-cultural similarities and differences in the feasibility, acceptability and usability of a multi-dimensional smartphone based behaviour change intervention for teenagers. The study will explore facilitating factors, challenges and barriers of engaging teenagers to adapt and maintain a healthy lifestyle when using smartphone technology. Positive results from this ICT based multi component intervention may have significant implications both at clinical level, improving teenagers health and at public health level since it can present an influential tool against the development of chronic disease during adulthood., Trial Registration: https://clinicaltrials.gov Registration number: NCT02930148, registered 4 October 2016.

We investigated how the size of the horizontal field of view (FoV) affects visual speed perception with individuals running on a treadmill. Twelve moderately trained to trained participants ran on a treadmill at two different speeds (8 and 12 km/h) in front of a moving virtual scene. Different masks were used to manipulate the visible visual field, masking either the central or the peripheral area of the virtual scene or showing the full visual field. We asked participants to match the visual speed of the scene to their actual running speed. For each trial, participants indicated whether the scene was moving faster or slower than they were running. Visual speed was adjusted according to the responses using a staircase method until the Point of Subjective Equality was reached, that is until visual and running speed were perceived as matching. For both speeds and all FoV conditions, participants underestimated visual speed relative to the actual running speed. However, this underestimation was significant only when the peripheral FoV was masked. These results confirm that the size of the FoV should absolutely be taken into account for the design of treadmill-mediated virtual environments (VEs)., (Copyright © 2019 Caramenti, Pretto, Lafortuna, Bresciani and Dubois.)

In virtual reality, visual speed is usually underestimated relative to locomotor speed. Here we investigated how physical activity and fitness affect perceived visual speed when running in a treadmill-mediated virtual environment. Thirty healthy participants (ten sedentary individuals, ten team sport players and ten expert runners) ran on a treadmill at two different speeds (8, 12km/h) in front of a moving virtual scene. Participants were asked to match the speed of the visual scene to their running speed (i.e. treadmill speed), indicating for each trial whether the scene was moving slower or faster than the treadmill. The speed of the visual scene was adjusted according to the participant's response using a staircase until visual and running speeds were perceived as equivalent. More sedentary participants underestimated visual speed relative to their actual running speed. Specifically, visual speed had to exceed running speed to be perceived as equivalent. The underestimation of visual speed was speed-dependent, and it was significantly larger for sedentary participants than for team sports players and expert runners. The volume of physical activity per week was found to be the best predictor of visual speed perception for both running speeds, while the perceived effort constituted a good predictor only at 8km/h. Physical fitness, on the other hand turned out to be a poor predictor of visual speed perception. Therefore, in order to enhance users' engagement and their adherence to physical activity programs, the development of "personalized" treadmill-mediated virtual environments should take into account users' personal characteristics to provide the most natural and engaging feedback possible., Competing Interests: The authors have declared that no competing interests exist.

Gait and balance disorders are among the main predisposing factors of falls in elderly. Clinical scales are widely employed to assess the risk of falling, but they require trained personnel. We investigate the use of objective measures obtained from a wearable accelerometer to evaluate the fall risk, determined by the Tinetti clinical scale. Seventy-nine patients and eleven volunteers were enrolled in two rehabilitation centers and underwent a full Tinetti test, while wearing a triaxial accelerometer at the chest. Tinetti scores were assessed by expert physicians and those subjects with a score ≤18 were considered at high risk. First, we analyzed 21 accelerometer features by means of statistical tests and correlation analysis. Second, one regression and one classification problem were designed and solved using a linear model (LM) and an artificial neural network (ANN) to predict the Tinetti outcome. Pearson's correlation between the Tinetti score and a subset of 9 features (mainly related with standing and walking) was 0.71. The misclassification error of high risk patient was 0.21 and 0.11, for LM and ANN, respectively. The work might foster the development of a new generation of applications meant to monitor the time evolution of the fall risk using low cost devices at home., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background & Aims: Accurate predictive equations of resting energy expenditure (REE) are crucial in devising nutritional strategies to manage overweight/obesity, especially in countries where these are highly prevalent. REE is the most common measurement used to estimate energy requirements in the nutritional context; the most accurate method of measuring REE is indirect calorimetry (IC). However, this method is costly and often rarely feasible in many clinical settings. The objective of the present study was to develop and validate a new equation for predicting REE in adults with overweight and obesity., Methods: This was a cross-sectional study including 410 men and women with overweight and obesity (20-60 y). Participants were randomly assigned; the development group included 200 subjects and the validation group 210 subjects. The new predictive equation was derived using stepwise multiple linear regression analysis. The accuracy of the new equation was compared to several existing predictive equations (PEs). The accuracy rate was calculated as the percentage of subjects whose REE-PE was within ±10% of the REE-IC. REE was measured by IC and anthropometric measurements., Results: One predictive equation was developed (NEQ) in which weight was the strongest predictor of REE. Compared with others predicted equations already using, the new designed equation showed the less mean bias (Kj/day): NEQ: 25.7, Valencia:129, WHO/FAO/United Nations University: 270, Mifflin-St Jeor: 308, Owen: -808, Carrasco: -1097, Korth: -36.4, Johnstone: -375, Livingstone: -315, De Lorenzo: -28.3, Lazzer: -123, Muller: -145, Huang: -399 and Bernstein: -1335., Conclusions: The present equation had the highest predictive accuracy in subjects with overweight or obesity compared with the previous equations derived from different populations. Thus, these new equation can be used to assist the nutritional management of these subjects., (Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

We investigated how visual and kinaesthetic/efferent information is integrated for speed perception in running. Twelve moderately trained to trained subjects ran on a treadmill at three different speeds (8, 10, 12 km/h) in front of a moving virtual scene. They were asked to match the visual speed of the scene to their running speed-i.e., treadmill's speed. For each trial, participants indicated whether the scene was moving slower or faster than they were running. Visual speed was adjusted according to their response using a staircase until the Point of Subjective Equality (PSE) was reached, i.e., until visual and running speed were perceived as equivalent. For all three running speeds, participants systematically underestimated the visual speed relative to their actual running speed. Indeed, the speed of the visual scene had to exceed the actual running speed in order to be perceived as equivalent to the treadmill speed. The underestimation of visual speed was speed-dependent, and percentage of underestimation relative to running speed ranged from 15% at 8km/h to 31% at 12km/h. We suggest that this fact should be taken into consideration to improve the design of attractive treadmill-mediated virtual environments enhancing engagement into physical activity for healthier lifestyles and disease prevention and care.

Overweight and obesity are highly prevalent conditions worldwide, linked to an increased risk for death, disability and disease due to metabolic and biochemical abnormalities affecting the biological human system throughout different domains. Biomarkers, defined as indicators of biological processes in health and disease, relevant for body mass excess management have been identified according to different criteria, including anthropometric and molecular indexes, as well as physiological and behavioural aspects. Analysing these different biomarkers, we identified their potential role in diagnosis, prognosis and treatment. Epigenetic biomarkers, cellular mediators of inflammation and factors related to microbiota-host interactions may be considered to have a theranostic value. Though, the molecular processes responsible for the biological phenomenology detected by the other analysed markers, is not clear yet. Nevertheless, these biomarkers possess valuable diagnostic and prognostic power. A new frontier for theranostic biomarkers can be foreseen in the exploitation of parameters defining behaviours and lifestyles linked to the risk of obesity, capable to describe the effects of interventions for obesity prevention and treatment which include also behaviour change strategies.

Falling in elderly is a worldwide major problem because it can lead to severe injuries, and even sudden death. Fall risk prediction would provide rapid intervention, as well as reducing the over burden of healthcare systems. Such prediction is currently performed by means of clinical scales. Among them, the Tinetti Scale is one of the better established and mostly used in clinical practice. In this work, we proposed an automatic method to assess the Tinetti scores using a wearable accelerometer. The balance and gait characteristics of 13 elderly subjects have been scored by an expert clinician while performing 8 different motor tasks according to the Tinetti Scale protocol. Two statistical analysis were selected. First, a linear regression study was performed between the Tinetti scores and 8 features (one feature for each task). Second, the generalization quality of the regression model was assessed using a Leave-One SubjectOut approach. The multiple linear regression provided a high correlation between the Tinetti scores and the features proposed (adj. R(2) = 0.948; p = 0.003). Moreover, six of the eight features added statistically significantly to the prediction of the scores (p <; 0.05). When testing the generalization capability of the model, a moderate linear correlation was obtained (R(2) = 0.67; p <; 0.05). The results suggested that the automatic method might be a promising tool to assess the falling risk of older individuals.

Context: In adults with Prader-Willi syndrome (PWS), abnormal body composition with decreased lean body mass and skeletal muscle (SM) volume has been related to altered GH secretion and may possibly contribute to greatly reduced motor capacity., Objective: The scope of the study was to test the hypothesis that GH treatment has favorable effects on SM characteristics and motor performance in adults with PWS., Design, Setting, and Participants: Fifteen obese PWS subjects (nine males and six females; age range, 19-35 y; body mass index, 37.7-59.9 kg/m(2)) were investigated before and after 12 (GH12) and 24 (GH24) months of GH treatment., Main Outcome Measures: SM cross-sectional area and SM attenuation were determined with computed tomography at the lumbar and midthigh levels. Maximal isometric handgrip strength and isokinetic knee extension peak torque were measured. Motor performance was evaluated with different indoor walking tests, whereas exercise endurance was assessed with a treadmill incremental test to exhaustion., Results: A condition of severe GH deficiency was found in six patients (40%). GH treatment significantly increased lean body mass (GH12, P < .05; GH24, P < .05), reduced percentage of body fat (GH12, P < .05; GH24, P < .05), and augmented SM cross-sectional area and SM attenuation of both lumbar (GH12, P < .01; GH24, P < .001) and thigh muscles (GH24, P < .05). Handgrip strength increased by 7% at GH12 (P < .05) and by 13% at GH24 (P < .001). Peak torque of knee extension extrapolated at zero angular velocity was significantly higher at GH24 (P < .01), and exercise endurance rose by 13% (P < .05) and 17% (P < .05) before exhaustion at GH12 and GH24, respectively, whereas no change was detected with walking tests. No significant difference in the response to GH treatment was detected between patients with and without GH deficiency., Conclusion: Long-term GH treatment in adult PWS patients improves body composition and muscle size and quality and increases muscle strength and exercise tolerance independently from the GH secretory status.

The structure of skeletal muscle (SM) can be characterized by quantitative (size) and qualitative (composition) attributes, which are disparately reported to be influenced by body adiposity. This study tests the hypothesis that body adiposity exerts a systematic influence on these muscle characteristics and evaluates the possible functional implications for movements. Lower limb SM volume (VSM) and attenuation (ATTSM), an inverse measure of lipid infiltration in muscle, were determined with computed tomography in 21 men (BMI = 21-36 kg m(-2) ; age = 31-71 years.) and 18 women (BMI = 19-35 kg m(-2) ; age = 32-76 years.). After adjusting for age, a multivariate regression analysis revealed that body adiposity positively correlated (P<0·05-0·001) with absolute VSM and cross-sectional area (CSA) in both genders, while VSM per unit body mass (VSM/BM) decreased with adiposity (P<0·001) in women and was constant in men. ATTSM was higher in men (P<0·05) and decreased (P<0·05) with adiposity in both genders. The product of ATTSM by average muscle CSA (predictor of maximal strength) and by VSM/BM (predictor of maximal dynamic performance) was lower in women (P<0·001) and was reduced by age in both genders (P<0·05-0·01), while obesity had a negative effect (P<0·001) only on the predictor of performance. In conclusion, body adiposity significantly increases SM size and reduces ATTSM. Structural indicators accounting for both quantitative and qualitative characteristics of SM may be useful predictors of the effects of obesity on motor function at different ages. With rising body adiposity and advancing age, women appear mostly affected by the decline of SM features relevant for motor performance., (© 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

Background: Mechanical overload and poor quality of contractile elements related to metabolic abnormalities concur to motor disability of obesity. The independent contribution of these factors to motor dysfunction in obese individuals is scarcely defined., Aim: Aim of the study is to test the hypothesis that metabolic factors may independently affect motor function in obesity., Methods: Leg maximum power output per unit body mass (W Mb), per unit fat-free mas (W FFM) and fatigue in daily functioning were assessed in 635 obese [body mass index (BMI)≥ 35 kg/m(2)] individuals (286 men, 349 women) aged 19-78 yr. The independent effects of age, BMI, insulin resistance and the five components of the metabolic syndrome on W Mb, W FFM and fatigue were evaluated by multivariate analysis., Results: A multiple regression analysis revealed that in both genders W Mb (denoting the individual's performance capability during anaerobic tasks) was independently reduced by age (p<0.001), BMI (p<0.05-0.001) and abnormalities of glucose metabolism (p<0.06-0.01), while W FFM (representing the muscle intrinsic anaerobic capability) was affected only by age (p<0.001) and glucose metabolism impairment (p<0.06-0.01). In both genders fatigue was increased by age (p<0.001) and BMI (p<0.05-0.01), but augmented by low levels of HDL-cholesterol in men only (p<0.05)., Conclusions: Besides depending on mechanical overload and age, low muscle power output in obese individuals was independently associated also with metabolic abnormalities related to impaired glucose homeostasis. Fatigue and performance, although similarly influenced by age and body mass excess, are affected by different metabolic factors.

Objective: Assessment of the prevalence of the metabolic syndrome (MetS) and its components in Italian obese individuals., Methods: Cross-sectional estimate of MetS prevalence using the IDF definition in 635 obese (BMI ≥ 35 kg/m(2)) individuals (286 men, 349 women) aged 19-78 years hospitalised for mass excess treatment., Results: MetS prevalence was significantly (p < 0.001) higher in males (75.9%) than in females (61.9%), due to the increased prevalence of 4/5 involved abnormalities. A multivariate binary logistic regression analysis disclosed a contributory independent effect of ageing (p < 0.01-0.001), but not of BMI, whereas large waist circumference (p < 0.01) and high waist-to-hip ratio (p < 0.01) contributed to MetS prevalence only in women. Affected individuals were significantly older (males p = 0.022; females p < 0.001), affected men being younger than affected women (p < 0.01). The prevailing clinical picture included all abnormalities (21.2% in men, 22.2% in women); in minimal trait MetS (3/5 abnormalities), the prevailing combination was, beside central obesity, hypertension-hyperglycaemia in men (12.4%), and hypertension-dyslipidemia in women (19.4%)., Conclusions: MetS is a highly prevalent condition among Italian obese individuals. Prevalence and combinations of involved abnormalities differ considerably between genders and suggest a different pathophysiology of the MetS in men and women, with possible relevance for prevention and treatment of the condition., (Copyright © 2012 S. Karger AG, Basel.)

An ontology-supported e-knowledge base aimed to the evaluation of obesity and related co-morbidities is presented. The main goal of such a clinical profiling tool is to help determine the health status of a subject, supporting the knowledge transfer between medical researchers and general practitioners.

Background: In contrast with maximal voluntary resistance exercise, which is allegedly considered a potent GH stimulus in young subjects, evaluation of GH response to whole-body vibrations (WBV) has yielded conflicting results., Methods: The acute effects of WBV alone (test A), maximal voluntary isometric contractions (MVC) (test B), and combination of WBV and MVC (test C) on serum GH and blood lactate (LA) levels were studied in 9 healthy adult males. Muscle soreness was assessed 24 and 48 h after exercise by a visual analogue scale., Results: GH responses were significantly higher after tests B and C than after test A (GH peaks: 18.8 ± 9.5 ng/ml or 20.8 ± 13.7 ng/ml, respectively, vs 4.3 ± 3.5 ng/ml; p<0.05), with no difference between tests B and C. LA concentrations significantly increased after tests A, B, and C, being significantly higher after tests B and C than after test A (LA peaks: 2.0 ± 0.5 mmol/l or 6.7 ± 2.3 mmol/l, respectively, vs 7.6 ± 0.9 mmol/l; p<0.05). Peak LA values were significantly correlated to GH peaks in the 3 tests (r=0.48; p<0.05). Muscle soreness was significantly higher 24-48 h after tests B and C than after test A, no significant differences being present between tests B and C., Conclusions: WBV stimulates GH secretion and LA production, with no additive effect when combined with repeated isometric voluntary contractions. Optimization of protocols based on WBV seems important to maximize the positive effects of this intervention on the somatotropic function.

Aims: The purpose of the study was to assess energy expenditure and cardiovascular response to rhythmic activity with 6 machines exercising different arm and leg muscle groups in normal-weight (NW) and obese (OB) individuals., Methods: In 16 extremely OB subjects and 15 NW controls, oxygen uptake (VO2), heart rate (HR), blood lactate (LA) concentration and ratings of perceived exertion (RPE) were determined during submaximal rhythmic exercise at different intensities obtained by increasing the frequency of the movement (FOM) with each machine. Peak VO2 (VO2p) for each equipment was determined with incremental tests up to exhaustion, whereas maximal VO2 was estimated at cycle ergometer., Results: Net energy cost (Enet) of exercise increased (p<0.001) for effect of FOM, in both NW and OB with all equipments. Enet was higher in OB than NW during submaximal exercise with Chest/Back, Shoulder Press/Lat Pull, and Leg Press. Higher VO2p were attained with lower limbs than with upper limbs, in both NW (p<0.001) and OB (p<0.001). At the same VO2 (relative to maximal), HR, LA, and RPE were similar in NW and OB but higher during arm than leg activity (p<0.001), while at the same VO2 (relative to VO2p) no difference was detected., Conclusion: Enet of rhythmic exercise is higher in OB than NW with machines requiring wide displacement of large body segments. For both NW and OB, physiological responses and RPE are importantly affected by the relative activation of involved muscles. LA concentration is an important determinant of RPE, independent of the limb in activity.

We developed an automatic method for regional analysis of femoral neck images acquired by peripheral quantitative computed tomography (pQCT), based on automatic spatial re-alignment and segmentation; the segmentation method, based on a morphological approach, explicitly accounts for the presence of three different bone compartments: cortical region, trabecular region, and transition zone between cortical and trabecular compartments. The proposed method was applied on 13 femoral neck sections derived from female donors who were undergoing hip replacement surgery for primary degenerative arthritis or fracture, and a typical densitometric and structural analysis was performed both globally and regionally. The proposed segmentation method was quantitatively evaluated by comparing automatic contour and the corresponding manual contours delineated by three operators using metrics based on surface distance (average symmetric distance, ASD) and volumetric overlapping (dice similarity coefficient, DSC). The same approach was used to validate the automatic spatial orientation, considering as metric the difference between manual and automatic angle orientation. Results confirm a satisfactory agreement between automatic and manual performances (ASD < 0.41 mm, DSC > 0.91, orientation difference = 3.61°) and show that globally our algorithm performs very well. Concerning regional analysis application, from our results we can observe that significant differences are present among the four bone quadrants.

Background: Pharmacological or exercise stimuli repeated at a short interval (but not electrical muscle stimulation) are associated with a blunting of GH responsiveness., Aim: To compare GH responses to repeated bout of three different GH-releasing stimuli., Methods: The effects of two consecutive bouts (with a 2-h interval) of whole body vibrations (WBV), maximal voluntary contractions alone (MVC), or alternated with WBV (MVC-WBV) on blood GH and lactate (LA) were assessed in nine young males., Results: Baseline levels of both GH and LA increased significantly after the first bout of all the tested stimuli, and were significantly lower after WBV than after MVC or MVC alternated with WBV, no difference being detected between these last. The administration of a second bout resulted in significantly lower GH increases than those elicited in the first bout in the three different tests; significantly lower LA responses were recorded after the second bout of MVC and MVC-WBV when compared with those obtained after the first bout, while no significant differences were observed after the two WBV bouts for LA. All responses after the second bout of MVC and MVC-WBV were significantly higher than those observed after WBV alone. GH concentrations were significantly correlated with LA after all stimuli, although LA concentrations after the second bout were associated with markedly lower GH levels., Conclusions: A significant blunting of GH responsiveness ensues after a second bout of different GH-releasing stimuli, independent from the amount of GH released after the first bout. This is a pattern also observed for other pharmacological stimuli and exercise modalities, and suggests a common mechanism underlying different GH-releasing stimuli., (Copyright © 2010 Growth Hormone Research Society. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate in severely obese adolescents the effects of a 3-week multidisciplinary weight-reduction intervention involving moderate energy restriction, individualised physical activity and behavior therapy on the response of some hormonal and metabolic parameters to meals and exercise., Design: Clinical longitudinal study on inpatients in a specialised institution., Subjects: A total of 20 obese adolescents (10 boys and 10 girls) aged 12-17 yr [body mass index (BMI): 37.7±6.1 kg/m2; fat mass (FM): 44.8±13.2 kg]., Measurements: The changes in plasma concentration of leptin, ghrelin, GH, IGF-I, insulin, glucose, and non-esterified fatty acids (NEFA) in response to standardised meals and exercise bouts were measured before and after the weight-reduction intervention. At the same times, body composition was assessed by bioelectrical impedance as well as appetite sensations using a visual analog scale., Results: At the end of the intervention, the adolescents had lost body weight and FM (expressed both in kg and %) (p<0.05), without any significant fat-free mass loss (in % terms). In response to both meals and exercise, after the 3-week intervention, plasma leptin concentration decreased significantly (p<0.05), whereas the other hormones (insulin, ghrelin, GH, and IGF-I) and metabolic parameters (glucose and NEFA) did not change. Interestingly, appetite was not affected by the intervention., Conclusion: This 3-week multidisciplinary intervention in obese adolescents induced a significant body weight loss with beneficial changes in body composition. However, despite there being no change in metabolic parameters and ghrelin in response to meals and exercise after the intervention, plasma concentrations of leptin were decreased. The failure of ghrelin levels to increase by this approach might explain the good control of appetite observed at the end of the study.