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[Purpose] We compared and analyzed energy consumption and excess post-exercise oxygen consumption (EPOC) following Taekwondo Taegeuk Poomsae performances.[Methods] Forty-two healthy men who could perform Taegeuk Poomsae 1–8 Jangs were enrolled in this study. To reduce the impact of Poomsae, a random cross-design was used. The washout time was set to at least three days. Oxygen consumption (VO2) was monitored after performing each Poomsae until a reference line was resumed. Each Taegeuk Poomsae was performed at a speed of 60 bpm.[Results] There was no significant difference in VO2, carbon dioxide excretion, and heart rate after performing the Taegeuk Poomsae once; however, all variables increased significantly in combined results of EPOC metabolism (Fp2p2

[Purpose] The purpose of this study was to evaluate the effects of a 12-week non-contact exercise intervention on body composition and health-related physical fitness in adults.[Methods] One hundred adults were initially enrolled; however, ninety-seven participants (men: n = 41, women: n = 56) completed the study. The non-contact exercise was performed for 12 weeks using a smart tracker (Charge 4, Fitbit, USA) and mobile phone applications. The non-contact exercise program included resistance, aerobic, and flexibility exercises.[Results] The results showed that percent body fat (F=4.993, p=.016, ηp2=.049), fat-free mass (F=4.690, p=.024, ηp2=.047), and skeletal muscle mass (F=5.623, p=.004, ηp2=.055) significantly changed during the intervention period. Further, significant increases were seen in hand grip strength (F=12.167, pp2=.112), sit-and-reach (F=20.497, pp2=.176), sit-ups (F=42.107, pp2=.305), and VO2max (F=4.311, p=.037, ηp2=.043).[Conclusion] Our findings suggest that 12 weeks of non-contact exercise improves body composition and health-related physical fitness. Wearable technologies encourage individuals to modify their lifestyles by increasing physical activity and achieving the goal of maintaining health conditions among adults.

Background: Despite the various benefits of exercise, women's participation in exercise is low. Therefore, we need to consider ways to maximize the effect of exercise. Excess post-exercise oxygen consumption (EPOC) can maximize energy consumption. We aimed to compare the EPOC during different exercise modalities including continuous exercise (CE), interval exercise (IE), and accumulated exercise (AE) that spent the homogenized energy expenditure during exercise in healthy women. Methods: Study design: Randomized crossover trial. Participants: Forty-four participants (age, 36.09 ± 11.73 years) were recruited and randomly allocated to three groups. Trials: The intensity of each modality was set as follows: CE was performed for 30 min at 60% peak oxygen uptake (VO2peak). IE was performed once for 2 min at 80% VO2peak, followed by 3 min at 80% VO2peak, and 1 min at 40% VO2peak, for a total of six times over 26 min. AE was performed for 10 min with a 60% VO2peak and was measured three times a day. Results: During exercise, carbohydrate oxidation (CHO) and fatty acid oxidation (FAO) were the largest in IE (p < 0.05) and CE (p < 0.001), respectively, and there was no difference in energy expenditure (EE) (p = 0.635) between exercise modalities. On the other hand, CHO, FAO, and EE were the largest in AE (all p < 0.001) during EPOC. As a result, the greatest energy metabolism was shown in AE (all p < 0.001) during exercise and EPOC. Conclusions: We confirmed that more effective energy metabolism can occur due to the accumulation of EPOC when short-time exercise is repeated several times. In recommending regular exercise, AE can increase compliance with exercise participation through a short exercise time and can help improve health with an exercise modality that maximizes energy consumption through EPOC. Trial registration: Clinical number (KCT0007298), Institutional Review Board of Konkuk University (7001355-202201-E-160).

The present study aimed to examine and compare the effects of a rehabilitation exercise (RE) using neuromuscular electrical stimulation (NMES) and blood flow restriction (BFR) on muscle function and knee functional abilities in patients who underwent anterior cruciate ligament reconstruction (ACLR). A total of 45 patients who underwent ACLR (28.76 ± 0.8 years; 34 males and 11 females) were retrospectively divided into three groups: control (CON, n = 15), NMES (n = 15), and BFR (n = 15). All participants carried out the RE program for 60 min, thrice a week for 12 weeks. The Lysholm score, International Knee Documentation Committee (IKDC) subjective score, thigh circumference at 5 cm from the knee joint, Y-balance posterior medial, and lateral significantly increased in all groups via intervention (p < 0.05). However, NMES showed a higher thigh circumference at 15 cm from the knee joint than CON via intervention (p < 0.05), and the strength and endurance of quadriceps femoris and hamstrings and Y-balance anterior showed a significant increase via intervention in NMES and BFR compared with CON (p < 0.05). In conclusion, we confirmed that RE using NMES and BFR effectively enhances muscle function and balance in ACLR patients.

This review aims to summarize the health benefits of exposure to hypoxic conditions during exercise in patients with type 2 diabetes mellitus (T2DM). Exposure to hypoxic conditions during exercise training positively changes the physiological response in healthy subjects. Exposure to hypoxic conditions during exercise could markedly increase skeletal muscle glucose uptake compared to that in normoxic conditions. Furthermore, post-exercise insulin sensitivity of T2DM patients increases more when exercising under hypoxic than under normoxic conditions. Regular exercise under short-term hypoxic conditions can improve blood glucose control at lower workloads than in normoxic conditions. Additionally, exercise training under short-term hypoxic conditions can maximize weight loss in overweight and obese patients. Previous studies on healthy subjects have reported that regular exercise under hypoxic conditions had a more positive effect on vascular health than exercising under normoxic conditions. However, currently, evidence indicating that exposure to hypoxic conditions could positively affect T2DM patients in the long-term is lacking. Therefore, further evaluations of the beneficial effects of exercise under hypoxic conditions on the human body, considering different cycle lengths, duration of exposures, sessions per day, and the number of days, are necessary. In this review, we conclude that there is evidence that exercise under hypoxic conditions can yield health benefits, which is potentially valuable in terms of clinical care as a new intervention for T2DM patients.

[Purpose] This preliminary study aimed to develop a regression model to estimate the non-exercise activity thermogenesis (NEAT) of Korean adults using various easy-to-measure dependent variables. [Methods] NEAT was measured in 71 healthy adults (male n = 29; female n = 42). Statistical analysis was performed to develop a NEAT estimation regression model using the stepwise regression method. [Results] We confirmed that ageA, weightB, heart rate (HR)_averageC, weight × HR_averageD, weight × HR_ sumE, systolic blood pressure (SBP) × HR_restF, fat mass ÷ height2G, gender × HR_averageH, and gender × weight × HR_sumI were important variables in var ious NEAT activity regression models. There was no significant difference between the measured NEAT values obtained using a metabolic gas analyzer and the predicted NEAT. [Conclusion] This preliminary study developed a regression model to estimate the NEAT in healthy Korean adults. The regression model was as follows: sitting = 1.431 - 0.013 × (A) + 0.00014 × (D) - 0.00005 × (F) + 0.006 × (H); leg jiggling = 1.102 - 0.011 × (A) + 0.013 × (B) + 0.005 × (H); standing = 1.713 - 0.013 × (A) + 0.0000017 × (I); 4.5 km/h walking = 0.864 + 0.035 × (B) + 0.0000041 × (E); 6.0 km/h walking = 4.029 - 0.024 × (C) + 0.00071 × (D); climbing up 1 stair = 1.308 - 0.016 × (A) + 0.00035 × (D) - 0.000085 × (F) - 0.098 × (G); and climbing up 2 stairs = 1.442 - 0.023 × (A) - 0.000093 × (F) - 0.121 × (G) + 0.0000624 × (E).

[Purpose] This pilot study aimed to develop a re gression model to estimate the excess post-exercise oxygen consumption (EPOC) of Korean adults using various easy-to-measure dependent variables. [Methods] The EPOC and dependent variables for its estimation (e.g., sex, age, height, weight, body mass index, fat-free mass [FFM], fat mass, % body fat, and heart rate_sum [HR_sum]) were measured in 75 healthy adults ( 31 males, 44 females). Statistical anal ysis was performed to develop an EPOC estimation re gression model using the stepwise regression method. [Results] We confirmed that FFM and HR_sum were important variables in the EPOC regression models of various exercise types. The explanatory power and standard errors of estimates (SEE) for EPOC of each exercise type were as follows: the continuous exercise (CEx) regression model was 86.3% (R2) and 85.9% (adjusted R2), and the mean SEE was 11.73 kcal, interval exercise (IEx) regression model was 83.1% (R2) and 82.6% (adjusted R2), while the mean SEE was 13.68 kcal, and the accumulation of short-duration exercise (AEx) regression models was 91.3% (R2) and 91.0% (adjusted R2), while the mean SEE was 27.71 kcal. There was no significant difference between the measured EPOC using a metabolic gas analyzer and the predicted EPOC for each exercise type. [Conclusion] This pilot study developed a regression model to estimate EPOC in healthy Korean adults. The regression model was as follows: CEx = -37.128 + 1.003 × (FFM) + 0.016 × (HR_sum), IEx = -49.265 + 1.442 × (FFM) + 0.013 × (HR_sum), and AEx = -100.942 + 2.209 × (FFM) + 0.020 × (HR_sum).

Purpose This study aimed to investigate the effects of acute cold stress (10℃, 0℃) compared with ordinary temperature (20℃) on exercise performance and physiological response at rest and during exercise. Methods A total of 10 healthy men (21.55 ± 2.16) were selected. In each environmental condition (20℃, 10℃, 0℃), the three testing order was randomly selected at crossover, and there was a week interval between the graded exercise test (GXT). On the testing day, they remained resting for 30 min in each environmental condition. Dependent variables (body temperature, energy metabolism parameters, skeletal muscle oxygenation profiles, and exercise performance parameters) were measured at rest and during GXT. Results In body temperature, at each environmental condition, there was a significant decrease (p

Interval training under hypoxia (IHT) is commonly used to enhance endurance exercise performance. However, previous studies examining hematologic changes related to the immune system that affect health and conditioning are lacking. This study aimed to evaluate the effects of IHT for 6-weeks on hematological parameters, hemodynamic function, and endurance exercise performance in amateur Korean female runners. Twenty healthy amateur Korean female runners (age: 24.85 ± 3.84 years) were equally assigned to normoxic training group (NTG) for interval training under normoxia (760 mmHg) and hypoxic training group (HTG) for interval training under hypobaric hypoxia (526 mmHg, 3000 m simulated altitude) according to their body composition and endurance exercise performance. All participants performed 120-min of training sessions, consisting of 20-min of warm-up, 60-min of interval training, and 20-min of cool-down. The training program was performed 3-days per week for 6-weeks. Warm-up and cool-down were performed for 20-min at 60% maximal heart rate (HRmax). The interval training sessions comprised 10 repetitions of interval exercise (5-min of exercise corresponding to 90–95% HRmax and 1-min of rest) on a treadmill. All participants underwent measurements of hematological parameters, hemodynamic function, and endurance exercise performance before and after training. Both groups showed a significant increase in erythropoietin (EPO) level and a decrease in monocyte abundance, with EPO showing a greater increase in the HTG than in the NTG. B cell abundance significantly increased in the NTG; hematocrit and neutrophil counts significantly increased, and lymphocyte counts significantly decreased in the HTG. The HTG showed a significant improvement in oxygen uptake, stroke volume index, and end-diastolic volume index compared to the NTG. In addition, both groups showed significant improvements in heart rate, end-systolic volume index, and cardiac output index. The maximal oxygen uptake and 3000 m time trial record were significantly improved in both groups, and the HTG showed a tendency to improve more than the NTG. In conclusion, the IHT was effective in enhancing endurance exercise performance through improved hemodynamic function. Furthermore, hematological parameters of immune system showed a normal range before and after training and were not negatively affected.

[Purpose] This study aimed to investigate the effects of gradient and age on energy expenditure and fat metabolism during aerobic exercise at equal intensity in women.[Methods] Thirty women in their twenties (n=15) and fifties (n =15) were enrolled. All subjects performed aerobic exercise on a treadmill for 10 min at 0% and 6% gradient repeatedly to elicit 50%, 60%, and 70% VO2max.[Results] Energy expenditure and fat oxidation were higher during aerobic exercise at 6% of the gradient than at 0%, and there was no significant difference in carbohydrate oxidation in any age group.[Conclusion] Aerobic exercise at a 6% gradient was more favorable for fat oxidation than a 0% gradient in all age groups. In particular, in the case of women in their fifties, walking on a gradient of 6%, which is favorable for increasing fat oxidation, was more effective than walking on flat ground for preventing and reducing obesity. However, to examine the difference in fat oxidation among exercise intensities more accurately, exercise performed for longer than 30 min is required. Follow-up studies are required to investigate the effect of various gradients on physiological and metabolic characteristics when carrying out aerobic exercises for more than 30 min.

Hun-Young Park,1,2 Won-Sang Jung,2 Sung-Woo Kim,2 Kiwon Lim1– 3 1Department of Sports Medicine and Science, Graduated School, Konkuk University, Seoul, Republic of Korea; 2Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea; 3Department of Physical Education, Konkuk University, Seoul, Republic of KoreaCorrespondence: Kiwon LimDepartment of Physical Education, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, Republic of Korea, Tel +82-2-450-3827, Fax +82-2-450-3949, Email exercise@konkuk.ac.krPurpose: The present study verified the effects of interval training under hypoxia, a novel exercise modality for health promotion, on the autonomic nervous system (ANS) and arterial and hemorheological function in healthy women.Methods: Twenty healthy Korean women (age: 19– 29 [24.85 ± 3.84] years) were equally assigned to interval normoxic training (INT, n = 10; residing and training under normoxia) and interval hypoxic training (IHT, n = 10; residing under normoxia and training under 526 mmHg hypobaric hypoxia) groups. All participants performed 90-min of training sessions composed of 15-min of warm-up, 60-min of interval training, and 15-min of cool-down. The interval training sessions composed of 10 repetitions of interval exercise using a treadmill (5 min of exercise corresponding to 90– 95% maximal heart rate [HR] and 1 min of rest). The training was performed 3 days per week for 6 weeks. All participants underwent body composition, HR variability, brachial-ankle pulse wave velocity, flow-mediated dilation (FMD), red blood cell (RBC) deformability and aggregation, and maximal oxygen uptake (VO2max) measurements before and after training.Results: There were no significant differences in body composition between the groups. The IHT group showed a significant improvement in the ANS function (root mean square of successive differences, high frequency, and low frequency/high frequency ratio), arterial stiffness, arterial endothelial function (FMD), hemorheological function (RBC deformability and aggregation), and aerobic performance (VO2max) compared with the INT (all p < 0.05).Conclusion: In comparison with the interval training under normoxia, the interval training under hypoxia is a novel and effective exercise modality for promoting aerobic performance with the ANS and arterial and hemorheological function in healthy women.Keywords: interval training, hypoxia, heart rate variability, arterial stiffness, arterial endothelial function, erythrocyte deformability and aggregation, maximal oxygen uptake

This study aimed to compare vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness in middle-aged Korean women according to obesity defined using body mass index (BMI). A total of 32 Korean women aged between 34 and 60 years (16 without obesity, mean age 46.31 ± 7.49 years and 16 with obesity, mean age 49.68 ± 6.69 years) participated in this study. Obesity was defined as BMI ≥ 25 kg/m2. The body composition, vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness of all participants were measured. Statistical differences in the dependent parameters between individuals with and without obesity were analyzed, and the correlations between BMI and the dependent variables were verified. The obese group showed significantly worse results (p p r = 0.430); total cholesterol (r = 0.376), triglyceride (r = 0.411), low-density lipoprotein cholesterol (r = 0.462), and insulin (r = 0.477) levels; HOMA-IR (r = 0.443); and erythrocyte aggregation (r = 0.406), and a significant negative correlation (p r = −0.482) and FMD (r = −0.412). Our study confirmed that obesity is a major determinant for deterioration of vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness.

The purpose of the study was to examine the development of a multiple linear regression model to estimate heart rate variability (HRV) parameters using easy-to-measure independent variables in preliminary experiments. HRV parameters (time domain: SDNN, RMSSD, NN50, pNN50; frequency domain: TP, VLF, LF, HF) and the independent variables (e.g., sex, age, body height, body weight, BMI, HR, HRmax, HRR) were measured in 75 healthy adults (male n = 27, female n = 48) for estimating HRV. The HRV estimation multiple linear regression model was developed using the backward elimination technique. The regression model’s coefficient of determination for the time domain variables was significantly high (SDNN = R2: 72.2%, adjusted R2: 69.8%, P < .001; RMSSD = R2: 93.1%, adjusted R2: 92.1%, P < .001; NN50 = R2: 78.0%, adjusted R2: 74.9%, P < .001; pNN50 = R2: 89.1%, adjusted R2: 87.4%, P < .001). The coefficient of determination of the regression model for the frequency domain variable was moderate (TP = R2: 75.6%, adjusted R2: 72.6%, P < .001; VLF = R2: 41.6%, adjusted R2: 40.3%, P < .001; LF = R2: 54.6%, adjusted R2: 49.2%, P < .001; HF = R2: 67.5%, adjusted R2: 63.4%, P < .001). The coefficient of determination of time domain variables in the developed multiple regression models was shown to be very high (adjusted R2: 69.8%–92.1%, P < .001), but the coefficient of determination of frequency domain variables was moderate (adjusted R2: 40.3%–72.6%, P < .001). In addition to the equipment used for measuring HRV in clinical trials, this study confirmed that simple physiological variables could predict HRV.

A 41-year-old male was diagnosed with tongue cancer. Preoperative imaging revealed no metastatic lymph nodes. Intraoperative sonography detected a minute hypoechoic lesion in the sublingual space. A pea-sized mass was found during dissection of that space and histopathology revealed a metastatic lymph node. The lingual lymph node should routinely be evaluated sonographically prior to surgical resection of tongue cancer.

[Purpose] This preliminary study aimed to develop a regression model to estimate the resting metabolic rate (RMR) of young and middle-aged Koreans using various easy-to-measure dependent variables. [Methods] The RMR and the dependent variables for its estimation (e.g. age, height, body mass index, fat-free mass; FFM, fat mass, % body fat, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and resting heart rate) were measured in 53 young (male n = 18, female n = 16) and middle-aged (male n = 5, female n = 14) healthy adults. Statistical analysis was performed to develop an RMR estimation regression model using the stepwise regression method. [Results] We confirmed that FFM and age were important variables in both the regression models based on the regression coefficients. Mean explanatory power of RMR1 regression models estimated only by FFM was 66.7% (R2) and 66.0% (adjusted R2), while mean standard errors of estimates (SEE) was 219.85 kcal/ day. Additionally, mean explanatory power of RMR2 regression models developed by FFM and age were 70.0% (R2) and 68.8% (adjusted R2), while the mean SEE was 210.64 kcal/day. There was no significant difference between the measured RMR by the canopy method using a metabolic gas analyzer and the predicted RMR by RMR1 and RMR2 equations. [Conclusion] This preliminary study developed a regression model to estimate the RMR of young and middle-age healthy Koreans. The regression model was as follows: RMR1 = 24.383 × FFM + 634.310, RMR2 = 23.691 × FFM - 5.745 × age + 852.341.

Purpose The purpose of this study was to examine the effects of 16 weeks’ combined exercise training on insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness in elderly women with type 2 diabetes mellitus (DM). Methods Twenty-eight participants were randomly assigned into one of two groups, i.e., exercise training group (EX: n=14) and control group (CON: n=14). Subjects in EX participated in 3 sessions of 60 min-combined exercise for 16 weeks, whereas subjects in CON were asked to maintain their normal life pattern during the same period. The variables regarding insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness were measured and compared between two groups as well as between pre-post test utilizing a repeated two-way ANOVA. Results Main results were as follows: 1) Fasting plasma insulin and HOMA-IR tended to decrease in EX, whereas increased significantly in CON. 2) IL-6, TNF-α, hs-CRP decreased in EX, but the changes were not statistically significant. 3) MDA increased significantly and GPx decreased significantly in both EX and CON. 4) Leukocyte telomere length increased significantly in EX. 5) Fat-free mass increased in EX, whereas fat mass and percent body fat decreased significantly in EX. 6) Arm curl, chair stand, sit & reach, tandem test, 10m walking speed, and up & go improved significantly in EX. Conclusion It was concluded that the combined exercise for 16 weeks had a positive effect on improving insulin resistance, increasing leukocyte telomere length, as well as enhancing body composition and daily living fitness in elderly women with type 2 diabetes.

Sarcopenia is defined as an age-related decrease in muscle mass, strength, and function. We investigated the effect of circuit training on body composition, balance, muscle mass and strength, and pulmonary function in Korean women with sarcopenia. We randomly assigned 26 Korean women with sarcopenia ( Mage = 74.9, SD = 4.5 years) to either an exercise group (EG) ( n = 13) or a control group (CG) ( n = 13). The EG performed 25-75 minutes of circuit exercise training (gradually increasing time periods) three times per week over 12 weeks, while the CG maintained their usual daily lifestyle during the intervention period. We measured body weight, body mass index, percent body fat, free fat mass, balance ability, peak torque in shoulder, knee, and lumbar joints normalized for bodyweight (BW), forced vital capacity, percentage of forced expiratory volume in one second, and forced expiratory flow 25–75% before and after the intervention. The EG showed improved body composition (i.e., body mass index, fat-free body mass, fat mass; all p 2 > 0.180), balance (i.e., right and left of static and dynamic balance and fast 10-m walk; all p 2 > 0.151), muscular function (i.e., 90°/s and 180°/s peak power per kilogram BW, 90°/s average power per kilogram BW, 180°/s total work, and 180°/s endurance ratio; all p 2 > 0.157), and pulmonary function (all p 2 > 0.292). On the other hand, the CG showed no significant changes. Circuit exercise training improves muscle mass and strength, body composition, balance, and pulmonary function in women with sarcopenia.

[Purpose] The purpose of this study was to confirm that the difference in excess post-exercise oxygen consumption (EPOC) during exercise of the spending the same calories between the continuous and interval exercise. [Methods] Thirty-four healthy college students who did not regularly exercise volunteered to participate in our study. Continuous exercise was performed on an ergometer for 30 min at 60% of maximal oxygen consumption (VO2 max). Interval exercise was performed on a cycle ergometer at 80% VO2 max for 2 min initially, followed by 40% VO2 max for 1 min, and 80% VO2 max for 3 min. This was repeated six times for a total of 26 min. [Results] The major findings were as follows: (1) energy consumption during exercise was not significantly different between continuous exercise and interval exercise groups; (2) EPOC was higher in interval exercise than in continuous exercise for all dependent variables (i.e., total oxygen consumption, total calories, summation of heart rate); and (3) there were no significant differences in the lipid profile between continuous and interval groups. [Conclusions] Our study confirmed that after equalizing energy expenditure for continuous and interval exercise on a cycle ergometer in subjects in their twenties, interval exercise results in higher EPOC than continuous exercise. These data suggest that interval exercise may be more effective than continuous exercise in reducing body fat, for a given amount of energy expenditure.

Resistance exercise effectively improves bone mineral density (BMD) and muscle quality (e.g., muscle mass and muscle strength). The present study aimed to examine the effect of a 24-week resistance exercise training (RT) program on body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women. Forty obese older women were initially enrolled. Among them, 30 participants (age: 80.55 ± 4.94 years; body fat percentage: 36.25 ± 3.44%) completed the study. The participants were randomly assigned into two groups: the RT group (n = 15) and the control (CON) group (n = 15). The RT group participated in the exercise for 60 min per session and two sessions per week for 24 weeks. Pre-test and post-test body composition, BMD, functional fitness, and isokinetic muscle strength were evaluated. The RT group increased significantly in functional fitness (hand grip strength: 1.70 kg, p < 0.01, and lower body strength: 3.87 n, p < 0.001), and isokinetic muscle strength (non-dominant leg extensor peak torque %BW at 60°/s: 13.20%, p < 0.05, dominant leg (DL) flexor peak torque at 60°/s: 3.87 Nm, p < 0.05, and DL flexor peak torque %BW at 60°/s: 7.60%, p < 0.05). However, the CON group showed negative changes in body composition (fat mass: 1.15 kg, p < 0.001, body fat percentage: 1.59%, p < 0.001, and fat-free mass: −0.58 kg, p < 0.05), BMD (whole-body: −0.01 g/cm2, p < 0.001 and forearm: −0.01 g/cm2, p < 0.05), functional fitness (lower body flexibility: −3.23 cm, p < 0.01, upper body strength: −2.06 n, p < 0.01, and agility and dynamic balance: 0.54 s, p < 0.01), and isokinetic muscle strength at 60°/s and 180°/s (all peak torque % body weight variables: −7.31–−1.50, p < 0.05). Our findings show that the CON group negatively affects body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women for 24 weeks.

Sarcopenic obesity is a physiological issue caused by ageing that worsens the elderly's quality of life by reducing bodily function, increasing body fat, and decreasing muscle mass. Furthermore, it leads to a variety of social and economic issues, including the progression and contraction of a chronic condition, increased health-care expenses, and a rise in the prevalence or mortality rate. It has an adverse influence on metabolic illness symptoms such as decreased body function and physical strength, blood lipids, and body inflammation and hormones. Exercise therapy is currently recommended as a treatment for elderly health concerns. Regular aerobic exercise is effective in increasing body function and muscle mass, and regular resistance exercise is effective in improving body function and muscle mass. Resistance exercise has recently been highlighted in obese elderly persons in order to improve muscular function and prevent falls. Resistance exercise, on the other hand, has several drawbacks, such as the risk of injury, the inability to exercise in a specific location, and the inability to reduce obesity, so a new exercise approach for the sarcopenic obese elderly should be offered. The circuit exercise with weight bearing offers a lower risk of injury, and it can be done in a group setting without regard to cost or location, and it can be done continuously with interest. Circuit training is also advised for the elderly because it improves body composition and a variety of physical characteristics in a very short period of time. Despite these positive effects, the studies reported so far are limited. Future research is needed to confirm the effects of different intensities, frequency, time, and duration of circuit exercise in sarcopenic obesity elderly. Therefore, this review summarizes recent research evidences suggesting that the improvement of muscle mass and body fat mass via circuit exercise program might be a valuable and viable “sarcopenic obesity therapeutic modality.

This study aimed to analyze the status of sarcopenia, obesity, osteoporosis, and cardiometabolic disease according to the level of physical activity (PA) among elderly people in Korea. Among the data obtained from the National Health and Nutrition Survey (2008–2011), we analyzed the data of a total of 3,573 Korean elderly people over 65 years of age who were surveyed for dual X-ray absorptiometry (DXA) and PA. Higher levels of PA were associated with a lower prevalence of cardiometabolic disease (χ2 = 33.865, p < 0.001), osteoporosis (χ2 = 94.198, p < 0.001), sarcopenia, obesity, and sarcopenic obesity (χ2 = 71.828, p < 0.001). Above moderate-active PA was associated with lower body weight (p < 0.001), body fat mass (p < 0.001), and percent body fat (p < 0.001), and higher free-fat mass (p < 0.001) and appendicular skeletal muscle mass (ASM) (p < 0.001) than in low-active PA. In addition, when high-active is the risk factors of cardiometabolic were lower in waist circumference (p = 0.001), total cholesterol (TC) (p = 0.015), and triglyceride (TG) (p < 0.001) than low- and moderate-active PA, and higher in high-density lipoprotein cholesterol (HDL-C) (p < 0.001). The prevalence of cardiometabolic diseases was significantly decreased in high-active PA (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.50–0.71); waist circumference (OR 0.85, 95% CI, 0.73–0.99; OR 0.59, 95% CI, 0.50–0.70) and HDL-C (OR 0.76, 95% CI, 0.65–0.88; OR 0.56, 95% CI, 0.47–0.67) significantly improved in moderate- and high-active PA, respectively, and TG (0.67 95% CI, 0.55–0.80) significantly improved in high-active PA. Osteoporosis (OR 0.62, 95% CI, 0.53–0.74; OR 0.46, 95% CI, 0.38–0.55) and sarcopenia (OR 0.77, 95% CI, 0.60–0.98; OR 0.73, 95% CI, 0.57–0.93) were significantly improved in moderate- and high-active PA, respectively. The incidence of obesity (OR 0.47, 95% CI, 0.39–0.57) and sarcopenic obesity (OR 0.47, 95% CI, 0.30–0.75) were significantly decreased in high-active PA. Therefore, we verified a lower prevalence of sarcopenia, osteoporosis, obesity, and cardiac metabolic disease in Korean elderly with more active PA. This suggests that more active PA maybe reduce the prevalence of sarcopenia, osteoporosis, obesity, and cardiometabolic diseases in older adults.

We investigated the effects of acute thermal stress (30 °C and 40 °C) and ordinary temperature (20 °C) on cardiorespiratory function, skeletal muscle oxygenation, and exercise performance in healthy men. Eleven healthy males (21.5 ± 2.3 years) performed a graded exercise test (GXT) using a cycle ergometer in each environmental condition (20 °C, 30 °C, and 40 °C) in a random order with an interval of 1 week between each test. Before the test, they were allowed to rest for 30 min in a given environmental condition. All dependent variables (body temperature, cardiorespiratory function parameters, skeletal muscle oxygenation profiles, and exercise performance) were measured at rest and during GXT. GXT was started at 50 W and increased by 25 W every 2 min until subjects were exhausted. Body temperature increased proportionally at rest and at the end of exercise as thermal stress increased. There were no differences in the rating of perceived exertion, oxygen uptake, respiratory exchange ratio, and carbon dioxide excretion between environmental conditions. Heart rate (HR), minute ventilation (VE), and blood lactate levels were significantly higher at 30 °C and 40 °C than at 20 °C, and oxygen pulse was significantly lower at 40 °C than at 20 °C at various exercise loads. None of the skeletal muscle oxygenation profiles showed significant changes at rest or during exercise. Maximal oxygen uptake, peak power, and exercise time significantly decreased proportionally as thermal stress increased, and this decrease was most pronounced at 40 °C. Acute thermal stress induces a decrease in exercise performance via increased body temperature, HR, VE, and blood lactate levels and decreased oxygen pulse during load-homogenized exercise. This phenomenon was more prominent at 40 °C than at 30 °C and 20 °C.

Purpose To review our experiences of descending necrotizing mediastinitis (DNM) secondary to deep neck infection (DNI) and determine appropriate airway management for decreasing mortality and morbidity of patients with DNM. Methods Medical records of 20 patients (8 women and 12 men) who had been managed for DNM secondary to DNI between March 2006 and December 2019 were analyzed. Diagnosis and extent of infection were confirmed by computed tomography of the neck and chest. The upper airway was closely monitored with a fiberoptic laryngoscope. Complications were evaluated according to various types of airway management in our serial cases. Results Five (25%) out of 20 patients died as a result of septic shock and multiorgan failure. None of these patients died of accidental airway obstruction or airway management mishaps. Keeping short-term orotracheal intubation was safe and adequate after the initial surgery. Early tracheotomy was performed for 4 patients and it was significantly associated with mortality (P = .032). Three patients who underwent late tracheotomy had no mortality. Patients with tracheotomy had longer duration of overall hospital stay than those without tracheotomy. Conclusions Well-controlled airway management might decrease mortality, hospitalization, and airway complications in patients with DNM secondary to DNI. Keeping orotracheal intubation rather than upfront tracheotomy should be first considered when managing airway along with examination of the upper airway with a fiberoptic laryngoscope.

Hypoxic training is often performed by competitive swimmers to enhance their performance in normoxia. However, the beneficial effects of aerobic continuous and interval training under hypoxia on hemodynamic function, autonomic nervous system (ANS) function, and endurance exercise performance remain controversial. Here we investigated whether six weeks of aerobic continuous and interval training under hypoxia can improve hematological parameters, hemodynamic function, ANS function, and endurance exercise performance versus normoxia in amateur male swimmers. Twenty amateur male swimmers were equally assigned to the hypoxic training group or normoxic training group and evaluated before and after six weeks of training. Aerobic continuous and interval training in the hypoxia showed a more significantly improved hemodynamic function (heart rate, −653.4 vs. −353.7 beats/30 min, oxygen uptake, −62.45 vs. −16.22 mL/kg/30 min, stroke volume index, 197.66 vs. 52.32 mL/30 min) during submaximal exercise, ANS function (root mean square of successive differences, 10.15 vs. 3.32 ms, total power, 0.72 vs. 0.20 ms2, low-frequency/high-frequency ratio, −0.173 vs. 0.054), and endurance exercise performance (maximal oxygen uptake, 5.57 vs. 2.26 mL/kg/min, 400-m time trial record, −20.41 vs. −7.91 s) than in the normoxia. These indicate that hypoxic training composed of aerobic continuous and interval exercise improves the endurance exercise performance of amateur male swimmers with better hemodynamic function and ANS function.

We demonstrated the hypothesis that combined exercise improves body composition, cardiometabolic risk factors, blood pressure (BP), arterial stiffness, and physical functions, in obese older men. Older men (n = 20) were randomly assigned to combined exercise training (EXP, n = 10) or control groups (CON, n = 10). The combined exercise was comprised of elastic-band resistance training and walking/running on a treadmill and bicycle at 60&ndash, 70% of maximal heart rate for 3 days/weeks. EXP showed significant decreases in body weight, body mass index, and %body fat (p &lt, 0.05). The exercise program significantly reduced BP, mean arterial pressure, pulse pressure, and brachial-ankle pulse wave velocity. Furthermore, while the plasma levels of low-density lipoprotein cholesterol and epinephrine were significantly reduced in EXP, VO2 peak and grip strength were significantly enhanced (p &lt, 0.05). In conclusion, it is indicated that 12-week regular combined exercise improves body composition, cardiometabolic risk factors, hemodynamics, and physical performance in obese older men.

[Purpose] The purpose of this study was to comparatively investigate the correlation among body composition, resting metabolic rate (RMR), and physical activity (PA) between young and middle-aged Korean adults. [Methods] A total of 53 [male n=23, female n=30] subjects were included in this study, among whom 34 subjects were healthy young adults [male n=18, female n=16] and 19 were middle-aged adults [male n=5, female n=14]. The body composition and RMR of all the participants were measured after overnight fasting (≥8 h). The Korean version of the WHO Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity. [Results] Body composition was not significantly different between young adults and middle-aged adults. Whole-body bone mineral density and bone mineral contents (BMC) were significantly lower in middle-aged adults than in young adults. Total blood cholesterol (TC) and blood glucose levels were significantly higher in middle-aged adults (TC; 195.21 ± 43.34, glucose; 103.57 ± 12.61 mg/dL) than in young adults. RMR was significantly lower in middle-aged adults (1619.57 ± 290.28 kcal/day) than in young adults (1894.37 ± 405.00 kcal/day). In middle-aged adults physical activity (PA). PA (METs, min, EE) was inversely correlated with fat mass (FM, kg, and %) and blood triglyceride (TG) level in young adults. In middle-aged adults, PA showed a significant positive correlation with lean body mass (LBM), FM (%), and RMR. Furthermore, PA EE showed significant interrelatedness with BMC among middle-aged adults. [Conclusion] These results demonstrated that high PA levels enable LBM and RMR maintenance in middle- aged adults. Furthermore, in young adults, more PA is required to induce change in body composition.

This study evaluated the effects of intermittent interval training in hypoxic conditions for six weeks compared with normoxic conditions, on hemodynamic function, autonomic nervous system (ANS) function, immune function, and athletic performance in middle- and long-distance runners. Twenty athletes were divided into normoxic training (normoxic training group (NTG), n = 10, residing and training at sea level) and hypoxic training (hypoxic training group (HTG), residing at sea level but training in 526-mmHg hypobaric hypoxia) groups. All dependent variables were measured before, and after, training. The training frequency was 90 min, 3 d per week for six weeks. Body composition showed no significant difference between the two groups. However, the HTG showed more significantly improved athletic performance (e.g., maximal oxygen uptake). The hemodynamic function (e.g., oxygen uptake, oxygen pulse, and cardiac output) during submaximal exercise and ANS function (e.g., standard deviation and root mean square of successive differences, high frequency, and low/high frequency) improved more in the HTG. Immune function parameters were stable within the normal range before and after training in both groups. Therefore, hypoxic training was more effective in enhancing athletic performance, and improving hemodynamic and ANS function, further, it did not adversely affect immune function in competitive runners.

This study aimed to compare the effects of an acute Pilates program under hypoxic vs. normoxic conditions on the metabolic, cardiac, and vascular functions of the participants. Ten healthy female Pilates experts completed a 50-min tubing Pilates program under normoxic conditions (N trial) and under 3000 m (inspired oxygen fraction = 14.5%) hypobaric hypoxia conditions (H trial) after a 30-min exposure in the respective environments on different days. Blood pressure, branchial ankle pulse wave velocity, and flow-mediated dilation (FMD) in the branchial artery were measured before and after the exercise. Metabolic parameters and cardiac function were assessed every minute during the exercise. Both trials showed a significant increase in FMD, however, the increase in FMD was significantly higher after the H trial than that after the N trial. Furthermore, FMD before exercise was significantly higher in the H trial than in the N trial. In terms of metabolic parameters, minute ventilation, carbon dioxide excretion, respiratory exchange ratio, and carbohydrate oxidation were significantly higher but fat oxidation was lower during the H trial than during the N trial. In terms of cardiac function, heart rate was significantly increased during the H trial than during the N trial. Our results suggested that, compared to that under normoxic conditions, Pilates exercise under hypoxic conditions led to greater metabolic and cardiac responses and also elicited an additive effect on vascular endothelial function.

[Purpose] The study was designed to examine the effects of a 10-week sports climbing training on body composition and surrogate indices of major lifestyle disease in obese elderly women. [Methods] Twenty elderly women, whose percent body fat was over 35%, were randomly assigned into one of two groups, i.e., sports climbing training group (TR: n=10) and control group (CON: n=10). The subjects in TR completed sports climbing training program with 5.8 and 5.9 of difficulty, at 11-13 of ratings of perceived exertion (RPE), 60 min/session, three sessions/wk for 10 weeks. Independent variables regarding body composition and major lifestyle disease, i.e., hypertension, dyslipidemia, and atherosclerosis, were measured and compared between two groups as well as between two tests simultaneously using a repeated two-way ANOVA. [Results] Regarding physique and body composition, there were significant interactions between group and test in body weight, body mass index, fat mass, and percent body fat. These variables decreased significantly in TR. 2) Regarding indices of hypertension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure decreased significantly in TR. Regarding indices of dyslipidemia, triglyceride decreased significantly in TR. Regarding indices of atherosclerosis, TG/HDL-C ratio decreased significantly in TR. [Conclusions] It was concluded that the 10-week sports climbing training would be beneficial for reduction of body fat despite its’ influence on fat-free mass was limited, and would also contribute on improving surrogate indices of hypertension, dyslipidemia, and atherosclerosis in obese elderly women. Future research investigating the effects of various period, intensity, duration, and frequency of sports climbing training would be warranted.

Objective Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. Methods One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. Results Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. Conclusion Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.

[Purpose] Hemodynamic function is a parameter indicating oxygen delivery and utilization capacity and is an important determinant of exercise performance. The present study aimed to determine whether intermittent hypoxic training (IHT) ameliorates hemodynamic function and exercise performance in competitive swimmers. [Methods] Twenty competitive swimmers (10 men, 10 women) volunteered to participate in the study. Participants were divided into the normoxic training (NT) group and the hypoxic training (HT) group and were subjected to training in a simulated altitude of 3000 m. We evaluated hemodynamic function profiles over 30 min of submaximal exercise on a bicycle and exercise performance before and after 6 weeks of training, which involved continuous exercise at 80% maximal heart rate (HRmax) for 30 min and interval exercise at 90% of HRmax measured before training for 30 min (ten rounds comprising 2 min of exercise followed by 1 min of rest each round). [Results] Significant changes in oxygen consumption (decrease) and end-diastolic volume (increase) were observed only in the HT group. Heart rate (HR), cardiac output (CO), and ejection fraction (EF) were significantly reduced in both groups, but the reduction rates of HR and CO were greater in the HT group than in the NT group. Exercise performance measures, including maximal oxygen consumption and 400-m time trial, were significantly increased only in the HT group. [Conclusion] Our findings suggested that 6 weeks of IHT, which involved high-intensity continuous and interval exercise, can effectively improve exercise performance by enhancing hemodynamic function in competitive swimmers.