Fit for Surgery – Effects of short-course multimodal individualized prehabilitation in high-risk frail colon cancer patients prior to surgery: A feasibility study

Background Prehabilitation is a promising modality for improving patient-related outcomes after major surgery, however, very little research has been done for those who may need it the most; the elderly and the frail. The study aimed to investigate if high risk, frail patients with colorectal cancer and WHO performance status I and II could adhere to a short course multimodal prehabilitation intervention prior to surgery.Methods The study was conducted as a single-center, prospective one-arm feasibility study with limited-efficacy testing of eight patients. The intervention consisted of a physical training program tailored to the patients with both high-intensity interval training and resistance training three times a week, nutritional support with protein and vitamins, a consultation with a dietician, and medical optimization prior to surgery. The primary outcomes were the increase in maximum oxygen intake (VO2 peak) during the intervention and per-protocol compliance and adherence. Secondary outcomes were: increase in body weight, increase in albumin, adverse events during the intervention, postoperative length of stay, and complications within 30 days after surgery. Results The mean age vas 80 (range: 66-88). Seven completed the intervention. The mean increase in maximum oxygen intake (VO2 peak) was 17 % (range: 0.6% - 28 %), with two patients being non-responders. All patients who had a prediagnostic weight loss increased their body weight with a mean of 2.5 kg (range: 1.3 – 4.0 kg). Adherence to high-intensity interval training was 87 %, whereas adherence to nutritional support was 57 %. The median postoperative length of stay was 3 days (range: 1-26).Conclusions This one-arm feasibility study indicates that multimodal prehabilitation including high-intensity interval training can be performed with high adherence to the program in patients with colorectal cancer and WHO performance status I and II Clinical trial registration Clinicaltrials.gov: NCT04167436, Date of registration November 18 2019. Retrospectively registered.

HIGH INTENSITY INTERVAL TRAININGS IN SCHOOLCHILDREN

High-intensity interval training is used to improve maximum oxygen intake and aerobic functional capacity of school children. So far, it has been discovered that high-intensity interval training (HIIT) is effective in improving anaerobic capacity. Aim of the study was to determine the effectiveness and impact of HIIT training on the improvement of VO2 in schoolchildren based on a systematic review of a large number of studies that have addressed the impact of high-intensity interval training. Following electronic databases were searched: Google Scholar, PubMed, Web of Science and Research Gate, using all papers available by April 30, 2020. The following keywords were used: "high-intensity interval", "training", "HIIT", "training". The search was mostly related to English and original scientific papers from available journals. In the first phase of the search, the relevance of the titles and abstracts of the identified papers was checked. In the second phase of the search, the complete papers were downloaded and considered for inclusion. References from all collected papers were reviewed to obtain more research that studied this area. Total of 10 studies met the criteria and were included into the systematic review. High-intensity interval training leads to the improvement of VO2, VO2max, O2 and other physiological parameters in school children by applying various high-intensity interval training programs. Programs in duration of six, ten and twelve weeks lead to the improvement of physiological parameters of school children, while the seven-week program of high-interval training proved to be the best program in relation to the duration and intensity of the program. Based on the analysis and discussion of the papers observed in the systematic research, it can be concluded that, according to the duration of the program, the minimum period where VO2 and VO2max and other physiological abilities can improve is six weeks, and the usual weekly load is two to three workouts per week.

PO-176 The Effects of Different Intensity Treadmill Exercise to Kidney Functions

Objective To provide more scientific and authoritative theoretical basis for body-building exercises after analyzing the changes of exercises of different intensities for the kidney functions. Methods The objects of the research are eight male students from Guangzhou Sport College, being exerted the treadmill exercises according to their own maximum oxygen intake. The intensities of exercises are respectively 55%VO2max, 75%VO2max, 85%VO2max, 95%VO2max. The urine 40ml and venous blood 3ml will be collected and tested before sport and 15minutes after the exercises. Results After four different intensities of exercise, the renin of each exercise group increased compared with the quiet value, and the greater the intensity, the more obvious the trend of change. Compared with the quiet value, the expression of angiotensin II increased in all groups after exercise, but there was no significant difference between the 55%VO2max intensity group and the 75%VO2max intensity group (P > 0.05), and there was significant difference between the 85%VO2max intensity group and the 95%VO2max intensity group (P < 0.05). Compared with the quiet value, the expression of aldosterone increased after each exercise. The mean value of 55%VO2max intensity group, 75%VO2max intensity group and 85%VO2max intensity group increased, but the difference was not significant (P > 0.05), and the 95%VO2max intensity group had a very significant difference (P < 0.01). The expression of urine beta 2 microglobulin was compared with the quiet value. There was significant difference in 85%VO2max intensity group and 95%VO2max intensity group (P<0.05). Conclusions High-intensity exercise causes renal function and body function decline. It is more appropriate to select 75% intensity exercise for body-building.

Case Study: Physical Capacity and Nutritional Status Before and After a Single-Handed Yacht Race

During solitary sailing, the sailor is exposed to sleep deprivation and difficulties in consuming regular meals. Sailor weight loss is often reported. In the present case study, we describe changes in the physical capacity and nutritional status of an athlete attempting a single-handed yacht race around the globe. An Italian male ocean racer (Gaetano Mura) asked for our help to reach an optimum level of physical and nutritional preparation. We planned his diet after assessing his anthropometric parameters and body composition, as well as his usual energy intake and nutritional expenditure. The diet consisted of 120 meals stored in sealed plastic bags. Before his departure, GM performed two incremental exercise tests (cycle ergometry and arm crank ergometry) to assess his physical capacity. Cardiac functions were also estimated by Doppler echocardiography. All measures and exercise tests were repeated 10 days after GM finished the race, which lasted 64 days. Anthropometric measures did not change significantly, with the exception of arm fat area and thigh muscle area, which decreased. There were evident increments in maximum oxygen intake and maximum workload during arm cranking after the race. On the contrary, maximum oxygen uptake and maximum workload decreased during cycling. Finally, end-diastolic and stroke volume decreased after the race. It was concluded that nutritional counseling was useful to avoid excessive changes in nutritional status and body composition due to 64 days of solitary navigation. However, a reduction in physical leg capacity and cardiovascular functions secondary to leg disuse were present.

PHYSIOLOGICAL AND BIOCHEMICAL CHANGES IN ADOLESCENT JUDO ATHLETES CAUSED BY TRAINING DURING START PERIOD

Study aim: The goal of the present study was to estimate and compare dynamics of physical fitness indices of judo athletes and non-sporting persons aged 11-17 years during this stage ontogeny and their importance of the body’s functional adaptation. Study material: The studies involved 47 judo athletes, 11–17 years old, who were divided into three age groups GP 11-13 years n=16; GP 14-15 years n=16; GP 16-17 years n=15, and 48 schoolchildren not involved in sports GK 11-13 years n=16; GK 14-15 years n=15; GK 16-17 years n=17. Aerobic and anaerobic capacity was studied in all groups. The initial studies were carried out in January and follow-up studies were conducted six months later. Results: Power indicators increased in all groups, but judo athletes’ anaerobic capacity was significantly higher comparing to other groups. Judo athletes’ simulation fights resulted in increased La concentrations, pH changes, and heart rate alterations, whereas the level of changes depended on athletes’ age, training, and training experience. Comparison of maximum oxygen intake parameters of judo players and untrained children of the same age did not reveal significant differences between these groups. Wrestlers aged 12 and 16 years presented significantly higher anaerobic prevalence in comparison with untrained children. The differences indicate that anaerobic performance potential in older judo athletes (16 years old and above) is increased, which is reflected by a higher intensity and elevated exercise loads as well as training experience. Conclusions: No significant differences were reported in terms of VO2 max between the study groups. The indicators of anaerobic performance of children training in judo (W/kg, W average /kg, Time achieved max power, Time to maintain max power) were significantly better in comparison with untrained peers. The maximum loads (Wingate test, especially in simulative judo fights) caused a significant increase in La levels accompanied by a decrease in pH in the chosen period of growth period.

Comparison of Maximum Oxygen Intake (VO2max) In Ten and Fourteen-Year-Old Girls // Usporedba maksimalnog primitka kisika (VO2max) djevojčica dobi 10 i 14 godina

The objective of the present research was to determine whether aerobic capacity of fourteen-year-old girls is higher than that of ten-year-old girls. The research aimed to establish if the level of cardio respiratory fitness in girls decreases with age, and if their overall physical activity also decreases. A low level of cardio respiratory fitness from an early age has been confirmed in a number of studies, and it has been highly correlated with a sedentary lifestyle. Research participants were 94 fourth and eighth grade primary school girls. The variables were anthropometric measures for body height, body weight, waist circumference, and hips circumference. All the measurements were done in accordance with the International Biological Program (IBP). Body fat percentage (BF%) was also measured with the Omron (Type BF511, Japan). A multistage 20m shuttle run test was used to obtain the values for aerobic capacity, and PAQ-C questionnaire was used to estimate the level of physical activity. The results indicate that only 5% of female students meet the recommendations for physical activity while 83% engage in moderate physical activity. Statistically significant differences were determined for the variables used to estimate the aerobic capacity, with ten-year-old girls (p=0.00) having better aerobic capacity than the fourteen-year-old girls. Furthermore, ten-year-old girls were found to be significantly more physically active (p=0.00). The results of the correlation test between the aerobic capacity (VO2 max) and the overall physical activity (PA) indicate significant positive correlation (r = 0.42; p = 0.00). Girls who do not engage in physical activity at least for the recommended 60 minutes need to be directed towards various forms of healthy lifestyle with a special emphasis on everyday physical exercise that may increase their aerobic capacity.

Effects of clenbuterol on horses

Clenbuterol was intended as a treatment for respiratory diseases in horses, but has been used in multiple species, including humans, for its repartitioning of fat to lean effects (free fatty acids are released from adipose tissue to be used by tissues of higher priority). In the horse industry clenbuterol application is restricted to the treatment of chronic obstructive pulmonary disease and reactive airway disease (heaves). Negative effects of clenbuterol exposure include a decrease in maximum oxygen intake and increased muscle fatigue upon exercise. As a result of these and other negative effects, clenbuterol remains strictly controlled by the US Food and Drug Administration.