ANALYSIS OF THE CARDIOPULMONARY ENDURANCE RESPONSE OF WOMEN TO AEROBIC EXERCISE

ABSTRACT Introduction: The main purpose of aerobic exercise is to enhance cardiopulmonary endurance, so it is necessary to build cardiopulmonary endurance response models based on different frequencies of aerobic exercise. Objective: To study the cardiopulmonary endurance response of women to different frequencies of aerobic exercise. Methods: Twenty young female desk workers (female teachers and civil servants) who worked out at a fitness club were randomly divided into two groups. Cardiopulmonary function, both before and after 16 weeks of aerobic exercise at different exercise loads, was studied and analyzed. Results: After 16 weeks of aerobic exercise at different exercise loads, all the young women had significantly improved their vital capacity (VC), and their maximum oxygen uptake ability was improved to a certain extent. Compared with the 45-minute aerobic exercise group, the vital capacity (VC)of 90-minute aerobic exercise group was significantly increased (P>0.05). Conclusions: When performed at a consistent frequency level, aerobic exercise with a relatively high exercise load can better develop the body’s respiratory system function. This may be due to deep stimulation of the respiratory system from high-load aerobic exercise, and ultimately to the intensive exercising of lung function. Level of evidence II; Therapeutic studies - investigation of treatment results.

Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy

Background The Ankylosing Spondylitis Association of Switzerland (SVMB) aimed to implement physical activity recommendations (PAR) within their exercise groups (EGs). The PAR promote exercise in all fitness dimensions at the correct dose. To implement the PAR within EGs, they were translated into a new EG concept with five key activities: (a) training for supervising physiotherapists (PTs), (b) correctly dosed exercises in all fitness dimensions, (c) exercise counselling, (d) bi-annual fitness assessments, and (e) individual exercise training, in addition to EG. All these activities were realized in close coordination with SVMB management. Objectives To analyse the implementation success by evaluating adherence/fidelity, feasibility, and satisfaction at the patient, PTs, and organisational level. Methods The five key activities of the new EG concept were developed, executed, and assessed after 6 months. The primary outcomes for implementation success were adherence of patients to the recommended exercise behaviour, self-reported by electronic diary; fidelity of PTs to the new concept, self-reported by diary; SVMB organisational changes. Secondary outcomes were feasibility and satisfaction with the new EG concept at all three levels. The tertiary outcome, to evaluate the effectiveness of PAR, was patient fitness, assessed through fitness assessments. Results 30 patients with axSpA (ten women, mean age 58 ± 9 years) and four PTs (three women, mean age 46 ± 9 years) participated. The patients' self-reporting of adherence to the PAR was insufficient (43%), possibly due to technical problems with the electronic dairy. The PTs' fidelity to the new EG concept was satisfactory. On all levels, the new concept was generally perceived as feasible and useful for supporting personalised exercise.The frequency of exercise counselling and the fitness assessments was found by patients and PTs to be too high and rigid. Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months. Conclusions The pilot implementation of PAR showed acceptance and satisfaction to be sufficient, thus confirming the need for evidence-based EGs, provided by a patient organisation in order to support active PA behaviour. However, adaptations are necessary to increase its feasibility for nationwide implementation. Trial Registration: SNCTP, SNCTP000002880. Registered 31 May 2018, https://www.kofam.ch/en/snctp-portal/search/0/study/42491.

The Wound Healing Effect of Nanoclay, Collagen, and Tadalafil in Diabetic Rats: An In Vivo Study

The diabetic wound is the most challenging one to manage, which is associated with microvascular and macrovascular dysfunction, and novel strategies such as using hydrogels demonstrate their promising prospect in treatment and management approaches of the diabetic wound. This study aimed to investigate the effect of collagen/nanoclay/tadalafil hydrogel on wound healing in diabetic rats under HIIT exercise. Hydrogel was synthesized, and then biocompatibility and antibacterial tests were performed. The therapeutic effect of collagen/nanoclay/tadalafil hydrogel was assessed after induction of diabetes in the rat model, and wound healing was evaluated with macroscopic and microscopic tests. The result of the MTT test showed no significant cytotoxicity of collagen/nanoclay/tadalafil hydrogel. Furthermore, the inhibitory effect of hydrogel was detected on E. coli and S. aureus. The macroscopic results demonstrated that the wound contraction was considerable in the hydrogel/HIIT exercise and hydrogel groups compared with the HIIT exercise and control groups during 21 days. The microscopic results showed that the presence of fibroblasts, the amount of collagen, the epidermis density, and the formation of hair follicles were increased in the hydrogel/HIIT exercise group compared with other groups in the diabetic rate model. It can be concluded that collagen/nanoclay/tadalafil hydrogel with HIIT exercise could accelerate diabetic wound healing and can be an appropriate candidate for skin regeneration in medical applications.

Impact of aerobic exercises on taste perception for sucrose in patients with type 2 diabetes mellitus; A randomized controlled trial

Background Regular exercise is a key element in the management of type 2 diabetes mellitus (T2DM). Although the importance of regular exercises on glycemic control in people with diabetes is studied extensively, evidence is lacking on its impact on sweet taste perception. Thus, the aim of this study was to determine the impact of aerobic exercises on taste perception for sucrose in people with diabetes. Methods A sample of 225 people with diabetes aged 35-60 years was assigned randomly into 3 groups; aerobic exercise, combined exercise and a control group. The outcomes of the combined exercise group is not reported. The aerobic exercise group performed brisk walking 30min/day, 4-5days/week for 6 months. The primary outcome measures were supra-threshold intensity ratings and preference for sucrose assessed at baseline, at 3 and 6 months using ‘general Labeled Magnitude Scale’ and ‘Monell 2-series-forced choice method’ respectively. Glycated haemoglobin (HbA1c) level was assessed at baseline and at 6 months to determine glycemic control. Results Aerobic exercise group showed significantly increased ratings (mm) for higher sucrose concentrations at 3 months (mean difference for 2.02M; +6.63±2.50, p=0.048 and for 0.64M; +7.26±2.76, p=0.026) and at 6 months (mean difference for 0.64M; +7.79±4.49, p= 0.044) compared to baseline and also when compared to controls (mean difference for 2.02M between baseline and 3 months; intervention: +6.63±2.50, control: -4.01±1.79, p=0.02 and between baseline and 6 months for 2.02M; intervention: +3.15±0.57, control: -7.96±0.40, p=0.022 and for 0.64M; intervention: +7.79±4.49, control: -8.98±0.99, p=0.003). A significantly reduced preference (mol/L) was seen both at 3 (mean difference; -0.03±0.02, p= 0.037) and at 6 months (mean difference; -0.05±0.12, p=0.011) compared to baseline within the intervention group. Also, a significant reduction was seen in the intervention group compared to controls at 6 months (mean difference; intervention: -0.05±0.12, control: 0.01±0.03, p=0.044). HbA1c was significantly reduced in the intervention group compared to controls at 6 months (mean difference; intervention -0.43±1.6%, control +0.33±1.8%, p=0.018). Conclusion Regular aerobic exercises increase the sweet taste sensitivity, especially for higher concentrations of sucrose and decrease sweet taste preference in people with diabetes . These alterations in sweet taste perception, are likely to contribute to a better glycemic control in people with diabetes. Trial registration This trial was registered at the Sri Lanka Clinical Trial registry on 16/12/2015. (Trial registration number- SLCTR/2015/029, https://slctr.lk/trials/slctr-2015-029).

The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain

Background and purpose In recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain. Materials and methods A total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index. Results The pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05). Conclusion A vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.

Methylglyoxal reduces molecular responsiveness to 4 weeks of endurance exercise in mouse plantaris muscle

Endurance exercise triggers skeletal muscle adaptations, including enhanced insulin signaling, glucose metabolism, and mitochondrial biogenesis. However, exercise-induced skeletal muscle adaptations may not occur in some cases, a condition known as exercise-resistance. Methylglyoxal (MG) is a highly reactive dicarbonyl metabolite and has detrimental effects on the body such as causing diabetic complications, mitochondrial dysfunction, and inflammation. This study aimed to clarify the effect of methylglyoxal on skeletal muscle molecular adaptations following endurance exercise. Mice were randomly divided into 4 groups (n = 12 per group): sedentary control group, voluntary exercise group, MG-treated group, and MG-treated with voluntary exercise group. Mice in the voluntary exercise group were housed in a cage with a running wheel, while mice in the MG-treated groups received drinking water containing 1% MG. Four weeks of voluntary exercise induced several molecular adaptations in the plantaris muscle, including increased expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC1α), mitochondria complex proteins, toll-like receptor 4 (TLR4), 72-kDa heat shock protein (HSP72), hexokinase II, and glyoxalase 1; this also enhanced insulin-stimulated Akt Ser473 phosphorylation and citrate synthase activity. However, these adaptations were suppressed with MG treatment. In the soleus muscle, the exercise-induced increases in the expression of TLR4, HSP72, and advanced glycation end products receptor 1 were inhibited with MG treatment. These findings suggest that MG is a factor that inhibits endurance exercise-induced molecular responses including mitochondrial adaptations, insulin signaling activation, and the upregulation of several proteins related to mitochondrial biogenesis, glucose handling, and glycation in primarily fast-twitch skeletal muscle.

Postural control and risk of falling in people who are blind: The effect and durability of perturbation and vestibular exercises

The aim of this study was to compare the effect and durability of perturbation and vestibular exercises on balance and the risk of falling in people with visual impairment (VI). Thirty-six men with VI were divided into three groups, including a control and two experimental (perturbation and vestibular) groups. The experimental groups performed perturbation and vestibular exercises for 4 weeks and three sessions per week. Biodex balance system was used to assess balance and falling risk before and after training interventions. To evaluate the effects within and between groups at three levels of measurement: pre-test, post-test, and durability effect between three groups, repeated measures analysis of variance (ANOVA) and one-way ANOVA were used. Repeated measures ANOVA test showed that both experimental groups showed significant improvements in static balance, dynamic balance, and falling risk. In comparison between the groups, the results showed that in the post-test and durability stages, there was a significant difference between the groups and the perturbation exercise group had a greater effect on the dependent variables. Due to the effectiveness of exercises, it is recommended that people with VI pay attention to balance-based perturbation exercises to strengthen the somatosensory system and vestibular exercises to strengthen the vestibular system.

Effect of 3 Months Exercise on Ovarian Reserve and Ovulatory Status of Premenopausal Students of Nnamdi Azikiwe University, Nnewi Campus

There is a traditional believe that if premenopausal women engage in prolonged physical exercise, they are likely to have infertility. This study assessed the effect of prolonged moderate – vigorous exercise on ovarian reserve and ovulatory status in premenopausal students of Nnamdi Azikiwe University, Nnewi Campus. The objectives were to determine the effect of moderate – vigorous intensity exercise on Anti-Mullerian hormone (AMH), day 3 Follicle stimulating hormone (FSH), Luteinizing Hormone (LH), day 3 Estrogen, day 21 Estrogen, and day 21 Progesterone levels in premenopausal women. This was a prospective comparative study involving 80 participants aged between 19 and 25 years, randomly selected and assigned to exercise group and control group. The exercise group comprised 40 participants who engaged in moderate – vigorous intensity exercise using elliptical bike for 30 minutes, five days a week for 3 months; however, 30 individuals completed the exercise. The control group comprised of 40 individuals that did not do exercise but 30 individuals completed the study. Blood (8ml) was collected from each of the participants at baseline, 1 month, 2 months, and 3 months. AMH, FSH, LH, Estrogen and Progesterone levels were analyzed using enzyme- linked Immunosorbent assay (ELISA) method. Results were regarded as significant at p˂ 0.05. In the exercise group, the serum level of day 3 FSH, LH, Estrogen were significantly lower from 7.27±0.77 mIU/ml, 7.00±0.77 mIU/ml, 36.33±5.13 pg/ml respectively at baseline to 5.62±0.48 mIU/ml, 5.36±0.80 mIU/ml, 21.36±4.34 pg/ml respectively after 3 months of exercise while there was significantly higher levels of AMH and day 21 progesterone after 3 months of exercise compared with the baseline and respective control (p<0.05). Prolonged Moderate-to-vigorous exercise may enhance fertility and well-being of premenopausal women. Key words: Anti-Mullerian hormone (AMH), day 3 Follicle stimulating hormone (FSH), Luteinizing Hormone (LH), day 3 Estrogen, day 21 Estrogen, day 21 Progesterone, moderate – vigorous exercise, ovarian reserve, ovulatory status, premenopausal women.

Effectiveness of Therapeutic Exercise and Patient Education on Cancer-Related Fatigue in Breast Cancer Survivors: A Randomised, Single-Blind, Controlled Trial with a 6-Month Follow-Up

This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised, single-blind, clinical trial was conducted with a total of 80 breast cancer survivors who presented cancer-related fatigue. Women were randomised into a supervised therapeutic exercise group (STE-G) (n = 40) or an unsupervised exercise group (UE-G) (n = 40). Both interventions included patient therapeutic education and were delivered in three sessions per week over eight weeks. The main outcome was perceived fatigue as assessed by the Spanish version of the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F). Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-Minute Walk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.

Effect of an Exercise Bout Prior to the Booster Dose of an Inactivated SARS-CoV-2 Vaccine on Immunogenicity in Immunocompromised Patients

This study aimed to investigate whether a single bout of exercise prior to the homologous booster dose of a SARS-CoV-2 inactivated vaccine (Sinovac-CoronaVac) could enhance immunogenicity in patients with dysfunctional immune system. This was a randomized controlled trial (1:1) within a single-arm, phase 4 vaccination trial, conducted in São Paulo, Brazil. Patients with spondyloarthritis assigned to the intervention group performed an exercise bout comprising three unilateral strength exercises involving eccentric and concentric contractions. After exercising, patients remained at rest for 1 h prior to vaccination, which was applied to the exercised arm. The control group remained at rest before vaccination. Immunogenicity was assessed before (Pre) and one month after (Post) the booster dose using seropositivity rates of total anti-SARS-CoV-2 S1/S2 IgG, geometric mean titers of anti-S1/S2 IgG (GMT), frequency of NAb positivity, and NAb activity. Before the booster dose, 16 patients from the exercise group and 16 patients from the control group exhibited seropositivity for IgG (59% vs. 57.1%), one month after the booster dose, seropositivity occurred in 96% vs. 100% of the cases (p = 0.84, group by time interaction). Only 10 patients from the exercise group and 12 patients from the control group showed positive NAb serology at Pre (37% vs. 42.8%). One month following the booster, NAb positivity was 96% vs. 93% (p = 0.41, group-by-time interaction). GMT was comparable between groups at Pre (p > 0.05). At Post, GMT increased similarly in both groups (exercise: 56.9%; control: 57.9%), with no group-by-time interaction (p = 0.82; estimated mean difference between groups at Post [EMD]: -40.4 UA/mL, 95%CI: -327, 246 UA/mL). Likewise, NAb activity was similar between groups at Pre and increased similarly in both of them as a result of the booster (47.5% vs. 39.9%), with no group-by-time interaction (p = 0.99; EMD: -6.19%, 95%CI: -17; 4.6%). In conclusion, a single bout of exercise did not enhance immunogenicity to a homologous booster dose of an inactivated SARS-CoV-2 vaccine among patients with spondyloarthritis. Studies assessing exercise as an adjuvant to first or second doses remain necessary.