Effects of Two Different Self-Adapted Occlusal Splints on Electromyographic and Force Parameters During Elbow Flexors Isometric Contraction.

Limonta, E, Arienti, C, Rampichini, S, Venturelli, M, Cè, E, Veicsteinas, A, and Esposito, F. Effects of two different self-adapted occlusal splints on electromyographic and force parameters during elbow flexors isometric contraction. J Strength Cond Res 32(1): 230-236, 2018-The study was aimed at determining the acute effects of 2 types of occlusal splints on maximum isometric strength and fatigue of the elbow flexors muscles. The hypothesis was that splint-induced masticatory muscle repositioning might improve primary muscles recruitment by stretching masticatory muscles especially with the thicker splint. On 9 physically active volunteers with no temporomandibular joint and masticatory muscles disorders, we assessed maximum voluntary contraction (MVC) of the elbow flexors with diurnal (OSD, 1-mm thick) and sport (OSSP, 3-mm thick) splints, and without splint (control, Ctrl). On different days, participants performed 60 seconds of isometric contraction at 100% MVC (100%60s) and 80% MVC contraction until exhaustion (80%exh) under OSD, OSSP, and Ctrl in random order. Time of force output within target (t-target), force distance from target (ΔF), and force coefficient of variation were calculated. Percentage of force decay (ΔFi-Fe) was determined during 100%60s. From the electromyographic (EMG) signal, root mean square (EMG RMS) and mean frequency (EMG MF) were determined. Neuromuscular efficiency (NE) was calculated as the ratio between force and EMG RMS. MVC contraction and NE were significantly higher in OSSP and OSD than in Ctrl. During MVC, EMG MF was significantly lower in both splint conditions, and EMG RMS showed a nonstatistical tendency to lower values under both splint conditions. During 80%exh, t-target was longer in OSD and OSSP (+7.8% and +5.2%, respectively) than in Ctrl. ΔFi-Fe was lower in OSSP than in Ctrl and OSD. These results support the hypothesis of a NE improvement of the elbow flexors possibly induced by acute, splint-induced masticatory muscles repositioning.

Comparison between continuous and discontinuous incremental treadmill test to assess velocity at V̇O2max.

BACKGROUND: The velocity associated with maximum aerobic power (vV̇O2max) is an important physiological parameter, which is utilized to determine relative workloads on the field. The testing modality adopted to evaluate it, though, may cause differences in vV̇O2max assessment and, in turn, in training intensity. The aim of the study was to compare two different testing modalities (continuous incremental ramp and discontinuous square wave (SW) protocols) for vV̇O2max assessment on the treadmill. METHODS: Seventeen physically active participants performed three maximum incremental tests on a treadmill: two continuous ramp protocols, with different ramp slopes (R1, 1 km/h every minute; and R2, 1 km/h every 2 minutes), and one discontinuous SW protocol, in random order, for maximum oxygen uptake (V̇O2max) and vV̇O2max determination. Cardiorespiratory and metabolic parameters were collected breath-by-breath at rest and during exercise. RESULTS: vV̇O2max was significantly higher in R1 and R2 compared to SW (20.7±0.5, 18.6±0.4, 16.8±0.6 km/h for R1, R2, and SW, respectively; P<0.001). No significant differences were found among protocols for V̇O2max (56.7±1.1, 57.0±1.2, and 56.6±1.2 mL/min/kg for SW, R1, R2, respectively) as well as for expiratory ventilation, carbon dioxide production, blood lactate concentration, and heart rate. CONCLUSIONS: In spite of similar V̇O2max values, vV̇O2max was higher during continuous incremental ramp tests compared to SW possibly due to the longer time for cardiorespiratory and metabolic adjustments, suggesting different aerobic and anaerobic metabolism involvement. The differences among protocols should be considered when vV̇O2max is used for training purposes.

Motor unit activation strategy during a sustained isometric contraction of finger flexor muscles in elite climbers.

The aim of the study was to evaluate, by an electromyographic (EMG) and mechanomyographic (MMG) combined approach, whether years of specific climbing activity induced neuromuscular changes towards performances related to a functional prevalence of fast resistant or fast fatigable motor units. For this purpose, after the maximum voluntary contraction (MVC) assessment, 11 elite climbers and 10 controls performed an exhaustive handgrip isometric effort at 80% MVC. Force, EMG and MMG signals were recorded from the finger flexor muscles during contraction. Time and frequency domain analysis of EMG and MMG signals was performed. In climbers: (i) MVC was higher (762 ± 34 vs 512 ± 57 N; effect size: 1.64; confidence interval: 0.65-2.63; P < 0.05); (ii) endurance time at 80% MVC was 43% longer (34.2 ± 3.7 vs 22.3 ± 1.5 s; effect size: 1.21; confidence interval: 0.28-2.14; P < 0.05); (iii) force accuracy and stability were greater during contraction (P < 0.05); (iv) EMG and MMG parameters were higher throughout the entire isometric effort (P < 0.05). Collectively, force, EMG and MMG combined analysis revealed that several years of specific climbing activity addressed the motor control system to adopt muscle activation strategies based on the functional prevalence of fast resistant motor units.

Effects of endurance, circuit, and relaxing training on cardiovascular risk factors in hypertensive elderly patients.

Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.

Hyaluronic acid injections protect patellar tendon from detraining-associated damage.

INTRODUCTION: Having previously demonstrated that detraining affects patellar tendon (PT) proteoglycan content and collagen fiber organization, we undertook the present study with two aims: to improve knowledge on the adaptation of PT and its enthesis to detraining from a histological and histomorphometric point of view, and to investigate the hypothesis that repeated peri-patellar injections of hyaluronic acid (HA) on detrained PT may reduce and limit detrained associated-damage. METHODS: Twenty-four male Sprague-Dawley rats were divided into 3 groups: Untrained (n=6), Trained (n=6) (10 wks-treadmill) and Detrained (n=12). In the detrained rats, the left tendon was untreated while the right tendon received repeated peri-patellar injections of either HA or saline (NaCl). Structure and morphology of PTs (modified Movin score, tear density, collagen type I and III) and enthesis (cell morphology, chondrocyte cluster formation, tidemark integrity, matrix staining and vascularization) were evaluated. RESULTS: The left PT and enthesis of the Detrained groups showed altered structure and morphology with the highest Movin score values, the highest percentage of collagen III and the lowest of collagen I; the lowest score values were observed in the Trained and Detrained-HA groups. Detrained-NaCl PTs showed the highest collagen III and the lowest collagen I values with respect to Detrained-HA PTs. CONCLUSION: This study strengthens previously published data showing the alteration in tendon and enthesis morphology due to discontinuation of training, and provides new data showing that treatment with HA is effective in the maintenance of the structural properties of PT and enthesis in Detrained rats. Such beneficial effects could play a significant role in the management of conservative and rehabilitation strategies in athletes that change type, intensity and duration of training.

Electromechanical delay components during relaxation after voluntary contraction: reliability and effects of fatigue.

INTRODUCTION: Fatigue effects on total relaxation delay (R-DelayTOT ) components and measurement reliability were investigated. METHODS: Electromyogram (EMG), force (F), and mechanomyogram (MMG) were recorded during maximum voluntary contraction from the biceps brachii muscle before and after fatigue. The delays between EMG cessation and onset of F decay (R-EMD), between F decay and onset of MMG largest displacement (MMG p-p) (R-Δt F-MMG), from the beginning to the end of MMG p-p (R-Δt MMGp-p ), and from the end of MMG p-p to F cessation (R-Δt MMG-Fend ) were calculated. RESULTS: R-DelayTOT lasted 366 ± 10 ms. R-EMD, R-Δt F-MMG, R-Δt MMGp-p , and R-Δt MMG-Fend accounted for 6%, 8%, 59%, and 27% of R-DelayTOT , respectively. After fatigue, R-DelayTOT , R-EMD, R-Δt F-MMG, and R-Δt MMGp-p increased by 38%, 22%, 40%, 40%, and 38%, respectively (P<0.05). Reliability was very high (0.853-0.960). CONCLUSIONS: R-Δt MMGp-p was the main contributor to R-DelayTOT . Fatigue affected all R-DelayTOT contributors, with a smaller effect on R-EMD.

Autonomic modulations of heart rate variability and performances in short-distance elite swimmers.

PURPOSE: Endurance exercise is associated with high cardiac vagal tone, but how the cardiac autonomic control correlates with shorter anaerobic performances is unknown. Therefore, the aim of this study was to evaluate how autonomic modulations of heart rate (HR) variability (V) correlate with performances of short- (<1 min) and very short (<30 s) duration in elite athletes. METHOD: Thirteen male swimmers, national-level crawl specialists in short (100-m) and very short (50-m) distances, were enrolled. HR was recorded during 15-min supine rest: (1) in the morning after wake up, (2) in the afternoon before sprint-oriented training sessions, (3) few minutes after training (first recovery phase after swimming cooldown). Heart rate variability (HRV) vagal and sympatho/vagal indices were calculated in time, frequency and complexity domains. Correlations of best seasonal times on 100- or 50-m distances with HRV indices and the velocity at blood lactate accumulation onset (V OBLA) were calculated. RESULTS AND CONCLUSION: Vagal indices were highest in the morning where they positively correlated with very short-distance times (higher the index, worse is the 50-m performance). Sympatho/vagal indices were highest after training where they negatively correlated with short-distance times (higher the index, better is the 100-m performance). V OBLA did not correlate with the performances. Therefore, autonomic HRV indices and not V OBLA predict short and very short, most anaerobic, performances. Results also suggest that a strong cardiac vagal control has no effect on short performances and is even detrimental to very short performances, and that the capacity to powerfully increase the sympathetic tone during exercise may improve short, but not very short performances.

Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings.

Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of VO(2max) during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the VO(2max) estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating VO(2max), one has to be aware of the effects of medication on heart rate-based submaximal protocols. In the home setting, the submaximal protocols need to be accessible to users with a broad range of characteristics in terms of age, equipment, time available, and an absence of supervision. In this setting, the smart use of sensors such as accelerometers and heart rate monitors will result in protocol-free VO(2max) assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of VO(2max) has brought about the development and the validation of a large number of submaximal exercise tests. It is of paramount importance to use these tests in the right context (sports, clinical, home), to consider the population in which they were developed, and to be aware of their limitations.

Effects of temperature and fatigue on the electromechanical delay components.

INTRODUCTION: Neuromuscular activation can be influenced by both muscle temperature (Tm) and fatigue. METHODS: To assess the effects of Tm and fatigue on the electromechanical delay (EMD), 15 participants performed voluntary isometric contractions of different intensities under neutral (TmN), low (TmL), and high (TmH) Tm, before and after a fatiguing exercise. During contraction, electromyogram (EMG), mechanomyogram (MMG), and force (F) were recorded from the biceps brachii muscle. The EMD and the latencies between EMG and MMG (Δt EMG-MMG, which includes the electrochemical processes of EMD) and between MMG and F (Δt MMG-F, which includes the mechanical processes of EMD) were calculated. RESULTS: TmL increased only Δt EMG-MMG, both before and after fatigue. Fatigue lengthened EMD, Δt EMG-MMG, and Δt MMG-F under all Tm to a similar extent. CONCLUSIONS: While fatigue increased all EMD components, muscle cooling affected only the electrochemical but not the mechanical processes of EMD.

Stretching and deep and superficial massage do not influence blood lactate levels after heavy-intensity cycle exercise.

The study aimed to assess the role of deep and superficial massage and passive stretching recovery on blood lactate concentration ([La(-)]) kinetics after a fatiguing exercise compared to active and passive recovery. Nine participants (age 23 ± 1 years; stature 1.76 ± 0.02 m; body mass 74 ± 4 kg) performed on five occasions an 8-min fatiguing exercise at 90% of maximum oxygen uptake, followed by five different 10-min interventions in random order: passive and active recovery, deep and superficial massage and stretching. Interventions were followed by 1 hour of recovery. Throughout each session, maximum voluntary contraction (MVC) of the knee extensor muscles, [La(-)], cardiorespiratory and metabolic variables were determined. Electromyographic signal (EMG) from the quadriceps muscles was also recorded. At the end of the fatiguing exercise, [La(-)], MVC, EMG amplitude, and metabolic and cardiorespiratory parameters were similar among conditions. During intervention administration, [La(-)] was lower and metabolic and cardiorespiratory parameters were higher in active recovery compared to the other modalities (P < 0.05). Stretching and deep and superficial massage did not alter [La(-)] kinetics compared to passive recovery. These findings indicate that the pressure exerted during massage administration and stretching manoeuvres did not play a significant role on post-exercise blood La(-) levels.

Effects on body composition of different short-term rehabilitation programs in long-stay hospitalized elderly women.

BACKGROUND AND AIMS: Long-stay hospitalized elderly women usually reduce daily living activities: this may lead to an accelerated worsening of body composition, cardio-metabolic condition and falls risk. Exercise training and electrical stimulation may ameliorate such condition. METHODS: The effects of 3 different short-term rehabilitation programs on lower limbs (kinesitherapy [KT], electrical stimulation [ES], KT combined with ES [KT+ES], 3 day/week for 6 weeks) were assessed on 40 hospitalized elderly women (82±7 yrs, 59.5±12.3 kg, 152±7 cm [m±SD]; n=10 for each intervention group and n=10 as control subjects [no intervention]). Segmental (upper and lower limbs) and total body fat mass (FM), fat free mass (FFM), bone mineral content (BMC) and density (BMD), resting energy expenditure (REE), maximum voluntary force (MVC) of leg extensor muscles and cardiorespiratory performance (6-min walking test [6MVT]) were evaluated before and after intervention. RESULTS: Compared to baseline, the distance covered by the 6MWT significantly increased after all rehabilitation programs (from 247±79 to 271±87 m, p<0.01), whereas significant increases in leg extensor muscles MVC were found after ES (+26%) and KT+ES (+16%) only, p<0.05. No changes in segmental and total body FM, FFM and REE were observed, whereas legs BMC significantly increased (2.7%) after KT only (p<0.05). CONCLUSIONS: Although all treatments increased cardiorespiratory performance, and KT and ES ameliorated muscle force, the proposed short-term exercise programs had poor effects on body composition. This suggests that longer programs, maybe combined with a tailored dietary intervention, should be administered to improve body composition in rehabilitating institutionalized elderly people.

Combined effects of fatigue and temperature manipulation on skeletal muscle electrical and mechanical characteristics during isometric contraction.

Peripheral fatigue and muscle cooling induce similar effects on sarcolemmal propagation properties. The aim of the study was to assess the combined effects of muscle temperature (Tm) manipulation and fatigue on skeletal muscle electrical and mechanical characteristics during isometric contraction. After maximum voluntary contraction (MVC) assessment, 16 participants performed brief and sustained isometric tasks of different intensities in low (Tm(L)), high (Tm(H)) and neutral (Tm(N)) temperature conditions, before and after a fatiguing exercise (6s on/4s off at 50% MVC, to the point of fatigue). During contraction, the surface electromyogram (EMG) and force were recorded from the biceps brachii muscle. The root mean square (RMS) and conduction velocity (CV) were calculated off-line. After the fatiguing exercise: (i) MVC decreased similarly in all Tm conditions (P<0.05), while EMG RMS did not change; and (ii) CV decreased to a further extent in Tm(L) compared to Tm(N) and Tm(H) in all brief and sustained contractions (P<0.05). The larger CV drop in Tm(L) after fatigue suggests that Tm(L) and fatigue have a combined and additional effect on sarcolemmal propagation properties. Despite these changes, force generating capacity was not affected by Tm manipulation. A compensatory mechanism has been proposed to explain this phenomenon.

Energy cost of spontaneous walking in Parkinson's disease patients.

In healthy subjects, comfortable walking minimizes the energy cost (E (c)) of locomotion. In Parkinson's disease (PD) patients walking is slower than in healthy subjects: this may increase E (c). Our aims were to analyze gait and E (c) in PD patients during walking, particularly at self-selected speed, and the possible pathological, mechanical, and cardiorespiratory limitations. Fourteen mild-to-moderate PD and 14 control subjects were enrolled. Subjects underwent 5-min walking tests at two speeds: self-selected and as-fast-as-possible speeds. Cardiopulmonary and gait parameters (heart rate, ventilation, gas exchanges, step count) were recorded. Velocity was reduced in PD compared to control subjects at both speeds (P < 0.05), and PD patients had shorter strides (P < 0.05) at both speeds and reduced cadence (P = 0.01) at fastest speed. No significant difference was found in E (c) at self-selected (0.12 ± 0.04 versus 0.11 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) and maximal (0.14 ± 0.03 versus 0.15 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) speed. However, the E (c) increment from self-selected to fastest velocity was significantly lower (P = 0.02) in PD patients. PD patients failed to walk at a self-selected speed, which minimizes the E (c). This could be mainly due to the inability to develop a wider stride. Cardiorespiratory adaptation was not affected, except for the possible reduced cardiac adaptation observed in some (28%) cases. Presumably, rehabilitation procedures that improve flexibility and step length may help maintain walking ability.

Proteomic analysis and protein carbonylation profile in trained and untrained rat muscles.

Understanding the relationship between physical exercise, reactive oxygen species and skeletal muscle modification is important in order to better identify the benefits or the damages that appropriate or inappropriate exercise can induce. Unbalanced ROS levels can lead to oxidation of cellular macromolecules and a major class of protein oxidative modification is carbonylation. The aim of this investigation was to study muscle protein expression and carbonylation patterns in trained and untrained animal models. We analyzed two muscles characterized by different metabolisms: tibialis anterior and soleus. Whilst tibialis anterior is mostly composed of fast-twitch fibers, the soleus muscle is mostly composed of slow-twitch fibers. By a proteomic approach we identified 15 protein spots whose expression is influenced by training. Among them in tibialis anterior we observed a down-regulation of several glycolitic enzymes. Concerning carbonylation, we observed the existence of a high basal level of protein carbonylation. Although this level shows some variation among individual animals, several proteins (mostly involved in energy metabolism, muscle contraction, and stress response) appear carbonylated in all animals and in both types of skeletal muscle. Moreover we identified 13 spots whose carbonylation increases after training.

Aerobic training affects fatty acid composition of erythrocyte membranes.

The effect of exercise training on the fatty acid composition of erythrocyte membranes was evaluated in an experimental animal model where rats were subjected to a ten-wk aerobic training. Five groups of rats were compared: sedentary rats at 19 or 23 wks of age, rats trained at moderate or high intensity sacrificed at 19 wks of age, and rats trained at high intensity, and sacrificed following 4 weeks of sedentary life. We had already demonstrated that cardioprotection correlates with training intensity and partially persists in detrained rats. Main findings are that rats trained at higher intensity display consistent signs of lipid peroxidation but a lower ω6/ω3 ratio and a lower content of trans fatty acids when compared to rats trained at lower intensity and to older sedentary rats. Trans fatty acids negatively affect cell membrane fluidity and permeability. Detrained rats showed intermediate values. Gene expression evaluation of selected enzymes involved in lipid biosynthesis revealed some of the adaptive mechanisms leading to the maintenance of membrane fatty acid homeostasis following exercise. The decrease in the amount of trans fatty and in the inflammatory pathways (i.e. ω6/ω3 ratio) in high-intensity trained rats underscores the protective effect of high intensity aerobic training.

Effect of training on airways inflammatory response and remodeling in a rat model.

Training has many beneficial effects, however few studies report its effects on the lungs. The aim of this study was to assess the effects of acute exercise and exercise training on inflammatory responses and remodeling in central and peripheral airways. Sixteen Sprague-Dawley rats trained for 10 weeks, while 14 rats served as controls. Before sacrifice, 8 trained (TR(AC)) and 8 untrained control (CON(AC)) rats underwent a single acute exercise bout, while 8 trained (TR) and 6 untrained control (CON) rats were sacrificed without acute exercise. The central and peripheral airways were morphologically examined for inflammatory cells and immunostained for decorin, collagen I, α-smooth muscle actin. No significant differences were found for morphometric analysis in central and peripheral airways, however CON(AC) showed a significant increase in polymorphonuclear cells in the central airways compared to CON. In contrast, TR(AC) did not show an inflammatory response different from TR. A similar trend was present in peripheral airways. Training did not induce differences in airways inflammation and remodeling as compared to CON. However, training seemed to limit the inflammatory response induced by acute exercise in the central airways.

Effect of training and sudden detraining on the patellar tendon and its enthesis in rats.

BACKGROUND: Different conditions may alter tendon characteristics. Clinical evidence suggests that tendon injuries are more frequent in athletes that change type, intensity and duration of training. Aim of the study was the assessment of training and especially detraining on the patellar tendon (PT) and its enthesis. METHODS: 27 male adult Sprague-Dawley rats were divided into 3 groups: 20 rats were trained on a treadmill for 10 weeks. Of these, 10 rats were euthanized immediately after training (trained group), and 10 were caged without exercise for 4 weeks before being euthanized (de-trained group). The remaining 7 rats were used as controls (untrained rats). PT insertion, structure (collagen fiber organization and proteoglycan, PG, content), PT thickness, enthesis area, and subchondral bone volume at the enthesis were measured by histomorphometry and microtomography. RESULTS: Both PG content and collagen fiber organization were significantly lower in untrained and detrained animals than in trained ones (p < 0.05 and p < 0.0001). In the detrained group, fiber organization and PG content were worse than that of the untrained groups and the untrained group showed a significantly higher score than the detrained group (p < 0.05). In the trained group, the PT was significantly thicker than in untrained group (p < 0.05). No significant differences in the enthesis area and subchondral bone volume among the three groups were seen. CONCLUSIONS: Moderate exercise exerts a protective effect on the PT structure while sudden discontinuation of physical activity has a negative effect on tendons. The present results suggest that after a period of sudden de-training (such as after an injury) physical activity should be restarted with caution and with appropriate rehabilitation programs.

Myocardial tolerance to ischemia-reperfusion injury, training intensity and cessation.

Training has been shown to induce cardioprotection. The mechanisms involved remain still poorly understood. Aims of the study were to examine the relevance of training intensity on myocardial protection against ischemia/reperfusion (I/R) injury, and to which extent the beneficial effects persist after training cessation in rats. Sprague-Dawley rats trained at either low (60% [Formula: see text]) or high (80% [Formula: see text]) intensity for 10 weeks. An additional group of highly trained rats was detrained for 4 weeks. Untrained rats served as controls. At the end of treatment, rats of all groups were split into two subgroups. In the former, rats underwent left anterior descending artery (LAD) ligature for 30 min, followed by 90-min reperfusion, with subsequent measurement of the infarct size. In the latter, biopsies were taken to measure heat-shock proteins (HSP) 70/72, vascular endothelial growth factor (VEGF) protein levels, and superoxide dismutase (SOD) activity. Training reduced infarct size proportionally to training intensity. With detraining, infarct size increased compared to highly trained rats, maintaining some cardioprotection with respect to controls. Cardioprotection was proportional to training intensity and related to HSP70/72 upregulation and Mn-SOD activity. The relationship with Mn-SOD was lost with detraining. VEGF protein expression was not affected by either training or detraining. Stress proteins and antioxidant defenses might be involved in the beneficial effects of long-term training as a function of training intensity, while HSP70 may be one of the factors accounting for the partial persistence of myocardial protection against I/R injury in detrained rats.

Effect of respiratory muscle training on maximum aerobic power in normoxia and hypoxia.

To assess the effects of respiratory muscle training (RMT) on maximum oxygen uptake (VO2max) in normoxia and hypoxia, 9 healthy males (age 24 +/- 4 years; stature 1.75 +/- 0.08 m; body mass 72 +/- 9 kg; mean +/- SD) performed on different days maximal incremental tests on a cycle ergometer in normoxia and normobaric hypoxia (FIO2=0.11), before and after 8 weeks of RMT (5 days/week). During each test, gas exchange variables were measured breath-by-breath by a metabolimeter. After RMT, no changes in cardiorespiratory and metabolic variables were detected at maximal exercise in normoxia. On the contrary, in hypoxia expired and alveolar ventilation (V(E(and V(A), respectively) at maximal exercise were significantly higher than pre-training condition (+12 and +13%, respectively; P < 0.05). Accordingly, alveolar O2 partial pressure (PAO2) after RMT significantly increased by approximately 10%. Nevertheless, arterial PO2 and VO2max did not change with respect to pre-training condition. In conclusion, RMT improved respiratory function but did not have any effect on VO2max, neither under normoxic nor hypoxic condition. In hypoxia, the significant increase in V(E) and V(A) at maximum exercise after training lead to higher alveolar but not arterial PO2 values, revealing an increased A-a gradient. This result, according to the theoretical models of VO2max limitation, seems to contradict the lack of VO2max increase in hypoxia, suggesting a possible role of increased ventilation-perfusion mismatch.

Electrical stimulation versus kinesitherapy in improving functional fitness in older women: a randomized controlled trial.

Long-stay hospitalized elderly patients frequently develop a decrease in strength, cardiovascular fitness and balance, which can be improved by exercise. Neuromuscular electrical stimulation (ES) might also be effective in this population. The effect of different lower limb rehabilitation programs (3 interventions/week for 6 weeks) on functional fitness in 40 hospitalized old females (82+/-7 years) were evaluated: kinesitherapy (KT), ES, KT alternated with ES (KT+ES), and no treatment (C). Outcome variables after rehabilitation were: (a) maximal strength of leg extensor and finger flexor muscles; (b) cardiorespiratory fitness (6-min walking test, 6MWT; heart rate, HR); (c) static and dynamic balance and gait skills (Tinetti test). The maximal strength of leg extensor (but not finger flexor) muscles significantly improved in ES (+26%) and KT+ES (+16%) groups only. The distance covered during the 6MWT significantly increased in KT (+15%), ES (+14%) and KT+ES (+9%) groups, but the post-test HR recovery improved in KT group only. Balance (but not gait) skill scores significantly and similarly increased in KT (+11%), ES (+10%) and KT+ES (+11%) groups. In long-stay hospitalized old females ES and KT+ES improved lower limbs isometric strength. Walking ability was improved by all treatments, whereas cardiovascular performance and recovery were ameliorated by KT only.