Hot water immersion: Maintaining core body temperature above 38.5°C mitigates muscle fatigue.

PURPOSE: Hot water immersion (HWI) has gained popularity to promote muscle recovery, despite limited data on the optimal heat dose. The purpose of this study was to compare the responses of two exogenous heat strains on core body temperature, hemodynamic adjustments, and key functional markers of muscle recovery following exercise-induced muscle damage (EIMD). METHODS: Twenty-eight physically active males completed an individually tailored EIMD protocol immediately followed by one of the following recovery interventions: HWI (40°C, HWI40 ), HWI (41°C, HWI41 ) or warm water immersion (36°C, CON36 ). Gastrointestinal temperature (Tgi ), hemodynamic adjustments (cardiac output [CO], mean arterial pressure [MAP], and systemic vascular resistance [SVR]), pre-frontal cortex deoxyhemoglobin (HHb), ECG-derived respiratory frequency, and subjective perceptual measures were tracked throughout immersion. In addition, functional markers of muscle fatigue (maximal concentric peak torque [Tpeak ]) and muscle damage (late-phase rate of force development [RFD100-200 ]) were measured prior to EIMD (pre-), 24 h (post-24 h), and 48 h (post-48 h) post-EIMD. RESULTS: By the end of immersion, HWI41 led to significantly higher Tgi values than HWI40 (38.8 ± 0.1 vs. 38.0°C ± 0.6°C, p < 0.001). While MAP was well maintained throughout immersion, only HWI41 led to increased (HHb) (+4.2 ± 1.47 µM; p = 0.005) and respiratory frequency (+4.0 ± 1.21 breath.min-1 ; p = 0.032). Only HWI41 mitigated the decline in RFD100-200 at post-24 h (-7.1 ± 31.8%; p = 0.63) and Tpeak at post-48 h (-3.1 ± 4.3%, p = 1). CONCLUSION: In physically active males, maintaining a core body temperature of ~25 min within the range of 38.5°C-39°C has been found to be effective in improving muscle recovery, while minimizing the risk of excessive physiological heat strain.

Comparative effects of various running exercise modalities on femoral bone quality in rats.

BACKGROUND: It is now well established that physical exercise is an effective preventive method to reduce and treat certain chronic diseases, particularly musculoskeletal disorders. At the bone level, running exercise is well known for its positive effects on various parameters of bone quality. There is, however, no consensus regarding the effects of different running exercise modalities on bone quality. AIM: The objective of this study was to compare the effects of three treadmill running modalities: intermittent, moderate continuous, and a combination of both-on bone quality parameters in rats. METHODS: Thirty-nine, 5-week-old, male Wistar rats were randomly divided in 4 groups: sedentary control (SED; n = 10), intermittent running exercise (IE; n = 10), continuous running exercise (CE; n = 10) and combined running exercise (COME; n = 9). Rats in running groups were exercised 45 min/day, 5 days/week, for 8 consecutive weeks. Femoral micro-architectural parameters were assessed by micro-CT; femoral osteocyte apoptosis, osteoclast resorption and bone histomorphometry were assessed by histology. RESULTS: Femoral trabecular thickness in the combined running group was increased (p < 0.0001) compared to respective results in the other running groups (0.13 mm vs 0.11 mm). The cortical thickness, osteocyte lacunae occupancy rate in the whole femur, numbers of apoptotic osteocytes and osteoclastic resorption surfaces were not significantly different between groups. Statistical differences were occasionally noted depending on the femoral anatomical region. CONCLUSION: These results suggest that the femur should not be considered as the better bone to study the effects of running protocols.

Electromyogram Power Spectrum and Cardiac Function Changes After Combined Aerobic Interval Training and Inspiratory Muscle Training in Chronic Heart Failure Patients.

Exercise intolerance and dyspnea are the major symptoms of patients with chronic heart failure (CHF) and are associated with a poor quality of life. In addition to impaired central hemodynamics, symptoms may be attributed to changes in peripheral skeletal muscles. This study aimed to evaluate the effects of aerobic interval training (AIT) combined with inspiratory muscle training (IMT) on cardiac and skeletal muscle function and on functional capacity and dyspnea in patients with CHF and inspiratory muscle weakness.Left ventricle ejection fraction was improved significantly after AIT and AIT & IMT with a high percentage of amelioration (17%, P < 0.042) in the combined group compared to the control group. Therefore, we showed a significant improvement in maximal voluntary isometric force, isometric endurance time, root mean square, and frequency median in both strength and endurance manipulations in the aerobic and combined group; however, the improvement was superior in the combined group compared to the control group. Significant amelioration was proved in functional capacity and dyspnea after all types of training but was performed at 18% higher in 6 minutes' walk test and 43% lower in dyspnea for the combined group compared to the control group.Combining AIT to IMT had optimized exercise training benefits in reversing the cardiac remodeling process and improving skeletal muscle function, functional capacity, and dyspnea in patients with CHF.

Effects of Powerchair Football: Contextual Factors That Impact Participation.

The aim of this study was to identify contextual factors that negatively affect activity and participation among powerchair football (PF) players. Thirty-seven semistructured interviews were conducted with PF players (Mage = 27.9 ± 8.2 years) in France (n = 18) and the United States (n = 19). Participants reported acute back and neck pain as the primary morbidities resulting from PF participation, with sustained atypical posture in the sport chair as the primary cause. Competition-related physical and mental stress were also identified as participation outcomes. Accompanying the many benefits of PF, participants recognized negative impacts of discomfort, physical fatigue, and mental fatigue. Interventions such as seating modifications, thermotherapy to combat pain, napping to combat acute physical stress, and mental preparation to manage state anxiety were all identified as prospective interventions.

Post-exercise Heart Rate Variability: Whole-body Cryotherapy vs. Contrast Water Therapy.

High-intensity training sessions are known to alter cardiac autonomic modulation. The purpose of this study was to compare the effects of whole-body cryotherapy, contrast water therapy and passive recovery on the time course of cardiac autonomic markers following a standardized HIT session. Eleven runners completed a high intensity session followed by one of the following recovery interventions: whole-body cryotherapy, contrast water therapy or passive recovery. Changes in cardiac autonomic modulation were assessed in supine and standing positions during an active tilt test at pre-, post-14 h and post-38 h. In supine, high-frequency power increased from pre- to post-14 h following whole-body cryotherapy (1661.1±914.5 vs. 2799.0±948.4 ms2, respectively; p=0.023) and contrast water therapy (1906.1±1327.9 vs. 4174.3±2762.9 ms2, respectively; p=0.004) whereas high frequency power decreased in response to passive recovery (p=0.009). In standing, low-frequency power increased from pre-to post-38 h (1784.3 ± 953.7 vs. 3339.8±1862.7 ms2, respectively; p=0.017) leading to an increase in total power from pre- to post-38 h (1990.8 ± 1089.4 vs. 3606.1±1992.0 ms2, respectively; p=0.017). Spectral analysis revealed that contrast water therapy appears to be a more efficient recovery strategy than whole-body cryotherapy in restoring cardiac autonomic homeostasis.

Sensitivity of the Footeval Test to Different Training Modes.

Manouvrier, C, Cassirame, J, and Ahmaidi, S. Sensitivity of the footeval test to different training modes. J Strength Cond Res 34(5): 1440-1447, 2020-The aim of this study is to assess the impact of preseason training and more specifically about different training modality to Footeval test. This study also compares those sensibility with classic test, Vameval. A total of 36 young elite players' performance were split in 3 groups to perform 2 times a week a specific complements training: generic (GENERIC), small-sided game (SSG), and technical (TECH). After 4 weeks with training intervention, all players improved their performance to Footeval and Vameval tests. Regarding improvement, we noted that each training complement obtained different magnitude of modification. For all groups, Footeval increase was more important than Vameval. Small-sided game obtained highest improvement to Footeval (15 ± 1.8%) but lowest to Vameval (5 ± 0.9%). Oppositely, GENERIC and TECH groups obtained highest improvement to Vameval test (8 ± 1.4 and 8 ± 2.0%) but lower modification to Footeval (11 ± 2.2 and 16 ± 2.3%), respectively. Even if we removed the effect of maximum aerobic speed increase, SSG obtains better improvement than other training modality to Footeval.

Physical Performance Variables and Bone Parameters in a Group of Young Overweight and Obese Women.

The aim of this study was to explore the relationships between physical performance variables and bone parameters such as bone mineral density (BMD), bone mineral content, hip geometry indices, and trabecular bone score in a group of young overweight and obese adult women. Sixty-eight overweight/obese (body mass index ≥25 kg/m2; 25.5-42.4 kg/m2) young women whose ages range from 18 to 35 yr participated in this study. Body composition and bone outcomes were measured by dual-energy X-ray absorptiometry. Maximum oxygen consumption (VO2 max, in liter per minute) was determined indirectly using a progressive shuttle run test. One-repetition-maximum half-squat was directly measured. Vertical jump was measured and maximum power (P max) of the lower limbs was calculated. Lean mass was positively correlated to whole body (WB) BMD, total hip BMD, femoral neck (FN) BMD, femoral neck cross-sectional area (FN CSA) and femoral neck cross sectional moment of inertia (FN CSMI) (p < 0.05). VO2 max (in liter per minute) and muscle power were positively correlated to WB BMD, total hip BMD, FN BMD, FN CSA, and FN CSMI (p < 0.05). One-repetition-maximum half-squat was positively correlated with lumbar spine trabecular bone score, WB BMD, FN BMD, FN CSA and FN CSMI (p < 0.05). This study suggests that lean mass, vertical jump, VO2 max (liter per minute), muscle power and one-repetition-maximum half squat are positive determinants of BMD and hip geometry indices in young overweight and obese women.

Effects of Precompetitive Preparation Period on the Isokinetic Muscular Characteristics in World Class Handball Players.

Maurelli, O, Bernard, PL, Dubois, R, Ahmaidi, S, and Prioux, J. Effects of precompetitive preparation period on the isokinetic muscular characteristics in world class handball players. J Strength Cond Res 33(4): 1065-1074, 2019-The aim of this study was to describe the effects of 8 weeks of precompetitive preparation period (Pc2P) on the isokinetic muscular characteristics in world-class handball players. Nineteen male professional players (age, 26.6 ± 5.4 years) participated in the study. Two bilateral isokinetic tests of knee joint flexors (H; hamstring) and extensors (Q; quadriceps) were performed before and after Pc2P to determine the peak torque (PT), the mean power (MP), and the ratios (agonist-antagonist, dominant-nondominant, and combined). For the PT, Q at low angular velocity (60°·s) in concentric mode revealed no significant increase for the dominant or nondominant legs. For H, results showed a significant increase for both legs (p < 0.001). At the higher angular velocity (240°·s), Q was significantly increased for the dominant (p < 0.005) and nondominant (p < 0.002) legs and also H for both sides (p < 0.001). Eccentric mode (30°·s) showed a significant increase for dominant (p < 0.005) and nondominant (p < 0.01) legs. For MP, results showed significant increase at low angular velocity (p < 0.003) and high angular velocity (p < 0.01) for both legs. In eccentric mode, values showed a significant increase after Pc2P for dominant (p < 0.001) and nondominant (p < 0.02) legs. The ratios showed significant increase for the agonist-antagonist ratio at 60°·s for dominant leg (p < 0.003) and the nondominant leg (p < 0.01). At 240°·s, the values showed a significant difference for both side (p < 0.02). From an injury risk perspective, in addition to optimizing performance, these results demonstrated that 8 weeks of Pc2P increased the maximum strength and muscle power of international handball players, even if the ratios of the knee joint muscles did not change during this period.

Effects of the Competitive Season on the Isokinetic Muscle Parameters Changes in World-Class Handball Players.

Maurelli, O, Bernard, PL, Dubois, R, Ahmaidi, S, and Prioux, J. Effects of the competitive season on the isokinetic muscle parameters changes in world-class handball players. J Strength Cond Res 33(10): 2778-2787, 2019-The aim of this study is to investigate the effects of the competitive season on isokinetic muscular parameters of the lower limbs in world-class handball players. Nineteen, male, world-class, handball players (age, 26.6 ± 5.4 years) participated in the study. Two bilateral isokinetic tests of knee joint flexors (H; hamstring) and extensors (Q; quadriceps) were performed in the beginning and end of the competitive season to determine the peak torque (PT), the mean power, and agonist-antagonist ratio, dominant-nondominant ratio (DNDR), and combined ratio. The results showed a significant decrease in PT values at low angular velocity (60°·s) in concentric mode for Q on dominant leg (p < 0.001). The other PT values for dominant and nondominant legs at low and high angular velocities (240°·s) and in eccentric mode (30°·s) were not significantly different for Q and H. For mean power, values did not change at 60°·s. At 240°·s, we found a significant decrease in H for dominant leg (p < 0.001) but not for nondominant leg. In eccentric mode, the results showed a significant increase on both legs (p < 0.001). For the ratios, values significantly decreased for DNDR at 60°·s for Q (p < 0.03) and for agonist/antagonist ratio at 240°·s for the dominant leg (p < 0.01). The present results highlight the importance of integrating regular strength training sessions during the competitive season in world-class handball players. Accordingly, this study should help trainers to modify their planning to maximize strength and power qualities of the lower limbs of their players in addition to avoiding injuries.

Relationship Between Electromyogram Spectrum Parameters and the Tension-Time Index During Incremental Exercise in Trained Subjects.

The inspiratory muscle tension-time index TT0.1 (given by P0.1/PImax x TI/TTOT) could be used to reliably assess inspiratory muscle activity during exercise. So far, the correlation between the TT0.1 and diaphragmatic activity has not been measured and the TT0.1 has not been compared with other measurements of the inspiratory muscle load such as the transdiaphragmatic pressure index or TTdi. In this study we hypothesize that the TT0.1 measuring the mouth is a noninvasive reflection of the electromyographic activity of the diaphragm. We simultaneously measured TT0.1 and surface EMG (SEMG) of 8 trained subjects at rest and during incremental exercise. The curvature of TT0.1 and the root mean square (RMS) follow the same trend during the incremental exercise with a significant correlation between TT0.1 and surface EMG parameters (RMS; r = 0.81 p < 0.001 and MPF; r = 0.80 p < 0.001 respectively). We conclude that TT0.1 measured as s an adequate noninvasive method reflects the diaphragmatic activity during incremental exercise in healthy subjects.

Proposal for a Specific Aerobic Test for Football Players: The "Footeval".

The aim of this study was to evaluate the reproducibility and validity of the "Footeval" test, which evaluates football players' aerobic level in conditions close to those of football practice (intermittent, including technical skills). Twenty-four highly trained subjects from an elite football academy (17.8 ± 1.4 years, 5 training sessions per week) performed two Footeval sessions in a period of 7 days. Physiological variables measured during these sessions (VO2max 58.1 ± 5.6 and 58.7 ± 6.2 ml·min-1·kg-1; RER 1.18 ± 0.06 and 1.19 ± 0.05; LaMax 11.0 ±1.4 and 10.8 ±1.1 µmol·L-1; HRmax 194 ± 6 and 190 ± 7 b·min-1; Final step 10.71 ± 1.2 and 10.83 ± 1.13 and the RPE = 10) highlighted maximal intensity and confirmed that players reached physiological exhaustion. Comparison of values measured in both sessions showed large to very large correlations (Final level; 0.92, VO2max; 0.79, HRmax; 0.88, LaMax; 0.87) and high ICC (Final level; 0.93, VO2max; 0.87, HRmax; 0.90, LaMax; 0.85) except for RER (r = 0.22, ICC = 0.21). In addition, all subjects performed a time limit (Tlm) exercise with intensity set at maximal aerobic specific speed + 1 km·h-1, in order to check the maximal value obtained during the Footeval test. Statistical analysis comparing VO2max, HRmax and RER from the Footeval and Tlm exercise proved that values from Footeval could be considered as maximal values (r for VO2max; 0.82, HRmax; 0.77 and ICC for VO2max; 0.92, HRmax; 0.91). This study showed that Footeval is a reproducible test that allows maximal aerobic specific speed to be obtained at physiological exhaustion. Moreover, we can also affirm that this test meets the physiological exhaustion criteria as defined in the literature (RER ≥ 1, 1; LaMax ≥ 8 µmol·L-1; HR = HRmax; no increase of VO2 despite the increase of speed; RPE =10).

Hot But Not Cold Water Immersion Mitigates the Decline in Rate of Force Development following Exercise-Induced Muscle Damage.

PURPOSE: In recent years, there has been significant advancement in the guidelines for recovery protocols involving heat or cold water immersion. Yet, comparison between the effects of hot and cold water immersion on key markers of neuromuscular recovery following exercise-induced muscle damage (EIMD) is lacking. METHODS: Thirty physically active males completed an individualized and tailored EIMD protocol immediately followed by one of the following recovery interventions: cold water immersion (11 °C, CWI11), hot water immersion (41 °C, HWI41) or warm-bath control (36 °C, CON36). Gastrointestinal temperature was tracked throughout HWI41. Knee extensors' maximal isokinetic strength [peak torque (Tpeak)] and explosive strength [late-phase rate of force development, (RFD100-200)] were measured prior to EIMD (pre-), 24 h (post-24 h) and 48 h (post-48 h) post-EIMD. In addition, pressure pain threshold (PPT) was measured to quantify the recovery from muscle soreness. Surface electromyography signals (sEMG) from the vastus lateralis were captured to extract the rates of electromyography rise (REMGR) and the spectral power in the low-frequency band. RESULTS: At post-48 h, Tpeak returned to baseline values following both CWI11 (-8.3 ± 6.8 %, p = 0.079) and HWI41 (-1.4 ± 4.1%, p = 1). In contrast, RFD100-200 (-2.3 ± 29.3%, p = 1) and PPT (+5.6 ± 14.6%, p = 1) returned to baseline values at post-48 h only following HWI41. Spectral analysis of the sEMG signal revealed that the low-frequency band was significantly increased following CWI11 (+9.0 ± 0.52%, p = 0.012). REMGR was unchanged regardless of the condition (all p > 0.05). CONCLUSIONS: A single session of HWI41, rather than CWI11, improved the recovery of the late-phase rate of force development following EIMD in physically active males. This suggests that in athletic contexts where a rapid force development is a key performance determinant, hot bath should be preferred over cold bath.

Influence of dorsiflexion shoes on neuromuscular fatigue of the plantar flexors after combined tapping-jumping exercises in volleyball players.

Dorsiflexion shoes could be useful to increase jumping performance. The aim of the present study was to investigate the impact of wearing shoes inducing moderate dorsiflexion (2°) on neuromuscular fatigue induced by volleyball exercises involving multiple stretch-shortening cycles. Squat jump (SJ) and countermovement jump (CMJ) performance, and plantar flexors isometric voluntary and evoked contractile properties were assessed in 10 unfamiliarized trained volleyball players before and after a 10-minute intensive combined tapping-jumping volleyball exercise performed, in blinded randomized conditions, with neutral (0°) or moderate dorsiflexion (2°). No significant difference was observed on SJ performance in neutral and moderate dorsiflexion conditions. However, CMJ height was initially lower with 2° dorsiflexion compared with 0° (p < 0.05). Height in CMJ was increased after exercise with 2° dorsiflexion shoes and remained unchanged in neutral 0° condition. Combined tapping-jumping volleyball exercise also induced a significant decrease in maximal voluntary contraction (p < 0.001), peak-twitch torque (p = 0.009), contraction time (p < 0.001) and twitch relaxation rate (p = 0.001) values without any significant difference between neutral and dorsiflexion conditions. Voluntary activation level (p = 0.014) and rate of force development (p = 0.05) were also decreased in both conditions. In conclusion, acute moderate dorsiflexion had no effect on jumping performance and neuromuscular fatigue in unfamiliarized trained subjects and altered the elastic energy store in plyometric condition (CMJ). Future studies are necessary to investigate the chronic effect of moderate dorsiflexion on jumping performance and neuromuscular fatigue in trained volleyball players.

Six-minute walk test in children with cerebral palsy gross motor function classification system levels I and II: reproducibility, validity, and training effects.

OBJECTIVES: To assess the reproducibility and validity of the 6-minute walk test (6MWT) with gas collection, and to evaluate effectiveness of a walking program in children with cerebral palsy (CP). DESIGN: Assessment and controlled training study. SETTING: Rehabilitation service. PARTICIPANTS: Children/adolescents with CP (N=24; 12 boys, 12 girls; mean age, 14.2±2.0 y, Gross Motor Function Classification System levels I and II). INTERVENTION: After a cycle-ergometer stress test and the 6MWT, subjects were assigned to training (n=12, 40 min of moderate walking exercise 3 times per week for 8 wk) or a matched control group (n=12). MAIN OUTCOME MEASURES: Peak oxygen consumption (VO(2)peak), peak ventilation, peak heart rate, and 6MWT distance. RESULTS: Test-retest correlations for the 6MWT were good (VO(2)peak: r=.90, P<.001, intraclass correlation coefficient [ICC]=.85; peak ventilation: r=.88, P<.001, ICC=.83; peak heart rate: r=.86, P<.001, ICC=.82; distance walked: r=.87, P=.007, ICC=.80). Mean scores for the 6MWT also closely matched corresponding cycle-ergometer data. Significant improvements in 6MWT VO(2)peak, peak ventilation, and peak heart rate were found after 8 weeks of training (P<.05). CONCLUSIONS: The 6MWT appears reproducible and valid relative to cycle-ergometer assessments of cardiorespiratory responses, and offers a simple method of clinical assessment. An 8-week moderate walking program improves the cardiopulmonary fitness of children with CP, as measured by 6MWT.

Repeated sprints with directional changes: do angles matter?

To examine whether performance, physiological and perceptual responses to repeated sprints including changes of direction are angle-dependent, twelve team-sport players performed (1) single 30-m sprints without or with two (45°, 90° or 135°) changes of direction and (2) repeated-sprint sequences matched for initial sprint time without (Line [6x30m]) or with (45° [6x28.0m], 90° [6x22.2m] or 135° [6x19.5m]) two changes of direction. For each sequence, mean sprint time (RS(mean)), peak heart rate (HR(peak)), blood lactate concentration (Δ[La](b)) and rating of perceived exertion (RPE) were recorded. Results show that performance, physiological and perceptual responses were angle-dependent. Compared with Line, RS(mean) was likely lower for 45˚ (-1.7%(90%CL:-3.5;0.1); chances for greater/similar/lower values of 1/23/76%, respectively) and possibly greater for 135˚ (+0.8%(90%CL:-0.6;2.3), 44/53/3%). HR(peak), Δ[La](b) and RPE were likely greater for Line compared with the three other protocols. RPE during 45˚ was greater than during 90˚(+14%(90%CL:8;19), 0/1/99%) and 135˚ (+11%(90%CL:1;22), 2/15/83%). The correlation coefficients describing the relationships between the four single 30-m sprints were <0.70; these for RS(mean) times were >0.70. Performance, physiological and perceptual response during repeated sprints with changes of direction are angle-dependent. However, unlike changes of direction speed, repeated-sprint ability with changes of direction is more likely to be a general quality.

Recovery During a Congested Schedule and Injury in Professional Football.

PURPOSE: To analyze the relationships between the recovery kinetics experienced by professional football players and noncontact injury. METHODS: A cohort of 46 professional football players (age 24.2 [4.7] y) from the same team (French Ligue 1) was monitored each day between matches when the team played twice a week. The recovery monitoring procedure was implemented after 38 matches and included some questionnaires: duration of sleep, Hooper scale (quality of sleep, level of stress, fatigue, and muscle soreness), perceived recovery status scale, creatine kinase concentrations, a countermovement jump, and an isometric force test. Noncontact injuries were collected during these periods. RESULTS: Noncontact injuries were associated with perceived fatigue and muscle soreness 2 days (relative risk [RR] = 1.89 and 1.48, respectively) and 3 days following the matches (RR = 2.08 and 2.08, respectively). An increase of sleep quantity during the 2 nights following a match was significantly associated with a lower RR (RR = 0.65), as well as a lower decrement score on the isometric force test on each of the 3 days after the matches (RR = 0.97, RR = 0.99, and RR = 0.97, respectively). No other association was reported for the variables sleep quality, stress, perceived recovery, creatine kinase concentrations, countermovement jump, and noncontact injuries. CONCLUSION: During a congested schedule, implementing a recovery monitoring protocol including questionnaires about fatigue, muscle soreness, quantity of sleep, and a physical test of isometric force could help practitioners prevent injuries.

Effects of multimodal training program on muscle deoxygenation in women with breast cancer: A randomized controlled trial.

Purpose: Chemotherapy and/or radiation are the most often delivered treatments to cancer patients. Usually during the adjuvant treatment, patients complain about fatigue. In addition, physical exercise during adjuvant treatment of cancer seems to have beneficial effects. The aim of this investigation was to assess the effects of multimodal aerobic and strength exercises programs on muscle deoxygenation of patients with breast cancer undergoing adjuvant chemotherapy treatment. Methods: Thirty-two women with breast cancer (20 patients as the training group and 12 patients as the control group) undergoing adjuvant chemotherapy participated in the study. The training group took part in 6 weeks of supervised intermittent aerobic cycling, home-based walking, isometric and electrical muscle stimulation (EMS) exercise training programs. The Outcome measures were muscle deoxygenation (ΔHHb), Maximal Voluntary isometric Contraction (MViC) and Endurance Time (ET) before and after the training period. Results: Compared to the control group, a significant increase in ΔHHb (P < 0.01) accompanied with an increase in ET (P < 0.01) and MViC (P < 0.01) of the quadriceps was obtained in the training group. However, no significant differences of MViC, ET and ΔHHb were observed in the control group. Conclusion: Multimodal aerobic and strength exercise programs enhance muscle oxygen utilization, which may partly explain the improvement in muscular strength and endurance, and the reduction of muscle fatigue in patients with breast cancer during an adjuvant chemotherapy period.

A randomized controlled trial of high-intensity interval training and inspiratory muscle training for chronic heart failure patients with inspiratory muscle weakness.

OBJECTIVES: Chronic heart failure is a major public health problem in which supervised exercise programs are recommended as part of non-pharmacological management. There are various reports of the success of high-intensity aerobic interval training (HI-AIT) and inspiratory muscle training (IMT) in the management of chronic heart failure patients. This study tested the hypothesis that the combination of HI-AIT and IMT could result in additional benefits over the IMT and the HI-AIT alone in terms of inspiratory muscle function, exercise capacity, and quality of life in patients with chronic heart failure and inspiratory muscle weakness. METHODS: Forty patients with ejection fraction ≤45% and inspiratory muscle weakness described by maximal inspiratory pressure <70% predicted, underwent three exercise training sessions per week for 12 weeks. Patients were randomly allocated to one of four groups: the HI-AIT group, the IMT group, the combined (HI-AIT & IMT) group, and the control group. Before and after completing their training period, all patients underwent different tests that are mentioned above. RESULTS: No changes were detected in the control group. However, the combined group, when compared to HI-AIT and IMT groups, respectively, resulted in additional significant improvement in maximal inspiratory training (62%, 24%, 25%), exercise time (62%, 29%, 12%), the 6-minute walk test (23%, 15%, 18%), and the Minnesota Living with Heart Failure Questionnaire (56%, 47%, 36%). CONCLUSION: In patients with chronic heart failure and inspiratory muscle weakness, the combination of the HI-AIT and the IMT resulted in additional benefits in respiratory muscle function, exercise performance, and quality of life compared to that of HI-AIT or IMT alone.Trial Registration number: NCT03538249.

Impact of Urinary Incontinence on Physical Function and Respiratory Muscle Strength in Incontinent Women: A Comparative Study between Urinary Incontinent and Apparently Healthy Women.

Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function.