The Effects of a Single Session of a Rhythmic Movement Program on Selected Biopsychological Parameters in PD Patients: A Methodological Approach.

The aim of the present study is to examine the acute effects of a specially designed musicokinetic (MSK) program for patients with Parkinson's disease (PD) on (a) anxiety levels, (b) select kinematic and kinetic parameters, and (c) frontal cortex hemodynamic responses, during gait initiation and steady-state walking. Methods: This is a blind cross-over randomized control trial (RCT) in which 13 volunteers with PD will attend a 45 min MSK program under the following conditions: (a) a synchronous learning format and (b) an asynchronous remote video-based format. Changes in gait biomechanics and frontal cortex hemodynamic responses will be examined using a 10-camera 3D motion analysis (Vicon T-series, Oxford, UK), and a functional near-infrared spectroscopy (f-NIRS-Portalite, Artinis NL) system, respectively, while anxiety levels will be evaluated using the Hamilton Anxiety Rating Scale. Expected results: Guided by the rules of music, where periodicity is distinct, our specially designed MSK program may eventually be beneficial in improving motor difficulties and, hence, reducing anxiety. The combined implementation of f-NIRS in parallel with 3D gait analysis has yet to be evaluated in Parkinsonian patients following a MSK intervention. It is expected that the aforementioned intervention, through better rhythmicity, may improve the automatization of motor control, gait kinematics, and kinetics-supported by decreased frontal cortex hemodynamic activity-which may be linked to reduced anxiety levels.

Pharmacological and Non-Pharmacological Treatments for Depression in Parkinson's Disease: An Updated Review.

Depression represents one of the most common non-motor disorders in Parkinson's disease (PD) and it has been related to worse life quality, higher levels of disability, and cognitive impairment, thereby majorly affecting not only the patients but also their caregivers. Available pharmacological therapeutic options for depression in PD mainly include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants; meanwhile, agents acting on dopaminergic pathways used for motor symptoms, such as levodopa, dopaminergic agonists, and monoamine oxidase B (MAO-B) inhibitors, may also provide beneficial antidepressant effects. Recently, there is a growing interest in non-pharmacological interventions, including cognitive behavioral therapy; physical exercise, including dance and mind-body exercises, such as yoga, tai chi, and qigong; acupuncture; therapeutic massage; music therapy; active therapy; repetitive transcranial magnetic stimulation (rTMS); and electroconvulsive therapy (ECT) for refractory cases. However, the optimal treatment approach for PD depression is uncertain, its management may be challenging, and definite guidelines are also lacking. It is still unclear which of these interventions is the most appropriate and for which PD stage under which circumstances. Herein, we aim to provide an updated comprehensive review of both pharmacological and non-pharmacological treatments for depression in PD, focusing on recent clinical trials, systematic reviews, and meta-analyses. Finally, we discuss the pharmacological agents that are currently under investigation at a clinical level, as well as future approaches based on the pathophysiological mechanisms underlying the onset of depression in PD.

Physiological, perceptual and affective responses to high-intensity interval training using two work-matched programs with different bout duration in obese males.

Objectives: This study compared physiological, perceptual, and affective responses to high-intensity interval training (HIIT) between two work-matched programs with different bout durations in obese males. Methods: Sixteen low-to-moderately active obese men completed an eight-week cycling program of supervised HIIT (3 days/week) using either short bouts [48 × 10 s at 100% of peak power output (PPO) with 15 s of recovery (HIIT10)] or long bouts [8 × 60 s at 100% PPO with 90 s of recovery (HIIT60)]. Workload was progressively adjusted, to maintain high intensity (100% PPO), throughout training. Blood lactate (BLa), heart rate (HR), ratings of perceived exertion (RPE), and feeling scale ratings (pleasure/displeasure) were measured in each HIIT session. Results: Average HR decreased in the last 2 weeks of training in both groups by 2.2 ± 1.8% of peak HR (p < 0.001). Training resulted in a reduction in BLa during exercise by 28 ± 19% (p < 0.001) from the 10th min onward only in HIIT10. Similarly, during the last weeks of training, RPE decreased (by 1.0 ± 1.1 units, p < 0.05) and feeling scale ratings were improved only in HIIT10, while RPE remained unchanged and feeling scale ratings deteriorated in HIIT60 (from 3.0 ± 1.1 to 2.1 ± 0.9 units, p < 0.001). No differences in post-exercise enjoyment were found. Conclusion: Both HIIT formats induced similar HR adaptations, but improvement of BLa, perceptual and affective responses occurred only when bout duration was shorter. Our findings suggest that, in low-to-moderately active obese men, HIIT may be more effective in improving metabolic, perceptual, and affective responses when shorter, rather than longer, bouts of exercise are used.

A Neuroprotective Bovine Colostrum Attenuates Apoptosis in Dexamethasone-Treated MC3T3-E1 Osteoblastic Cells.

Glucocorticoid-induced osteoporosis (GIO) is one of the most common secondary forms of osteoporosis. GIO is partially due to the apoptosis of osteoblasts and osteocytes. In addition, high doses of dexamethasone (DEX), a synthetic glucocorticoid receptor agonist, induces neurodegeneration by initiating inflammatory processes leading to neural apoptosis. Here, a neuroprotective bovine colostrum against glucocorticoid-induced neuronal damage was investigated for its anti-apoptotic activity in glucocorticoid-treated MC3T3-E1 osteoblastic cells. A model of apoptotic osteoblastic cells was developed by exposing MC3T3-E1 cells to DEX (0-700 µM). Colostrum co-treated with DEX was executed at 0.1-5.0 mg/mL. Cell viability was measured for all treatment schedules. Caspase-3 activation was assessed to determine both osteoblast apoptosis under DEX exposure and its potential prevention by colostrum co-treatment. Glutathione reduced (GSH) was measured to determine whether DEX-mediated oxidative stress-driven apoptosis is alleviated by colostrum co-treatment. Western blot was performed to determine the levels of p-ERK1/2, Bcl-XL, Bax, and Hsp70 proteins upon DEX or DEX plus colostrum exposure. Colostrum prevented the decrease in cell viability and the increase in caspase-3 activation and oxidative stress caused by DEX exposure. Cells, upon colostrum co-treated with DEX, exhibited higher levels of p-ERK1/2 and lower levels of Bcl-XL, Bax, and Hsp70. Our data support the notion that colostrum may be able to reduce DEX-induced apoptosis possibly via the activation of the ERK pathway and modulation of the Hsp70 system. We provided preliminary evidence on how bovine colostrum, as a complex and multi-component dairy product, in addition to its neuroprotective action, may affect osteoblastic cell survival undergoing apoptosis.

Fit to Dance Survey: Elements of Lifestyle and Injury Incidence in Chinese Dancers.

The Fit to Dance survey has been conducted using primarily Western participants and has provided foundation data for other studies. The purpose of the current study was to replicate the Fit to Dance 2 survey focusing on features of health and injuries in pre-professional and professional Chinese dancers of different genres. The survey was translated into Chinese with several new and modified questions. The survey was posted online for a 3-month period. A total of 1,040 individuals (82.8% female) completed the questionnaire, including 871 dance students (83.7%) and 169 professional dancers (16.3%), with focus in Chinese folk dance (44.4%), Chinese classical dance (25.6%), ballet (10.2%), and contemporary dance (9.8%). Compared to the Fit to Dance 2 survey, alcohol consumption (29% vs 82%; p<0.01) and smoking (13% vs 21%; p<0.05) were significantly less in Chinese dancers, but a higher percentage reported using weight-reducing eating plans (57% vs 23%; p<0.01) or having psychological issues with food (27% vs 24%; p<0.05). Reported injuries in a 12-month period prior to data collection were significantly lower in Chinese dancers (49% vs 80%; p<0.01). The type of injury (muscle and joint/ligament) and perceived cause of injury (fatigue, overwork, and reoccurrence of an old injury) were the same in both the current and previous survey. Mean injury rate ranged from 4.9 injuries/dancer (contemporary) to 3.4 injuries/dancer (Chinese folk dance), which is comparable to previously reported data on Western dance populations. This report provides the first comprehensive data on the health and injury incidence of Chinese dancers.

Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case-control study.

Given the lack of relevant data, the aim of this study was to examine femur cortical and trabecular bone in female and male professional ballet dancers. 40 professional ballet dancers and 40 sex- and age-matched non-exercising controls volunteered. Femoral bone density was scanned by dual-energy X-ray absorptiometry (DXA) scan. A 3D-DXA software was used to analyse trabecular and cortical bone. Anthropometry, maturation (Tanner staging), menstrual parameters (age at menarche and primary amenorrhea), energy availability and nutritional analysis (3-day record) were also assessed.Compared to non-exercising participants, dancers exhibited significantly higher volumetric density for integral, cortical and trabecular bone, and thicker cortex at the femur. Ballet dancers demonstrated lower body weight compared to controls (p < 0.01). Female dancers had their menarche later than controls, and the prevalence of primary amenorrhea were significantly higher in dancers than controls (p < 0.01). Dancer's energy availability was below the normal range (<30 kcal/kgFFM/day). Despite the presence of certain osteoporosis risk factors such as low energy availability, primary amenorrhoea and lower body weight, professional ballet dancers revealed higher bone density for both cortical and trabecular bone compartments compared to controls.

Associations Between Balance Ability and Dance Performance Using Field Balance Tests.

AIMS: Although balance is a key element of dance, it remains to be confirmed which balance components are associated with dance performance. The aim of this study was to assess the associations between different field balance tests and dance performance in an in-house measure in ballet, contemporary, and jazz genres. METHODS: 83 female undergraduate dance students (20±1.5 yrs, 163.04±6.59 cm, 60.97±10.76 kg) completed the Star Excursion Balance Test (SEBT), the airplane test, a dance-specific pirouette test, the modified Romberg test, and the BioSway™ Balance System. Results from these balance tests were compared to the participants' technique and repertoire performance scores in ballet, contemporary, and jazz genres. RESULTS: Ballet scores were best predicted by SEBT 90° and Romberg for technique (r=0.4, p=0.001, SEE ±2.49) and Romberg, SEBT 90°, and SEBT 225° for repertoire (r=0.51, p=0.001, SEE±1.99). Contemporary data indicated SEBT 90° and Romberg for technique (r=0.37, p=0.001, SEE±2.67) and SEBT 225° for repertoire (r=0.27, p=0.015, SEE±2.29). Jazz indicated SEBT 90°, Romberg, SEBT 315°, and SEBT 225° for technique (r=0.51, p=0.001, SEE±2.28) and SEBT 225° and Romberg for repertoire (r=0.41, p=0.001, SEE±2.29). CONCLUSION: The present study suggests that balance ability has a limited influence on dance performance, with existing field balance tests demonstrating low to moderate associations with dance technique and repertoire.

The effect of pre-exercise ingestion of corinthian currant on endurance performance and blood redox status.

The present study investigated the effect of Corinthian currant pre-exercise supplementation on metabolism, performance and blood redox status during, and after prolonged exercise. Eleven healthy participants (21-45y) performed a 90-min constant-intensity (60-70% VO2max) submaximal-trial, plus a time-trial (TT) to exhaustion (95% VO2max) after consuming an isocaloric (1.5g CHO/kg BM) amount of randomly assigned Corinthian currant or glucose-drink, or water (control). Blood was drawn at baseline, pre-exercise, 30min, 60min, 90min of submaximal-trial, post-TT, and 1h post-TT. Post-ingestion blood glucose (GLU) under Corinthian currant was higher compared with water, and similar compared with glucose-drink throughout the study. Respiratory quotient under Corinthian currant was similar with glucose-drink and higher than water throughout the submaximal trial. Accordingly, higher CHO and lower fat oxidation were observed under Corinthian currant compared with water. The TT performance was similar between Corinthian currant, glucose-drink and water. Redox status were similar under all three conditions. Reduced glutathione (GSH) declined while total antioxidant capacity (TAC) and uric acid increased during exercise. GSH and TAC returned to baseline, while uric acid remained increased the following 1h. Corinthian currant, although did not alter exercise-mediated redox status changes and performance, was equally effective to a glucose-drink in maintaining GLU levels during prolonged cycling.

Balance in Theatrical Dance Performance: A Systematic Review.

AIM: Due to movement complexity and the use of interdisciplinary styles, all theatrical dance genres require dancers to have excellent balance skills to meet choreographic demands. The aim of this systematic review was to evaluate the experimental evidence for the relationship between balance and dance performance, including balance testing, balance training, and balance performance. The key focus was on balance and theatrical styles of dance, involving adult participants who were either in full-time dance training or professional dancers. METHODS: The databases MEDLINE, PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), SPORTDiscus, Cochrane, ScienceDirect, and Google Scholar were searched using MeSH terms "postural balance," "balance, postural," "musculoskeletal equilibrium," and "postural equilibrium," and used in combination with "dance," between 1980 and 2016. PRISMA recommendations were applied in modifications to the search terms. RESULTS: The initial search revealed 1,140 published articles. After applying inclusion and exclusion criteria, 47 articles were judged to be relevant for further assessment using the GRADE system. Results revealed only 1 randomized controlled trial (RCT); the remaining articles were experimental without randomisation or pre-experimental, thus achieving low scores. A total of 39 articles focused on balance ability, including postural sway and control; 5 were related to multi-joint coordination; and 3 investigated laterality and balance. Female ballet dancers were the most studied population, while a wide range of measurement tools and balance tasks were employed. CONCLUSION: The available material on balance and dance performance is of rather low quality. There is a need for more RCTs and intervention balance studies.

The Effects of Acute Low-Volume HIIT and Aerobic Exercise on Leukocyte Count and Redox Status.

A single bout of exercise can result in inflammatory responses, increased oxidative stress and upregulation of enzymatic antioxidant mechanisms. Although low-volume high-intensity interval training (HIIT) has become popular, its acute responses on the above mechanisms have not been adequately studied. The present study evaluated the effects of HIIT on hematological profile and redox status compared with those following traditional continuous aerobic exercise (CET). Twelve healthy young men participated in a randomized crossover design under HIIT and CET. In HIIT session, participants performed four 30-sec sprints on a cycle-ergometer with 4 min of recovery against a resistance of 0.375 kg/kg of body mass. CET consisted of 30-min cycling on a cycle-ergometer at 70% of their VO2max. Blood was drawn at baseline, immediately post, 24h, 48h and 72h post-exercise and was analyzed for complete blood count and redox status (thiobarbituric acid reactive substances, [TBARS]; protein carbonyls, [PC]; total antioxidant capacity, [TAC]; catalase and uric acid). White blood cells (WBC) increased after both exercise protocols immediately post-exercise (HIIT: 50% and CET: 31%, respectively). HIIT increased (+22%) PC post-exercise compared to baseline and CET (p < 0.05). HIIT increased TAC immediately post-exercise (16%) and at 24h post-exercise (11%, p < 0.05), while CET increased TAC only post-exercise (12%, p < 0.05) compared to baseline, and TAC was higher following HIIT compared to CET (p < 0.05). Both HIIT and CET increased uric acid immediately post- (21% and 5%, respectively, p < 0.05) and 24h (27% and 5%, respectively, p < 0.05) post-exercise and the rise was greater following HIIT (p < 0.05). There were no significant changes (p > 0.05) for TBARS and catalase following either exercise protocol. Low-volume HIIT is associated with a greater acute phase leukocyte count and redox response than low-volume CET, and this should be considered when an exercise training program is developed and complete blood count is performed for health purposes.

A Comparison of Exercise-Induced Muscle Damage Following Maximal Eccentric Contractions in Men and Boys.

PURPOSE: Research regarding exercise-induced muscle-damage mainly focuses on adults. The present study examined exercise-induced muscle-damage responses in adults compared with children. METHOD: Eleven healthy boys (10-12 y) and 15 healthy men (18-45 y) performed 5 sets of 15 maximal eccentric contractions of the knee extensors. Range of motion (ROM), delayed onset muscle soreness (DOMS) during squat and walking, and peak isometric, concentric and eccentric torque were assessed before, post, 24, 48, 72, and 96 hr postexercise. Creatine kinase (CK) activity was assessed before and 72 hr postexercise. RESULTS: Eccentric exercise resulted in DOMS during squat that persisted for up to 96h in men, and 48 hr in boys (p < .05), and DOMS during walking that persisted for up to 72 hr in men, and 48 hr in boys (p < .01). The ROM was lower in both age groups 48 hr postexercise (p < .001). Isometric (p < .001), concentric (p < .01) and eccentric (p < .01) force decreased post, and up to 48 hr postexercise in men. Except for a reduction in isometric force immediately after exercise, no other changes occurred in boys' isokinetic force. CK activity increased in men at 72 hr postexercise compared with pre exercise levels (p = .05). CONCLUSION: Our data provide further confirmation that children are less susceptible to exercise-induced muscle damage compared with adults.

Chronic Eccentric Exercise and Antioxidant Supplementation: Effects on Lipid Profile and Insulin Sensitivity.

Eccentric exercise has been shown to exert beneficial effects in both lipid profile and insulin sensitivity. Antioxidant supplementation during chronic exercise is controversial as it may prevent the physiological training-induced adaptations. The aim of this study was to investigate: 1) the minimum duration of the eccentric exercise training required before changes on metabolic parameters are observed and 2) whether antioxidant supplementation during training would interfere with these adaptations. Sixteen young healthy men were randomized into the Vit group (1 g of vitamin C and 400 IU vitamin E daily) and the placebo (PL) group. Subjects received the supplementation for 9 weeks. During weeks 5-9 all participants went through an eccentric exercise training protocol consisting of two exercise sessions (5 sets of 15 eccentric maximal voluntary contractions) per week. Plasma triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), apolipoproteins (Apo A1, Apo B and Lpa) and insulin sensitivity (HOMA) were assessed before the supplementation (week 0), at weeks 5, 6, 7, 8 and 9. TG, TC and LDL were significantly lower compared to pre supplementation at both weeks 8 and 9 (P<0.05) in both groups. HDL was significantly elevated after 4 weeks of training (p < 0.005) in both groups. There was no effect of the antioxidant supplementation in any of the variables. There was no effect of either the training or the supplementation protocol in apolipoproteins levels and insulin sensitivity. A minimum duration of 3 weeks of eccentric exercise training is required before beneficial effects in lipid profile can be observed in healthy young men. Concomitant antioxidant supplementation does not interfere with the training-induced adaptations.

Acute Effects of Vitamin D3 Supplementation on Muscle Strength in Judoka Athletes: A Randomized Placebo-Controlled, Double-Blind Trial.

OBJECTIVE: Indoor athletes have been shown to be prone to vitamin D3 deficiency. The aim of the study was to examine the acute effects of vitamin D supplementation on muscle function using isokinetic dynamometry. DESIGN: Randomized placebo-controlled, double-blind study. SETTING: Institutional. PARTICIPANTS: Adult male white national level judoka athletes (n = 22) who were involved in full-time training. Exclusion criteria were vitamin supplementation, overseas travel to sunny climes, and/or an injury incurred during the last 3 months before testing. INTERVENTIONS: Subjects were randomly allocated to the treatment (150 000IU vitamin D3) or placebo and given blinded supplements by an independent researcher. Participants were tested twice, 8 days apart, on a Monday morning before the start of judo training and after 2 days of rest. A 5 to 7 mL of blood sample was collected followed by isokinetic concentric quadriceps and hamstring muscle function assessments on the right leg at 30 and 200°·s. MAIN OUTCOME MEASURES: Repeated-measures analysis of variance was used to analyze isokinetic muscle force and serum 25(OH)D3. Regression to the mean was used to examine changes in 25(OH)D3 levels over the study period. RESULTS: The treatment group demonstrated a significant increase in serum 25(OH)D levels (34%, P ≤ 0.001) and muscle strength (13%, P = 0.01) between days 1 and 8. No significant differences were found for the placebo group for the same period. CONCLUSIONS: A single bolus of 150 000IU vitamin D3 had a significant positive effect on serum 25(OH)D levels and muscle function in vitamin D insufficient elite indoor athletes. CLINICAL RELEVANCE: Serum 25(OH)D3 levels of indoor athletes should be monitored throughout the year and especially during winter months. Beneficial responses, in muscle strength and serum 25(OH)D3, to 1 dose of vitamin D3 supplementation can be observed within 1 week of ingestion. Muscle strength is linked to serum 25(OH)D levels.

Antioxidant responses following active and passive smoking of tobacco and electronic cigarettes.

CONTEXT: It has been indicated that acute active and passive tobacco cigarette smoking may cause changes on redox status balance that may result in significant pathologies. However, no study has evaluated the effects of active and passive e-cigarette smoking on redox status of consumers. OBJECTIVE: To examine the acute effects of active and passive e-cigarette and tobacco cigarette smoking on selected redox status markers. METHODS: Using a randomized single-blind crossover design, 30 participants (15 smokers and 15 nonsmokers) were exposed to three different experimental conditions. Smokers underwent a control session, an active tobacco cigarette smoking session (smoked 2 cigarettes within 30-min) and an active e-cigarette smoking session (smoked a pre-determined number of puffs within 30-min using a liquid with 11 ng/ml nicotine). Similarly, nonsmokers underwent a control session, a passive tobacco cigarette smoking session (exposure of 1 h to 23 ± 1 ppm of CO in a 60 m(3) environmental chamber) and a passive e-cigarette smoking session (exposure of 1 h to air enriched with pre- determined number of puffs in a 60 m(3) environmental chamber). Total antioxidant capacity (TAC), catalase activity (CAT) and reduced glutathione (GSH) were assessed in participants' blood prior to, immediately after, and 1-h post-exposure. RESULTS: TAC, CAT and GSH remained similar to baseline levels immediately after and 1-h-post exposure (p > 0.05) in all trials. CONCLUSIONS: Tobacco and e-cigarette smoking exposure do not acutely alter the response of the antioxidant system, neither under active nor passive smoking conditions. Overall, there is not distinction between tobacco and e-cigarette active and passive smoking effects on specific redox status indices.

Cardiorespiratory fitness levels and their association with cardiovascular profile in patients with rheumatoid arthritis: a cross-sectional study.

OBJECTIVE: The aim of this study was to investigate the association of different physical fitness levels [assessed by the maximal oxygen uptake (VO2max) test] with cardiovascular disease (CVD) risk factors in patients with RA. METHODS: A total of 150 RA patients were assessed for cardiorespiratory fitness with a VO2max test and, based on this, were split in three groups using the 33rd (18.1 ml/kg/min) and 66th (22.4 ml/kg/min) centiles. Classical and novel CVD risk factors [blood pressure, body fat, insulin resistance, cholesterol, triglycerides, high-density lipoprotein (HDL), physical activity, CRP, fibrinogen and white cell count], 10-year CVD risk, disease activity (DAS28) and severity (HAQ) were assessed in all cases. RESULTS: Mean VO2max for all RA patients was 20.9 (s.d. 5.7) ml/kg/min. The 10-year CVD risk (P = 0.003), systolic blood pressure (P = 0.039), HDL (P = 0.017), insulin resistance and body fat (both at P < 0.001), CRP (P = 0.005), white blood cell count (P = 0.015) and fibrinogen (P < 0.001) were significantly different between the VO2max tertiles favouring the group with the higher VO2max levels. In multivariate analyses of variance, VO2max was significantly associated with body fat (P < 0.001), HDL (P = 0.007), insulin resistance (P < 0.003) and 10-year CVD risk (P < 0.001), even after adjustment for DAS28, HAQ and physical activity. CONCLUSION: VO2max levels are alarmingly low in RA patients. Higher levels of VO2max are associated with a better cardiovascular profile in this population. Future studies need to focus on developing effective behavioural interventions to improve cardiorespiratory fitness in RA.

Association between habitual physical activity and brown adipose tissue activity in individuals undergoing PET-CT scan.

OBJECTIVE: Augmented brown adipose tissue (BAT) mass and activity lead to higher basic metabolic rate which is beneficial against obesity. Our aim was to investigate whether habitual (i.e. usual weekly participation) physical activity is linked with BAT activity and mass in humans, in a group of patients undergoing (18) F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scanning. DESIGN: Cross-sectional study. PATIENTS: Forty patients with cancer [26 male; 14 female; age 52·7 ± 17·5; body mass index (BMI) 26·4 ± 4·5]. MEASUREMENTS: Patients completed the 'usual week' form of the International Physical Activity Questionnaire and underwent assessment of BAT activity/mass via (18) F-fluorodeoxyglucose PET/CT. RESULTS: We detected a significant association between habitual physical activity (METs-minute/week) and BAT activity [normalized by body weight (BW) (τ = 0·28, P = 0·02), body surface area (BSA) (τ = 0·29, P = 0·02) and lean body mass (LBM) (τ = 0·38, P = 0·002)]. We also found a significant negative relationship between BMI and BAT activity [normalized by BW (τ = -0·30, P = 0·006), BSA (τ = -0·31, P = 0·004) and LBM (τ = -0·45, P = 0·001)] as well as a significant negative relationship between age and BAT activity [normalized by LBM (τ = -0·28, P = 0·01)]. The results also indicate significant differences between low/moderate/high levels of habitual physical activity and BAT activity (P < 0·05). Moreover, BAT activity was different across the BMI categories (normal/overweight/obese) in both sexes (P < 0·05). Finally, BAT activity was greater in women than in men (P < 0·05). CONCLUSIONS: Increased participation in habitual physical activity is associated with higher BAT activity. Moreover, individuals with normal BMI demonstrate higher BAT activity compared to overweight and obese individuals. Finally, age is inversely linked with BAT activity, while women demonstrate higher BAT activity than men.

Dynamic Effect of Quadriceps Muscle Activation on Anterior Tibial Translation After Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction.

PURPOSE: To examine differences in anterior tibial translation in 3 groups: single-bundle anterior cruciate ligament (ACL)-reconstructed, double-bundle ACL-reconstructed, and ACL-intact knees under gradual dynamic quadriceps muscle activation. METHODS: Thirty male patients underwent successful single-bundle (n = 15) and double-bundle (n = 15) ACL reconstructions; 15 healthy controls were included in the study. Anterior tibial translation was assessed at 30° of knee flexion in the resting position (0% quadriceps activation) and under 50% and 100% of maximum quadriceps concentric contraction using an isokinetic dynamometer with the KT-2000 arthrometer securely attached to the participants' knees. RESULTS: The 2 ACL-reconstructed groups were similar regarding International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score (KOOS), Tegner, and Lysholm scores and preliminary isokinetic evaluation (P = .38). Quadriceps activation significantly affected anterior tibial translation (P = .001, α = 0.98). In all 3 study groups, anterior tibial translation was significantly higher under 100% quadriceps activation compared with 0% contraction (P = .01) and 50% quadriceps activation (P = .047). There were no between-group differences in anterior tibial translation with 0%, 50%, or 100% quadriceps activation (P = .46). CONCLUSIONS: Under quadriceps muscle activation, anteroposterior knee laxity in ACL-intact and ACL-reconstructed knees is gradually increased. Single-bundle and double-bundle ACL-reconstructed knees show a similar increase in anterior tibial translation under gradual quadriceps contraction. When comparing different ACL reconstruction techniques in the experimental setting, dynamic, in addition to static, testing is advised to reach a comprehensive assessment of anteroposterior knee stability. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Adiponectin, Resistin, and Visfatin in Childhood Obesity and Exercise.

Childhood obesity is increasing alarmingly, and a strong association with chronic diseases has been established. Specific adipokines are released from the adipose tissue and relate with chronic diseases even in the pediatric population. Adiponectin levels are lower in obesity and increase with decreasing body weight. A few pediatric studies examining a possible relationship between resistin and obesity do not provide a clear picture. Most studies agree that visfatin levels appear elevated in childhood obesity. Exercise seems to increase adiponectin levels whereas resistin levels are reduced. The lack of data on the effects of acute and chronic exercise on visfatin levels precludes us from making safe conclusions as to what the effects of exercise (acute or chronic) would be on visfatin levels in children. Clearly, exercise has an impact on the adipose tissue and the release of adiponectin, resistin, and visfatin. However, other factors affect the secretion rate of these adipokines from the adipose tissue; these factors should also be taken into consideration when examining the effects of exercise on adipokines. Gender, age, body composition, physical activity levels, mode and intensity of exercise are some of the factors that should be looked into in future studies.

Individualised exercise improves endothelial function in patients with rheumatoid arthritis.

BACKGROUND: We investigated the effects of individualised combined resistance and aerobic exercise on microvascular and macrovascular function in rheumatoid arthritis (RA) patients. METHODS: Forty age-matched, gender-matched and body mass index (BMI)-matched patients were allocated to either an exercise group, receiving a 6 months tailored aerobic and resistance exercise intervention, or controls receiving only information about the benefits of exercise. Participants were assessed for microvascular (acetylcholine (Ach) and sodium nitroprusside (SNP)) and macrovascular (flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)) endothelial function, maximal oxygen uptake, disease activity and severity (C-reactive protein (CRP), disease activity score 28 and health assessment questionnaire). Data were collected at baseline, 3 months and at the end of the intervention (6 months). RESULTS: At baseline, demographic, anthropometric, disease-related characteristics and endothelial function parameters were similar between the exercise and control groups (p>0.05). Repeated measures analysis of variance revealed a significant improvement in endothelial function parameters at 3 (GTN: p<0.001) or 6 months (Ach: p=0.016, SNP: p=0.045, FMD: p=0.016) in the exercise but not in the control group. Generalised estimated equations detected that maximal oxygen uptake was a strong predictor for the observed changes in Ach (p=0.009) and GTN (p<0.001) whereas logCRP for SNP (p=0.017) and GTN (p=0.008). CONCLUSIONS: An exercise programme designed to meet individual needs and physical abilities significantly improves microvascular and macrovascular function in parallel with disease-related characteristics in RA patients. The potential long-term beneficial effects of such interventions at reducing cardiovascular risk in these patients merit further exploration. CLINICAL TRIAL REGISTRATION: ISRCTN50861407.

Fostering autonomous motivation, physical activity and cardiorespiratory fitness in rheumatoid arthritis: protocol and rationale for a randomised control trial.

BACKGROUND: People with rheumatoid arthritis are at greater risk of morbidity and mortality from cardiovascular disease than the general population. Sustained physical activity increases cardio-respiratory fitness and reduces cardiovascular disease risk factors. However, little is known about how we can effectively promote long-term participation in physical activity in patients with rheumatoid arthritis. The literature consistently calls for physical activity interventions, and their implementation, to be theoretically-grounded. METHODS/DESIGN: This paper documents the protocol of a randomised control trial that investigates whether a Self-determination Theory-based intervention fosters the adoption and maintenance of physical activity (3, 6 and 12 months) sufficient to provide sustained cardiovascular and personal well-being benefits in patients with rheumatoid arthritis. The cost effectiveness of the intervention will also be determined. The trial is registered as Current Controlled Trials ISRCTN04121489. DISCUSSION: Results from this trial will provide guidance regarding key social environmental factors that can be manipulated to support motivational processes conducive to positive health behaviour change and optimal functioning in patients with Rheumatoid Arthritis.