Evaluating the effectiveness of neurofeedback in chronic pain management: a narrative review.

The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients.

Italian Canyoning Guides: Physiological Profile and Cardiometabolic Demand during Rope Activities.

Canyoning activities require physical effort, highlighting the importance of maintaining a proper physical fitness. Canyoning guides emerge as key figures, not only to ensure safety during the experience but also to handle unforeseen situations promptly. This study aims to assess the physiological profile of canyoning guides and the cardiorespiratory demands experienced during rope activities by means of oxygen uptake and heart rate measurements. Seventeen canyoning guides (42.6 y ± 10.78; BMI of 24.0 kg/m2 ± 2.95) carried out coordinative and conditional tests. The participants showed good values in strength tests (27.3 cm ± 5.97 and 23.3 rep ± 8.06 in SJ and PUp tests, respectively), while the flexibility of males and females was below and well above the average, respectively. A noteworthy result was observed in the reaction test, in which a better performance was recorded with the non-dominant hand (168.1 ms vs. 202.0 ms). All subjects exhibited a low aerobic capacity by means of an RD test (10.6 ua ± 6.62). During rope activities and emergency/support simulations, metabolic and cardiovascular data indicated that a moderate/high effort was exerted, confirmed by an oxidative stress analysis. In conclusion, this study demonstrated how canyoning guides face significant physical requirements, but their physiological profile regarding aerobic power was not appropriate. Therefore, these findings could offer valuable insights into the development of specific training to ensure an appropriate aerobic fitness to perform canyoning safely.

Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review.

In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.

Improving Mental Skills in Precision Sports by Using Neurofeedback Training: A Narrative Review.

Primary objectives of neurofeedback training (NFT) are to improve concentration, stress and anxiety management, and performance optimisation. This narrative review examines the role of NFT as a tool to improve mental and cognitive skills of target shooting and archery athletes. Current research discusses how neurofeedback training can act on brain waves by influencing specific EEG frequency bands in order to improve cognitive flexibility. This contribution reports studies that have applied neurofeedback protocols in precision disciplines such as archery and shooting. The results of the studies considered showed that neurofeedback can lead to faster reaction times, more sustained attention, and better emotion management, contributing significantly to athletes' performance. Furthermore, it is emphasised that neurofeedback could be combined with other techniques such as motor imagination to maximise effectiveness in precision sports training. This review emphasises the importance of future studies that focus on the integration of neurofeedback with biofeedback in neuromodulation protocols. Current perspectives and limitations of research in this area are also indicated. Neuromodulation by means of neurofeedback represents a promising strategy to improve the overall mental and cognitive abilities of target shooting and archery athletes with an interesting potential for high-level performance. Future research should focus on integrated approaches and customised protocols to optimise the use of neurofeedback in a precision sports context.

Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review.

Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.

Plastic changes induced by muscle focal vibration: A possible mechanism for long-term motor improvements.

Repetitive focal vibrations can induce positive and persistent after-effects. There is still no satisfactory interpretation of the underlying mechanisms. A rationale, which can provide consistency among different results, is highly desirable to guide both the use of the application and future research. To date, interpretive models are formulated to justify the results, depending on the specific protocol adopted. Indeed, protocol parameters, such as stimulus intensity and frequency, intervention time and administration period, are variable among different studies. However, in this article, we have identified features of the protocols that may allow us to suggest a possible common mechanism underlying the effectiveness of focal vibration under different physiologic and pathologic conditions. Since repetitive focal muscle vibration induces powerful and prolonged activation of muscle proprioceptors, we hypothesize that this intense activation generates adaptive synaptic changes along sensory and motor circuits. This may lead to long-term synaptic potentiation in the central network, inducing an enhancement of the learning capability. The plastic event could increase proprioceptive discriminative ability and accuracy of the spatial reference frame and, consequently, improve motor planning and execution for different motor functions and in the presence of different motor dysfunctions. The proposed mechanism may explain the surprising and sometimes particularly rapid improvements in motor execution in healthy and diseased individuals, regardless of specific physical training. This hypothetic mechanism may require experimental evidence and could lead to extend and adapt the application of the "learning without training" paradigms to other functional and recovery needs.

Perceived Pain in Athletes: A Comparison between Endurance Runners and Powerlifters through a Cold Experimental Stimulation and Two Sessions of Various Physical Activation.

Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.

The Nutraceuticals as Modern Key to Achieve Erythrocyte Oxidative Stress Fighting in Osteoarthritis.

Osteoarthritis (OA), the most common joint disease, shows an increasing prevalence in the aging population in industrialized countries. OA is characterized by low-grade chronic inflammation, which causes degeneration of all joint tissues, such as articular cartilage, subchondral bone, and synovial membrane, leading to pain and loss of functionality. Erythrocytes, the most abundant blood cells, have as their primary function oxygen transport, which induces reactive oxygen species (ROS) production. For this reason, the erythrocytes have several mechanisms to counteract ROS injuries, which cause damage to lipids and proteins of the cell membrane. Oxidative stress and inflammation are highly correlated and are both causes of joint disorders. In the synovial fluid and blood of osteoarthritis patients, erythrocyte antioxidant enzyme expression is decreased. To date, OA is a non-curable disease, treated mainly with non-steroidal anti-inflammatory drugs and corticosteroids for a prolonged period of time, which cause several side effects; thus, the search for natural remedies with anti-inflammatory and antioxidant activities is always ongoing. In this review, we analyze several manuscripts describing the effect of traditional remedies, such as Harpagophytum procumbens, Curcumin longa, and Boswellia serrata extracts, in the treatments of OA for their anti-inflammatory, analgesic, and antioxidant activity. The effects of such remedies have been studied both in in vitro and in vivo models, considering both joint cells and erythrocytes.

Both Gender and Agonistic Experience Affect Perceived Pain during the Cold Pressor Test.

BACKGROUND: Differences in pain perception in athletes have recently been highlighted in the literature. OBJECTIVES: To compare gender ratings of perceived pain in athletes with low and high agonistic experiences (N = 200) using the Cold Pressor Test (CPT). METHODS: A three-way repeated measures ANOVA to assess both the effects of the athletes' gender and lower vs. higher agonistic experiences in the intensity of perceived pain at the beginning of the cold box hand immersion (L0) and after a 90 s interval (L1). RESULTS: There was a statistically significant interaction effect between the level of the agonistic experience and gender in the two moments: p < 0.001; ηp2 = 0.266; F(1,49) = 9.771. Simple main effects analysis showed a significative difference for females at L0: F(1,99) = 93.567, p < 0.025, partial η2 = 0.302) and for males at L1: F(1,99) = 173.420, p < 0.025, partial η2 = 0.666. At the initial moment of CPT, the female athletes showed significantly higher perceived intensity than males, regardless of their experience level. After a 90 s interval, a significantly lower pain perception effect associated with the increased competitive experience of male athletes was observed. Female athletes did not appear to benefit from the experience effect on their pain tolerance. CONCLUSIONS: The study confirmed a significant difference in pain perception associated with the athletes' gender and agonistic experience. Separate explanations related to the pattern of pain inhibition and the acquired reduction in pain sensitivity are reported.

ATP release from erythrocytes: A role of adenosine1.

BACKGROUND: The oxygen required to meet metabolic needs of all tissues is delivered by the red blood cell (RBC), a small, flexible cell which, in mammals, is devoid of a nucleus and mitochondria. Despite its simple appearance, this cell has an important role in its own distribution, enabling the delivery of oxygen to precisely meet localized metabolic need. When red blood cells enter in hypoxic area, a signalling pathway is activated within the cell, resulting in the release of ATP in amounts adequate to activate purinergic receptors on vascular endothelium, which trigger secretion of nitric oxide and other factors resulting in vasodilatation. OBJECTIVE: The present study investigates the effect of adenosine exposure on this molecular mechanism. METHODS AND RESULTS: We report that RBC in the presence of adenosine in low oxygen conditions, ATP release increase after 24 h exposure. Adenosine induced-ATP release in deoxygenated red blood cell show data similar to that of RBC in high oxygen conditions: (1) RBC after band 3 modification by 4,4'- diisothio-cyanatostilbene- 2,2'-disulphonic acid; (2) CO-treated RBC. In the presence of Sphingosine kinase (SphK1) inhibitor, adenosine mediated effects on ATP release were abolished. Activity of adenylate cyclase increase following to adenosine exposure, on the contrary red cell phosphofructokinase is not modified within the RBC in the presence of adenosine. CONCLUSION: Our data support involvement of band 3/deoxyHb binding and adenylate cyclase in the pathway responsible for ATP release from RBC following exposure to adenosine.

Parkinson's Disease Patient Monitoring: A Real-Time Tracking and Tremor Detection System Based on Magnetic Measurements.

Reliable diagnosis of early-stage Parkinson's disease is an important task, since it permits the administration of a timely treatment, slowing the progression of the disease. Together with non-motor symptoms, other important signs of disease can be retrieved from the measurement of the movement trajectory and from tremor appearances. To measure these signs, the paper proposes a magnetic tracking system able to collect information about translational and vibrational movements in a spatial cubic domain, using a low-cost, low-power and highly accurate solution. These features allow the usage of the proposed technology to realize a portable monitoring system, that may be operated at home or in general practices, enabling telemedicine and preventing saturation of large neurological centers. Validation is based on three tests: movement trajectory tracking, a rest tremor test and a finger tapping test. These tests are considered in the Unified Parkinson's Disease Rating Scale and are provided as case studies to prove the system's capabilities to track and detect tremor frequencies. In the case of the tapping test, a preliminary classification scheme is also proposed to discriminate between healthy and ill patients. No human patients are involved in the tests, and most cases are emulated by means of a robotic arm, suitably driven to perform required tasks. Tapping test results show a classification accuracy of about 93% using a k-NN classification algorithm, while imposed tremor frequencies have been correctly detected by the system in the other two tests.

Influence of Cognitive Orientation and Attentional Focus on Pain Perception.

BACKGROUND: Recently, a growing interest has emerged in the role of attention and hypervigilance in the experience of pain. Shifting attention away from pain seems likely to reduce the perception of pain itself. OBJECTIVES: The present study has been designed to test the following overall hypotheses: (1) disposition to catastrophize, self-efficacy perceived in pain resistance (task self-efficacy), previous experiences concerning the tolerance of physical pain, and degree of impulsiveness are significant predictors of the decision to abandon a painful test such as the cold pressor test (CPT); (2) the manipulation of the attentive focus (internal or external) can influence the level of perceived pain. METHODS: Effects of the manipulation of attentional focus (internal and external) on pain perception and response of trial abandonment were evaluated in a sample of university students (n = 246) subjected to the cold pressor test. RESULTS: A significant effect (p < 0.05) was found through a test-retest comparison on the final level of perceived pain among subjects who had received instruction to externalize the focus of their attention (mixed factorial analysis of variance), but no significance was observed with respect to the decision to abandon the experiment. A general explanatory model of the abandonment behavior demonstrating overall good fit measurements was tested too. CONCLUSION: The abandonment of tests has been shown to be predicted mainly by catastrophic attitude. Attentive impulsiveness showed a further positive effect on catastrophic attitude. Perceived self-efficacy in the tolerance of pain limited learned helplessness, which in turn positively influenced catastrophizing.

Estimation of cardiovascular drift through ear temperature during prolonged steady-state cycling: a study protocol.

INTRODUCTION: The measurement of heart rate is commonly used to estimate exercise intensity. However, during endurance performance, the relationship between heart rate and oxygen consumption may be compromised by cardiovascular drift. This physiological phenomenon mainly consists of a time-dependent increase in heart rate and decrease in systolic volume and may lead to overestimate absolute exercise intensity in prediction models based on heart rate. Previous research has established that cardiovascular drift is correlated to the increase in core body temperature during prolonged exercise. Therefore, monitoring body temperature during exercise may allow to quantify the increase in heart rate attributable to cardiovascular drift and to improve the estimate of absolute exercise intensity. Monitoring core body temperature during exercise may be invasive or inappropriate, but the external auditory canal is an easily accessible alternative site for temperature measurement. METHODS AND ANALYSIS: This study aims to assess the degree of correlation between trends in heart rate and in ear temperature during 120 min of steady-state cycling with intensity of 59% of heart rate reserve in a thermally neutral indoor environment. Ear temperature will be monitored both at the external auditory canal level with a contact probe and at the tympanic level with a professional infrared thermometer. ETHICS AND DISSEMINATION: The study protocol was approved by an independent ethics committee. The results will be submitted for publication in academic journals and disseminated to stakeholders through summary documents and information meetings.

Is the Focal Muscle Vibration an Effective Motor Conditioning Intervention? A Systematic Review.

Mechanical vibration, applied to single or few muscles, can be a selective stimulus for muscle spindles, able to modify neuromuscular management, inducing short and long-term effects, are now mainly employed in clinic studies. Several studies reported as treatments with focal vibratory (FVT) can influence neuromuscular parameters also in healthy people. However, the application modalities and the consequent effects are remarkably fragmented. This paper aims to review these studies and to characterize the FVT effectiveness on long-term conditional capacities in relation to FVT characteristics. A systematic search of studies published from 1985 to 2020 in English on healthcare databases was performed. Articles had to meet the following criteria: (1) treatment based on a locally applied vibration on muscle belly or tendon; (2) healthy adults involved; (3) outcomes time analysis enduring for more than 24 h. Twelve studies were found, all of them presented an excellent quality score of ≥75%. All selected papers reported positive changes, comparable with traditional long-lasting training effects. Muscle force and power were the most investigated parameters. The after-effects persisted for up to several months. Among the different FV administration modalities, the most effective seems to show a stimulus frequency of ≈100 Hz, repeated more times within three-five days on a voluntary contracted muscle.

Effects of focal vibration on power and work in multiple wingate tests.

The aim of the study was to assess the effects of a specific protocol, based on a focal muscle vibration, on mechanical parameters in an exercise composed of five repeated bouts of sprint interval tests (Wingate Anaerobic Tests, 10 seconds duration). Twenty-eight young male healthy subjects were randomized to two groups (VIB and CTRL). Peak power (PP), average peak between bouts (aP) and total exercise work (TW) were measured. In both groups, three different exercise sessions were carried out, interspersed by seven days: T0, T1 and T2. Between the baseline (T0) and T1, in the VIB group the intervention was administered on three successive days on quadriceps muscles, whereas a placebo administration was carried out in the CTRL group at the same time. At T1 (30 minutes after intervention) and T2 (7 days after) CTRL did not show any significant change, whereas VIB showed significant increases in PP (11.4%-9.3%), aP (6.6%-6.9%) and TW (5.7%-7.9%) with respect to T0. The results could be explained by an ameliorative agonist-antagonist balance, and this hypothesis is coherent with the literature. On the basis of the present findings, the investigated intervention might be usefully adopted to increase muscular power and endurance.

Acoustic and visual pacesetter influence on the energy expenditure in a cycling exercise.

BACKGROUND: The aim of this study was to evaluate the effects of acoustic and visual pacesetters on the energy expenditure in a steady state 30-minute long cycling. METHODS: Eighteen healthy male subjects (age 27.6±4.59 years; height 1.78±0.07 m; body mass 80.1±7.85 kg) performed a 30-minute submaximal exercise at a constant workload on a cycle ergometer. The imposed workload required a metabolic expenditure corresponding to 70% of ventilatory threshold for each subject. Energy expenditure - expressed as a caloric equivalent relative to the total net oxygen consumption during exercise - was evaluated using three conditions: control (CT), no external pacesetter; acoustic (AT), listening to rhythmic acoustic stimuli at 120 beat per minute; and visual (VT), seeing footage consisting of eight different images in a looped sequence at 120 frames per minute. RESULTS: All measured parameters qualified the exercise as requiring mainly an aerobic metabolism, showing no pain and no fatigue. AT and VT energy expenditure (5.0±0.44 and 4.9±0.39 MET respectively) were significantly lower compared to CT (5.5±0.49 MET), while no difference between AT and VT were recognized. CONCLUSIONS: This study confirmed the ergogenic effect of the acoustic pacesetter on a 30-minute steady state rhythmic exercise. Novelty is that the visual pacesetter too was able to increase the mechanical efficiency as the same manner than the acoustic one. The present setting adopting visual pacesetter could be used in special categories, such as the deaf or in innovative technological tools as head-mounted display devices.

Assessment of Exercise Stroke Volume and Its Prediction From Oxygen Pulse in Paralympic Athletes With Locomotor Impairments: Cardiac Long-Term Adaptations Are Possible.

The determinants of cardiac output (CO) during exercise, i.e., stroke volume (SV) and heart rate (HR), could differ in Paralympic athletes (PAthl) with spinal cord injury (SCI) with respect to PAthl with locomotor impairments caused by different health conditions (HCs). The purposes of the present study were the comparisons of two groups of PAthl, one with SCI and the other with either amputation (AMP) or post poliomyelitis syndrome (PM), assessing the (1) peak cardiorespiratory responses and determinants (SV and HR) of CO during maximal and submaximal arm cranking exercise (ACE), respectively; (2) correlations between peak oxygen uptake (VO2peak) and the highest SV obtained during submaximal exercise; and (3) correlations between oxygen pulse (O2 pulse, ratio between VO2 and HR) and both SV and O2 arterio-venous difference [(a-v)O2diff]. Each athlete (19 PAthl with SCI, 9 with AMP, and 5 with PM) completed a continuous incremental cardiopulmonary ACE test to volitional fatigue to assess peak responses. In a different session, CO was indirectly measured through carbon dioxide (CO2) rebreathing method at sub-maximal exercise intensities approximating 30, 50, and 70% of the VO2peak. There were no significant differences between the PAthl groups in age, anthropometry, and VO2peak. However, peak HR was significantly lower, and peak O2 pulse was significantly higher in PAthl with AMP/PM compared to those with SCI. During sub-maximal exercise, PAthl with AMP/PM displayed significantly higher SV values (154.8 ± 17.60 ml) than PAthl with SCI (117.1 ± 24.66 ml). SV correlated significantly with VO2peak in both PAthl with SCI (R 2 = 0.796) and AMP/PM (R 2 = 0.824). O2 pulse correlated significantly with SV in both PAthl with SCI (R 2 = 0.888) and AMP/PM (R 2 = 0.932) and in the overall sample (R 2 = 0.896). No significant correlations were observed between O2 pulse and (a-v)O2diff. It was concluded that in PAthl with different HCs: (1) significant differences, as a consequence of the different HC, exist in the determinants of CO at maximal and submaximal ACE; (2) SV is a significant determinant of VO2peak, suggesting cardiac adaptations possible also in PAthl with SCI; and (3) SV can be predicted from O2 pulse measurements during submaximal exercise in both groups of PAthl.

Upper limb aerobic training improves aerobic fitness and all-out performance of America's Cup grinders.

This research on "America's Cup" grinders investigated the effects of a specific eight-week long-arm cranking ergometer (ACE) training on upper body (UB) aerobic fitness (ventilatory threshold - Tvent, respiratory compensation point- RCP, -oxygen uptake peak - VO2peak) and high intensity working capacity. The training consisted of sessions carried out for 20-30 mins, three times per week, at an intensity between the UB-Tvent and UB-RCP, and replaced part of a typical lower limb aerobic training whilst maintaining the usual weekly schedule of callisthenics, resistance training and sailing. Seven sailors, including four grinders and three mastmen (age 30 ± 5.5 years, height 1.9 ± 0.04 m, body mass 102 ± 3.6 kg), were evaluated through both an ACE cardiopulmonary maximal exercise test (CPET) and an ACE all-out up to exhaustion exercise test, before and after the ACE training. UB aerobic fitness improved significantly: UB-VO2peak increased from 4.29 ± 0.442 to 4.52 ± 0.522 l·min(-1) (6.4 ± 3.66%), VO2 at UB-Tvent from 2.42 ± 0.282 to 2.97 ± 0.328 l·min(-1) (22.8 ± 5.09%) and VO2 at UB-RCP from 3.25 ± 0.402 to 3.75 ± 0.352 l·min(-1) (16.1 ± 10.83%). Peak power at the ACE CPET increased from 351 ± 27.5 to 387 ± 33.5 W (10.5 ± 6.93%). The all-out test total mechanical work increased from 28.9 ± 2.35 to 40.1 ± 3.76 kJ (72.1 ± 4.67%). In conclusion, a high intensity aerobic ACE training can be effective in improving grinding performance by increasing UB aerobic fitness and all-out working capacity.

Downhill walking to improve lower limb strength in healthy young adults.

Walking is the most natural physical activity to maintain and improve fitness and health. Walking downhill is usefully adopted to plan training programmes to improve the strength, particularly in older adults. The present research was aimed to evaluate the influence of downhill walking on leg strength in young adult. A total of 32 females (age 26 ± 4 years; height 1.64 ± 0.05 m; body mass 57.6 ± 5.6 kg) were divided into four groups and they carried out an exercise intervention consisting of three sessions per week for 6 weeks, each lasting 30 minutes. Groups were defined at several workloads characterised by treadmill inclination (%) and walking speed (m · s(-1)): Level Walking at treadmill inclination 0% and walking speed 1.0; Uphill Walking at +20%, 0.75; Downhill Walking (DW) at -20%, 1.36; and Mixed Walking at +20%, 0.75 and -20%, 1.36 each lasting 15 minutes. Maximum voluntary contraction (MVC) developed by the Quadriceps Femoris and Endurance Time at 60% MVC were evaluated before and after experimental period. At the end of each session, Borg's scale and Visual Analogue Scale (VAS) were adopted in order to evaluate perception of rate exertion and pain. Statistical analysis showed significant only in MVC for DW in both right and left legs. Borg's scale and VAS described light activity free of pain. Present findings showed how an eccentric exercise, short lasting and at a low workload, can be useful in inducing improvements in leg strength.

Workload comparison between hiking and indoor physical activity.

Walking is a physical activity able to maintain and improve aerobic fitness. This activity can easily be performed in all seasons both outdoors and indoors, but when it is performed in its natural environment, the use of specific equipment is required. In particular, it has been demonstrated that the use of trekking boots (TBs) induces a larger workload than those used indoors. Because an adequate fitness level is needed to practice hiking in safety, it is useful to know the energy demand of such an activity. This research aims at defining the metabolic engagement of hiking on natural paths with specific equipment at several speeds and comparing this with indoor ones (on a treadmill). This can thence be used to define the load that better reflects the one required to walk on natural paths. The walking energy cost (joules per kilogram per meter) at several speeds (0.28, 0.56, 0.84, 1.11, and 1.39 m·s(-1))-on level natural terrain while wearing suitable footwear (TBs) and on a treadmill at various raising slopes (0, 1, 2, 3, 4%) while wearing running shoes-was measured in 14 healthy young men (age 23.9 ± 2.9 years, stature 1.75 ± 0.04 m, and body mass 72.9 ± 6.3 kg). A physiological evaluation of all the subjects was performed before energy cost measurements. The results showed that outdoors, the oxygen uptake was consistently less than the ventilatory threshold at all speeds tested and that a 3% slope on the treadmill best reflects the outdoor walking energy expenditure. These findings will prove useful to plan proper training for hiking activity or mixed (outdoors and indoors) training program.