Effect of blood flow restriction with low-intensity resistance training in patients with osteoarthritis and rheumatoid arthritis: a systematic review and meta-analysis based on randomized controlled trials.

PURPOSE: This study evaluated the effects of blood flow restriction with low-intensity resistance training (BFR + LIRT) on pain, adverse events, muscle strength, and function in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) through a systematic review and meta-analysis. METHODS: This study adhered to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 (PRISMA 2020) and applied the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) standards to ensure the high quality of the systematic review. A comprehensive literature search was conducted until August 2023 using four selected keywords (osteoarthritis, rheumatoid arthritis, blood flow restriction training, and resistance training) across five search engines (PubMed, Embase, Web of Science, CENTRAL, and PEDro). RESULTS: Ten studies were analyzed. The results showed that BFR + LIRT had similar effects on pain, risk of adverse events, muscle strength, self-reported function, and physical function compared with resistance training (RT). CONCLUSION: This systematic review and meta-analysis further support the potential of BFR + LIRT in the disease management of patients with OA or RA. According to this analysis, BFR + LIRT had a lower risk of adverse events than high-intensity resistance training (HIRT) and may be a safer training modality. BFR + LIRT offers greater advantages in improving physical function than LIRT and was able to provide similar benefits to HIRT without increasing the training load. These findings suggest that BFR + LIRT is a safe and effective strategy for treating patients with OA or RA. However, owing to the limited number of studies covered in this analysis, additional higher-quality studies are needed to strengthen this conclusion.

Effects of post-exercise intake of exogenous lactate on energy substrate utilization at rest.

PURPOSE: This study investigated the effects of exogenous lactate intake on energy metabolism during 1 h of rest after acute exercise. METHODS: Eight-week-old ICR mice were randomly divided into four groups: SED (no treatment), EXE (exercise only), LAC (post-exercise oral lactate administration), and SAL (post-exercise saline administration) (n=8 per group). The exercise intensity was at VO2max 80% at 25 m/min and 15° slope for 50 min. After acute exercise, the LAC and SAL groups ingested lactate and saline orally, respectively, and were allowed to rest in a chamber. Energy metabolism was measured for 1 h during the resting period. RESULTS: LAC and SAL group mice ingested lactate and saline, respectively, after exercise and the blood lactate concentration was measured 1 h later through tail blood sampling. Blood lactate concentration was not significantly different between the two groups. Energy metabolism measurements under stable conditions revealed that the respiratory exchange ratio in the LAC group was significantly lower than that in the SAL group. Additionally, carbohydrate oxidation in the LAC group was significantly lower than that in the SAL group at 10-25 min. No significant difference was observed in the fat oxidation level between the two groups. CONCLUSION: We found that post-exercise lactate intake modified the respiratory exchange ratio after 1 h of rest. In addition, acute lactate ingestion inhibits carbohydrate oxidation during the post-exercise recovery period.

Chronic Administration of Exogenous Lactate Increases Energy Expenditure during Exercise through Activation of Skeletal Muscle Energy Utilization Capacity in Mice.

We compared the effects of chronic exogenous lactate and exercise training, which influence energy substrate utilization and body composition improvements at rest and during exercise, and investigated the availability of lactate as a metabolic regulator. The mice were divided into four groups: CON (sedentary + saline), LAC (sedentary + lactate), EXE (exercise + saline), and EXLA (exercise + lactate). The total experimental period was set at 4 weeks, the training intensity was set at 60-70% VO2max, and each exercise group was administered a solution immediately after exercise. Changes in the energy substrate utilization at rest and during exercise, the protein levels related to energy substrate utilization in skeletal muscles, and the body composition were measured. Lactate intake and exercise increased carbohydrate oxidation as a substrate during exercise, leading to an increased energy expenditure and increased protein levels of citrate synthase and malate dehydrogenase 2, key factors in the TCA(tricarboxylic acid) cycle of skeletal muscle. Exercise, but not lactate intake, induced the upregulation of the skeletal muscle glucose transport factor 4 and a reduction in body fat. Hence, chronic lactate administration, as a metabolic regulator, influenced energy substrate utilization by the skeletal muscle and increased energy expenditure during exercise through the activation of carbohydrate metabolism-related factors. Therefore, exogenous lactate holds potential as a metabolic regulator.

Lactate administration induces skeletal muscle synthesis by influencing Akt/mTOR and MuRF1 in non-trained mice but not in trained mice.

The perception regarding lactate has changed over the past decades, and some of its physiological roles have gradually been revealed. However, the effects of exogenous lactate on skeletal muscle synthesis remain unclear. This study aimed to confirm the effects of a 5-week lactate administration and post-exercise lactate administration on skeletal muscle synthesis. Thirty-two Institute of Cancer Research mice were randomly assigned to non-trained + placebo, non-trained + lactate, trained + placebo, and trained + lactate groups. Furthermore, 3 g/kg of lactate or an equivalent volume of saline was immediately administered after exercise training (maximum oxygen uptake: 70%). Lactate administration and/or exercise training was performed 5 days/week for 5 weeks. After the experimental period, it was observed that lactate administration tended to elevate skeletal muscle weight, increased protein kinase B (p < 0.05) and mammalian target of rapamycin (p < 0.05) mRNA levels, and decreased muscle ring-finger protein-1 expression (p < 0.05). Lactate administration after exercise training significantly enhanced plantaris muscle weight; however, it had no additional effects on most signaling factors. This study demonstrated that a 5-week lactate administration could stimulate skeletal muscle synthesis, and lactate administration after exercise training may provide additional effects, such as increasing skeletal muscle.

Vitamin C and glutathione supplementation: a review of their additive effects on exercise performance.

PURPOSE: This review aimed to investigate the effects of vitamin C and glutathione supplementation on exercise performance. METHODS: We conducted a literature search across the PubMed, Google Scholar, and Web of Science databases using the keywords vitamin C, glutathione, antioxidants, exercise, and oxidative stress. RESULTS: The effects of vitamin C supplementation on exercise performance and oxidative stress levels are inconsistent. Glutathione, with its diverse forms of supplementation and methods, presents mixed outcomes. Vitamin C and glutathione have deeply interconnected antioxidant functions and are mutually essential to each other. Research investigating the combined intake of these two substances, which are intricately linked biochemically, and their effects on exercise performance remain largely unexplored. CONCLUSION: Studies on the effects of vitamin C and glutathione intake on exercise have been conducted using diverse approaches; however, the results have not been consistent. Although an additive effect is anticipated with the combined intake of vitamin C and glutathione, research on this topic is currently insufficient, and further studies are required.

Effect of exercise intervention using mobile healthcare on blood lipid level and health-related physical fitness in obese women: a randomized controlled trial.

PURPOSE: This study aimed to evaluate the effects of 12 weeks of non-face-to-face exercise intervention using mobile health (mHealth) on blood lipid levels and health-related physical fitness in obese women. METHODS: Thirty obese women (aged: 39.40 ± 11.07 years, percent body fat: 37.05 ± 5.15%) were enrolled, and all completed the study. Non-face-to-face exercises were performed for 12 weeks using a mHealth and smart tracker (Charge 4, Fitbit, USA). Participants were randomly assigned to an experimental (EXP) or control (CON) group. The 12-week exercise program using mHealth included resistance (twice a week for 60 min), aerobics (five times a week for 50 min), and flexibility (five times a week for 10 min). RESULTS: The results showed that high-density lipoprotein cholesterol (Post - Pre: 9.07 mg·dL-1, p < 0.001) and ratio of low-density to high-density lipoprotein cholesterol (Post - Pre: -0.71 mg·dL-1, p < 0.05) significantly changed during the intervention period in EXP. There were significant increases in sit-ups (Post - Pre: 7.73 numbers, p < 0.001), grip strength (Post - Pre: 2.92 kg, p < 0.001), and sit and reach (Post - Pre: 2.51 cm, p < 0.01) in EXP. CONCLUSION: Non-face-to-face exercise using mHealth for 12 weeks improved blood lipid levels and health-related physical fitness; therefore, it can help improve compliance through self-monitoring and lifestyle changes by increasing physical activity.

Effects of Online Pilates and Face-to-Face Pilates Intervention on Body Composition, Muscle Mechanical Properties, Cardiometabolic Parameters, Mental Health, and Physical Fitness in Middle-Aged Women with Obesity.

With the emergence of coronavirus disease 2019, individuals have been participating in online exercises to maintain their health while avoiding infection. Among these online exercises, Pilates intervention is a popular modality. This study aimed to examine the differences between online and face-to-face Pilates interventions in terms of various physiological parameters and included 30 middle-aged individuals (age 43.3 ± 5.5 years) with obesity. These individuals were randomly divided into a face-to-face Pilates group (FPG), an online Pilates group (OPG), and a control group (CG). The FPG and OPG performed a 60-min mat Pilates program with a Borg scale of 11-17, three times a week for 12 weeks. The participants in the CG maintained their daily routines. Body composition, mechanical muscle properties, cardiometabolic parameters, mental health, and physical fitness were assessed before and after 12 weeks of intervention. No significant differences in body composition or cardiometabolic parameters were observed between groups. However, the FPG and OPG showed greater improvements than the CG in terms of muscle mechanical properties, cardiometabolic parameters, mental health, and physical fitness. In addition, the FPG showed greater improvement than the OPG. In conclusion, face-to-face Pilates is a more effective modality than online Pilates, although both modalities improve health-related parameters.

Viewpoint-Agnostic Taekwondo Action Recognition Using Synthesized Two-Dimensional Skeletal Datasets.

Issues of fairness and consistency in Taekwondo poomsae evaluation have often occurred due to the lack of an objective evaluation method. This study proposes a three-dimensional (3D) convolutional neural network-based action recognition model for an objective evaluation of Taekwondo poomsae. The model exhibits robust recognition performance regardless of variations in the viewpoints by reducing the discrepancy between the training and test images. It uses 3D skeletons of poomsae unit actions collected using a full-body motion-capture suit to generate synthesized two-dimensional (2D) skeletons from desired viewpoints. The 2D skeletons obtained from diverse viewpoints form the training dataset, on which the model is trained to ensure consistent recognition performance regardless of the viewpoint. The performance of the model was evaluated against various test datasets, including projected 2D skeletons and RGB images captured from diverse viewpoints. Comparison of the performance of the proposed model with those of previously reported action recognition models demonstrated the superiority of the proposed model, underscoring its effectiveness in recognizing and classifying Taekwondo poomsae actions.

Exogenous lactate intake immediately after endurance exercise increases time to exhaustion in VO2max measurements in mice.

PURPOSE: The purpose of the study was to investigate the effects of 4 weeks of lactate intake immediately after endurance exercise on maximal oxygen uptake (VO2max) in exercise performance. METHODS: Seven-week-old mice from the Institute of Cancer Research (ICR) were randomly divided into four groups: vehicle intake (SE/CON), lactate intake (SE/LAC), endurance exercise with vehicle intake (EX/ CON), and lactate intake with endurance exercise (EX/ LAC). Mice were subjected to 60-70% VO2max endurance exercise with or without oral lactate intake 5 days/ week for 4 weeks. VO2max measurements (VO2max, time to exhaustion (TTE), respiratory exchange rate, fat oxidation, and carbohydrate oxidation) were recorded at the end of the study period. After 48 h of VO2max measurement, the mice were sacrificed, and three different abdominal fat samples (epididymal, perirenal, and mesenteric) were collected. RESULTS: Body weight and abdominal fat mass did not differ between the groups. When measuring VO2max, endurance exercise raised VO2max, and lactate intake after endurance exercise increased TTE. The change in energy substrate utilization during VO2max measurement demonstrated that although the respiratory exchange rate and fat oxidation were enhanced by lactate intake, there were no synergistic effects of lactate intake and endurance exercise. CONCLUSION: Lactate intake immediately after endurance exercises can improve exercise performance, indicating the benefit of long-term exogenous lactate intake as an exercise supplement.

Enhancing Supplemental Effects of Acute Natural Antioxidant Derived from Yeast Fermentation and Vitamin C on Sports Performance in Triathlon Athletes: A Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial.

This study investigated the acute effects of natural antioxidants, derived from yeast fermentation containing glutathione and dietary vitamin C supplementation, on metabolic function, skeletal muscle oxygenation, cardiac function, and antioxidant function during submaximal exercise in middle-aged triathlon athletes. Twelve participants (aged 49.42 ± 5.9 years) completed 90 min submaximal cycling trials corresponding to 70% maximal oxygen uptake with either vitamin C and glutathione (VitC+Glu), vitamin C (VitC), glutathione (Glu) supplementation, or placebo. Metabolic function (minute ventilation, oxygen uptake, carbon dioxide output [VCO2], respiratory exchange ratio [RER], oxygen pulse [O2pulse], carbohydrate oxidation, fat oxidation, and energy expenditure), skeletal muscle oxygenation (oxidized hemoglobin and myoglobin in skeletal muscle tissue, total hemoglobin and myoglobin in skeletal muscle tissue [tHb]), cardiac function (heart rate [HR], stroke volume [SV], cardiac output, end-diastolic volume, end-systolic volume, and ejection fraction), and antioxidant function parameters (blood lactate, superoxide dismutase, catalase, glutathione peroxidases, glutathione [GSH], diacron reactive oxygen metabolite [dROM], and biological antioxidant potential [BAP]) were measured during submaximal exercise and recovery. VCO2, RER, HR, blood lactate after exercise, and dROM were significantly lower, and O2pulse, tHb, and BAP were significantly higher for VitC+Glu than for the other trials (p < 0.05). In conclusion, combined vitamin C and glutathione supplementation was more effective in improving metabolic function, skeletal oxygenation, cardiac function, and antioxidant function during prolonged submaximal exercise in middle-aged triathletes.

Effects of a Mobile-Health Exercise Intervention on Body Composition, Vascular Function, and Autonomic Nervous System Function in Obese Women: A Randomized Controlled Trial.

Purpose: The present study verified the effect of an m-health exercise intervention using a 12-week exercise program on body composition, vascular function, and the ANS. Patients and Methods: Thirty obese adult women participants were randomized (n = 15 each) into the experimental (EXP) group, those who performed mobile-health (m-health) exercises using a wearable device (Charge 4, Fitbit, USA) and AI-fit web page, or the control (CON) group, those who continued their daily activities as before. Muscle function, cardiorespiratory endurance, and flexibility were assessed during the exercise program using the AI-fit web page and wearable device. The EXP group participated in exercise interventions using the m-health system for 12 weeks, while the CON group was encouraged to maintain their normal daily routines. Body composition, vascular function, and autonomic nervous system (ANS) were evaluated before and after the intervention. Results: Significant decreases were noted in fat mass (Post - Pre: -1.47 kg; p < 0.001) and percent body fat (Post - Pre: -2.11%; p < 0.05). Flow-mediated dilatation (Post - Pre: 2.63%; p < 0.001) was significantly increased, and brachial-ankle pulse wave velocity (Post - Pre: -91.49 cm·sec-1; p < 0.01) was significantly decreased. RMSSD (Post - Pre: 10.43 ms; p < 0.01), NN50 (Post-Pre: 24.04; p < 0.05), pNN50 (Post - Pre: 7.70%; p < 0.05) and HF (Post-Pre: 179.60 ms2; p < 0.05) increased significantly. Conclusion: In conclusion, m-health exercise interventions using AI fit and wearable devices are effective in preventing obesity and improving vascular function, and ANS.

Development of a Heart Rate Variability Prediction Equation Through Multiple Linear Regression Analysis Using Physical Characteristics and Heart Rate Variables.

Heart rate variability (HRV) is an effective tool for objectively evaluating physiological stress indices in psychological states. This study aimed to develop multiple linear regression equations to predict HRV variables using physical characteristics, body composition, and heart rate (HR) variables (eg, sex, age, height, weight, body mass index, fat-free mass, percent body fat, resting HR, maximal HR, and HR reserve) in Korean adults. Six hundred eighty adults (male, n = 236, female, n = 444) participated in this study. HRV variable estimation multiple linear regression equations were developed using a stepwise technique. The regression equation's coefficient of determination for time-domain variables was significantly high (SDNN = adjusted R2: 73.6%, P < .001; RMSSD = adjusted R2: 84.0%, P < .001; NN50 = adjusted R2: 98.0%, P < .001; pNN50 = adjusted R2: 99.5%, P < .001). The coefficient of determination of the regression equation for the frequency-domain variables was high without VLF (TP = adjusted R2: 75.0%, P < .001; LF = adjusted R2: 77.6%, P < .001; VLF = adjusted R2: 30.1%, P < .001; HF = adjusted R2: 71.3%, P < .001). Healthcare professionals, researchers, and the general public can quickly evaluate their psychological conditions using the HRV variables prediction equation.

Effect of pilates training on pain and disability in patients with chronic low back pain: a systematic review and meta-analysis based on randomized controlled trials.

PURPOSE: This systematic review and meta-analysis study evaluated the effects of Pilates on pain and disability in patients with chronic low back pain. METHODS: Six electronic databases were searched between January 2012 and December 2022. From these databases, only randomized controlled trials were selected. The criteria for assessing methodological quality using the PEDro scale were selected. The risk of bias was assessed using the Cochrane Risk of Bias Tool RoB 2.0. Additionally, the primary outcomes were pain and disability in this analysis. RESULTS: The corresponding results confirmed that Pilates training led to a significant improvement in pain (Visual Analog Scale: weighted mean difference = -29.38, 95% confidence interval, -33.24 to -25.52, I² value = 56.70%; Pain Numerical Rating Scale: weighted mean difference = -2.12, 95% confidence interval, -2.54 to -1.69, I² value = 0.00%) and disability (Roland- Morris Disability Index: weighted mean difference = -4.73, 95% confidence interval, -5.45 to -4.01, I² value = 41.79%). Six months after completion of Pilates training, the improvement in pain (Pain Numerical Rating Scale: weighted mean difference = -1.67, 95% confidence interval, -2.03 to -1.32, I² value = 0.00%) and disability (Roland-Morris Disability Index: weighted mean difference = -4.24, 95% confidence interval, -5.39 to -3.09, I² value = 52.79%) was maintained. CONCLUSION: Pilates training may be an effective strategy to improve pain and disability in patients with chronic low back pain.

Comparison of energy consumption and excess post-exercise oxygen consumption according to Taekwondo Taegeuk Poomsae performance in Taekwondo players.

PURPOSE: We compared and analyzed energy consumption and excess post-exercise oxygen consumption (EPOC) following Taekwondo Taegeuk Poomsae performances. METHODS: Forty-two healthy men who could perform Taegeuk Poomsae 1-8 Jangs were enrolled in this study. To reduce the impact of Poomsae, a random cross-design was used. The washout time was set to at least three days. Oxygen consumption (VO2) was monitored after performing each Poomsae until a reference line was resumed. Each Taegeuk Poomsae was performed at a speed of 60 bpm. RESULTS: There was no significant difference in VO2, carbon dioxide excretion, and heart rate after performing the Taegeuk Poomsae once; however, all variables increased significantly in combined results of EPOC metabolism (F<45.646, p<0.001, and ɳ2<0.527). Taegeuk 8 Jang had the highest levels of all the factors. There were noticeable variations in the oxidation of fat and carbohydrates throughout the Taegeuk Poomsae (F<9.250, p<0.001, ɳ2<0.184). Taegeuk 8 Jang demonstrated the greatest rate of carbohydrate oxidation, and 4-8 Jangs demonstrated much greater rates of fatty acid oxidation. Compared to 1 Jang, the energy consumption showed significant differences in all the variables and peaked in Taegeuk 8 Jang. CONCLUSION: The energy consumption during the Poomsae performances was the same. When the EPOC metabolism was coupled, it was evident that more energy was substantially used in each chapter of Poomsae. Consequently, it was determined that when performing Poomsae, not only should energy metabolism during exercise be taken into account but also EPOC metabolism, which can increase by 10-fold.

Exogenous lactate augments exercise-induced improvement in memory but not in hippocampal neurogenesis.

Adult hippocampal neurogenesis (AHN), the lifelong process of formation of new neurons in the mammalian brain, plays an important role in learning and memory. Exercise is an effective enhancer of AHN; however, the molecular mediators of exercise-induced AHN are unknown. Recently, lactate was considered as an important mediator of exercise-induced AHN. Therefore, we hypothesized that exercise with lactate intake could augment exercise-induced AHN. This study was conducted for 5 weeks with 7-week-old ICR male mice that performed mild-intensity exercise (just below lactate threshold, 55-60%VO2max) with or without oral administration of lactate 5 days/week. Cell proliferation, neuronal differentiation, neurogenesis-relevant factors, reference and retention memory, and spatial working memory were evaluated at the end of the experiment. The results showed that AHN was enhanced by lactate intake, but exercise-induced AHN was not augmented by exercise with lactate intake. Nevertheless, exercise-induced improvement in reference and retention memory was augmented by exercise with lactate intake. And spatial working memory was promoted by the co-treatment, also protein expression of hippocampal FNDC5, BDNF, PGC1α, and MCT2 were elevated by the co-treatment. Therefore, our findings suggest that lactate has a potential to be developed as a novel supplement that improves the positive effects of exercise on the hippocampus and its cognitive function.

Dietary Arginine and Citrulline Supplements for Cardiovascular Health and Athletic Performance: A Narrative Review.

The global market for nutritional supplements (NS) is growing rapidly, and the use of L-arginine (Arg), L-citrulline (Cit), and citrulline malate (CitMal) supplements has been shown to enhance cardiovascular health and athletic performance. Over the past decade, Arg, Cit, and CitMal supplements have received considerable attention from researchers in the field of exercise nutrition, who have investigated their potential effects on hemodynamic function, endothelial function, aerobic and anaerobic capacity, strength, power, and endurance. Previous studies were reviewed to determine the potential impact of Arg, Cit, and CitMal supplements on cardiovascular health and exercise performance. By synthesizing the existing literature, the study aimed to provide insight into the possible uses and limitations of these supplements for these purposes. The results showed that both recreational and trained athletes did not see improved physical performance or increased nitric oxide (NO) synthesis with 0.075 g or 6 g doses of Arg supplement per body weight. However, 2.4 to 6 g of Cit per day for 7 to 16 days of various NSs had a positive impact, increasing NO synthesis, enhancing athletic performance indicators, and reducing feelings of exertion. The effects of an 8 g acute dose of CitMal supplement were inconsistent, and more research is needed to determine its impact on muscle endurance performance. Based on the positive effects reported in previous studies, further testing is warranted in various populations that may benefit from nutritional supplements, including aerobic and anaerobic athletes, resistance-trained individuals, elderly people, and clinical populations, to determine the impact of different doses, timing of ingestion, and long-term and acute effects of Arg, Cit, and CitMal supplements on cardiovascular health and athletic performance.

Protein-Added Healthy Lunch-Boxes Combined with Exercise for Improving Physical Fitness and Vascular Function in Pre-Frail Older Women: A Community-Based Randomized Controlled Trial.

Purpose: Preventive or therapeutic interventions are key to maintaining independence in pre-frail and/or frail elderly. Therefore, we investigated whether multi-component interventions were effective in physical fitness levels and vascular functions in pre-frail older women. Patients and Methods: Sixty participants aged ≥ 65 years (81.5 ± 4.3 yrs) were divided equally into control group, diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group. For 8 weeks, the participants received a set of protein-added meals twice daily on weekdays. The aerobic exercise groups performed 45 mins of stepping exercise at 50-70% of the maximal heart rate for 3 days/week, and the aerobic exercise with electromyostimulation was applied on each limb in 8 weeks. Blood pressure, physical fitness, cardiovascular biomarkers, pulse wave velocity, and flow-mediated dilation were measured before and after the 8-week. Results: There were no group differences in age, height, weight, body mass index, free fat mass, and %body fat at baseline. The right grip strength significantly increased in the diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group (p < 0.05). Short physical performance battery, 6-min walking distance, and flow-mediated dilation significantly increased in the aerobic exercise and diet group and aerobic exercise with electromyostimulation and diet group (p < 0.05). Blood pressure and pulse wave velocity did not differ between interventions. High-density lipoprotein-cholesterol levels significantly increased after 8 weeks in all intervention groups (p < 0.05). There were no significant differences in glucose, HbA1c, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, Homeostatic Model Assessment for Insulin Resistance, nitric oxide, and C-reactive protein levels. Conclusion: These results show that multi-component interventions appear to improve physical fitness and vascular function in pre-frail older women. Thus, possible strategies to prevent early frailty including proper nutrition and exercise may be needed.

Effects of Neuromuscular Electrical Stimulation and Blood Flow Restriction in Rehabilitation after Anterior Cruciate Ligament Reconstruction.

The present study aimed to examine and compare the effects of a rehabilitation exercise (RE) using neuromuscular electrical stimulation (NMES) and blood flow restriction (BFR) on muscle function and knee functional abilities in patients who underwent anterior cruciate ligament reconstruction (ACLR). A total of 45 patients who underwent ACLR (28.76 ± 0.8 years; 34 males and 11 females) were retrospectively divided into three groups: control (CON, n = 15), NMES (n = 15), and BFR (n = 15). All participants carried out the RE program for 60 min, thrice a week for 12 weeks. The Lysholm score, International Knee Documentation Committee (IKDC) subjective score, thigh circumference at 5 cm from the knee joint, Y-balance posterior medial, and lateral significantly increased in all groups via intervention (p < 0.05). However, NMES showed a higher thigh circumference at 15 cm from the knee joint than CON via intervention (p < 0.05), and the strength and endurance of quadriceps femoris and hamstrings and Y-balance anterior showed a significant increase via intervention in NMES and BFR compared with CON (p < 0.05). In conclusion, we confirmed that RE using NMES and BFR effectively enhances muscle function and balance in ACLR patients.

Effects of Twenty-Four Weeks of Resistance Exercise Training on Body Composition, Bone Mineral Density, Functional Fitness and Isokinetic Muscle Strength in Obese Older Women: A Randomized Controlled Trial.

Resistance exercise effectively improves bone mineral density (BMD) and muscle quality (e.g., muscle mass and muscle strength). The present study aimed to examine the effect of a 24-week resistance exercise training (RT) program on body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women. Forty obese older women were initially enrolled. Among them, 30 participants (age: 80.55 ± 4.94 years; body fat percentage: 36.25 ± 3.44%) completed the study. The participants were randomly assigned into two groups: the RT group (n = 15) and the control (CON) group (n = 15). The RT group participated in the exercise for 60 min per session and two sessions per week for 24 weeks. Pre-test and post-test body composition, BMD, functional fitness, and isokinetic muscle strength were evaluated. The RT group increased significantly in functional fitness (hand grip strength: 1.70 kg, p < 0.01, and lower body strength: 3.87 n, p < 0.001), and isokinetic muscle strength (non-dominant leg extensor peak torque %BW at 60°/s: 13.20%, p < 0.05, dominant leg (DL) flexor peak torque at 60°/s: 3.87 Nm, p < 0.05, and DL flexor peak torque %BW at 60°/s: 7.60%, p < 0.05). However, the CON group showed negative changes in body composition (fat mass: 1.15 kg, p < 0.001, body fat percentage: 1.59%, p < 0.001, and fat-free mass: -0.58 kg, p < 0.05), BMD (whole-body: -0.01 g/cm2, p < 0.001 and forearm: -0.01 g/cm2, p < 0.05), functional fitness (lower body flexibility: -3.23 cm, p < 0.01, upper body strength: -2.06 n, p < 0.01, and agility and dynamic balance: 0.54 s, p < 0.01), and isokinetic muscle strength at 60°/s and 180°/s (all peak torque % body weight variables: -7.31--1.50, p < 0.05). Our findings show that the CON group negatively affects body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women for 24 weeks.

Effects of combined hip exercise and passive stretching on muscle stiffness, pain perception and painrelated disability, and physical function in older adults with low back pain.

PURPOSE: This study aimed to examine the effects of combined hip exercise and passive stretching as a novel treatment method for low back pain (LBP) in older adults. METHODS: Altogether, 20 Koreans with LBP aged 60-79 years (67.3 ± 5.92 years) were randomly assigned to undertake combined exercise (CE; n = 10) or lumbar stabilization exercise (LSE; n = 10). All participants performed their respective exercise program for 25-30 min with an OMNI scale of 6-8 for 8 weeks, three times a week. Body composition, muscle stiffness, pain-visual analog scale (P-VAS), Oswestry disability index, and physical function were evaluated before and after the exercise intervention. RESULTS: The CE group demonstrated greater improvements in lean body mass (η2 = 0.402, p = 0.003) and percent body fat (η2 = 0.222, p = 0.036) than the LSE group. Both groups demonstrated significant improvements in muscle stiffness, P-VAS scores, and Oswestry disability index scores, although no significant differences were observed between the interventions. All physical function parameters demonstrated a significant improvement in both groups, and the CE group demonstrated greater improvement in the YMCA sit-and-reach (η2 = 0.338, p = 0.007) and straight leg raise tests (η2 = 0.283, p = 0.016) than the LSE group. CONCLUSION: CE is comparable to LSE as an effective and successful exercise intervention that reduces muscle stiffness and P-VAS scores. Moreover, CE is more effective than LSE in enhancing the physical function of older adults with LBP.