Effects of high-intensity interval training and plyometric exercise on the physical fitness of junior male handball players.

OBJECTIVE: This study analyzed the effects of high intensity interval training (HIIT) combined with plyometric exercise on the physical fitness of junior male handball players. PATIENTS AND METHODS: Subjects (age ~17 years) were randomly divided between experimental (n=17) and control (n=15) groups. During the 8-week intervention, the experimental group replaced a part of their regular regimen by HIIT, combined with plyometric exercise. Assessments in both groups before and after the intervention included: squat jump (SJ), countermovement jump (CMJ), sprint performance (5 m, 10 m, 20 m and 30 m), change of direction tests (Illinois modified test [Illinois-MT] and T-half test), 20-m shuttle run, and repeated sprint T-test. RESULTS: The two-way analyses of variance revealed significant group-time interactions (all p<0.05), favoring the intervention group in 5 m, 10 m, 20 m and 30 m sprint (d=0.33, 8.3%; d=0.52, 7.6%; d=0.57, 6.8%; and d=0.58, 8.8%, respectively), T-half (d=0.25, 5.1%), Illinois-MT (d=0.47, 4.2%), SJ and CMJ (d=0.34-0.39, 34-4-34.9%), repeated sprint T-test best time, mean time and total time (d=0.83, 6.9%; d=0.62, 7.4%; and d=0.61, 7.2%, respectively), 20 meter shuttle run test aerobic maximum speed and predicted maximal oxygen intake (d=0.36, 7.5%; d=0.19, 9.4%, respectively). CONCLUSIONS: HIIT combined with plyometrics can aid in the development of physical fitness abilities, which are extremely important to junior male handball players.

Habitual intake of fermented milk products containing Lactobacillus casei strain Shirota and a reduced risk of hypertension in older people.

This study investigated relationships between the frequent intake of fermented milk products containing Lactobacillus casei strain Shirota (LcS) and the onset of hypertension (resting systemic pressure ≥140 mmHg [systolic]/≥90 mmHg [diastolic], a doctor's diagnosis and/or antihypertensive medicine use) during a 5-year period in 352 communityliving Japanese aged 65 to 93 years (125 men and 227 women). Initially normotensive subjects were divided into two groups (n=254 and n=98) on the basis of their intake of fermented milk products (<3 or ≥3 times/week, respectively), as estimated during an interview by a certified nutritionist. The incidence of hypertension over the 5-year interval was significantly lower in those who took fermented milk products ≥3 rather than <3 times/week (6.1 vs 14.2%, P=0.037). A multivariate-adjusted proportional hazards model predicted that blood pressures were significantly more likely to remain normal over 5 years in subjects who took ≥3 fermented milk products rather than <3 times/ week (relative risk 0.398 [95% confidence interval 0.167-0.948], P=0.037). These results suggest that after adjustment for potential confounders, the risk of developing hypertension is substantially lower in elderly people who take fermented milk products containing LcS at least 3 times a week.

Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects.

Recreational soccer (RS) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people. The objective of this paper was to conduct a detailed systematic review of the literature, identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients. PubMed, Google Scholar and ScienceDirect databases were searched using terms related to recreational soccer. Inclusion criteria were randomized controlled trials (RCT) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary, untrained subjects of any age or health status. All studies were assessed for methodological quality using the PEDro scale. Thirty-five articles met the inclusion criteria; seven examined the acute response to RS, and 28 assessed training effects. Clear evidence was found that RS had positive effects on many health-related indices and variables, including VO2max (gains of 7-16%), blood pressure (reductions of 6-13 mmHg), body composition (decreased fat mass and improved indices of bone health), and metabolic and cardiac function. These positive effects were observed in both healthy individuals and clinical patients, irrespective of age or sex. Although this review provides clear evidence of the positive effects of RS on health, most studies had limitations of methodology (an average PEDro score < 6). Furthermore, many of the training studies were from a small number of research groups. Future studies should be extended to other countries and institutions to ensure generality of the results. Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages, suggesting that RS is a potentially highly motivational method to enhance population health.

The Case for Increased Physical Activity in Chronic Inflammatory Bowel Disease: A Brief Review.

Regular physical activity reduces the risk of colon cancer, but there is little information on the merits of such activity in the prevention and management of chronic inflammatory bowel disease (CIBD). The present systematic review thus documents current levels of habitual physical activity and aerobic and muscular function in CIBD, and examines the safety, practicality and efficacy of exercise programmes in countering the disease process, correcting functional deficits and enhancing quality of life. A systematic search of the Ovid/Medline database from January 1996 to May 2015 linked the terms physical activity/motor activity/physical fitness/physical training/physical education/training/exercise/exercise therapy with Crohn's disease/colitis/ulcerative colitis/inflammatory bowel disease, supplementing this information by a scanning of reference lists and personal files.12 of 16 published studies show a low level of habitual physical activity in CIBD, with sub-normal values for aerobic power, lean tissue mass and muscular strength. 3 of 4 studies suggest physical activity may reduce the risk of developing IBD, and 11 interventions all note that exercise programmes are well tolerated with some decreases of disease activity, and functional gains leading to an increased health-related quality of life. Moreover, programme compliance rates compare favourably with those seen in the treatment of other chronic conditions. More information on mechanisms is needed, but regular moderate aerobic and/or resistance exercise improves the health status of patients with CIBD both by modulating immune function and by improving physical function. A regular exercise programme should thus become an important component in the management of CIBD.

Rapid weight loss in the context of Ramadan observance: recommendations for judokas.

Judo is a weight-classified combat sport, and many athletes seek to compete at the lightest possible weight category to gain an advantage from competing against shorter/smaller, and supposedly weaker opponents. To achieve a desired weight, most judokas opt for rapid weight loss techniques. Short-duration maximal efforts are not greatly affected by "making weight", but prolonged and/or repeated exercise is significantly impaired. Negative effects on mood, ratings of perceived exertion, and cognitive function are also reported. Moreover, rapid weight loss reduces maximal cardiac output and glycogen stores, and impairs thermo-regulation. Limited empirical data suggest that Ramadan reduces judokas' performance, and this is likely to be exacerbated by attempts at rapid weight loss. Weight reduction during Ramadan tends to be counterproductive, and judokas who aim for a lower weight category are advised to attempt any desired reduction of body mass during the weeks leading up to Ramadan, rather than during the holy month.

Daily physical education in primary school and physical activity in midlife: the Trois-Rivières study.

AIM: Although a commonly stated purpose of physical education (PE) classes is to foster life-long participation in physicalactivity (PA), few longitudinal studies have assessed the impact of childhood PE interventions on PA as an adult. The Trois-Rivières Growth and Development Study provided a unique opportunity to address this question. METHODS: In 2008, 86 participants in the original 1970-1977 Trois-Rivières Study (44 women and 42 men aged 44.0 ± 1.2 years) completed a questionnaire examining their current PA level and different correlates of PA (i.e. individual's intention to engage in PA, perceived enjoyment, usefulness and ease in engaging in PA, perceived social support and social norms). Participants had initially been assigned to either an experimental program (5 h/week of specialist-taught PE) or a control group (40 min/week of home-room teacher-taught PE) from grades 1 to 6. RESULTS: There were no current differences between the experimental and control groups neither in the frequency, duration nor volume of PA undertaken at the current follow-up. Furthermore, no differences between groups were found for any of the PA correlates examined. CONCLUSION: Providing daily PE throughout primary school seems insufficient to ensure that individuals will remain active in midlife. The development of a life-course approach to PA promotion is thus warranted.

Physical impairment in HIV infections and AIDS: responses to resistance and aerobic training.

AIM: The aim of this paper was to examine impairments in muscle strength and aerobic power associated with HIV and AIDS, to define optimal regimes of resistance and aerobic training, and to explore possible influences of HAART treatment upon responses. METHODS: Data from HealthStar/Ovid (1985 to 2013) were supplemented by references in identified articles and material in the author's personal files, yielding 133 citations. Detailed analysis was restricted to controlled trials (16 studies of resistance training, 17 of aerobic training). RESULTS: HIV infection and AIDS are often marked by substantial muscle wasting of multi-factorial origin. Impairment of aerobic function is more variable, with possible effects from physical inactivity, HAART therapy and muscular weakness. Most patients respond well to moderate resistance and aerobic training, showing substantial gains of strength, smaller improvements of aerobic power, and no adverse changes in CD4+ count or viral load. Moreover, these responses do not seem adversely affected by HAART therapy. CONCLUSION: Patients with HIV and AIDS should participate in moderate combined resistance and aerobic training programs. Such training elicits substantial gains in strength and cardiac function, and improves mood state and quality of life without adverse effects upon disease progression. Moreover, responses are not adversely affected by HAART therapy. The main challenge in the western world is to maintain compliance, since adherence to rehabilitation programs is often poor. There is also a need to develop exercise programs appropriate to regions where the disease is most prevalent, and to monitor possible interactions between rehabilitation and newly emerging forms of treatment.

Aerobic power and muscle strength of individuals living with HIV/AIDS.

AIM: We wished to evaluate any continuing adverse effects upon peak aerobic power and muscle strength associated with either HAART therapy or persistently low CD4⁺ counts in men living with HIV/AIDS. METHODS: We studied 39 HIV/AIDS patients with an average disease history of 6.1 years, and 28 normal sedentary volunteers. All subjects performed tests of peak aerobic power and isokinetic muscle force, and the HIV/AIDS group also completed the Profile of Mood States (POMS) and WHO Quality of Life questionnaires. Blood was sampled for standard measures of immune function (CD4⁺ and CD8⁺ counts) and viral load. RESULTS: Patient values were generally as in the normal subjects and appeared to be uninfluenced by the CD4+ nadir or the use of HAART therapy. However, the isokinetic muscle strength was lower in individuals with a low current CD4⁺ count. Isokinetic strength was also negatively correlated with current CD4⁺ and CD8⁺ counts. CONCLUSION: HAART therapy does not appear to have an adverse long-term effect on either aerobic power or muscle strength. Many ambulatory volunteers living with HIV/AIDS have a normal peak aerobic power. However, isokinetic strength can remain low, particularly in those with low current T-cell counts.

Aerobic training in children with cerebral palsy.

Rehabilitation is a major goal for children with cerebral palsy, although the potential to enhance cardio-respiratory fitness in such individuals remains unclear. This study thus compared current cardio-respiratory status between children with cerebral palsy and able-bodied children, and examined the ability to enhance the cardio-respiratory fitness of children with cerebral palsy by cycle ergometer training. 10 children with cerebral palsy (Gross Motor Function Classification System levels I and II) participated in thrice-weekly 30 min cycle ergometer training sessions for 8 weeks (mean age: 14.2±1.9 yrs). 10 additional subjects with cerebral palsy (mean age: 14.2±1.8 yrs) and 10 able-bodied subjects (mean age: 14.1±2.1 yrs) served as controls, undertaking no training. All subjects undertook a progressive cycle ergometer test of cardio-respiratory fitness at the beginning and end of the 8-week period. Cardio-respiratory parameters [oxygen intake V˙O2), ventilation V ˙ E) and heart rate (HR)] during testing were measured by Cosmed K4 b gas analyzer. The children with cerebral palsy who engaged in aerobic training improved their peak oxygen consumption, heart rate and ventilation significantly (p<0.05) and they also showed a non-significant trend to increased peak power output. In conclusion, children with cerebral palsy can benefit significantly from cardio-respiratory training, and such training should be included in rehabilitation programs.

Daily quality physical education in childhood and adult bone density.

AIM: Previous studies, mainly of self-selected athletes, have suggested that childhood activities can have a prolonged influence on bone mineral density. This investigation explored whether experimentally assigned daily quality physical education (PE) during childhood influenced bone density at an age of 42.8±1.5 years. METHODS: Participants from the Trois-Rivières Longitudinal Study were divided into 4 groups: the first 2 groups (19 women and 21 men) had received 5 h/week of specialist-taught PE in primary school in 1970-1977, whereas the third and fourth groups (10 women and 10 men) had followed the standard PE programme of 40 min/week. RESULTS: Bone densities, measured by dual X-ray absorptiometry (lumbar vertebrae and femoral neck), did not differ significantly between experimental and control subjects. CONCLUSION: This result may reflect a normal or even a faster decrease of bone mineral density in experimental subjects over the 30 years since completion of the program, or an intervention that was designed to enhance cardiorespiratory and muscular fitness rather than bone health.

Crossover and maximal fat-oxidation points in sedentary healthy subjects: methodological issues.

AIM: Our study aimed to assess the influence of protocol on the crossover point and maximal fat-oxidation (LIPOX(max)) values in sedentary, but otherwise healthy, young men. METHODS: Maximal oxygen intake was assessed in 23 subjects, using a progressive maximal cycle ergometer test. Twelve sedentary males (aged 20.5±1.0 years) whose directly measured maximal aerobic power (MAP) values were lower than their theoretical maximal values (tMAP) were selected from this group. These individuals performed, in random sequence, three submaximal graded exercise tests, separated by three-day intervals; work rates were based on the tMAP in one test and on MAP in the remaining two. The third test was used to assess the reliability of data. Heart rate, respiratory parameters, blood lactate, the crossover point and LIPOX(max) values were measured during each of these tests. RESULTS: The crossover point and LIPOX(max) values were significantly lower when the testing protocol was based on tMAP rather than on MAP (P<0.001). Respiratory exchange ratios were significantly lower with MAP than with tMAP at 30, 40, 50 and 60% of maximal aerobic power (P<0.01). At the crossover point, lactate and 5-min postexercise oxygen consumption (EPOC(5 min)) values were significantly higher using tMAP rather than MAP (P<0.001). During the first 5 min of recovery, EPOC(5 min) and blood lactate were significantly correlated (r=0.89; P<0.001). CONCLUSION: Our data show that, to assess the crossover point and LIPOX(max) values for research purposes, the protocol must be based on the measured MAP rather than on a theoretical value. Such a determination should improve individualization of training for initially sedentary subjects.

Maximal oxygen intake and independence in old age.

This brief review examines the likelihood that a deterioration of aerobic fitness will lead to a loss of independence in old age. The rate of deterioration of maximal aerobic power observed in middle-aged adults continues unabated during the retirement years. Loss of independence seems likely if maximal oxygen intake falls below a threshold of 18 ml/[kg x min] in men and 15 ml/[kg x min] in women, reached at 80-85 years. A regular programme of aerobic exercise can slow or reverse the functional deterioration, reducing the individual's biological age by 10 or more years, and potentially prolonging independence by a similar amount. There remains a need to clarify the importance of decreasing aerobic fitness relative to other potential causes of dependency but, from the practical viewpoint, regular aerobic activity should be commended to elderly people since it can address many of the issues of both functional loss and chronic disease.

Relationship of bone health to yearlong physical activity in older Japanese adults: cross-sectional data from the Nakanojo Study.

INTRODUCTION: We determined associations between bone health and the quantity and quality of habitual physical activity in a cohort of 172 free-living Japanese aged 65-83 years (76 men, 96 women). METHODS: The number of steps taken and the intensity of physical activity were measured every 4 s throughout each 24-h period for 1 year, using a specially adapted accelerometer that distinguished up to 11 levels of physical activity (expressed in metabolic equivalents, METs). At the end of the year, a quantitative ultrasonic technique assessed each participant's osteosonic index (OSI, reflecting bone stiffness in the calcaneus). RESULTS: The data were significantly described by linear and exponential regression models which showed that in both sexes the OSI score increased with increasing daily physical activity, up to the observed maximum values of approximately 14,000 steps/day and 50 min/day at an intensity >3 METs. However, when data were categorized into quartiles of physical activity, OSI scores were not significantly greater in persons exceeding recommended minimum standards of habitual physical activity (corresponding to counts of around 6,900 and 6,800 steps/day and durations >3 METs of around 18 and 16 min/day in men and women, respectively). All who met such criteria (with the exception of a few women) had OSI scores above the threshold for a clinical diagnosis of osteoporosis. Multivariate-adjusted logistic regression analyses predicted that men and especially women who engaged in <6,800 steps/day and <16 min/day of moderate-intensity physical activity were, respectively, 4.9-8.4 and 2.2-3.5 times more likely to sustain fractures than those participating in >8,200 steps/day and >25 min/day of activity >3 METs. CONCLUSION: Causation cannot be inferred from a cross-sectional study. Nevertheless, we suggest that from the viewpoint of bone health, elderly people should be encouraged to engage in low- and moderate-intensity habitual physical activity, taking >7,000 steps/day with a duration >15 min/day at >3 METs.

Effect of Ramadan fasting on fuel oxidation during exercise in trained male rugby players.

PURPOSE: The aim of this study was to assess the effect of Ramadan fasting on substrate oxidation in trained athletes during moderate-intensity exercise. METHODS: Nine trained men (age: 19+/-2 yr, Height: 1.78+/-0.74 m) were tested on three occasions: during a control period immediately before Ramadan (C), at the end of the first week (Beg-R), and during the fourth week of Ramadan (End-R). On each occasion, they performed submaximal cycle ergometer exercise, with work-rates that were increased progressively (loadings corresponding to 20, 30, 40, 50, 60% of Wmax). Steady-state substrate oxidation was evaluated by indirect calorimetry. RESULTS: Participants showed significant decreases in body mass and body fat at the end of Ramadan, relative to initial control values (P<0.001). The daily food intake was also reduced during Ramadan (P<0.01). Haemoglobin concentrations and hematocrit were significantly higher at the end-Ramadan, both at rest (P<0.001 and P<0.0001 respectively) and after exercise, (P<0.05 and P<0.01 respectively) compared to control measurements made before Ramadan. At the end of Ramadan, our subjects had increased their fat utilization during exercise. The cross-over was observed at a higher intensity at the End-R (35% vs. 30% of Wmax, P<0.001). For the same power output, the Lipox max was also higher at the End-R, compared to control value (265+/-38 vs. 199.1+/-20 mg/min, P<0.001). CONCLUSION: Ramadan fasting increases the lipid oxidation of trained athletes during submaximal exercise. The increased fat utilisation may be related to decreases in body mass and body fat content.

Chronic fatigue syndrome. A brief review of functional disturbances and potential therapy.

The chronic fatigue syndrome (CFS) is debilitating for both athletes and the general population. A review of etiology and mechanisms underlying functional disturbances is undertaken to provide a valid basis for therapeutic options. The review focuses on CFS as characterized by standard diagnostic criteria, building on previous reviews through use of articles identified by Medline search. Overtraining, a negative energy balance, excessive physical or environmental stress, disorders of personality and affect, dysfunction of the hypophyseal-pituitary adrenal axis, hormonal imbalance, nutritional deficits, immune suppression or activation and chronic infection have all been proposed as factors precipitating CFS, but none of these precipitants are observed consistently. Impairments of peak aerobic power and muscle strength, together with many functional disturbances, seem related to patient- or physician-imposed inactivity. Once CFS is established, treatment should aim at breaking the vicious cycle of effort avoidance, deterioration in physical condition and increasing fatigue through a combination of psychotherapy, general encouragement and a progressive exercise regimen.

Cytokine induction during exertional hyperthermia is abolished by core temperature clamping: neuroendocrine regulatory mechanisms.

The immunomodulatory effects of physiological temperature change remain poorly understood and inter-relationships between changes in core temperature, stress hormones and cytokines during exertional hyperthermia are not well established. This experimental study was designed to examine how cytokine (tumour necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-12 and IL-1ra (receptor antagonist)) and hormone (epinephrine (Epi), norepinephrine (NE), growth hormone (GH) and cortisol (CORT)) responses are modified when the exercise-induced rise in core temperature is attenuated or exacerbated by immersion in a water bath. Ten men ((mean +/- SD) age: 26.9 +/- 5.7 years; height 1.75 +/- 0.07 m; body mass 76.0 +/- 10.9 kg; O(2 peak): 48.0 +/- 12.4 mL kg(-1) min(-1)) completed two 40-min cycle ergometer exercise trials at 65% O(2 peak) while immersed to mid-chest. Rectal temperature (T(re)) peaked at 39.1 +/- 0.03 and 37.5 +/- 0.13 degrees C during the hot (39 degrees C) and cold (18 degrees C) conditions, respectively. Blood samples were collected before, during (20- and 40-min) and after (30- and 120-min) exercise. Increases in circulating NE (>350%), Epi (>500%), GH (>900%), IL-12 (>150%) and TNF-alpha (>90%) were greatest after 40-min exercise in the heat. Substantial elevations of CORT (80%), IL-1ra (150%) and IL-6 (>400%) did not occur until after exercise was complete. Core temperature clamping decreased the rise in circulating stress hormone concentrations and abolished increases in plasma cytokine concentrations. These findings suggest that exercise-associated elevations of T(re) mediate increases of circulating stress hormones, which subsequently contribute to induction of circulating cytokine release.

Test-retest errors and the apparent heterogeneity of training response.

Published reports have shown large apparent inter-individual differences of gains in maximal oxygen intake (VO(2max)) in response to a standard 20-week programme of aerobic conditioning that progressed to 75% of the individual's initial VO(2max). The observed gains of VO(2max) ranged from 0 to 1,000 ml min(-1), with a coefficient of variation (CV) of 8.4%. The present analysis evaluates the potential contribution of test-retest errors to these apparent large inter-individual differences in training response. The 2-day test-retest CV for VO(2max) readings in 742 healthy adults was initially 5.0%, dropping to 4.1% after training. Published training responses were estimated from the mean of paired measurements obtained before and after training if readings agreed by <5%, but from the highest of paired values if these differed by >5%. Taking account of the relative proportions of single and paired observations, the weighted VO(2max) data for the entire sample had an effective 2-day CV of 4.3% before and 3.4% after training. Assumption 1: if the 20-week test-retest error remained similar to the 2-day figure, measurement error would contribute a CV of 5.5% to apparent training responses, or (for the stated initial mean VO(2max) of 2,409 ml min(-1)) an SD of 132 ml min(-1). Assumption 2: if the 20-week CV was similar to that in other long-term studies (~5%), measurement error would contribute a CV of 6.1%, or a SD of 146 ml min(-1). The published data show a total SD of 202 ml min(-1) for apparent inter-individual differences in training response, with age, gender, race and baseline VO(2max) accounting for only 11% of this variance. After estimating the likely effect of test-retest measurement errors, the SD due to inter-individual differences would decrease to 138 ml min VO(2max) (assumption 1) or 123 ml min(-1) (assumption 2). We conclude that when estimating the extent of inter-individual differences in training response, allowance must be made not only for the minor effects of recognized covariates (age, gender, race and initial fitness), but also for the larger influence of test-retest measurement errors. Nevertheless, substantial inter-individual differences persist after making such adjustments. The most likely explanation of these differences is a familial aggregation of training responses.