Comparison of 10 × 1-minute high-intensity interval training (HIIT) versus 4 × 4-minute HIIT on glucose control and variability in females with type 2 diabetes.

Two high-intensity interval training (HIIT) regimens are often used in research and clinical settings. Yet, there has been no direct comparison to determine if one can improve glucose control and variability to a greater extent in individuals living with type 2 diabetes (T2D). Fourteen older females with T2D participated in a semi-randomized control trial where HIIT10 (10 × 1-min intervals at 90% heart rate max; HRmax) and HIIT4 (4 × 4-min intervals at 90% of HRmax) were compared to a control condition (CON; no exercise). Continuous glucose monitoring was used to assess glucose control and variability over 24 h after each condition. Both HIIT10 (-2.1 ± 1.1 mmol/L) and HIIT4 (-2.1 ± 1.3 mmol/L) acutely lowered glucose compared to CON (-0.7 ± 0.8 mmol/L; p = 0.001), with no difference between exercise conditions. This glucose-lowering effect did not persist over the 24-h post-exercise period, as both mean glucose (p = 0.751) and glucose variability (p = 0.168) were not significantly different among conditions. However, exploratory analyses focusing on individuals with less optimal glucose control (above median 24-h mean glucose in the CON condition; n = 7) revealed that 24-h mean glucose (7.4 [7.14-8.92] vs. 8.4 [7.5-9.9] mmol/L; p = 0.048), glucose variability (p = 0.010), and peak glucose (p = 0.048) were lower following HIIT10 compared to CON, while HIIT4 reduced time spent in moderate hyperglycemia compared to CON (p = 0.023). Both HIIT10 and HIIT4 acutely lower glycemia, but the effect does not persist over 24 h. However, in individuals with worse glucose control, HIIT10 may improve mean 24-h glucose and glycemic variability, while HIIT4 may reduce time spent in moderate hyperglycemia.

Acute effects of exercise on cerebrovascular response and cognitive performance in individuals with stable coronary heart disease.

BACKGROUND: Individuals with coronary heart disease (CHD) exhibit cognitive deficits and cerebrovascular dysfunctions, and are at higher risk of developing dementia. Cognitive function in individuals with CHD has never been studied during acute aerobic exercise. Given the increasing popularity of training at high peak power output (PPO), its impact on cerebrovascular and cognitive functions in individuals with CHD should be further studied. METHOD: Thirty-eight individuals with CHD and 16 healthy controls completed two exercise bouts at 30% and 70% of their individualized PPO on an ergocycle while performing a cognitive task including non-executive and executive conditions. Variations of oxy- deoxy-hemoglobin, and total hemoglobin concentrations were measured on left prefrontal cortex at both PPO using near-infrared spectroscopy. RESULTS: Cognitive task performances were equivalent between groups at all intensity levels. Individuals with CHD exhibited larger variation of deoxyhemoglobin in the executive condition and larger variation in total hemoglobin concentration in all task conditions compared to healthy controls at 70% of PPO. CONCLUSION: Exercising at high intensity seems to have a larger impact on cerebral blood volume in CHD patients compared to healthy age-matched controls. Higher exercise intensity has negative impacts on cerebral blood volume variations during a cognitive task in CHD patients and could potentially lead to other neurocognitive dysfunctions. Other studies are needed to determine if a cognitive task administered during an exercise test could help identify individuals with CHD at higher risk of developing cognitive decline.

Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients.

BACKGROUND: QT dispersion (QTd) is a marker of myocardial electrical instability, and is increased in metabolic syndrome (MetS). Moderate intensity continuous exercise (MICE) training was shown to improve QTd in MetS patients. OBJECTIVES: To describe long-term effects of MICE and high-intensity interval exercise training (HIIT) on QTd parameters in MetS. METHODS: Sixty-five MetS patients (53 ± 9 years) were assigned to either a MICE (60% of peak power output [PPO]), or a HIIT program (alternating phases of 15-30 s at 80% of PPO interspersed by passive recovery phases of equal duration), twice weekly during 9 months. Ventricular repolarization indices (QT dispersion=QTd, standard deviation of QT = sdQT, relative dispersion of QT = rdQT, QT corrected dispersion = QTcd), metabolic, anthropometric and exercise parameters were measured before and after the intervention. RESULTS: No adverse events were noted during exercise. QTd decreased significantly in both groups (51 vs 56 ms in MICE, P < 0.05; 34 vs 38 ms in HIIT, P < 0.05). Changes in QTd were correlated with changes in maximal heart rate (r = -0.69, P < 0.0001) and in heart rate recovery (r = -0.49, P < 0.01) in the HIIT group only. When compared to MICE, HIIT training induced a greater decrease in weight, BMI and waist circumference. Exercise capacity significantly improved by 0.82 and 1.25 METs in MICE and HIIT groups respectively (P < 0.0001). Lipid parameters also improved to the same degree in both groups. CONCLUSION: In MetS, long-term HIIT and MICE training led to comparable effects on ventricular repolarization indices, and HIIT might be associated with greater improvements in certain cardiometabolic risk factors.

Non-pharmacological strategies in cardiovascular prevention: 2011 highlights.

The clinical efficacy of cardiac rehabilitation programs is clearly recognized. Yet, as regards the three main currently employed strategies (exercise, education, and psychobehavioral support), new ideas regularly appear, stemming from studies aimed at providing proof of their efficacy and innocuousness, along with optimal modes of prescription and, at times, their cost-benefit ratio. This ongoing work, which was initially developed in view of enriching the "What's new in?" section of the Sofmer website, represents a selection of articles that may be non-exhaustive, yet is maximally diversified and as representative as possible of the main 2011 highlights in the field of cardiovascular prevention. Each of the articles selected puts forward an original idea, confirms the existence of an effect that was suspected or has had some impact on clinical practice in the field of non-pharmacological management of cardiovascular disease. In line with the multidisciplinary approach of Physical Medicine and Rehabilitation (PMR), the Sofmer cardiovascular rehabilitation group has associated itself with a wide range of specialists (PMR, cardiologists, exercise physiologists, experts in the science and technology of physical activities), all of whom are involved in clinical research and the management of more and more patients. Our objective was consequently to compile a selection of commented articles most likely to interest the different operatives (doctors, nurses, physiotherapists, dietitians, adapted physical activity instructors, psychologists) working with these patients in rehabilitation units or in phase III associative structures. Their goals may vary: (1) learners may wish to further their knowledge of cardiac rehabilitation techniques; (2) practitioners may be interested in continued education but not have the time for regular bibliographic updates; (3) researchers may be intent on informing themselves on the latest breakthroughs and/or arousing their imagination...Enjoy your reading!

Effects of fasting and/or postprandial glucose on heart rate recovery in patients with coronary heart disease.

AIM: The impact of both fasting and postprandial glycaemia on heart rate recovery (HRR) has not been studied in patients with coronary heart disease (CHD). For this reason, we sought to determine the relationships between HRR and both fasting and postprandial glycaemia. METHODS: A total of 4079 patients with baseline fasting plasma glucose (FPG) levels and 706 patients with 2-hour postprandial glucose (2hPG) levels were identified from the Coronary Artery Surgery Study registry, a database of 24,958 patients with suspected or proven CHD who had undergone cardiac catheterization between 1974 and 1979. Median long-term follow-up was 14.7 years (interquartile range: 9.8-16.2 years). The relationships between HRR and both FPG and 2hPG were studied. RESULTS: In univariate analyses, increasing levels of both FPG and 2hPG were significantly associated with lower HRR. In multivariate models adjusted for age, exercise tolerance in METs, resting heart rate and maximum systolic blood pressure during exercise testing, FPG remained significantly associated with HRR while 2hPG did not. CONCLUSION: Both raised FPG and decreased HRR are independent predictors of total and cardiovascular (CV) mortality in subjects with CHD. Our data suggest that the mortality risk associated with elevated FPG may in part be due to deleterious effects on autonomic regulation of CV function, as reflected by lower HRR. Further studies are required to determine whether or not non-pharmacological and/or pharmacological treatments of increased fasting glucose have a beneficial influence on HRR.

Effects of prior exercise on force-velocity test performance and quadriceps EMG.

This study investigated the effects of prior exercise on performance during a subsequent force-velocity (FV) exercise test. After determination of the individual maximal aerobic power (MAP) during maximal graded exercise testing, fifteen trained male subjects (age: 25 +/- 3 y) were randomly assigned to perform the FV exercise test without prior exercise (NPE) or preceded by prior exercise (PE) (10 min at 60 % of MAP, followed after 1-min rest interval by four intervals of 30-s cycling at 100 % MAP with 15-s rest intervals, then 10 min recovery). Blood samples were drawn at rest, and then for each work load at the 3rd minute of recovery. Skin temperature (T (sk)) from the rectus femoris and heart rate (HR) were measured continuously during prior exercise, the FV test, and during the 5-min recovery period at the end of each FV test. The Root Mean Square (RMS) of the surface electromyogram (EMG) signals obtained from the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) were calculated during each sprint for each FV test. The lactate increase for each load (deltaLa) during the FV test was significantly less following PE than NPE. However, the lactate concentration (La) was significantly higher in the FV test following PE than NPE. There was an improvement in power output during the first two sprints (2 and 4 kg) following PE compared to NPE. There was also a more pronounced decrease in VL, VM, and RF RMS in PE compared to NPE. Our results showed that the first few sprints may provide sufficient prior exercise for the FV test. The higher lactate concentration following PE than NPE, despite no difference in maximum power, suggests that a large lactate accumulation may not be detrimental to FV test performance. However, a greater lactate concentration and T(sk) may be associated with a decrease in RMS.

[Diagnosis and treatment of deafness in autistic children]. / Diagnostic et traitement de la surdité chez un enfant autiste.

The indifference to the sounds world leeds to explore the different levels of what can be a deafness: Including the ability to recognize the sounds, to memorize and the wish to communicate. After that, it is possible to organize an educative, reeducative, psychological program with audiophonology.

[Peripheral, central and psychic deafness: diagnosis difficulties in case of autism child]. / Surdité périphérique, surdité centrale, surdité psychique: les difficultés diagnostiques chez 1'enfant autiste.

The population ofchildren seen in the Georges Vacola day hospital, opened 20 years, suffer from serious personality disorders and from, hearing deficit. Speech and language disorders were present in every case. However. autism seems to be less prominent. The dtlfficulties in communicate are associated with problems of memory comprehension and hearing deficit. Many of the autistic children have associated deafness. The importance of central and functional deafness is highlighted. Deficits of mechanisms indispensable to the recognition, discrimination, structuralization, memorization of auditory stimuli are discussed. Another study including 500 autistic children showed that 15% of these children aged 11 to 13 years presented with auditory disorders.

Aerobic capacity and peripheral skeletal muscle function in coronary artery disease male patients.

The aim of this study was to determine if the diminished aerobic capacity of coronary artery disease male (CAD) patients is accompanied by an impaired skeletal muscle function compared to healthy control subjects. Thirteen CAD patients and 9 healthy subjects performed both a maximal laboratory exercise testing and an assessment of the peripheral skeletal muscle function on an isokinetic apparatus. The cardiorespiratory and mechanical parameters were measured at ventilatory threshold and at maximal effort during a maximal exercise testing. The peripheral skeletal muscle function of the quadriceps was assessed from the maximal voluntary isometric force (MVIF) and from the static endurance time (SET) at an intensity of 50 % of the MVIF. The CAD patients showed a diminished aerobic capacity compared to healthy control subjects at maximal effort (maximal VO(2) uptake: p < 0.0001, maximal ventilation: p < 0.01; maximal heart rate: p < 0.0001, maximal power: p < 0.001) but also at VT (VO(2) uptake VT: p < 0.0001, Power VT: p < 0.001). No difference was found on the MVIF (p < 0.90) between the CAD patients and the control subjects whereas the SET was lower in the CAD patients (p < 0.01). The CAD patients had a lower aerobic capacity and an impaired skeletal muscle endurance compared to healthy subjects.

[Central and peripheral deafness among autistic and deaf children]. / Surdité centrale et périphérique chez les enfants autistes et sourds.

Deafness concerns periphericals etiology but also central and psychics etiologies. Knowing the level and the mechanism is difficult with the best ORL exams. Amplification is a possibility to diagnose the reality of the lack of hearing with caution and repetition. It prepares to the use of a hearing aid which can obtain the diagnosis.

[On the family placement at the service of family therapy: 150 years of Medical-psychological annals]. / Du placement familial au service d'accueil familial thérapeutique: les Annales Médico-Psychologiques voici 150 ans.

The historic of families colony (Geel in Belgium) brought a great debate in the "Annales Medico-Psychologiques", 150 years ago. The controversy stay very actual between hospitalocentrisme orientation and deinstitutionalization movement. The economic motivations influence very often on the final orientation of the mental health system.

[The ego and dysphonias]. / Le moi et les dysphonies.

Every psycho-affective disorder may be a factor of language constitution and communication disorders. The study of it, particularly in psychosis is a major sign for diagnosis. Linguistic troubles are correlate with mind perturbations and the psychotic language is symptomatic. The most suggestive example is schizophrenia. Rythm and sound stay, yet semantics and syntactics expressions are down.