Maximal Running Speed and Critical Speed Are Positively Related to Phase Angle in Healthy Young Adults.

Phase Angle (PhA), derived from bioelectrical impedance analysis, is a measurement of cellular resistance to electrical current and a non-invasive tool to monitor neuromuscular performance. The relationship between PhA and components of athletic performance is not fully understood. The purpose of this study was to determine if maximal running speed, critical speed (CS), and/or D prime (D') derived from a 3-minute all-out-test (3MAOT) correlates to PhA, reactance (Xc), or resistance (R). Sixty-one (male n=35, female n=26) healthy young adults (23.4±3.9 years) completed bioelectrical impedance analysis (Inbody770) and a 3MAOT. The correlations between PhA, Xc, and R and 3MAOT results were evaluated using correlations. Simple and multiple linear-regressions were used to test if results from the 3MAOT (maximum running speed, CS, D') could predict PhA. Linear regression analysis indicated that maximum running speed and CS alone explained 32% and 9% of the variance in PhA, respectively (R2=0.32, p<0.05; R2=0.09, p<0.05). Multiple linear regression indicated that maximum running speed, CS, and D' explained 35% of the variance in PhA (R2=0.35; p<0.05). Only maximum running speed remained a significant predictor of PhA after controlling for age (ß=0.45; p<0.05), but not after controlling for both age and sex (ß=0.14; p>0.05). Since maximum running speed was a stronger predictor of PhA compared to CS (proxy for endurance performance), practitioners should use discernment when using PhA as a readiness tool to monitor endurance performance.

Stance Time and Impact Loading Rates are Significant Predictors of Critical Speed During a 3-Minute All-Out Running Test.

The addition of wearable technology during a 3-minute all-out overground running test (3MAOT) could provide additional insights to guide training and coaching strategies. The purpose of this study was to explore the relationships between critical speed (CS) and biomechanical parameters (cadence, stride length, vertical oscillation, stance time, form power, leg spring stiffness, and impact loading rate), and changes in biomechanical parameters throughout the 3MAOT. Sixty-three (male, n=37, female, n=26) recreationally active college-aged (23.4±3.9 years) subjects completed a 3MAOT while wearing a Stryd foot-pod. The correlations between CS and biomechanical parameters were evaluated using Pearson coefficients. Stepwise multiple linear regressions were used to test if biomechanical parameters could predict CS. Stance time and impact loading rate explained 69% and 63% of the variance in CS, respectively (R2=0.69, p<0.05; R2=0.63, p<0.05). Step-wise multiple linear regression analysis indicated that vertical oscillation, stance time, form power, leg spring stiffness, and impact loading rate explained 90% of the variance in CS (R2=0.90, p<0.05). Throughout the 3MAOT, changes in cadence (-29%), stride length (57%), vertical oscillation (-8%), stance time (82%), form power (-5%), leg spring stiffness (-24%), and impact loading rate (-48%) were observed. Interventions such as auditory cueing or training designed to improve CS should focus on maintaining large impact loading rates and short stance times, and efforts should be made to enhance an athlete's ability to maintain cadence, leg spring stiffness, vertical oscillation, and form power throughout the 3MAOT.

Hula as a physical activity and social support intervention for sustained activity in female breast and gynecologic cancer survivors.

Background: Physical activity improves health and psychosocial functioning for people who have been diagnosed with cancer. Native Hawaiians face disparities for some cancers, including breast cancer. Delivering culturally grounded interventions has the potential to improve enjoyment and adherence to the intervention. We sought to test the adherence and impact of a 6 month randomized wait-list controlled trial of hula. Methods: In this randomized wait-list controlled design people who had been diagnosed with breast or gynecologic cancers were invited to participate with other cancer survivors in a group based setting. Participants were randomized to begin hula immediately or after six months. Attendance was collected and heart-rate measured three times per session. In addition, demographic data, self-report psychosocial data, and biological data (findings will be reported elsewhere) were collected at three time points: baseline, 6 months, and 12 months. The study included six months of hula, twice per week, 60 min each session. In addition, participants committed to practice 60 min per week at home. Results: Participants in the study (n = 42) attended, on average, 72% of the sessions. Significant increase in moderate physical activity (d = 0.50, p = 0.03) was observed in the intervention versus control group. For the measures of intra-individual changes pre-and post-intervention, an increase in total physical activity were seen in the intervention group (d = 0.69, p = 0.003), daily caloric intake decreased (d = -0.62, p = 0.007), and a reduction in waist circumference (d = -0.89, p = 0.0002) that was sustained six months after completion of the intervention. Psychosocially, cognitive functioning significantly declined from baseline to 12 months (d = -0.50, p = 0.03), with role functioning improving (d = 0.55, p = 0.02), social constraints increasing (d = 0.49, p = 0.03), and financial difficulties improving (d = -0.55, p = 0.02). Conclusion: Sustainable physical activity is crucial to improve both the survival and quality of life of cancer survivors. Culturally grounded interventions, such as hula have the potential to increase the maintenance of physical activity. In addition, they create a support group where the benefits of people who have all experienced cancer can gather and garner those benefits of social support, too. This study was registered as a clinical trial through the National Cancer Institute (NCT02351479). Clinical trial registration: Clinicaltrails.gov, NCT02351479.

Utilizing a Team Kinesiology Model to Support Rehabilitative Care in Patients.

An approach that provides a standardized way of continuing rehabilitative care to help patients return to their lives and activities of daily living (ADL) in an economical and efficient manner is the Team Kinesiology Model (TKM). Many patients who are given a life-altering diagnosis (i.e., paralysis due to spinal cord injury, cerebral palsy, or cancer) are unable to return to employment, their family or a pre-diagnosis quality of life (QOL) given the current health care resources. This is a longstanding, and urgent problem as population aging and rising multi-morbidity is projected to negatively impact all regions of the world. Utilization of mid-level rehabilitation services is a proposed method to increase accessibility to all populations, including those of lower socioeconomic status or minority populations. Capitalizing on this idea, we describe two different programs that use the TKM to provide rehabilitative services to patients who were diagnosed with nervous system dysfunction or cancer. This model benefits the patient by improving physical fitness, psychosocial function, and QOL. Furthermore, we provide specific examples that show how this approach could have further-reaching impacts on society, education and research. Integrating kinesiologists and TKM in health care could assist in workflow, long-term health surveillance, rehabilitation and improvement of QOL.

Undergraduate Curriculum Designed to Facilitate a Cancer Exercise Rehabilitation Program.

In 2030, more than 22.1 million cancer survivors are expected to reside in the USA. A workforce knowledgeable in the unique issues of oncologic exercise design and delivery will help to fulfill the need for services that improve survivor health, prognosis, and quality of life (QOL). The purpose of this project was to describe the application of a cancer exercise rehabilitation training program on student performance benchmarks and patient outcomes. Thirty-seven kinesiology students were taught how to design an exercise program for cancer patients through face-to-face instruction (10 h) and online material. Students created and delivered exercise prescriptions to cancer patients (n = 111) over 12 weeks. Surveys evaluating student performance, patient fitness, and patient psychosocial outcomes were used to assess students' skill proficiency, ability to apply newly acquired knowledge, and academic/professional growth. A 2-way ANOVA evaluating student performance scores revealed a significant main effect of time (F(1, 165) = 22.92, p < 0.001), indicating that student performance was improved. Post hoc tests showed the "skill proficiency, knowledge and exercise leadership" dimension was significantly improved (p < 0.0001). Cancer patients had significant improvements in body composition, muscular function, flexibility, and balance (p < 0.05). Students succeeded in tasks directly related to content learned in prerequisite kinesiology courses, while 3 weeks was required for students to become proficient in clinic-related duties. Ninety percent of the students reported that the internship was an excellent learning experience. The curriculum was successful in teaching students how to design and implement exercise programs that improve cancer patient fitness and QOL.

Group-based Exercise Therapy Improves Psychosocial Health and Physical Fitness in Breast Cancer Patients in Hawai'i.

Cancer diagnosis and treatment often negatively impact quality of life, worsening prognosis, and long-term survival in cancer patients. Rehabilitation is effective at reversing cancer-related effects, but these services are not standardized. An implementation study was conducted to determine the usability and efficacy of group-based exercise therapy delivered from an outpatient therapy clinic. Thirty breast cancer patients (mean age ± standard deviation [SD],= 55 ± 10 years) completed 36 90-minute group-based exercise sessions in small groups. Team-based exercises were used to foster peer interaction and social support. Usability was evaluated with participant feedback, adherence, and occurrence of adverse events. Effectiveness was measured with the Revised Piper Fatigue, the City of Hope Quality of Life (QOL), and the Beck Depression Inventories. Paired t-tests and 2-way ANOVAs were used to detect significance (P<.05); Cohen's d was used to measure effect size. Twenty-five patients completed the program; they reported that they liked the program design. One anticipated, moderate adverse event occurred. The intervention improved fatigue and QOL, where significant main effects of time were detected [Fatigue: (F(1,76)=29.78, P <.001); QOL: (F(1,80)=24.42, P<.0001)]. Improvements in the fatigue inventory's behavioral/security and sensory dimensions (Cohen's d=-0.43 and È¡0.68, respectively) and the physical dimension of the QOL inventory were detected (Cohen's d=0.92). There were no significant changes in depression (P=.0735). Seven patients continued to participate in exercise classes for 2.5-years post-intervention, demonstrating achievability of program maintenance. Providing group-based exercise therapy services at an outpatient clinic is an effective and practical approach to improve cancer patients' QOL.

Paired exercise has superior effects on psychosocial health compared to individual exercise in female cancer patients.

PURPOSE: Exercise improves the quality of life (QOL) in cancer patients recovering from treatment. Since group exercise fosters cohesion, we sought to determine if paired exercise would have similar, positive effects. An experiential study design was used to compare the effect of exercise (12 weeks) on psychosocial health in paired versus individually trained cancer patients. METHODS: Female cancer patients (n = 28) who completed cancer treatment were placed into either the singly trained or paired group. Groups were matched for cardiorespiratory fitness (peak oxygen consumption, single: 24.1 ± 7.4, pair: 24.8 ± 6.3 ml/kg/min) and age (single: 58 ± 12, pair: 58 ± 9 years). Patients participated in 36, 90-min exercise sessions in accordance with exercise recommendations. QOL (Functional Assessment of Cancer Therapy-General, FACT-G), depressive, fatigue, and insomnia symptoms were measured before, midway, and after the intervention. Fitness was measured pre- and post-intervention. Participants did not meet prior to the intervention. Two-way ANOVAs and multiple comparisons tests were used to detect differences (p < 0.05). RESULTS: Emotional well-being and total FACT-G scores were significantly improved in the paired but not individually trained patients. Depressive symptoms were significantly improved at mid- and final time points in the paired group. Paired patients reported significant improvements in insomnia symptoms from pre- to mid-intervention. Depressive and insomnia symptoms in the individually trained group were unchanged. A significant main effect of group was detected in fatigue scores in patients who were not chronically tired at baseline (F(1, 12) = 6.318, p = 0.0272). Both groups exhibited similar improvements in fitness. CONCLUSION: Paired exercisers had greater benefits in QOL, emotional well-being, and insomnia and depressive symptoms compared to individual exercisers.

Effect of sphingosine kinase 1 inhibition on blood pressure.

Accumulating evidence suggests that sphingosine kinase 1 (SphK1) plays a key role in carcinogenesis by regulating cyclooxygenase-2 (COX-2) expression. Recent clinical studies have revealed that COX-2 inhibitors cause adverse cardiovascular side effects, likely due to inhibition of prostacyclin (PGI(2)). In this work, we investigated the roles of SphK1 inhibition on blood pressure (BP). The results show that lack of SphK1 expression did not exacerbate angiotensin II (Ang II)-induced acute hypertension, whereas celecoxib, a COX-2 inhibitor, augmented and sustained higher BP in mice. Interestingly, SphK1-knockout mice inhibited prostaglandin E(2) (PGE(2)) but not PGI(2) production in response to Ang II, whereas celecoxib blocked both PGE(2) and PGI(2) production. Mechanistically, SphK1 down-regulation by siRNA in human umbilical vein endothelial cells decreased cytokine-induced PGE(2) production primarily through inhibition of microsomal PGE synthase-1 (mPGES-1), not COX-2. SphK1 down-regulation also decreased MKK6 expression, which phosphorylates and activates P38 MAPK, which, in turn, regulates early growth response-1 (Egr-1), a transcription factor of mPGES-1. Together, these data indicate that SphK1 regulates PGE(2) production by mPGES-1 expression via the p38 MAPK pathway, independent of COX-2 signaling, in endothelial cells, suggesting that SphK1 inhibition may be a promising strategy for cancer chemoprevention with lack of the adverse cardiovascular side effects associated with coxibs.

Palm cooling does not reduce heat strain during exercise in a hot, dry environment.

To compare the effectiveness of the rapid thermal exchange device (RTX) in slowing the development of hyperthermia and associated symptoms among hand immersed in water bath (WB), water-perfused vest (WPV), and no cooling condition (NC). Ten subjects performed 4 heat stress trials. The protocol consisted of 2 bouts of treadmill walking, separated by a cooling-rehydration period. The times to reach the predetermined rectal temperature in the first (38.5 degrees C) and second bouts (39 degrees C) were not different among RTX, NC, and WB, but was longer for the WPV in both bouts (p<0.05). Heat storage was significantly lower for WPV only in the first bout vs. the other conditions (p<0.05). Heart rate (HR) was not different at 10, 20, and 30 min during the first bout among RTX, NC, and WB, but was lower for WPV (p<0.05). HR was not different among conditions during the second bout. The RTX was not effective in slowing the development of hyperthermia.

Perspectives in mammalian IGFBP-3 biology: local vs. systemic action.

Insulin-like growth factor (IGF) binding protein (IGFBP)-3 has traditionally been defined by its role as a binding protein and its association with IGF delivery and availability. Development of non-IGF binding IGFBP-3 analogs and the use of cell lines devoid of type 1 IGF receptors (IGF-R) have led to critical advances in the field of IGFBP-3 biology. These studies show that IGFBP-3 has IGF-independent roles in inhibiting cell proliferation in cancer cell lines. Nuclear transcription factor, retinoid X receptor (RXR)-alpha, and IGFBP-3 functionally interact to reduce prostate tumor growth and prostate-specific antigen in vivo. Moreover, IGFBP-3 inhibits insulin-stimulated glucose uptake into adipocytes independent of IGF. The purpose of this review is to highlight IGFBP-3 as a novel effector molecule and not just another "binding protein" by discussing its IGF-independent actions on metabolism and cell growth. Although this review presents studies that assume the role of IGFBP-3 as either an endocrine or autocrine/paracrine molecule, these systems may not exist as distinct entities, justifying the examination of IGFBP-3 in an integrated model. Also, we provide an overview of factors that regulate IGFBP-3 availability, including its production, methylation, and ubiquitination. We conclude with the role of IGFBP-3 in whole body systems and possible future applications of IGFBP-3 in physiology.

The effect of the rate of heat storage on serum heat shock protein 72 in humans.

Hsp72 concentration has been shown to be higher in the serum (eHsp72) of runners with symptoms of heat illness than in non-ill runners. Recently, it has been suggested that the rate of heat storage during exercise in the heat may be an important factor in the development of heat stroke. Therefore, we compared the effect of two rates of heat storage on eHsp72 concentration during exercise in which subjects reached the same final core temperature. We hypothesized that with a lower rate of heat storage the increase in eHsp72 would be attenuated compared to a higher rate of heat storage. Nine heat acclimated subjects performed two exercise trials in a counterbalanced order in the heat (42 degrees C, 30% relative humidity). The trials consisted of walking on a treadmill (approximately 50% VO (2) peak) dressed in military summer fatigues until rectal temperature reached 38.5 degrees C. A high rate of heat storage (HS, 1.04 +/- 0.10 W m(-2) min(-1), mean +/- SE) occurred when subjects walked without cooling. To produce a lower rate of heat storage (LS, 0.54 +/- 0.09 W m(-2) min(-1)) subjects walked while wearing a water-perfused cooling vest underneath clothing. eHsp72 increased pre- to post-exercise (P < 0.05) but there was no difference (P > 0.05) in eHSP between the two rates of heat storage (LS 1.25 +/- 0.73 to 2.23 +/- 0.70 ng ml(-1), HS 1.04 +/- 0.57 to 2.02 +/- 0.60 ng ml(-1)). This result suggests that eHsp72 is a function of the core temperature attained rather than the rate of heat storage.

Effect of heat acclimation on heat shock protein 72 and interleukin-10 in humans.

Heat acclimation (HA) results in whole body adaptations that increase heat tolerance, and in addition, HA may also result in protective cellular adaptations. We hypothesized that, after HA, basal intracellular heat shock protein (HSP) 72 and extracellular IL-10 levels would increase, while extracellular HSP72 levels decrease. Ten male and two female subjects completed a 10-day exercise/HA protocol (100-min exercise bout at 56% of maximum O(2) uptake in a 42.5 degrees C DB, 27.9% RH environment); subjects exhibited classic adaptations that accompany HA. Peripheral blood mononuclear cells (PBMCs) were isolated before and after each acclimation session on days 1, 6, and 10; plasma and serum were collected before and after exercise on the 1st and 10th day of HA. SDS-PAGE was used to determine PBMC HSP72 levels during HA, and ELISA was used to measure plasma IL-10 and serum HSP72 concentrations. The increase in PBMC HSP72 from pre- to postexercise on the 1st day of HA was not significant (mean +/- SD, 1.0 +/- 0 vs. 1.6 +/- 0.6 density units). Preexercise HSP72 levels on day 1 were significantly lower compared with the pre- and postexercise samples on days 6 and 10 (mean +/- SD, day 6: 2.1 +/- 1.0 and 2.2 +/- 1.0, day 10: 2.0 +/- 1.3 and 2.2 +/- 1.0 density units, respectively, P < 0.05). There were no differences in plasma IL-10 and serum HSP72 postexercise or after 10 days of HA. The sustained elevation of HSP72 from days 6 to 10 may be evidence of a cellular adaptation to HA that contributes to improved heat tolerance and reduced heat illness risk.