Cardiac Autonomic Modulation in Response to Three Types of Exercise in Patients with Type 2 Diabetic Neuropathy.

PURPOSE: Physical exercise is necessary in the handling DM, but it is not distinct which kind of physical exercise can improve cardiac autonomic modulation in T2DM. The purpose of this study was to compare the effects of three different modalities of exercise (aerobic, resistant, and combined) on cardiac autonomic modulation as measured by HRV in patients with type 2 diabetic neuropathy. METHODS: The participants were 45 men (age: 55.24 ± 8.11 years, weight: 89.5 ± 13.4 kg, height: 171.85 ± 6.98 cm, duration of diabetes: 12.51 ± 6.46 years) with type 2 diabetic neuropathy who were clinically free from signs and symptoms of cardiovascular disease. Participants were randomly assigned to one of four groups: aerobic-training (n = 11), dynamic resistant-training (n = 11), Combined-training (n = 11), or a non-exercise control group (n = 12). The exercise groups performed aerobic and resistant exercise for 25-45 min per day, 3-5 times per week for 12 weeks. Anthropometrics, biochemical markers (FBS, HbA1c, Lipid Profile, and Insulin), and heart rate variability in the exercise laboratory and under ambulatory conditions by 3-channel ECG digital Holter recorder were examined. RESULTS: All time and frequency-domain HRV parameters (except LF power) were significantly improved in the exercise groups, compared with the control group (p < 0.05). SDNN, rMSSD, and HF power were boosted, LF power was not different, and the LF/HF ratio decreased after versus before exercise training, independent of exercise modality. HbA1c in aerobic and resistant-training groups, and insulin and LDL in the resistant-training group were decreased after exercise training (p < 0.05). CONCLUSIONS: Exercise training, independent of modality, in patients with type 2 diabetic neuropathy who were clinically free of the cardiovascular disease cause to significant progress in cardiovascular autonomic function assessed by HRV via enhancing cardio-vagal and reducing cardio-sympathetic tone.

"I feel too lethargic to do physical activity": Perceptions of Iranian adults on the barriers to perform regular physical activity.

Background: Despite the intention to perform physical activity (PA), a number of individuals cannot manage to have PA program on a regular basis. In this study we explored the barriers of regular PA behavior among healthy adults in Tabriz, Iran. Methods: This qualitative study with a conventional content analysis approach, was carried out from June to September 2020. Nineteen 30-59 years old individuals, were purposefully (purposive sampling) selected to participate in the study. The participants were formerly registered as "physically inactive" in the health records of Tabriz Health System. Individual semi-structured interviews were conducted until data saturation. Data were managed using MAXQDA-10 software. Results: The barriers of regular PA that emerged from our data were being listless and lethargic, non-supportive environment, disintegration in PA education chain, and restrictive social norms. Conclusion: Our findings uncover several PA barriers that are less discussed in the literature. Poor level of regular PA among adults in Iran, as a developing context, is rooted in perceptions with social and economic origins, which should be taken into account by public health policy makers while planning PA promotion programs in such communities. To promote regular PA among healthy adults in developing countries, regular PA programs should be tailored to bridge the gap between their recognition of PA barriers and subsequent behavior change through creating group dynamics highlighting the measures to diminish the behavior.

Effect of aerobic training on nerve conduction in men with type 2 diabetes and peripheral neuropathy: A randomized controlled trial.

OBJECTIVE: Peripheral neuropathy (PN) is one of the long-term complications of diabetes. Few studies have investigated the role of regular exercise on diabetic PN. We examined the effect of aerobic training on nerve conduction velocity and action potential amplitude in the lower limbs of men with type 2 diabetes and PN. METHODS: In a randomized controlled study, 24 volunteers diagnosed with diabetic PN were randomly assigned to exercise or control groups. Aerobic training consisted of 20-45min walking or running at 50-70% of heart rate reserve for three sessions per week over 12weeks. Before and 48h after the experimental period, nerve conduction studies were performed and blood samples were taken to be analyzed for HbA1c, fasting and 2h postprandial glucose concentration. Data were analyzed using repeated-measures ANOVA at significance level of P<0.05. RESULTS: Sural sensory nerve conduction velocity (NCV) in the exercise group significantly increased (from 35.2±4.3m/s to 37.3±6.2m/s) compared to the control group (P=0.007). Changes in peroneal and tibial motor NCV and nerve action potential amplitude (NAPA) in all nerves studied were not different between groups (P>0.05). Moreover, HbA1c decreased to a greater extent in the exercise group compared to the control (P=0.014). CONCLUSION: Aerobic exercise training may have the potential to hinder the progression of diabetic PN by improving NCV. Given the sparse evidence in this domain, exercise-related mechanisms need to be studied in the future.

Effects of resistance exercise and the use of anabolic androgenic steroids on hemodynamic characteristics and muscle damage markers in bodybuilders.

BACKGROUND: Anabolic androgenic steroids (AAS), synthetic compounds of testosterone commonly used as sport performance enhancers, could cause cardiovascular dysfunction and cell damage. Even though the side effects of AAS intake have been widely studied, yet little is known about how resistance exercise can alter these side effects. This study aimed to determine the effects of one session resistance exercise and the use of AAS on hemodynamic characteristics and muscle damage markers in professional bodybuilders. METHODS: Sixteen bodybuilders were divided into two groups: bodybuilders using AAS for at least 5 years (users; N.=8) and AAS-free bodybuilders (non-users; N.=8). The exercise protocol was a circuit strength training session involved three sets of 8-9 repetitions at 80-85% of 1-RM. Heart rate (HR), blood pressure (BP) and concentrations of serum creatine kinase (CK) and lactate dehydrogenase (LDH) were measured at three different time points, immediately before and after the exercise session and 24 hours following the exercise session. RESULTS: The users group showed greater basal levels of hemodynamic characteristics (i.e. HR and BP) and cell damage markers (i.e. CK and LDH) compared to those in the non-users group (all P<0.05). Furthermore, the exercise session significantly increased the levels of HR (P=0.02) and CK (P=0.01) in the users group compared to those in the non-users group immediately after the exercise. No significant differences were observed in BP and LDH responses to exercise between the users and the non-users groups (P>0.05). CONCLUSIONS: These findings indicate that the use of AAS could be potentially harmful as it enhances the levels of the hemodynamic characteristics and the muscle enzymes. These harmful effects of AAS intake could be more evident in response to resistance exercise.

The Effect of a Pedometer-based Program Improvement of Physical Activity in Tabriz University Employees.

BACKGROUND: Regular physical activity (PA) has been shown to reduce risk of morbidity and overall mortality. A study has displayed that achieving 10,000 steps/day is associated with important health outcomes and have been used to promote PA. Pedometers are a popular tool for PA interventions in different setting. This study investigated the effects on pedometer-based and self-reported PA among Tabriz University employees. METHODS: This experimental study assessed the effects of 16 weeks pedometer-based workplace intervention. Participants (n = 154) were employees of two worksites. Pedometer-based and self-reported PA from one intervention worksite was compared with the data of a comparison workplace. International Physical Activity Questionnaire (IPAQ) for self-reported measure of PA, and demographic (age, marital status, educational level, employment status, and stage of change) variables were obtained. To measure PA objectively pedometer was used. RESULTS: Participants reported to increase the step counts from baseline (end of summer) to posttest (winter). The intervention effect revealed significant increase in the intervention group (8279 ± 2759 steps/day than in the comparison work place (4118 ± 1136). Self-reported based on IPAQ concluded women in intervention worksite had a significant increase in the leisure time domain, but similar finding was not found in the comparison worksite. CONCLUSIONS: Pedometer used might rather benefit those individuals who want feedback on their current PA, also walking should be considered to increase PA in employee women.

Effects of age on hemorheological responses to acute endurance exercise.

The purpose of this investigation was to examine the effects of age on the acute responses of hemorheological variables and biochemical parameters to a single bout of sub-maximal endurance exercise. Fifteen young (20-30 years), 15 middle-aged (40-50 years) and 12 old (60-70 years) male subjects participated in the study. All subjects performed one single bout of endurance exercise encompassed 30-min cycling at 70-75% of maximal heart rate which was followed by 30-min recovery. Three blood samples were taken before, immediately after exercise and after 30-min recovery. Resting levels of hematocrit, red blood cells count, plasma albumin and fibrinogen concentrations, plasma viscosity and whole blood viscosity were significantly different among the three groups (P < 0.01). Thirty minutes of cycling resulted in significant increases (P < 0.05) in all parameters; while these changes were temporary and returned to pre-exercise level at the end of recovery. Responses of all parameters to exercise and recovery were not significantly different among the three groups (P > 0.05). Fibrinogen changes during exercise and recovery were corrected for exercise- and recovery-induced changes in plasma volume. Data analysis showed effects of exercise and recovery only for raw data (P > 0.05). In addition, raw and corrected fibrinogen data in response to exercise and recovery were not age-related. Our results demonstrate that age does not affect the hemorheological responses to an acute endurance exercise in healthy men.