Exercise training and cognitive performance in persons with multiple sclerosis: A systematic review and multilevel meta-analysis of clinical trials.

BACKGROUND: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. OBJECTIVE: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. METHODS: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). RESULTS: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): -0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null (I(2)2= 0.0%) and between studies was low (I(3)2= 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10-5, R(2)2 = 100%, R(3)2 = 52.34%). CONCLUSION: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.

Birth sex ratio in the offspring of professional male soccer players: influence of exercise training load.

STUDY QUESTION: Can the exercise training load of elite male athletes influence the sex ratio of their offspring? SUMMARY ANSWER: This is the first study assessing the influence of exercise training load on the offspring sex ratio of children from male professional athletes, observing a bias toward more females being born as a result of both high-intensity and high-volume loads, with intensity having the greatest effect. WHAT IS KNOWN ALREADY: There is a relatively constant population sex ratio of males to females among various species; however, certain events and circumstances may alter this population sex ratio favoring one sex over the other. STUDY DESIGN, SIZE, DURATION: Observational, descriptive cross-sectional study with a duration of 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS: Seventy-five male professional soccer players from First Division soccer teams. Offspring variables were sex of the offspring, number of children and order of birth. Exercise training variables were volume and intensity. MAIN RESULTS AND THE ROLE OF CHANCE: Total offspring was 122 children (52 males (42.6%), 70 females (57.4%)). Analysis revealed that increase in either the volume (P < 0.001) or intensity (P < 0.001) of training by the players shifted the birth offspring ratio more toward females. Within the sample of females born, more births (i.e. number) were observed as a consequence of training at the highest intensity (45 out of 70; P < 0.001), no such pattern occurred within males (P > 0.05). When female versus male births were compared within each intensity, only the high-intensity comparison was significant (45 (75%) females vs 15 (25%) males, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: While this is the first study assessing differences in the sex ratio of the offspring of male athletes (i.e. soccer players), we acknowledge there are limitations and confounders within our approach; e.g. small sample size, ethnic background and variations in the timing of intercourse relative to ovulation as well as in sex hormone levels. As such, we propose that future research is needed to confirm or refute our findings. It is recommended that such work expand on the measurements obtained and conduct direct assessment of sperm characteristics. WIDER IMPLICATIONS OF THE FINDINGS: The findings of the study support the fact that different stressors on the body may alter the sex of the offspring. While in the present study the stressor is the excessive training load of soccer players, other events may lead to similar results. The bias in offspring sex ratio may have important implications for demography and population dynamics, as well as genetic trait inheritance. STUDY FUNDING/COMPETING INTEREST(S): There is no funding nor competing interests. TRIAL REGISTRATION NUMBER: N/A.

Intense resistance training induces pronounced metabolic stress and impairs hypertrophic response in hind-limb muscles of rats.

Skeletal muscle hypertrophy is an exercise-induced adaptation, particularly in resistance training (RT) programs that use large volumes and low loads. However, evidence regarding the role of rest intervals on metabolic stress and muscular adaptations is inconclusive. Thus, we aimed to investigate the effects of a strenuous RT model (jump-training) on skeletal muscle adaptations and metabolic stress, considering the scarce information about RT models for rats. We hypothesized that jump-training induces metabolic stress and influences negatively the growth of soleus (SOL) and extensor digitorum longus (EDL) muscles of rats. Male Wistar rats (aged 60 days) were randomly assigned to non-trained or trained groups (n = 8/group). Trained rats performed jump-training during 5 days a week for 1, 3, or 5 weeks with 30 s of inter-set rest intervals. Forty-eight hours after the experimental period, rats were euthanized and blood samples immediately drawn to measure creatine kinase activity, lactate and corticosterone concentrations. Muscle weight-to-body weight ratio (MW/BW), cross-sectional area (CSA) and myosin heavy chain (MHC) isoform expression were determined. Higher lactate levels occurred after 20 min of training in weeks 1 and 3. Corticosterone levels were higher after 5 weeks of training. Jump-training had negative effects on hypertrophy of types-I and II muscle fibers after 5 weeks of training, as evidenced by decreased CSA and reduced muscle weight. Our results demonstrated that pronounced metabolic stress and impairment of muscle growth might take place when variables of exercise training are not appropriately manipulated. Lay summary Resistance training (RT) has been used to increase muscle mass. In this regard, training variables (intensity, volume, and frequency) must be strictly controlled in order to evoke substantial muscular fitness. This study shows that rats submitted to 5 weeks of intensive resistance jump-training - high intensity, large volume, and short rest intervals - present high levels of blood corticosterone associated with negative effects on hypertrophy of types-I and II muscle fibers.

Dose-response effects of exercise on bone mineral density and content in post-menopausal women.

Exercise is one of the most widely used non-pharmacological strategies to prevent bone resorption during menopause. Given the detrimental consequences of bone demineralization, the purpose of this study was to examine the effects of prescribing different exercise volumes on bone mineral density and content in previously inactive, post-menopausal women during a 12-month intervention and 1 year after intervention completion. Four hundred post-menopausal women were randomized to either 150 min/wk (MODERATE dose group) or 300 min/wk (HIGH dose group) of aerobic exercise. Total bone mineral density (g/cm2 ) and bone mineral content (g) were assessed at baseline, 12 months (end of the intervention) and 24 months (follow-up) using whole body dual-energy X-ray absorptiometry. At 12 months, mean bone mineral density among women in the HIGH dose group was estimated to be 0.006 g/cm2 (95% CI: 0.001-0.010; P = 0.02) higher than that of women randomized to the MODERATE dose group. At 24 months, the mean difference between groups remained statistically significant, indicating higher mean bone mineral density among women in the HIGH dose group (0.007 g/cm2 ; 0.001-0.001; P = 0.04). No significant differences between groups were found at any time point for bone mineral content. In an exploratory analysis, women who completed more min/wk of impact exercises had significantly higher mean levels of bone mineral density at 12 months compared to baseline (0.006 g/cm2 , 95% CI: 0.006-0.012; P = 0.03). These findings suggest that higher volumes of exercise, especially impact exercise, lead to a smaller decline in total bone mineral density, which may remain following intervention completion.

Electrical support during outdoor cycling in patients with coronary artery disease: impact on exercise intensity, volume and perception of effort.

BACKGROUND: Electrical assisted bicycles (EAB's) could be used to overcome barriers and difficulties to outdoor cycling and thus assist in achieving a sufficient physical activity level in coronary artery disease (CAD) patients, but it is unknown whether sufficient exercise intensities and volumes could be elicited during cycling on EAB's. In this study we examined, for the first time, the acute physiological impact of electrical support during outdoor cycling in CAD patients (ISRCTN32238279). METHODS: Fifteen CAD patients (13 males), aged 64 ± 7 years executed a maximal cardiopulmonary exercise test and afterwards cycled a predefined outdoor route of 10 km, in three different conditions: classical cycling (no support), EAB with low support (EABlow) and high support (EABhigh). Oxygen uptake (VO2) and carbon dioxide output (VCO2) was measured continuously by a portable gas-analysing system. Cycling time was recorded and ratings of perceived exertion (RPE) was assessed at 3 and 7 km. RESULTS: Mean VO2 during EABhigh (1721 ± 537 ml•min-1) was significantly lower compared to EABlow (1890 ± 619 ml•min-1, p < .05), but no differences were found between EABlow and classical cycling (1846 ± 523 ml•min-1). EABlow and EABhigh elicited a sufficient volume and intensity (6.6 ± 2.0 MET's (74 ± 6% VO2peak) and 6.0 ± 1.8 MET's (68 ± 7% VO2peak), respectively) to adhere to the guidelines for secondary prevention in CAD. RPE was significantly lower p < .05) during EABhigh (9 ± 2), than during EABlow (11 ± 2) or classical cycling (11 ± 2). CONCLUSIONS: Outdoor cycling with electrical support leads to a sufficiently high exercise intensity and volume in CAD patients, and may be considered as an alternative exercise modality.

Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis.

The purpose of this paper was to systematically review the current literature and elucidate the effects of total weekly resistance training (RT) volume on changes in measures of muscle mass via meta-regression. The final analysis comprised 34 treatment groups from 15 studies. Outcomes for weekly sets as a continuous variable showed a significant effect of volume on changes in muscle size (P = 0.002). Each additional set was associated with an increase in effect size (ES) of 0.023 corresponding to an increase in the percentage gain by 0.37%. Outcomes for weekly sets categorised as lower or higher within each study showed a significant effect of volume on changes in muscle size (P = 0.03); the ES difference between higher and lower volumes was 0.241, which equated to a percentage gain difference of 3.9%. Outcomes for weekly sets as a three-level categorical variable (<5, 5-9 and 10+ per muscle) showed a trend for an effect of weekly sets (P = 0.074). The findings indicate a graded dose-response relationship whereby increases in RT volume produce greater gains in muscle hypertrophy.

Effect of aerobic exercise training followed by a low-calorie diet on metabolic syndrome risk factors in men.

BACKGROUND AND AIMS: Whether low-volume, high-intensity, interval training (HIIT) is an adequate exercise method for improving metabolic risk factors is controversial. Moreover, it is not known if performing a short-term, low-calorie diet intervention (LCDi) after a HIIT program affects risk factors. This study investigated how an 8-week, 3 times/week exercise intervention (EXi) incorporating either HIIT or moderate-intensity continuous training (MICT) followed by a 4-week LCDi affects risk factors. METHODS AND RESULTS: Twenty-six male workers with metabolic risk factors (47.4 ± 7.1 years; cardiorespiratory capacity (VO2peak) of 28.5 ± 3.9 ml/kg/min) were randomly assigned to either the HIIT (3 sets of 3-min cycling with a 2-min active rest between sets, 180 kcal) or MICT (45 min, 360 kcal) group. After the EXi, all subjects participated in a 4-week LCDi (4 counseling sessions). During the EXi, VO2peak improved more (P < 0.05) through HIIT (25.4 ± 14.6%) than through MICT (14.9 ± 12.8%), whereas improvements in body fat and HDL cholesterol were similar. During the LCDi, some risk factors improved further (P < 0.05) without any group differences, while VO2peak in the HIIT group decreased (P < 0.05) to the same level as in the MICT group. CONCLUSION: VO2peak increased more with HIIT than with MICT during the EXi despite HIIT having a lower exercise volume than MICT, but this advantage of HIIT promptly disappeared through detraining. An intervention strategy consisting of 8 weeks of either HIIT or MICT followed by a 4-week LCDi has a positive effect on metabolic risk factors. CLINICAL TRIAL REGISTRATION: UMIN11352.

Muscle activation during three sets to failure at 80 vs. 30% 1RM resistance exercise.

PURPOSE: The purpose of this study was to investigate electromyographic amplitude (EMG AMP), EMG mean power frequency (MPF), exercise volume (VOL), total work and muscle activation (iEMG), and time under concentric load (TUCL) during, and muscle cross-sectional area (mCSA) before and after 3 sets to failure at 80 vs. 30 % 1RM resistance exercise. METHODS: Nine men (mean ± SD, age 21.0 ± 2.4 years, resistance training week(-1) 6.0 ± 3.7 h) and 9 women (age 22.8 ± 3.8 years, resistance training week(-1) 3.4 ± 3.5 h) completed 1RM testing, followed by 2 experimental sessions during which they completed 3 sets to failure of leg extension exercise at 80 or 30 % 1RM. EMG signals were collected to quantify EMG AMP and MPF during the initial, middle, and last repetition of each set. Ultrasound was used to assess mCSA pre- and post-exercise, and VOL, total work, iEMG, and TUCL were calculated. RESULTS: EMG AMP remained greater at 80 % than 30 % 1RM across all reps and sets, despite increasing 74 and 147 % across reps at 80 and 30 % 1RM, respectively. EMG MPF decreased across reps at 80 and 30 % 1RM, but decreased more and was lower for the last reps at 30 than 80 % 1RM (71.6 vs. 78.1 % MVIC). mCSA increased more from pre- to post-exercise for 30 % (20.2-24.1 cm(2)) than 80 % 1RM (20.3-22.8 cm(2)). VOL, total work, iEMG and TUCL were greater for 30 % than 80 % 1RM. CONCLUSION: Muscle activation was greater at 80 % 1RM. However, differences in volume, metabolic byproduct accumulation, and muscle swelling may help explain the unexpected adaptations in hypertrophy vs. strength observed in previous studies.

Preliminary Evaluation of Self-Reported Training Volume as an Adjunct Measure of Female Athlete Triad Risk in Division 1 Collegiate Female Runners.

Background/Objectives: This study tested whether self-reported training volume is predictive of female athlete triad risk collected using an established twelve-question triad screening tool in National Collegiate Athletic Association (NCAA) Division I (DI) collegiate female runners. Methods: A total of 319 institutions were initially contacted, seven of which agreed to distribute surveys to their female cross-country and track and field athletes. A total of 41 of 149 respondents completed the survey and met all inclusion criteria. Linear and binomial logistic regressions examined the relationships between self-reported training volumes and estimated triad risk. Independent samples t-tests were also used to compare training volumes across the high (> 50th percentile for risk factor counts) vs. low-risk groups. Results: Total weekly competition and conditioning resistance training hours were associated with the total number of triad risk factors (p = 0.044) and were also predictive of the triad risk group (p = 0.037). Likewise, both competition and conditioning resistance training hours (p = 0.034) were higher in the high-risk group versus the low-risk group. Conclusions: These findings suggest that self-reported resistance training volume is predictive of triad risk, but additional research is required to determine if monitoring training volume can provide valuable, real-time assessments of triad risk in DI collegiate female runners.

Effects of volume-matched acute exercise on metacognition in late middle-aged adults: The roles of exercise intensity and duration.

Increasing studies have observed the benefit of acute exercise on core executive functions (EFs). However, the effects of high-order EFs (i.e., metacognition) are poorly investigated. Additionally, the beneficial effect varies depending on exercise-related variables (e.g., intensity, duration). Exercise volume, represented by exercise intensity and duration, is one approach to examine the relationship between acute exercise and metacognition. Therefore, this study aims to investigate the effects of acute exercise, involving three volume-matched evaluations, on metacognition in late middle-aged adults. It recruited 40 community-dwelling late middle-aged adults (22 females; Mage=61.05±4.17years). Its counterbalanced and repeated-measure experimental design included a control reading session and three exercise sessions: (1) acute moderate-intensity exercise for 30min, (2) higher-intensity exercise for 16min, and (3) lower-intensity exercise for 40min. After each session, all participants were asked to perform the Tower of London (TOL) task to assess their metacognition related to planning and problem-solving. This study showed that regardless of exercise intensity and duration variation, acute exercise led to higher move-related (i.e., total correct and move scores) and time-related (i.e., total executive and problem-solving times) scores but did not affect total initial time and violation-related scores compared to reading treatment. These findings suggest enhanced performance in metacognition after acute exercise regardless of its intensity and duration variation.

Exercise Prescription for Postprandial Glycemic Management.

The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response.

Associations between postrace atrial fibrillation and measures of performance, racing history and airway disease in horses.

BACKGROUND: Atrial fibrillation (AF) is the most common performance limiting arrhythmia in racehorses. High dose exercise and airway disease promote AF in humans. Few studies have investigated epidemiological factors associated with AF in horses. OBJECTIVES: Explore variables relating to performance, exercise volume and postrace endoscopic findings in horses with AF. ANIMALS: A total of 164 horses with poor race performance and postrace AF were compared to 321 horses with poor performance without AF (PP) and 314 horses performing to expectation (TE). METHODS: Horse-level and race-level variables for horses racing in Australia and Hong Kong from 2009 to 2021 were compared using univariable and multivariable logistic regression. Postrace endoscopic exercise-induced pulmonary hemorrhage (EIPH) and tracheal mucus accumulation (TMA) grades for AF and PP horses were compared using chi-squared analysis. RESULTS: Variables that were significant in the multivariable model of AF compared to TE were distance (lengths) behind the winner, (odds ratio [OR]; 95% confidence interval [95% CI], 1.41 [1.32-1.51], P < .0001), cumulative prize money per start before the event (OR [95% CI] 1.02 [1.01-1.03], P = .01) and age (OR [95% CI] 0.72 [0.55-0.92], P = .01). More AF horses had EIPH grade ≥ 3 (23/109; 21.1%) than PP horses (7/213; 3.3%; OR [95%CI] 7.9 [3.3-20.2], P < .0001). CONCLUSIONS AND CLINICAL IMPORTANCE: Acute race performance was substantially impaired by AF but career earnings before the event were not inferior. Exercise volume did not promote AF. Higher grades of EIPH found in AF horses suggests a mechanistic relationship between these conditions.

Endothelial progenitor cell mobilization based on exercise volume in patients with cardiovascular disease and healthy individuals: a systematic review and meta-analysis.

Endothelial progenitor cells (EPCs) play a vital role in protecting endothelial dysfunction and cardiovascular disease (CVD). Physical exercise stimulates the mobilization of EPCs, and along with vascular endothelial growth factor (VEGF), promotes EPC differentiation, and contributes to vasculogenesis. The present meta-analysis examines the exercise-induced EPC mobilization and has an impact on VEGF in patients with CVD and healthy individuals. Database research was conducted (PubMed, EMBASE, Cochrane Library of Controlled Trials) by using an appropriate algorithm to indicate the exercise-induced EPC mobilization studies. Eligibility criteria included EPC measurements following exercise in patients with CVD and healthy individuals. A continuous random effect model meta-analysis (PROSPERO-CRD42019128122) was used to calculate mean differences in EPCs (between baseline and post-exercise values or between an experimental and control group). A total of 1460 participants (36 studies) were identified. Data are presented as standard mean difference (Std.MD) and 95% confidence interval (95% CI). Aerobic training stimulates the mobilization of EPCs and increases VEGF in patients with CVD (EPCs: Std.MD: 1.23, 95% CI: 0.70-1.76; VEGF: Std.MD: 0.76, 95% CI:0.16-1.35) and healthy individuals (EPCs: Std.MD: 1.11, 95% CI:0.53-1.69; VEGF: Std.MD: 0.75, 95% CI: 0.01-1.48). Acute aerobic exercise (Std.MD: 1.40, 95% CI: 1.00-1.80) and resistance exercise (Std.MD: 0.46, 95%CI: 0.10-0.82) enhance EPC numbers in healthy individuals. Combined aerobic and resistance training increases EPC mobilization (Std.MD:1.84, 95% CI: 1.03-2.64) in patients with CVD. Adequate exercise volume (>60%VO2max >30 min; P = 0.00001) yields desirable results. Our meta-analysis supports the findings of the literature. Exercise volume is required to obtain clinically significant results. Continuous exercise training of high-to-moderate intensity with adequate duration as well as combined training with aerobic and resistance exercise stimulates EPC mobilization and increases VEGF in patients with CVD and healthy individuals.

Effect of Exercise Volume on Plantar Microcirculation and Tissue Hardness in People With Type 2 Diabetes.

Objective: Exercise has been reported to be beneficial for people with type 2 diabetes (T2DM), but exercise, especially weight-bearing exercise, may increase the risk of diabetic foot ulcers (DFUs). This study aimed to explore the associations between different volumes of weight-bearing physical activities and plantar microcirculation and tissue hardness in people with T2DM. Methods: 130 elderly people with T2DM were enrolled for this cross-sectional study. They were classified into the high exercise volume group and the low exercise volume group based on their weekly energy expenditure (metabolic equivalents per week) in the past year. Weekly energy expenditure was calculated using the International Physical Activity Questionnaire and the Compendium of Physical Activities. The plantar oxygen saturation (SO2) and soft tissue hardness of each participant's right foot were measured. Results: A total of 80 participants completed the trial. The average exercise energy expenditure of the high exercise volume group and the low exercise volume group were significantly different (p < 0.05). The results showed that the SO2 of the high exercise volume group (67.25 ± 6.12%) was significantly higher than the low exercise volume group (63.75 ± 8.02%, p < 0.05). The plantar tissue hardness of the high exercise volume group was lower than the low exercise volume group in the big toe, midfoot and hindfoot regions (p < 0.05). Conclusion: This study demonstrates that higher volumes of exercise are associated with better plantar microcirculation and lower plantar tissue hardness in people with T2DM. The findings of this study indicate that weight-bearing exercise may not increase risk of developing diabetic foot ulcers.

Optimizing the Interaction of Exercise Volume and Metformin to Induce a Clinically Significant Reduction in Metabolic Syndrome Severity: A Randomised Trial.

Insulin resistance is a central mediating factor of the metabolic syndrome (MetS), with exercise training and metformin proven antidotes to insulin resistance. However, when the two therapies are combined there is conflicting data regarding whether metformin blunts or improves exercise training-induced adaptations. The volume of exercise (duration, intensity, and frequency) on the interaction of exercise training and metformin has yet to be investigated. The aim of this study is therefore to explore the impact of a combination of different exercise volumes and metformin on MetS severity. This is a secondary analysis of data from one of the sites of the 'Exercise in Prevention of Metabolic Syndrome' (EX-MET) study. Ninety-nine adults with MetS were randomized into a 16-week exercise program completing either: (i) moderate-intensity continuous training (MICT) at 60-70% of peak heart rate (HRpeak) for 30 min/session (n = 34, 150 min/week); (ii) high-volume high-intensity interval training (HIIT) consisting of 4 × 4 min bouts at 85-95% HRpeak, interspersed with 3 min of active recovery at 50-70% HRpeak (n = 34, 38 min/session, 114 min/week); or (iii) low volume HIIT, 1 × 4 min bout of HIIT at 85-95% HRpeak (n = 31, 17 min/session, 51 min/week). Metformin intake was monitored and recorded throughout the trial. MetS severity was calculated as z-scores derived from MetS risk factors assessed at pre- and post-intervention. Sixty-five participants had complete pre- and post-intervention data for MetS z-score, of which 18 participants (28%) were taking metformin. Over the 16-week intervention, a similar proportion of participants clinically improved MetS severity (Δ ≥ -0.87) with metformin (8/18, 44%) or without metformin (23/47, 49%) (p = 0.75). While there were no between-group differences (p = 0.24), in those who did not take metformin low-volume HIIT had more likely responders (10/15, 67%) compared to MICT (6/16, 38%) and high-volume HIIT (7/16, 44%). In those taking metformin, there was a lower proportion of participants who clinically improved MetS severity following high-volume HIIT (1/6, 17%) compared to MICT (2/4, 50%) and low-volume HIIT (5/8, 63%), but with no between-group difference (p = 0.23). Moreover, in those who performed high-volume HIIT, there was a statistically significantly higher proportion (p = 0.03) of likely non-responders with improved MetS severity in participants taking metformin (4/6, 67%) compared to those not taking metformin (3/16, 19%). In individuals with MetS, the effect of high volume HIIT on MetS severity may be blunted in those taking metformin. These findings need to be confirmed in a larger study.

Endurance training on rodent brain antioxidant capacity: A meta-analysis.

The influence of physical exercise on brain antioxidant defense mechanisms has been studied. Nevertheless, the effect of training volume on the brain`s redox balance remains unclear. In this meta-analysis, we compared the effect of training volume on antioxidant enzymatic resource and lipid peroxidation on various brain regions. The activities of the enzymes glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT) and the levels of thiobarbituric acid reactive substances (TBARS) were also evaluated. The effects of training periods (weeks) and exercise duration were compared. Meta-analysis revealed that protocols over 8 weeks were associated with an increase in SOD (p = 0.0008) and CAT activities (p = 0.0001). Exercise durations for 30 and 60 min were associated with higher CAT activity (p = 0.04). Joint analysis revealed that moderate physical exercise over 4 and 8 weeks promoted a healthy enzymatic balance. However, high volumes of exercise over 8 weeks were associated with the increased antioxidant enzymatic activity, indicating higher reactive oxygen species (ROS) levels. The data also indicated that there is still limited research and inaccurate information, on the safety conditions of training periods that simulate tests of ultra resistance in humans.

The impact of exercise frequency upon microvascular endothelium function and oxidative stress among patients with coronary artery disease.

PURPOSE: This study compared the effects of low and high weekly exercise frequencies on microvascular endothelium function and oxidative stress among patients with coronary artery disease. METHODS: Thirty-four male patients completed a 6-month cardiac rehabilitation programme, from which 23 performed exercise with a high frequency (HF) and 11 with a low frequency (LF). Systemic microvascular blood flow, maximal aerobic capacity, blood lipids, oxidative stress and anthropometric data were assessed prior to and after the cardiac rehabilitation programme. Microvascular blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with iontophoresis of acetylcholine. RESULTS: Maximal aerobic capacity, biochemical analysis and anthropometric data were similar between groups prior to and after the cardiac rehabilitation programme (P>0·05). However, after 6 months of cardiac rehabilitation performed with HF, there was an increase in the peak response to acetylcholine compared with LF (83·5 ± 58·5 versus 21·8 ± 22·4%; P<0·05). Changes in lipid peroxidation (HF: -5·5 ± 9·4 versus LF: 2·2 ± 12·0 pmol MDA mg-1 ; P = 0·19), catalase activity (HF: 0·07 ± 0·17 versus LF: 0·04 ± 0·08 U mg-1 ; P = 0·74) and nitric oxide levels (HF: 1·8 ± 15·3 versus LF: -3·2 ± 12·3 µM; P = 0·36) were similar between groups after cardiac rehabilitation. CONCLUSION: Six months of aerobic exercise training performed with high frequency is preferable to low frequency aiming endothelium microvascular function increases in patients with coronary artery disease. The mechanisms involved in this response are unclear and warrant additional research.

Relationship between exercise volume and muscle protein synthesis in a rat model of resistance exercise.

Resistance exercise (RE) volume is recognized as an important factor that stimulates muscle protein synthesis (MPS) and is considered, at least in part, to be involved in the mammalian target of rapamycin complex 1 (mTORC1)-associated signaling. However, the effects of relatively high-volume RE on mTORC1 and MPS remain unclear. In the present study, we used an animal model of RE to investigate the relationship between RE volume and MPS. Male Sprague-Dawley rats were subjected to RE, and muscle samples were obtained 6 h after performing 1, 3, 5, 10, or 20 sets of RE. Although 1 set of RE did not increase MPS [measured by the surface sensing of translation (SUnSET) method], multiple sets (3, 5, 10, and 20 sets) significantly increased MPS. However, the increase in MPS reached a plateau after 3 or 5 sets of RE, and no further increase in MPS was observed with additional RE sets. In contrast to the MPS response, we observed that p70S6K phosphorylation at Thr389, a marker of mTORC1 activity, and Ser240/244 phosphorylation of rpS6, a downstream target of p70S6K, gradually increased with higher RE volume. The above results suggest that the relationship between RE volume and MPS was not linear. Thus the increase in MPS with increasing RE volume saturates before p70S6K phosphorylation, suggesting a threshold effect for the relationship between p70S6K activation and MPS.NEW & NOTEWORTHY The aim of this study was to investigate the relationship between resistance exercise (RE) volume and muscle protein synthesis. We found that the relationship between RE volume and p70S6K phosphorylation was almost linear, but the increase in muscle protein synthesis began to plateau after approximately five sets of RE.

Exercise dose and all-cause mortality within extended cardiac rehabilitation: a cohort study.

AIMS: To investigate the relationship between exercise participation, exercise 'dose' expressed as metabolic equivalent (MET) hours (h) per week, and prognosis in individuals attending an extended, community-based exercise rehabilitation programme. METHODS: Cohort study of 435 participants undertaking exercise-based cardiac rehabilitation (CR) in Leeds, West Yorkshire, UK between 1994 and 2006, followed up to 1 November 2013. MET intensity of supervised exercise was estimated utilising serial submaximal exercise test results and corresponding exercise prescriptions. Programme participation was routinely monitored. Cox regression analysis including time-varying and propensity score adjustment was applied to identify predictors of long-term, all-cause mortality across exercise dose and programme duration groups. RESULTS: There were 133 events (31%) during a median follow-up of 14 years (range, 1.2 to 18.9 years). The significant univariate association between exercise dose and all-cause mortality was attenuated following multivariable adjustment for other predictors, including duration in the programme. Longer-term adherence to supervised exercise training (>36 months) was associated with a 33% lower mortality risk (multivariate-adjusted HR: 0.67; 95% CI: 0.47 to 0.97; p=0.033) compared with all lesser durations of CR (3, 12, 36 months), even after adjustment for baseline fitness, comorbidities and survivor bias. CONCLUSION: Exercise dose (MET-h per week) appears less important than long-term adherence to supervised exercise for the reduction of long-term mortality risk. Extended, supervised CR programmes within the community may play a key role in promoting long-term exercise maintenance and other secondary prevention therapies for survival benefit.

The Effect of Increasing Volume of Exercise on Activation Pattern of Vastus Medialis and Lateralis and its Correlation With Anterior Knee Pain in Karate Elites.

BACKGROUND: The effects of exercise volume on the pattern of muscle activity is one of the most important factors in training management and injury risk reduction. In the lower limb, the quadriceps muscle which plays a determining role in performing the stance and other karate techniques could be injured in intensive exercise and may induce anterior knee pain in athletes. OBJECTIVES: The aim of this study was to determine the relationship between training volume and muscle activity of vastus medialis and vastus lateralis and its association with anterior knee pain in karate elites. PATIENTS AND METHODS: Male and female athletes from national junior and cadet karate team (14 to 18 years) were invited to participate in the study at the beginning and the end of the training camps. Studies involved measurement of electromyographic muscle activity of vastus medialis and vastus lateralis in both lower extremities with surface electromyography device and assessment of movement by electrogoniometery. Muscle activity was recorded in three tests of dachi, walking up and walking down stairs. Simultaneously, anterior knee pain was evaluated using visual analogue scale and anterior knee pain scale questionnaire. RESULTS: Eight athletes of a total number of 23 reported increased ratings of pain in their right knees. No differences in muscle activity were observed in tests of Dachi and stairs between the groups with and without pain. Comparing Dachi task pattern at the beginning and end of training camps, there was no significant difference in pattern of biomechanical movement; however, reducing the amount of muscle activity in early and late phases of tasks was observed in electromyographic assessment. CONCLUSIONS: The results showed that performing the same task after a six-week training period, less muscle activity was required in all phases in two groups of tasks, including karate-specific movement (dachi) and activities of daily living (up or down stairs).