Anthropometric and physiologic profiles of female professional yoga practitioners and energy expenditure during asanas execution.

AIM: The present study aimed to: 1) define the anthropometric and physiological profiles of female professional yoga practitioner compared to that of other athletes; 2) evaluate the energy expenditure (EE) during a yoga session. METHODS: The percentage fat mass (FM%) and fat free mass (FFM%), the maximal aerobic power (VO2max), the maximal voluntary contraction (MVC) of knee extensor muscles and the maximal anaerobic alactacid power (Wmax) were assessed in a group of yoga practitioners (Yo), long distance runners (LDR), sprinters (Spr), karate practitioners (Ka) and sedentary control subjects (Con). EE was evaluated in Yo during a yoga session (execution of a sequence of six yoga postures, called asanas). RESULTS: FM% was significantly higher in Con (24.2±2.6%) than in other groups (18±1.9%, pooled data, P<0.05). FFM% did not differ among groups. VO2max was higher in LDR (55.6±1.8 mL min-1 kg-1) compared to other groups (41.7±3 mL min-1 kg-1, pooled data, P<0.05). MVC and Wmax were higher in Yo, Spr and Ka than in LDR and Con (P<0.05). In Yo, EE increased in comparison to baseline, during Sirasana execution only (+59%, P<0.05). CONCLUSION: These data suggest that chronic yoga practice is associated with 1) values of FM%, FFM%, MVC and Wmax similar to those induced by sports requiring high degree of force and power of lower limb muscles, with maximal aerobic performance similar to control subjects; 2) low EE during most asanas execution.

Heart adaptations to long-term aerobic training in paraplegic subjects: an echocardiographic study.

STUDY DESIGN: Case-control. OBJECTIVES: To execute an echocardiographic comparison between trained and untrained spinal cord injury (SCI) subjects, and to evaluate whether long-term heart adjustments to endurance training are comparable to those observed in able-bodied (ABL) subjects. SETTING: Italy. METHODS: We enrolled: (1) 17 male SCI patients (lesion level T1-L3, 34±8 years, body mass index (BMI) 23.0±2.8 kg m(-2)), 10 of whom were aerobically trained for >5 years (SCI(T)); (2) 18 age-, sex- and BMI-matched ABL subjects (35±6 years, BMI 23.6±2.8 kg m(-2)), 10 of whom were aerobically trained for >5 years (ABL(T)). Training frequency and volume were recorded by a dedicated questionnaire. All subjects underwent a trans-thoracic echocardiography; SCI subjects also performed an exhaustive incremental exercise test. Comparisons were made between ABL and SCI groups, between trained and untrained subjects within each group (analysis of variance). RESULTS: Effects of SCI-Compared with ABL subjects, SCI patients showed lower end-diastolic volume (76±21 vs. 113±23 ml, P<0.05) and ejection fraction (61±7% vs. 65±5%, P<0.05). Effects of training-Compared with untrained status, the intra-ventricular septum thickness (SCI, +18%; ABL, +4%), the posterior wall thickness (SCI, +17%; ABL, +2%) and the total normalized heart mass (SCI, +48%; ABL, +5%) were higher in both SCI(T) and in ABL(T). VO2peak was higher in the SCI(T) subgroup compared with the SCI(U) group. CONCLUSIONS: Heart seems to positively adapt to long-term endurance training in SCI patients. Regular exercise may therefore increase heart size, septum and posterior wall thickness, which likely contributes to improved VO2peak. These morphological and functional changes may reduce cardiovascular risk in SCI individuals.

Heart rate and blood lactate evaluation in bouldering elite athletes.

AIM: Bouldering contests consist of a series of short routes, called ''problems'', which shall be climbed without ropes. The purpose of this study was to determine blood lactate [Lac] concentration and heart rate (HR) adaptations both during an official bouldering competition and a simulated contest. METHODS: Eleven Italian elite climbers (6 males, 5 females) were tested from two bouldering national competitions (BNC). [Lac] assessments were done before and 2, 4, 6, 8 min after the contest. On a separate occasion, 9 different elite climbers (6 males, 3 females), matched for anthropometric features and ranking, were assessed in a simulated bouldering contest (SBC), under conditions and difficulties comparable to BNC. HR was measured through the whole performance; [Lac] was assessed before and 3 min after the achievement of each problem. RESULTS: The ascending time in both BNC and SBC was 391+/-85 s and 551+/-96 s (P<0.001), respectively. During SBC the mean HR peak of each problem was 93+/-8% of the subjects' age-predicted maximal HR (HRmax), and HR showed a full recovery after each problem, but in males only. Peak [Lac] after last problem was 6.6+/-1.1 mmol/L and 5.6+/-1.1 mmol/L during BNC and SBC, respectively. A regression analysis showed that temporal changes in [Lac] depend on the attempts duration, with a critical cut-off time of 20 s. CONCLUSIONS: Bouldering contest requires an intense intermittent effort. The high HR may be due to the repeated isometric contractions, particularly of arm and forearm muscles. The net lactate production may depend on the attempts duration.

Effects of short term cast wearing on respiratory and cardiac responses to submaximal and maximal exercise in adolescents with idiopathic scoliosis.

AIM: Bracing is widely used to treat adolescent scoliosis. However, bracing may also affect respiratory and cardiovascular function. In this thirteen-weeks longitudinal study we evaluated the effect of brace wearing on maximal and submaximal cardiorespiratory capacity in adolescents with moderate idiopathic scoliosis. METHODS: Eight boys and 8 girls (12-18 years) with scoliosis of the thoracic spine (Cobb angle range 32 degrees - 42 degrees in boys and 32 degrees - 60 degrees in girls) were enrolled. Respiratory basal function (forced vital capacity, FVC, and forced expired volume in 1 s, FEV(1)) and cardiorespiratory adjustments to submaximal and maximal cycle ergometer exercise (heart rate, HR, pulmonary ventilation, VE, and oxygen consumption, VO(2)) were measured a week before fitting a brace, after 1 and 12 weeks of brace wearing, and a week after brace removal. RESULTS: With respect to pretreatment values: a) after 1 week of brace wearing FVC and FEV(1) were significantly reduced in both genders; b) after 12 weeks of bracing the amount of oxygen consumed per heart beat was reduced during maximal and submaximal exercises in females only; c) ventilatory efficiency was unchanged in both genders in each condition; d) oxygen uptake during maximal exercise was decreased (by about 10-20%) in females only; e) after brace removal all variables tended to regress to pretreatment values. CONCLUSIONS: Although data are preliminary and need to be confirmed on larger samples of patients, the brace appears to limit maximal exercise performance especially in girls, where it affects the cardiopulmonary efficiency. Thus, moderate physical exercise during brace wearing is advised to counteract respiratory, cardiovascular and muscle inefficiency due to ribcage movement limitations.

Relationship between anthropometric or functional characteristics and maximal serve velocity in professional tennis players.

AIM: This study aims at investigating the possible relationships between anthropometric and functional parameters and maximal serve speed in professional tennis players. METHODS: Eight professional male tennis players (age 23±4 [mean±SD] years; height 181±4 cm; body mass 80±4 kg; playing experience 14±4 years; weekly training practice 29±6 hours) were recruited. Anthropometric parameters (height, body mass, arm-racquet length, arm muscle area), jump performance (squat jump, counter movement jump; counter movement jump free), handgrip strength and first and second maximal serve speed were assessed. RESULTS: Pearson's correlation coefficient showed significant (P<0.05) positive relationships between height and ball speed in both the first (r=0.78; P=0.02) and second (r=0.80; P=0.017) serve, and a significant negative correlation between serve speed and arm muscle area in first serve only (r=-0.78; P=0.03). In addition, a trend towards a positive correlation was observed between string tensions and serves speed for both first and second serves (r=0.54; P=0.16 and r=0.60; P=0.11, respectively). No significant relationship was found between serve speed and the other variables considered, including jumping performance parameters. CONCLUSION: Height was confirmed to be the main anthropometric determinant of serves speed in professional tennis players.

Aerobic training program for the enhancements of HR and VO2 off-kinetics in elite judo athletes.

AIM: The purpose of this study was to investigate the physiologic and performance changes with the addition of high-intensity interval training (HIIT) to a traditional judo programme. METHODS: Nine elite judokas (6 males and 3 females; age: 20±4 yrs; body mass: 69±2 kg; height: 172±7 cm; judo practice time: 13±6 yrs; weekly training volume: 13±5 hours, mean±SD) were recruited to perform a 12-week specific aerobic training program, which consisted of 2 session/week of 30-min continuous run at 60% at Vmax and one session/week of high-intensity interval training 15x1-min at 90% of Vmax with 1 min of active recovery at 60% of Vmax. Before and after the intervention all athletes performed a graded maximal exercise Test to measure maximal oxygen consumption (V̇O2max), ventilatory threshold (VT), maximal velocity (Vmax), heart rate (HR) and V̇O2 off kinetics. V̇O2 and HR recovery kinetics were evaluated on a breath-by-breath basis using a single component exponential function. Anaerobic capacity during specific movements was assessed with the Special judo fitness Test (SJFT). RESULTS: The maximal speed reached during the maximal aerobic power test significantly increaseed (P=0.04), but V̇O2max did not change. τ of HR and of V̇O2 recovery significantly decreased by 17.3% (P=0.04) and 22.0% (P<0.01), respectively. VT increased (6.6%; P=0.03) and the SJFT Index improved (12%; P<0.001) 12% after training. CONCLUSION: The aerobic fitness of elite judokas may be improved by adding aerobic routines to the normal training enhancing the recovery capacity.

Erythrocyte Na+,K+,Cl- cotransport and kidney function in essential hypertension.

OBJECTIVE: To determine whether essential hypertensive patients with high Na+,K+,Cl- cotransport (COT) display alterations of some indices of kidney tubular reabsorption similar to those observed in Milan hypertensive (MHS) rats, which have high COT in both erythrocytes and kidney tubular cells, and hypertension caused by a primary increase of tubular reabsorption. DESIGN: Two sets of experiments were performed. First, renal function in two subgroups of hypertensive patients (one with 'high' and one with 'normal' COT was compared with that in normotensive controls. Secondly, the natriuretic and diuretic effects of a single oral dose of frusemide (25 mg) were analysed in six high- and in six normal- COT hypertensive patients. RESULTS: Compared with normotensives and with normal-COT hypertensives, high-COT hypertensives had lower fractional uric acid excretion and plasma renin activity with similar glomerular filtration rate and urinary sodium and potassium excretion. COT was negatively correlated with fractional uric acid excretion in the essential hypertensive patients but not in the normotensives. The diuretic natriuretic response to frusemide was much higher in high- than in normal-COT hypertensives. CONCLUSION: These results are consistent with the hypothesis that patients with high COT have abnormal renal handling of sodium similar to that observed in MHS rats.

Protein S mRNA in patients with protein S deficiency.

A protein S gene polymorphism, detectable by restriction analysis (BstXI) of amplified exonic sequences (exon 15), was studied in seven Italian families with protein S deficiency. In the 17 individuals heterozygous for the polymorphism the study was extended to platelet mRNA through reverse transcription, amplification and densitometric analysis. mRNA produced by the putative defective protein S genes was absent in three families and reduced to a different extent (as expressed by altered allelic ratios) in four families. The allelic ratios helped to distinguish total protein S deficiency (type I) for free protein S deficiency (type IIa) in families with equivocal phenotypes. This study indicates that the study of platelet mRNA, in association with phenotypic analysis based upon protein S assays in plasma, helps to classify patients with protein S deficiency.

Factor V gene mutation is a risk factor for cerebral venous thrombosis.

To evaluate the association between coagulation defects and cerebral venous thrombosis, a case-control study was conducted in 25 patients who had no autoimmune, neoplastic or infections disease and 75 healthy individuals. There were no patients with deficiency of protein C or protein S. Four had resistance to activated protein C (APC) and one had APC resistance associated with antithrombin deficiency. APC resistance was investigated by DNA analysis, and diagnosed by the presence of a point mutation in the factor V gene, which predicts replacement of Arg506 with Gln at one of the two APC cleavage sites in activated factor V. The prevalence of APC resistance was 20% in patients and 2.7% in controls. This difference was statistically significant (p = 0.01) and the odds ratio was 9.1. A circumstantial factor predisposing to cerebral venous thrombosis (such as oral contraceptive intake, pregnancy, puerperium, trauma or prolonged immobilization) was reported in 72% of cases. In conclusion, APC resistance is the most frequent coagulation abnormality associated with cerebral venous thrombosis.

A 23bp insertion in the endothelial protein C receptor (EPCR) gene impairs EPCR function.

EPCR is a type I transmembrane protein, highly expressed on the endothelium of large vessels, that binds protein C and augments its activation. In this study, a 23bp insertion in the EPCR gene was found in 4/198 survivors of myocardial infarction and 3/194 patients with deep vein thrombosis. The EPCR gene with the insertion predicts a protein that lacks part of the extracellular domain, the transmembrane domain and the cytoplasmic tail. Expression studies showed that the truncated protein is not localized on the cell surface, cannot be secreted in the culture medium, and does not bind activated protein C. Since protein C activation depends on the concentration of EPCR, patients with the EPCR insertion could have a diminished protein C activation capacity. Further clinical studies of adequate samples size are necessary to establish whether or not the EPCR insertion predisposes to the development of thrombotic events.

Genetic risk factors in young adults with 'cryptogenic' ischemic cerebrovascular disease.

Mutations such as factor V Leiden G1691A (FVL), prothrombin G20210A (FIIM), methylenetetrahydrofolate reductase (MTHFR) C677T, cystathionine beta-synthase (CBS) 844ins68 and endothelial cell protein C receptor (EPCR) 4031ins23 are risk factors for thromboembolism. To assess the role of these mutations in young adults with cerebral ischemia of otherwise undetermined etiology, 93 patients younger than 50 years old with thromboembolic strokes or transient ischemic attacks were studied. One hundred and eighty-six healthy age-matched and sex-matched blood donors served as controls. The FVL mutation was detected in 15/93 patients and 13/186 controls. After adjustment for smoking, arterial hypertension, and hyperlipidemia, the association of the FVL mutation with cerebral ischemia [odds ratio (OR), 3.19; 95% confidence interval (CI), 1.38-7.39] remained significant. One of 93 patients and 6/186 controls were carriers of FIIM (OR, 0.33; 95% CI, 0.04-2.75). We detected the MTHFR TT677 genotype in 9/93 patients and 26/186 controls (OR, 0.66; 95% CI, 0.30-1.47), a CBS 844ins68 mutation in 12/93 patients and 19/186 controls (OR, 1.30; 95% CI, 0.60-2.81), and an EPCR 4031ins23 mutation in 1/93 patients and in no control individual (P = 0.33). In conclusion, in younger adults the FVL mutation is a risk factor for cerebrovascular disease. FIIM, the MTHFR TT677 genotype and the CBS 844ins68 mutation did not contribute to the risk in this group of patients. The EPCR 4031ins23 mutation is very rare, its possible role needs further investigation.

Body composition assessment in spinal cord injury subjects.

Total and segmental body composition (fat mass, FM; fat-free mass, FFM; bone mineral density, BMD) were evaluated in 13 sedentary spinal cord injury (SCI) subjects and in 13 able-bodied healthy males (control, C) using dual X-ray absorptiometry (DXA) and skinfold methods. In the SCI group, total FM was significantly higher (31.1+/-8.2 vs. 20.8+/-6.9%) and total FFM was significantly lower (62.2+/-8.9 vs. 73.5+/-6.4%) than in C subjects. Total BMD did not differ between the SCI and C groups (1.20+/-0.11 vs. 1.30+/-0.11 g/cm(2)). In the SCI group, segmental FM was higher in the legs and trunk, whereas BMD was lower in legs only. The skinfold method significantly underestimated FM in the SCI group. Body composition is severely modified in paralyzed segments. The predictive equations developed for healthy populations appear to be inapplicable to SCI subjects.

Cardiovascular adaptation to mudpack therapy in hypertensive subjects treated with different antihypertensive drugs.

OBJECTIVE: In selected hypertensive subjects, cardiovascular adaptation to warm environments may be inadequate or even harmful: heating associated to mudpack therapy may cause unexpected hypotension. How different antihypertensive drugs may affect the cardiovascular response to mudpack therapy is poorly studied. AIMS: To evaluate the effects of ß-blockers and angiotensin II receptor antagonists/ACE inhibitors on the acute cardiovascular adaptation to mudpack treatment in SPA in elderly hypertensive patients. PATIENTS AND METHODS: Thirty-one elderly subjects were divided in normotensive subjects (N; n=10) and hypertensive patients treated with ACE-inhibitors/Angiotensin II receptor antagonists (HTA; n=12) or with selective ß1-blockers (HTB; n=9). Systolic (SBP) and diastolic (DBP) blood pressure were continuously recorded (10 min) in supine position, immediately before and during mudpack treatment (40°C). Heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were assessed. RESULTS: During mudpack treatment SBP did not significantly change in both HTA and N groups (132±11 and 112±13 mmHg, respectively), but significantly decreased in HTB (111±18 mmHg, p < 0.01 vs baseline) patients. HR increased in all groups (HTA: 72±10 bpm; HTB: 65±6 bpm; N: 70±10 bpm; p < 0.01 vs baseline). A significant reduction (p < 0.01 vs baseline) in SV and CO occurred in HTB, but not in HTA and N groups. TPR significantly increased in HTB (1335±464 dyn.s.cm-5, p < 0.01 vs baseline) but not in HTA and N subjects (1389±385 dyn.s.cm-5 and 1245±323 dyn.s.cm-5, respectively). CONCLUSIONS: Mud treatment did not cause relevant haemodynamic changes in normotensive and HTA-treated hypertensive subjects. Conversely, ß-blocking treatment apparently limited the cardiovascular adaptation to thermic stress, through a possible reduction in myocardial contractility, thereby, causing a significant decrease, although not dangerous, in systolic blood pressure.

Polymorphisms of alpha-actinin-3 and ciliary neurotrophic factor in national-level Italian athletes.

AIM: The R577X polymorphism of the alpha-actinin-3 (ACTN3) gene and the IVS1-6G>A polymorphism of the ciliary neurotrophic factor (CNTF) gene have been associated with a favourable muscle phenotype (more muscle fibres with high glycolytic activity), reduced predisposition for congenital dystrophy and resistance to sarcopenia in old age. The aim of this study was to look for evidence of selective pressure towards genotypes favourable for strong muscle activity in a sample of national-level Italian athletes. METHODS: We analysed two stop codon polymorphisms in the DNA of 50 Italian athletes, specialised in power or endurance sports, and compared their genotypic distribution with those of a population of 50 controls. In a representative sub-group of athletes (N.=42) we then compared the genetic data with anaerobic threshold, assessed by an incremental exercise test up to exhaustion. RESULTS: The athlete group showed an allelic distribution of ACTN3 (R/R:64%, R/X:16%, X/X:20%) and CNTF (G/G:72%, G/A:26%, A/A:2%), significantly imbalanced towards alleles R/R and G/G, respectively, compared to controls (ACTN3=R/R:40% R/X:22% X/X:38% and CNTF=G/G:52%, G/A:24%, A/A:24%) (p=0.0024 and p=0.0001, respectively). Only the ACTN3 577X/X polymorphism showed a significant association with the anaerobic threshold of athletes (F-ratio= 4.037; p=0.025). Factorial ANOVA demonstrated a non significant interaction between favourable allelic patterns of ACTN3 and CNTF genes on aerobic performance in the athlete group. CONCLUSION: The relationship found between favourable muscle phenotype and this genetic profile may have interesting implications in sport performance and training, athlete selection and different clinical activities, such as physical rehabilitation and modifying phenotypes associated with neuromuscular diseases.

Wearable seismocardiography: towards a beat-by-beat assessment of cardiac mechanics in ambulant subjects.

Seismocardiogram (SCG) is the measure of the micro-vibrations produced by the heart contraction and blood ejection into the vascular tree. Over time, a large body of evidence has been collected on the ability of SCG to reflect cardiac mechanical events such as opening and closure of mitral and aortic valves, atrial filling and point of maximal aortic blood ejection. We recently developed a smart garment, named MagIC-SCG, that allows the monitoring of SCG, electrocardiogram (ECG) and respiration out of the laboratory setting in ambulant subjects. The present pilot study illustrates the results of two different experiments performed to obtain a first evaluation on whether a dynamical assessment of indexes of cardiac mechanics can be obtained from SCG recordings obtained by MagIC-SCG. In the first experiment, we evaluated the consistency of the estimates of two indexes of cardiac contractility, the pre-ejection period, PEP, and the left ventricular ejection time, LVET. This was done in the lab, by reproducing an experimental protocol well known in literature, so that our measures derived from SCG could have been compared with PEP and LVET reference values obtained by traditional techniques. Six healthy subjects worn MagIC-SCG while assuming two different postures (supine and standing); PEP was estimated as the time interval between the Q wave in ECG and the SCG wave corresponding to the opening of aortic valve; LVET was the time interval between the SCG waves corresponding to the opening and closure of the aortic valve. The shift from supine to standing posture produced a significant increase in PEP and PEP/LVET ratio, a reduction in LVET and a concomitant rise in the LF/HF ratio in the RR interval (RRI) power spectrum. These results are in line with data available in literature thus providing a first support to the validity of our estimates. In the second experiment, we evaluated in one subject the feasibility of the beat-by-beat assessment of LVET during spontaneous behavior. The subject was continuously monitored by the smart garment from 8 am to 8 pm during a workday. From the whole recording, three data segments were selected: while the subject was traveling to work (M1), during work in the office (O) and while traveling back home (M2). LVET was estimated on a beat-by-beat basis from SCG and the RRI influence was removed by regression analysis. The LVET series displayed marked beat-by-beat fluctuations at the respiratory frequency. The amplitude of these fluctuations changed in the three periods and was lower when the LF/HF RRI power ratio was higher, at O, thus suggesting a possible influence of the autonomic nervous system on LVET short-term variability. To the best of our knowledge this case report provides for the first time a representation of the beat-by-beat dynamics of a systolic time interval during daily activity. The statistical characterization of these findings remains to be explored on a larger population.

Nutritional counselling in disabled people: effects on dietary patterns, body composition and cardiovascular risk factors.

AIM: Disabled persons are frequently affected by nutritional status impairment, consequent to quantitative and qualitative inadequacy of diet and physical inactivity, resulting in a significant reduction of fat-free mass and bone mineral density (BMD), and an over-expression of fat mass and an increased number of biochemical risk factors for chronic degenerative diseases. The aim of this study was to analyse the applicability and the efficacy of a nutritional counselling intervention in order to improve dietary intake and nutritional status in disabled people. METHODS: Thirty-seven disabled subjects (24 with physical disability and 13 with both mental retardation and physical disability; age 33.5+/-9.2 years) underwent an assessment of nutritional status, and an intervention with nutritional counselling was proposed to each patient for one year. Anthropometric measurements, indirect calorimetry, dual-energy X-ray absorptiometry, dietary intake, and biochemical analysis at baseline (T0) and after one year (T1) of counselling intervention were performed. RESULTS: Sixty-five percent of patients dropped out. Overall, no significant improvement in cardiovascular risk factors, body composition and dietary patterns was reported at T1 in completer subjects. Six subjects who were obese or overweight at T0, reported significant weight and fat mass (FM) reduction at T1 (P=0.01 and P=0.00, respectively). CONCLUSION: Nutritional counselling seems to be ineffective and poorly applicable to disabled people. Further studies should be directed towards a treatment program associated with careful screening, motivation analysis, and follow-up in this patient population.