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There is increasing interest in the role of physical exercise as a therapeutic strategy for individuals with Alzheimer's disease (AD). We assessed the effect of 26 weeks (6 months) of a supervised aerobic exercise program on memory, executive function, functional ability and depression in early AD. This study was a 26-week randomized controlled trial comparing the effects of 150 minutes per week of aerobic exercise vs. non-aerobic stretching and toning control intervention in individuals with early AD. A total of 76 well-characterized older adults with probable AD (mean age 72.9 [7.7]) were enrolled and 68 participants completed the study. Exercise was conducted with supervision and monitoring by trained exercise specialists. Neuropsychological tests and surveys were conducted at baseline,13, and 26 weeks to assess memory and executive function composite scores, functional ability (Disability Assessment for Dementia), and depressive symptoms (Cornell Scale for Depression in Dementia). Cardiorespiratory fitness testing and brain MRI was performed at baseline and 26 weeks. Aerobic exercise was associated with a modest gain in functional ability (Disability Assessment for Dementia) compared to individuals in the ST group (X2 = 8.2, p = 0.02). There was no clear effect of intervention on other primary outcome measures of Memory, Executive Function, or depressive symptoms. However, secondary analyses revealed that change in cardiorespiratory fitness was positively correlated with change in memory performance and bilateral hippocampal volume. Aerobic exercise in early AD is associated with benefits in functional ability. Exercise-related gains in cardiorespiratory fitness were associated with improved memory performance and reduced hippocampal atrophy, suggesting cardiorespiratory fitness gains may be important in driving brain benefits. ClinicalTrials.gov NCT01128361.

An inverse association between physical activity or fitness status and health outcomes has been reported by several cohort studies. When fitness categories are established in quartiles or quintiles based on the peak exercise capacity achieved, the association is graded. Although significant health benefits of increased cardiorespiratory fitness (CRF) have been uniformly reported, the degree of protection has varied substantially between studies. This variability is likely due to varying methods used to define CRF categories, and not considering age, despite its strong effect on CRF. To ameliorate these methodological discrepancies, we propose standardized guidelines by which age-specific CRF categories should be defined.

The purpose of the present study was to investigate the effect of a short-term, high-intensity, low-volume Mixed Martial Arts (MMA) specific strength and conditioning training program on performance in national level MMA athletes. Seventeen experienced fighters were divided into two groups: (A) Specific Training Group (STG; n = 10), which followed a specific strength and conditioning program designed according to the demands of MMA competition and (B) Regular Training Group (RTG; n = 7), in which participants followed a regular strength and conditioning program commonly used by MMA athletes. Before and after the four-week training period (3 days per week), body composition, aerobic fitness, strength, power and speed were evaluated. Significant improvements in estimated VO , average power during the 2000 m rowing, bench press, back squat and deadlift 1RM, SJ power, CMJ height power, medicine ball throw velocity, 10 m sprint and 2 m take down speed and fat-free mass were found only in the STG (3.7 to 22.2%; p < 0.05; Hedge's g = -0.42 - 4.1). No significant changes were found for the RTG (p = 0.225 to 0.811). Significant differences between the groups were found for almost all post-training assessments (p < 0.05; Hedge's g = 0.25 - 1.45) as well as for the percentage changes from pre to post training (p < 0.05; Hedge's g: 0.25 - 1.45). Significant relationships were found between percentage changes in fat-free mass, endurance capacity, muscle strength/power and speed (r: -0.475 to 0.758; p < 0.05). These results suggest that a high-intensity low-volume strength and conditioning training intervention designed according to the demands of MMA competition may result in significant performance improvements for well-trained fighters.

Modifying basal elongation of elastic bands (EB) has been proven useful to increase some parameters of the intensity in variable resistance training. Therefore, the question arises as to whether the pertinent resistance could be applied with EB immediately above the sticking point in squat exercises to optimize the performance. The purpose was to analyze some variables of the external (kilograms and number of repetitions) and internal load (heart rate, blood pressure, and rate of perceived exertion) after six different conditions of the squat exercise when using weight plates (WP) or EB (placed at different points of the range of motion) and applying maximal or submaximal effort. Twenty physically active males (25.50 ± 5.26 yrs) underwent two sessions for familiarization and one for assessment. The six conditions (three with WP and three with EB) were randomly performed. The sticking point of each subject was measured using the knee joint angle and the resistance was applied with EB at this height. Immediately after finishing each set subjects reported perceived effort rate and cardiovascular measurements were taken. Repetitions completed, and kilograms used were recorded. Repeated measures testing evaluated differences between conditions. EB permitted performing 8 more repetitions compared to WP when the same load was added at standing position. Adding the load immediately above the sticking point significantly (p < 0.05) increased 24.7% the kilograms used and permitted participants to perform 3 more repetitions. Internal load measurements suggested that EB could significantly (p < 0.05) reduce the perceived effort rate and/or physiological stress depending on their application. EB are a suitable device to load the bar for squat exercises in fit young men. According to the necessities of the subjects, if the load with EB is added at different points of the range of motion, it could be possible to overcome the sticking point, to maximize the performance and/or modulate cardiovascular and perceptual responses.

This study investigated the effects of acute and repeated ischemic preconditioning (IPC) on recovery following high-intensity swim training. Thirty male amateur freestyle swimmers (21 ± 1 years, with at least 2 years of training experience) were randomly assigned to one of three groups: sham IPC (SHAM, n = 10, 4×5 min, 20 mmHg), acute IPC (AIPC, n = 10, 4×5 min, 220 mmHg), or repeated IPC (RIPC, n = 10, 7 days×4×5 min, 220 mmHg). A 7×200m swim incremental load training was conducted 20 minutes after the intervention. External load measures (grip strength, upper limb work, lower limb relative peak torque, average power) and internal load measures [limb circumferences, creatine kinase (CK), malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), total antioxidant capacity (T-AOC), interleukin-6 (IL-6), C-reactive protein (CRP)] were recorded at baseline, immediately, 24h and 48h post exercise. For external load, RIPC exhibited higher upper limb total work and average power than SHAM at all post-training points (P < 0.05), while AIPC exceeded SHAM at 48h (P < 0.05). For internal load, immediately post-training, RIPC had higher T-AOC, lower MDA and IL-6 than the other two groups (P < 0.05); AIPC showed lower MDA than SHAM (P < 0.05). At 24h, RIPC had higher T-AOC than the other two groups; both RIPC and AIPC had lower MDA and IL-6 than SHAM (P < 0.05). Moreover, RIPC had lower CK than SHAM at 24h and 48h (P < 0.05). Findings indicated that both AIPC and RIPC, compared to SHAM, promoted internal and external recovery following intensive swim training, with RIPC being more effective. These results suggest that incorporating repeated IPC sessions into athletes’ training routines could be a practical strategy to optimize recovery and improve subsequent performance.

Cardiovascular responses of traditional resistance (TS) training have been extensively explored. However, the fatigue mechanisms associated with an intra-set rest configuration (ISR) have not been investigated. This study compares two modalities of set configurations for resistance exercise that equates work to rest ratios and measures the central and peripheral fatigue in combination with cortical, hemodynamic and cardiovascular measures. 11 subjects performed two isometric knee extension training sessions using TS and ISR configurations. Voluntary activation (VA), single twitch amplitude, low frequency fatigue (LFF), Mwave, motor evoked potential (MEP), short intracortical inhibition (SICI), intracortical facilitation (ICF) and heart rate variability were evaluated before and after each training session. During each session beat to beat heart rate, blood pressure and rate pressure product (RPP) were also evaluated. After exercise VA decreased significantly for TS but not for ISR (P < 0.001), single twitch amplitude and LFF values were lower for TS than ISR (P < 0.004), and SICI was reduced only for the TS configuration (P = 0.049). During exercise RPP values were significantly higher for the TS than for ISR (P = 0.001). RPP correlated with VA for TS (r = -.85 P < 0.001) suggesting a relationship between central fatigue and cardiovascular stress. We conclude that ISR induced lower central and peripheral fatigue as well as lower cardiovascular stress in comparison with TS configuration. Our study suggests that set configuration is a key factor in the regulation of the neuromuscular and cardiovascular responses of resistance training.

This study investigated the efficacy of ischemic preconditioning (IPC) on the recovery of maximal aerobic performance and physiological responses compared with commonly used techniques. Nine endurance athletes performed two 5-km cycling time trials (TT) interspersed by 45 minutes of recovery that included either IPC, active recovery (AR) or neuromuscular electrical stimulation (NMES) in a randomized crossover design. Performance, blood markers, arterial O saturation (S O ), heart rate (HR), near-infrared spectroscopy-derived muscle oxygenation parameters and perceptual measures were recorded throughout TTs and recovery. Differences were analyzed using repeated-measures ANOVAs and Cohen's effect size (ES). The decrement in chronometric performance from TT1 to TT2 was similar between recovery modalities (IPC: -6.1 sec, AR: -7.9 sec, NMES: -5.4 sec, p = 0.84, ES 0.05). The modalities induced similar increases in blood volume before the start of TT2 (IPC: 13.3%, AR: 14.6%, NMES: 15.0%, p = 0.79, ES 0.06) and similar changes in lactate concentration and pH. There were negligible differences between conditions in bicarbonate concentration, base excess of blood and total concentration of carbon dioxide, and no difference in S O , HR and muscle O extraction during exercise (all p > 0.05). We interpreted these findings to suggest that IPC is as effective as AR and NMES to enhance muscle blood volume, metabolic by-products clearance and maximal endurance performance. IPC could therefore complement the athlete's toolbox to promote recovery.

Coronary effluent collected from ischemic preconditioning (IPC) treated hearts induces myocardial protection in non-ischemic-preconditioned hearts. So far, little is known about the number of IPC cycles required for the release of cardioprotective factors into the coronary effluent to successfully induce cardioprotection. This study investigated the cardioprotective potency of effluent obtained after various IPC cycles in the rat heart. Experiments were performed on isolated hearts of male Wistar rats, mounted onto a Langendorff system and perfused with Krebs-Henseleit buffer. In a first part, effluent was taken before (Con) and after each IPC cycle (Eff 1, Eff 2, Eff 3). IPC was induced by 3 cycles of 5 min of global myocardial ischemia followed by 5 minutes of reperfusion. In a second part, hearts of male Wistar rats were randomized to four groups (each group n = 4–5) and underwent 33 min of global ischemia followed by 60 min of reperfusion. The previously obtained coronary effluent was administered for 10 minutes before ischemia as a preconditioning stimulus. Infarct size was determined at the end of reperfusion by triphenyltetrazoliumchloride (TTC) staining. Infarct size with control effluent was 54±12%. Effluent obtained after IPC confers a strong infarct size reduction independent of the number of IPC cycles (Eff 1: 27±5%; Eff 2: 35±7%; Eff 3: 35±8%, each P<0.05 vs. Con). Effluent extracted after one cycle IPC is comparably protective as after two or three cycles IPC.

We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI). The statistical significance and heterogeneity were assessed with both Z-test and Q-test. A total of six RCTs including 651 recipients, were eventually identified. Compared to the controls, RIC could reduce the incidence of delayed graft function (DGF) after kidney transplantation (random-effects model: RR = 0.89; fixed-effect model: RR = 0.84). However, the decrease did not reveal statistical significance. The subgroup analysis by RIC type demonstrated no significant difference among the three interventions in protecting renal allografts against DGF. Furthermore, no significant difference could be observed in the incidence of acute rejection, graft loss, 50% fall in serum creatinine, as well as the estimated glomerular filtration rate and hospital stay between the RIC and Control groups. This meta-analysis suggested that RIC might exert renoprotective functions in human kidney transplantation, and further well-designed RCTs with large sample size are warranted to assess its clinical efficacy.

In healthy arteries, blood flow is regulated by microvascular tone assessed by changes in blood flow volume and vascular resistance to endothelium-dependent and -independent vasodilators. We developed a novel method of using intravascular ultrasound (IVUS) and a Doppler flow wire to measure changes in blood flow volume and vascular resistance of the profunda arterial bed. We assessed the variability over 6 months in measuring microvascular endothelium-dependent dilation to acetylcholine and endothelium-independent dilation to adenosine in 20 subjects who were part of a larger study of Gulf War Illness without obstructive peripheral artery disease. Vasomotor function was assessed by Infusions of control (dextrose), acetylcholine (10-6M), adenosine (50μg), and nitroglycerin (25μg/ml). 400 IVUS and 240 flow velocity images were measured a mean 6 (SD = 2) months apart blind to measurement and infusion stage. The mean (SD) baseline profunda flow was 227 (172) ml/min and vascular resistance 4.6 x 104 (2.4 x 104) dynes-s/cm5. The intraclass correlation coefficients for 6-month variability for vascular function were excellent (range 0.827-0.995). Bland-Altman analyses showed mean differences of less than 2% for microvascular endothelium-dependent function (flow volume and resistance) and less than 1% for macrovascular endothelium-dependent function with acceptable limits of agreement. In 49 subjects assessing concurrent validity of the technique against atherosclerosis risk factors, we observed greater impairment in microvascular endothelium-dependent function per year of age (flow volume = -1.4% (p = 0.018), vascular resistance = 1.5% (p = 0.015)) and current smoking (flow volume = -36.7% (p = .006), vascular resistance = 50.0% (p<0.001)). This novel method of assessing microvascular vasomotor function had acceptable measurement reproducibility and validity.