-
Contemporary Clinical Trials Aug 2023As the global population ages, the prevalence of cognitive decline and dementia is expected to rise, creating a significant health and economic burden. The purpose of...
As the global population ages, the prevalence of cognitive decline and dementia is expected to rise, creating a significant health and economic burden. The purpose of this trial is to rigorously test, for the first time, the efficacy of yoga training as a physical activity intervention to mitigate age-related cognitive decline and impairment. We are conducting a 6-month randomized controlled trial (RCT) of exercise among 168 middle aged and older adults to compare the efficacy of yoga vs. aerobic exercise on cognitive function, brain structure and function, cardiorespiratory fitness, and circulating inflammatory and molecular markers. Using a single-blind, three arm RCT, 168 older adults ages 55-79 will be assigned to either: a Hatha yoga group, an aerobic exercise group or a stretching-toning active control group. Participants will engage in hour long group exercise 3x/week for 6-months. A comprehensive neurocognitive test battery, brain imaging, cardiovascular fitness test, and a blood draw will take place at baseline; end of the 6-month intervention, and at 12-month follow-up. Our primary outcomes of interest are brain regions, such as hippocampal volume and prefrontal cortex, and cognitive functions, such as episodic memory, working memory and executive functions, that are typically affected by aging and Alzheimer's disease. Not only will this RCT test whether yoga is a means to mitigate age-related cognitive decline, but it may also offer an alternative to aerobic exercise, which could be particularly appealing to older adults with compromised physical functioning. ClinicalTrials.gov Identifier: NCT04323163.
Topics: Middle Aged; Humans; Aged; Yoga; Exercise; Cognition; Executive Function; Alzheimer Disease; Exercise Therapy; Randomized Controlled Trials as Topic
PubMed: 37244365
DOI: 10.1016/j.cct.2023.107240 -
Gut and Liver Jul 2023
Topics: Humans; Non-alcoholic Fatty Liver Disease; Resistance Training; Exercise; Liver; Insulin Resistance
PubMed: 37449428
DOI: 10.5009/gnl230236 -
Journal of Health Psychology Sep 2023This study investigated the effects of resistance training (RT) on the sleep quality of patients with fibromyalgia (FM), through a systematic review. The search was... (Review)
Review
This study investigated the effects of resistance training (RT) on the sleep quality of patients with fibromyalgia (FM), through a systematic review. The search was carried out in the PubMed, Embase, Scopus, and Web of Science databases. Initially, 148 studies were found, of which six were included for qualitative analysis. Four studies showed significant improvement in sleep after RT. Compared to other exercise modalities, RT proved to be superior to flexibility training and equivalent to aerobic exercise. Interventions lasted from 4 to 21 weeks, the weekly frequency ranged from two to three times, and the intensity ranged from 40% to 80% 1RM, with exercises for the major muscle groups. RT is an intervention that can be used to treat FM, however, more studies are needed to verify its effectiveness in improving sleep.
Topics: Humans; Fibromyalgia; Resistance Training; Exercise Therapy; Exercise; Sleep
PubMed: 37183814
DOI: 10.1177/13591053231172288 -
American Journal of Physiology. Heart... Jan 2024Vascular aging, featuring endothelial dysfunction and large elastic artery stiffening, is a major risk factor for the development of age-associated cardiovascular... (Review)
Review
Vascular aging, featuring endothelial dysfunction and large elastic artery stiffening, is a major risk factor for the development of age-associated cardiovascular diseases (CVDs). Vascular aging is largely mediated by an excessive production of reactive oxygen species (ROS) and increased inflammation leading to reduced bioavailability of the vasodilatory molecule nitric oxide and remodeling of the arterial wall. Other cellular mechanisms (i.e., mitochondrial dysfunction, impaired stress response, deregulated nutrient sensing, cellular senescence), termed "hallmarks" or "pillars" of aging, may also contribute to vascular aging. Gonadal aging, which largely impacts women but also impacts some men, modulates the vascular aging process. Regular physical activity, including both aerobic and resistance exercise, is a first-line strategy for reducing CVD risk with aging. Although exercise is an effective intervention to counter vascular aging, there is considerable variation in the vascular response to exercise training with aging. Aerobic exercise improves large elastic artery stiffening in both middle-aged/older men and women and enhances endothelial function in middle-aged/older men by reducing oxidative stress and inflammation and preserving nitric oxide bioavailability; however, similar aerobic exercise training improvements are not consistently observed in estrogen-deficient postmenopausal women. Sex differences in adaptations to exercise may be related to gonadal aging and declines in estrogen in women that influence cellular-molecular mechanisms, disconnecting favorable signaling in the vasculature induced by exercise training. The present review will summarize the current state of knowledge on vascular adaptations to regular aerobic and resistance exercise with aging, the underlying mechanisms involved, and the moderating role of biological sex.
Topics: Middle Aged; Female; Humans; Male; Aged; Nitric Oxide; Endothelium, Vascular; Aging; Exercise; Cardiovascular Diseases; Inflammation; Estrogens; Vascular Stiffness
PubMed: 37921669
DOI: 10.1152/ajpheart.00392.2023 -
Heart Failure Reviews Sep 2023Exercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart... (Review)
Review
Exercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart failure, there is still no consensus on their prescription in patients hospitalized with acute heart failure undergoing clinical stabilization. The aim of this study is to identify the literature on exercise programs encompassing the components of aerobic and resistance training for hospitalized patients admitted for acute heart failure. A scoping review was conducted according to the proposed methodology of the Joanna Briggs Institute. Studies with adults over 18 years old, hospitalized, and diagnosed with acute heart failure who participated in aerobic and resistance exercise training programs during their hospital stay were included. Three studies met the inclusion criteria. One was a retrospective, observational analytical cohort study, in which the main outcome of the exercise program was improvement in the previous disabilities of the participants. The other two were multicenter randomized controlled studies that showed greater improvement in physical function, functional capacity, depression, quality of life, and frailty status in the intervention groups. The exercise prescriptions differed according to the principles of the exercise prescription-frequency of exercise, intensity of exercise, exercise time (duration), type (mode), exercise volume, and progression. It is too early to make recommendations based on evidence of the type structure of an exercise program with aerobic and strength-training components in this population. However, in the exercise programs of the reviewed studies, the predominance of light to moderate intensity and the importance of progressively increase the frequency and duration of the training sessions were demonstrated, with bicycle ergometers and walking being the most common types of aerobic exercises. It is recommended that investment and research in this area should continue with more methodologically robust studies.
Topics: Adult; Humans; Adolescent; Resistance Training; Quality of Life; Inpatients; Cohort Studies; Retrospective Studies; Exercise; Exercise Therapy; Heart Failure; Multicenter Studies as Topic
PubMed: 37046104
DOI: 10.1007/s10741-023-10311-8 -
Cells Oct 2023Accelerated biological vascular ageing is still a major driver of the increasing burden of cardiovascular disease and mortality. Exercise training delays this process,... (Review)
Review
Accelerated biological vascular ageing is still a major driver of the increasing burden of cardiovascular disease and mortality. Exercise training delays this process, known as early vascular ageing, but often lacks effectiveness due to a lack of understanding of molecular and clinical adaptations to specific stimuli. This narrative review summarizes the current knowledge about the molecular and clinical vascular adaptations to acute and chronic exercise. It further addresses how training characteristics (frequency, intensity, volume, and type) may influence these processes. Finally, practical recommendations are given for exercise training to maintain and improve vascular health. Exercise increases shear stress on the vascular wall and stimulates the endothelial release of circulating growth factors and of exerkines from the skeletal muscle and other organs. As a result, remodeling within the vascular walls leads to a better vasodilator and -constrictor responsiveness, reduced arterial stiffness, arterio- and angiogenesis, higher antioxidative capacities, and reduced oxidative stress. Although current evidence about specific aspects of exercise training, such as F-I-T-T, is limited, and exact training recommendations cannot be given, some practical implications can be extracted. As such, repeated stimuli 5-7 days per week might be necessary to use the full potential of these favorable physiological alterations, and the cumulative volume of mechanical shear stress seems more important than peak shear stress. Because of distinct short- and long-term effects of resistance and aerobic exercise, including higher and moderate intensities, both types of exercise should be implemented in a comprehensive training regimen. As vascular adaptability towards exercise remains high at any age in both healthy individuals and patients with cardiovascular diseases, individualized exercise-based vascular health prevention should be implemented in any age group from children to centenarians.
Topics: Child; Humans; Aged, 80 and over; Exercise; Muscle, Skeletal; Antioxidants; Aging; Oxidative Stress; Cardiovascular Diseases
PubMed: 37947622
DOI: 10.3390/cells12212544 -
Molecular & Cellular Proteomics : MCP Aug 2023Regular exercise has many favorable effects on human health, which may be mediated in part by the release of circulating bioactive factors during each bout of exercise....
Regular exercise has many favorable effects on human health, which may be mediated in part by the release of circulating bioactive factors during each bout of exercise. Limited data exist regarding the kinetic responses of plasma proteins during and after acute exercise. Proteomic profiling of 4163 proteins was performed using a large-scale, affinity-based platform in 75 middle-aged adults who were referred for treadmill exercise stress testing. Plasma proteins were quantified at baseline, peak exercise, and 1-h postexercise, and those with significant changes at both exercise timepoints were further examined for their associations with cardiometabolic traits and change with aerobic exercise training in the Health, Risk Factors, Exercise Training and Genetics Family Study, a 20-week exercise intervention study. A total of 765 proteins changed (false discovery rate < 0.05) at peak exercise compared to baseline, and 128 proteins changed (false discovery rate < 0.05) at 1-h postexercise. The 56 proteins that changed at both timepoints included midkine, brain-derived neurotrophic factor, metalloproteinase inhibitor 4, and coiled-coil domain-containing protein 126 and were enriched for secreted proteins. The majority had concordant direction of change at both timepoints. Across all proteins assayed, gene set enrichment analysis showed increased abundance of coagulation-related proteins at 1-h postexercise. Forty-five proteins were associated with at least one measure of adiposity, lipids, glucose homeostasis, or cardiorespiratory fitness in Health, Risk Factors, Exercise Training and Genetics Family Study, and 20 proteins changed with aerobic exercise training. We identified hundreds of novel proteins that change during acute exercise, most of which resolved by 1 h into recovery. Proteins with sustained changes during exercise and recovery may be of particular interest as circulating biomarkers and pathways for further investigation in cardiometabolic diseases. These data will contribute to a biochemical roadmap of acute exercise that will be publicly available for the entire scientific community.
Topics: Adult; Middle Aged; Humans; Proteomics; Kinetics; Exercise; Blood Proteins; Cardiovascular Diseases
PubMed: 37343698
DOI: 10.1016/j.mcpro.2023.100601 -
Systematic Reviews Nov 2023Prehabilitation programs focusing on exercise training as the main component are known as a promising alternative for improving patients' outcomes before cancer surgery....
BACKGROUND
Prehabilitation programs focusing on exercise training as the main component are known as a promising alternative for improving patients' outcomes before cancer surgery. This systematic review determined the benefits and harms of prehabilitation programs compared with usual care for individuals with cancer.
METHODS
We searched CENTRAL, MEDLINE, and EMBASE from inception to June 2022, and hand searched clinical trial registries. We included randomized-controlled trials (RCTs) in adults, survivors of any type of cancer, that compared prehabilitation programs that had exercise training as the major component with usual care or other active interventions. Outcome measures were health-related quality of life (HRQL), muscular strength, postoperative complications, average length of stay (ALOS), handgrip strength, and physical activity levels. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias and the certainty of the evidence.
RESULTS
Twenty-five RCTs (2682 participants) published between 2010 and 2022 met our inclusion criteria. Colorectal and lung cancers were the most common diagnoses. The studies had methodological concerns regarding outcome measurement, selective reporting, and attrition. Five prehabilitation programs were compared to usual care (rehabilitation): combined training, aerobic training, respiratory muscle training plus aerobic training, respiratory muscle training plus resistance training, and pelvic floor training. The studies provided no clear evidence of an effect between groups. We assessed the overall certainty of the evidence as very low, downgraded due to serious study limitations and imprecision.
CONCLUSION
Prehabilitation programs focusing on exercise training may have an effect on adults with cancer, but the evidence is very uncertain. We have very little confidence in the results and the true effect is likely to be substantially different from these. Further research is needed before we can draw a more certain conclusion.
SYSTEMATIC REVIEW REGISTRATION
CRD42019125658.
Topics: Adult; Humans; Preoperative Exercise; Exercise; Exercise Therapy; Neoplasms; Resistance Training; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 37978411
DOI: 10.1186/s13643-023-02373-4 -
Frontiers in Endocrinology 2023To evaluate the effects of different durations of continuous aerobic exercise on prediabetic patients. (Meta-Analysis)
Meta-Analysis
AIMS
To evaluate the effects of different durations of continuous aerobic exercise on prediabetic patients.
MATERIALS AND METHODS
The research encompassed randomized controlled trials that examined how various durations of aerobic exercise training affected outcomes related to Body Mass Index (BMI), Fasting blood glucose (FBG), 2-hour plasma glucose (2hPG), and glycated hemoglobin (HbA1c) in individuals diagnosed with prediabetes. PubMed, Embase, Web of Science, and the Cochrane Library were searched as of January 7, 2023. The Cochrane Risk of Bias, version 2 (ROB 2) tool was used to assess the risk of bias.
RESULTS
A total of 10 RCTs with 815 prediabetic patients were included. The average age of the participants was 56.1 years, with a standard deviation of 5.1 years. Among the participants, 39.2% were male. The interventions consisted of aerobic dance, treadmill running, walking, and a combination of aerobic exercises. The training sessions occurred three or four times per week. In prediabetic patients, aerobic exercise demonstrated a significant reduction in BMI compared to the control group, with a weighted mean difference (WMD) of -1.44 kg/m (95% confidence interval [CI] -1.89, -0.98). There was a decrease in FBG levels, with WMD of -0.51 mmol/L (95% CI -0.70, -0.32). Additionally, aerobic training led to significant improvements in 2hPG levels, with a WMD of -0.76 mmol/L (95% CI -1.14, -0.38). Furthermore, prediabetic patients showed a decrease in HbA1c levels after engaging in aerobic training compared to the control group, with a WMD of -0.34% (95% CI -0.45, -0.23).
CONCLUSION
In summary, engaging in aerobic exercise can have a significant positive impact on glycemic levels in individuals with prediabetes. It can also lead to reductions in BMI, FBG, 2hPG, HbA1c, and other relevant indicators. The extent of these improvements may vary slightly depending on the duration of the aerobic exercise intervention.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023395515.
Topics: Female; Humans; Male; Middle Aged; Diabetes Mellitus, Type 2; Exercise; Exercise Therapy; Glycated Hemoglobin; Prediabetic State
PubMed: 37522127
DOI: 10.3389/fendo.2023.1227489 -
Gut and Liver Jul 2023
Topics: Humans; Non-alcoholic Fatty Liver Disease; Resistance Training; Insulin Resistance; Exercise; Liver
PubMed: 37449429
DOI: 10.5009/gnl230232