Meta-analysis of the effects of high-intensity intermittent exercise on cardiopulmonary function rehabilitation in patients with stroke

Objective:Systematically evaluate the rehabilitation effect of high-intensity intermittent exercise(HIIT)on cardiovascular function in stroke patients,in order to provide a basis for selecting the best rehabilitation plan for stroke patients.Methods:Computer retrieval of CNKI,WanFang Data,VIP,CBM,Pubmed,EMbase,Web of science,The Cochrane Library databases was conducted from the establishment of the database until March 2023.Randomized controlled trials on HIIT improving cardiovascular function in stroke patients were included,and the included literature was screened,data extracted,and bias risk evaluated.Then,metaanalysis was conducted using RevMan 5.4 software and Stata17.0 software.Results:In the end,9 articles met the research criteria,with a total of 428 patients.The meta-analysis results showed that compared with the control group,HIIT had significant effects on peak oxygen uptake(VO2peak)[MD=3.87,95%CI(3.43,4.31),P<0.00001],minute ventilation(VE)[MD=7.14,95%CI(4.34,9.94),P<0.00001],peak power(WRpeak)[MD=17.13,95%CI(13.7320.54),P<0.00001],6-minute walking distance(6MWD)[MD=43.82,95%CI(16.08,71.56),P=0.002],The intervention effect of the 10 meter walking test(10MWT)[MD=-2.00,95%CI(-2.91,-1.08),P<0.0001]was better than that of the control group.Conclusion:The current analysis results show that compared to conventional rehabilitation therapy or continuous aerobic exercise,HIIT has more advantages in improving the cardiopulmonary function of stroke patients.

Exercise as a modality to improve heart transplantation-related functional impairments: An article review

Heart transplantation(HT),the treatment choice of advanced heart failure pa-tients,is proven effective in increasing the survival and functional status of the recipients.However,compared to normal controls,functional status is lower in HT recipients.Exercise given in cardiac rehabilitation has been shown to improve exercise capacity as measured with peak oxygen uptake(VO2 peak)and muscle strength after completion of the program and cessation of exercise results in loss of exercise benefits.Several factors related to cardiac denervation and the use of immunosuppressive agents in HT recipients result in functional impairments including cardiovascular,pulmonary,exercise capacity,psychological,and qua-lity of life(QoL)problems.High-intensity interval training(HIIT)is the most common type of exercise used in HT recipients and given as a hospital-based program.Improvement of functional impairments was found to have occurred due to primarily musculoskeletal adaptations through improvement of muscle structure and aerobic capacity and cardiovascular adaptations.In general,exercise given after transplantation improved VO2 peak significantly and improvement was better in the HIIT group compared to moderate intensity continuous training or no-exercise groups.Improvement of QoL was ascribed to improve-ment of exercise capacity,symptoms,pulmonary function,physical capacity improve-ment,anxiety,and depression.

Impact of a single bout of high-intensity interval exercise and short-term interval training on interleukin-6, FNDC5, and METRNL mRNA expression in human skeletal muscle

Background: Exercise promotes numerous phenotypic adaptations in skeletal muscle that contribute to improved function and metabolic capacity. An emerging body of evidence suggests that skeletal muscle also releases a myriad of factors during exercise, termed "myokines". The purpose of this study was to examine the effects of high-intensity interval training(HIIT) on the acute regulation of the mRNA expression of several myokines, including the prototypical myokine interleukin-6(IL-6), and recently identified myokines fibronectin type III domain-containing protein 5(FNDC5)(irisin) and meteorin-like protein(METRNL).Methods: Both before and after a 20-day period of twice-daily high-volume HIIT, 9 healthy males(20.5 ± 1.5 years performed a standardized bout of high-intensity interval exercise(HIIE; 5 × 4 min at ~80% pretraining peak power output) with skeletal muscle biopsy samples(vastus lateralis) obtained at rest, immediately following exercise, and at 3 h recovery.Results: Before training, a single bout of HIIE increased IL-6(p < 0.05) and METRNL(p < 0.05) mRNA expression measured at 3 h recovery when compared to rest. Following 20 days of HIIT, IL-6 and FNDC5 mRNA were increased at 3 h recovery from the standardized HIIE bout when compared to rest(both p < 0.05). Resting METRNL and FNDC5 mRNA expression were higher following training(p < 0.05), and there was an overall increase in FNDC5 mRNA post-training(main effect of training, p < 0.05).Conclusion: In human skeletal muscle(1) an acute bout of HIIE can induce upregulation of skeletal muscle IL-6 mRNA both before and after a period of intensified HIIT;(2) Resting and overall FNDC5 mRNA expression is increased by 20 days of HIIT; and(3) METRNL mRNA expression is responsive to both acute HIIE and short-term intense HIIT. Future studies are needed to confirm these findings at the protein and secretion level in humans.

How does high-intensity intermittent training affect recreational endurance runners? Acute and chronic adaptations: A systematic review

Objective: This systematic review aimed to critically analyze the literature to determine how high-intensity intermittent training(HIIT) affects recreational endurance runners in the short-and long-term.Methods: Electronic databases were searched for literature dating from January 2000 to October 2015. The search was conducted using the key words "high-intensity intermittent training" or "high-intensity interval exercise" or "interval running" or "sprint interval training" and "endurance runners" or "long distance runners". A systematic approach was used to evaluate the 783 articles identified for initial review. Studies were included if they investigated HIIT in recreational endurance runners. The methodological quality of the studies was evaluated using the Physiotherapy Evidence Database(PEDro) scale(for intervention studies) and the modified Downs and Black Quality Index(for cross-sectional studies).Results: Twenty-three studies met the inclusionary criteria for review. The results are presented in 2 parts: cross-sectional(n = 15) and intervention studies(n = 8). In the 15 cross-sectional studies selected, endurance runners performed at least 1 HIIT protocol, and the acute impact on physiological, neuromuscular, metabolic and/or biomechanical variables was assessed. Intervention studies lasted a minimum of 4 weeks, with 10 weeks being the longest intervention period, and included 2 to 4 HIIT sessions per week. Most of these studies combined HIIT sessions with continuous run(CR) sessions; 2 studies' subjects performed HIIT exclusively.Conclusion: HIIT-based running plans(2 to 3 HIIT sessions per week, combining HIIT and CR runs) show athletic performance improvements in endurance runners by improving maximal oxygen uptake and running economy along with muscular and metabolic adaptations. To maximize the adaptations to training, both HIIT and CR must be part of training programs for endurance runners.

High-intensity interval training for health benefits and care of cardiac diseases——The key to an efficient exercise protocol

Aerobic capacity, which is expressed as peak oxygen consumption (VO2peak), is well-known to be an independent predictor of all-cause mortality and cardiovascular prognosis. This is true even for people with various coronary risk factors and cardiovascular diseases. Although exercise training is the best method to improve VO2peak, the guidelines of most academic societies recommend 150 or 75 min of moderate- or vigorous- intensity physical activities, respectively, every week to gain health benefits. For general health and primary and secondary cardiovascular prevention, high-intensity interval training (HIIT) has been recognized as an efficient exercise protocol with short exercise sessions. Given the availability of the numerous HIIT protocols, which can be classified into aerobic HIIT and anaerobic HIIT [usually called sprint interval training (SIT)], professionals in health-related fields, including primary physicians and cardiologists, may find it confusing when trying to select an appropriate protocol for their patients. This review describes the classifications of aerobic HIIT and SIT, and their differences in terms of effects, target subjects, adaptability, working mechanisms, and safety. Understanding the HIIT protocols and adopting the correct type for each subject would lead to better improvements in VO2peak with higher adherence and less risk.

Effect of high-intensity interval training in adolescents with asthma:The eXercise for Asthma with Commando Joe’s^(■)(X4ACJ)trial

Background:Higher levels of cardiorespiratory fitness are associated with reduced asthma severity and increased quality of life in those with asthma.Therefore,the purpose of this study was to evaluate the effectiveness of a 6-month high-intensity interval training(HIIT)intervention in adolescents with and without asthma.Methods:A total of 616 adolescents(334 boys;13.0±1.1 years,1.57±0.10 m,52.6±12.9 kg,mean±SD),including 155 with asthma(78 boys),were recruited as part of a randomized controlled trial from 5 schools(4 control and 1 intervention).The 221 intervention participants(116 boys;47 asthma)completed 6 months of school-based HIIT(30 min,3 times per week,10-30 s bouts at>90%age-predicted maximum heart rate with equal rest).At baseline,mid-intervention,post-intervention,and 3-month follow-up,measurements for 20-m shuttle run,body mass index(BMI),lung function,Pediatric Quality of Life Inventory,Paediatric Asthma Quality of Life Questionnaire,and Asthma Control Questionnaire were collected.Additionally,69 adolescents(39 boys(of the 36 with asthma there were 21 boys))also completed an incremental ramp test.For analysis,each group’s data(intervention and control)were divided into those with and without asthma.Results:Participants with asthma did not differ from their peers in any parameter of aerobic fitness,at any time-point,but were characterized by a greater BMI.The intervention elicited a significant improvement in maximal aerobic fitness but no change in sub-maximal parameters of aerobic fitness,lung function,or quality of life irrespective of asthma status.Those in the intervention group maintained their BMI,whereas BMI significantly increased in the control group throughout the 6-month period.Conclusion:HIIT represents an effective tool for improving aerobic fitness and maintaining BMI in adolescents,irrespective of asthma status.HIIT was well-tolerated by those with asthma,who evidenced a similar aerobic fitness to their healthy peers and responded equally well to a HIIT program.

Effectiveness of sub-maximal intermittent exercise on muscle glycogen depletion, PGC-1<i>α</i>and PDK-4 gene expression

Several metabolic gene expressions are regulated in concert with muscle glycogen status. We hypothesized that intermittent exercise performed at high but sub-maximal intensities with long recovery periods would induce a low glycogen state that would stimul- ate peroxisome proliferator-activated receptor-γ coa- ctivator-1α (PGC1-α) and pyruvate dehydrogenase kinase-4 (PDK-4) gene expression in muscle. Nine young human subjects performed two intermittent exercise sessions. One session consisted of 60 s cycling bouts at VO2max (IE100%), and the other session consisted of 75 s cycling bouts at 80% VO2max (IE80%). Twelve bouts of exercise were completed in both sessions with a 4 min rest between each bout. Muscle specimens were obtained at pre-exercise and immediately, 1.5 h and 3 h post-exercise. Muscle gly- cogen was significantly decreased after both sessions (IE100%, 94.1 ± 5.8 to 38.7 ± 5.5 mmol/kg w.w.;IE80%, 94.6 ± 9.1 to 53.3 ± 4.8 mmol/kg w.w.;both P α and PDK- 4 mRNA expression were significantly increased after exercise in both IE100% and IE80% (PGC-1α: ~3.7 and ~2.9-fold, respectively;PDK-4: ~11.1 and ~3.5-fold, respectively;all P 100% than in IE80% (P a and PDK-4 mRNA expression, suggesting that increasing exercise intensity contributes to muscle glycogen depletion and PDK-4 mRNA expression in human skeletal muscle.

Effect of intermittent anaerobic exercise combined with inhalant therapy on airway remodeling and inflammatory response in children with asthma

Objective: To study the effect of intermittent anaerobic exercise combined with inhalant therapy on airway remodeling and inflammatory response in children with asthma. Methods:A total of 92 children who were diagnosed with bronchial asthma in Zigong Third People's Hospital between June 2015 and February 2017 were selected as the research subjects and randomly divided into exercise group and control group who received intermittent anaerobic exercise combined with inhalant therapy and regular inhalant therapy respectively. Results:4 weeks and 8 weeks after intervention, serum MMP2, MMP3, MMP9, ADAM33,TGF-β1, Smad3, CTGF, PINP, PIIINP, IL-4, IL-9, IL-21, TNF-α and hs-CRP levels of both groups of patients were significantly lower than those before intervention while TIMP1 levels were significantly higher than those before intervention, and serum MMP2, MMP3, MMP9, ADAM33,TGF-β1, Smad3, CTGF, PINP, PIIINP, IL-4, IL-9, IL-21, TNF-α and hs-CRP levels of exercise group were significantly lower than those of control group while TIMP1 levels were significantly higher than those of control group. Conclusion: Intermittent anaerobic exercise combined with inhalant therapy can improve airway remodeling and inflammatory response in children with asthma.

Exercise interventions for patients with type 1 diabetes mellitus:A narrative review with practical recommendations

Type 1 diabetes mellitus(T1DM)is a chronic endocrine disease that results from autoimmune destruction of pancreatic insulin-producingβcells,which can lead to microvascular(e.g.,retinopathy,neuropathy,and nephropathy)and macrovascular complications(e.g.,coronary arterial disease,peripheral artery disease,stroke,and heart failure)as a consequence of chronic hyperglycemia.Despite the widely available and compelling evidence that regular exercise is an efficient strategy to prevent cardiovascular disease and to improve functional capacity and psychological well-being in people with T1DM,over 60%of individuals with T1DM do not exercise regularly.It is,therefore,crucial to devise approaches to motivate patients with T1DM to exercise,to adhere to a training program,and to inform them of its specific characteristics(e.g.,exercise mode,intensity,volume,and frequency).Moreover,given the metabolic alterations that occur during acute bouts of exercise in T1DM patients,exercise prescription in this population should be carefully analyzed to maximize its benefits and to reduce its potential risks.

High-Intensity Interval Training v/s Steady-State Cardio in Rehabilitation of Neurological Patients

Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.

Intense Exercise in the Quality of Life of Breast Cancer Survivors:A Meta-Analysis

The treatment of breast cancer (BC) leaves emotional and functional sequels affecting the quality of life (QOL) of the survivors. We aim to investigate, intense exercises in the rehabilitation of BC survivors. Using the systematic search model in the PubMed databases;Lilacs Bireme and Scielo. Meta-Analysis used the Meta package implemented in software R (version 3.3.2) p < 0.05. We selected 29 articles, and after reading in the Integra, we excluded 27 texts being included in the meta-analysis only 2. In the QOL, the heterogeneity in the emotional function showed a difference of 75%, in the social function 36% and in the physics 32%. Using intense exercises in BC survivors during rehabilitation improves overall QOL, muscle structure, and preserves functional capacity.

The effect of acute aerobic exercise on central arterial stiffness,wave reflections,and hemodynamics in adults with diabetes:A randomized cross-over design

Background:Individuals with diabetes have greater central arterial stiffness,wave reflections,and hemodynamics,all of which promote the accelerated cardiovascular pathology seen in this population.Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness,wave reflections,and hemodynamics in healthy individuals;however,the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes.Recently,implementation of high-intensity interval exercise(HIIE)has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise.Yet,the effect of HIIE on the aforementioned outcomes in people with diabetes is not known.The purpose of this study was to(i)describe the central arterial stiffness,wave reflections,and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise(MICE)in adults with diabetes;and(ii)compare the effects of HIIE and MICE on the aforementioned outcomes.Methods:A total of 24 adult men and women(aged 29-59 years old)with type 1(n=12)and type 2(n=12)diabetes participated in a randomized cross-over study.All participants completed the following protocols:(i)HIIE:cycling for 4×4 min at 85%-95%of heart rate peak(HR_(peak)),interspersed with 3 min of active recovery at 60%-70%HR_(peak);(ii)MICE:33 min of continuous cycling at 60%-70%HR_(peak);and(iii)control(CON):lying quietly in a supine position for 30 min.Results:A significant group￡time effect was found for changes in central systolic blood pressure(F=3.20,p=0.01)with a transient reduction for the HIIE group but not for the MICE or CON groups.There was a significant group￡time effect for changes in augmentation index at a heart rate of 75 beats/min(F=2.32,p=0.04)with a decrease following for HIIE and MICE but not for CON.For all other measures of central arterial stiffness and hemodynamics,no significant changes were observed(p>0.05).Conclusion:A bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE;however,both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes.There was no significant difference in response to HIIE and MICE in all outcomes.This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.

Does low volume high-intensity interval training elicit superior benefits to continuous low to moderate-intensity training in cancer survivors?

AIM To determine the impact ofm low volume high-intensity interval training(LVHIIT) and continuous low to moderate-intensity exercise training(CLMIT) on cardiovascular disease(CVD) risk and health outcomes in cancer survivors.METHODS Sedentary cancer survivors(n=75,aged 51±12year)within 24 months of diagnosis,were randomised into three groups for 12 wk of LVHIIT(n=25),CLMIT(n=25)or control group(n=25).The exercise intervention involved 36 sessions(three sessions per week).The LVHIIT group performed 7 x 30 s intervals(≥85%predicted maximal heart rate)with a 60 s rest between intervals,and the CLMIT group performed continuous aerobic training for 20 min(≤55%predicted maximal heart rate)on a stationary bike.Outcome variables were measured at baseline and at12 weeks and analysed using a 3 x 2(group x time)repeated measures ANCOVA to evaluate main and interaction effects.RESULTS Significant improvements(time)were observed for seven of the 22 variables(ES 0.35-0.97,P≤0.05).There was an interaction effect(P<0.01)after 12 in the LVHIIT group for six-minute walk test(P<0.01;d=0.97;95%CI:0.36,1.56;large),sit to stand test(P<0.01;d=-0.83;95%CI:-1.40,-0.22;large)and waist circumference reduction(P=0.01;d=-0.48;95%CI:-1.10,0.10;medium).An interaction effect(P<0.01)was also observed for quality of life in both the LVHIIT(d=1.11;95CI:0.50,1.72;large)and CLMIT(d=0.57;95%CI:-0.00,1.20;moderate)compared with the control group(d=-0.15;95%CI:-0.95,0.65;trivial).CONCLUSION Low-volume high-intensity training shows promise as an effective exercise prescription within the cancer population,showing greater improvements in cardiorespiratory fitness,lower body strength and waist circumference compared with traditional CLMIT and control groups.Both LVHIIT and CLMIT improved quality of life.A proposed benefit of LVHIIT is the short duration(3 min)of exercise required,which may entice more cancer survivors to participate in exercise,improving health outcomes and lowing the risk of CVD.

Test-retest reliability of the 30-15 Intermittent Fitness Test:A systematic review

Purpose:This review aimed to synthesize previous findings on the test-retest reliability of the 30-15 Intermittent Fitness Test(IFT).Methods:The literature searches were performed in 8 databases.Studies that examined the test-retest reliability of the 30-15 IFT and presented the intraclass correlation coefficient(ICC) and/or the coefficient of variation(CV) for maximal velocity and/or peak heart rate were included.The consensus-based standards for the selection of health measurement instruments(COSMIN) checklist was used for the assessment of the methodological quality of the included studies.Results:Seven studies,with a total of 10 study groups,explored reliability of maximal velocity assessed by the 30-15 IFT.ICCs ranged from0.80 to 0.99,where 70% of ICCs were≥0.90.CVs for maximal velocity ranged from 1.5% to 6.0%.Six studies,with a total of 7 study groups,explored reliability of peak heart rate as assessed by the 30-15 IFT.ICCs ranged from 0.90 to 0.97(i.e.,all ICCs were≥0.90).CVs ranged from 0.6% to 4.8%.All included studies were of excellent methodological quality.Conclusion:From the results of this systematic review,it can be concluded that the 30-15 IFT has excellent test-retest reliability for both maximal velocity and peak heart rate.The test may,therefore,be used as a reliable measure of fitness in research and sports practice.

Importance of physical capacity and the effects of exercise in heart transplant recipients

One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation(HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis(cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality. In a worldwide perspective, 50% of the HTx patients survive past 10 years. Poor aerobic capacity prior to graft deterioration is not only limited to the failing heart, but also caused by peripheral factors, such as limited function in the skeletal muscles and in the blood vessels walls. Exercise rehabilitation after HTx is of major importance in order to improve physical capacity and prognosis. Effects of high-intensity interval training(HIT) in HTx recipients is a growing field of research attracting worldwide focus and interest. Accumulating evidence has shown that HIT is safe and efficient in maintenance HTx recipients; with superior effects on physical capacity compared to conventional moderate exercise. This article generates further evidence to the field by summarizing results from a decade of research performed at our center supported by a broad, but not strict formal, literature review. In short, this article demonstrates a strong association between physical capacity measured after HTx and long-term survival. It describes the possible "HITeffect" with increased levels of inflammatory mediators of angiogenesis. It also describes long-term effects of HIT; showing a positive effect in development of anxiety symptoms despite that the improved physical capacity was not sustained, due to downregulation ofexercise and intensity. Finally, our results are linked to the ongoing HITTS study, which investigates safety and efficiency of HIT in de novo HTx recipients. Together with previous results, this study may have the potential to change existing guidelines and contribute to a better prognosis for the HTx population as a whole.

CORRELATIONS BETWEEN OXY-HEMOGLOBIN AND RESPIRATORY EXCHANGE RATIO IN THE QUADRICEPS DURING THE EARLY PHASE OF EXERCISES

The early stage of exercises is crucial in sports training;however,its physiological mechanism is still unclear.The hemodynamic response was reported to be associated with respiratory exchange.Here,we aimed to explore the relationship between oxy-hemoglobin concentration change(HbO_(2))and respiratory exchange ratio(RER)during the early phase of exercises.Sixteen athletes of middle-distance race were selected from Wuhan Institute of Physical Education to conduct intermittent exercises on MERCURY4.0 at 80%VO_(2)peak intensity.Multiple physiological parameters were acquired by use of a near-infrared spectroscopy muscle oxygen monitor,a Cardiopulmonary Function MAX-II and a P-Lar,including HbO_(2),RER and others.A significant correlation was found between RER and HbO_(2)in quadriceps muscle in the thigh during the early phase of exercises.Thus,NIRS is capable of supervising sports training in terms of HbO_(2),which actually acted as an interpreter of RER change.

Effect of Low-Dose Sodium Bicarbonate Supplementation on Intermittent Endurance Performance

In this study, we investigated the effect of sodium bicarbonate (NaHCO3) supplementation at a dose of 0.2 g&middot;kg&minus;1 40 min before an exercise on intermittent endurance performance and gastrointestinal distress. The participants were six healthy male students of a university. The Yo-Yo intermittent recovery test level 2 (Yo-Yo IR2) was used for the evaluation of intermittent endurance. The participants ingested water (Cont) or NaHCO3 independently at three timings. After drinking water, the Yo-Yo IR1 was performed for 2 min as warm-up. After resting for 5 min, the Yo-Yo IR2 was initiated. The measurement items were exercise distance, nutrition intake, biochemical test results, and blood gas analysis findings. The participants who ingested NaHCO3 had a 14% extended distance than those who ingested Cont, and 2/3 of those who took NaHCO3 showed a better motor performance. No significant difference was observed between the participants who took Cont and NaHCO3 in terms of pH level at baseline, and the NaHCO3 level was significantly higher during pre- and post-exercise (p 3 in terms of bicarbonate ion level at baseline, and the NaHCO3 level was significantly higher during pre- and post-exercise (p 3 at a low dose (0.2 g&middot;kg&minus;1), their exercise ability during an intermittent endurance test has improved. Furthermore, when digestive absorption is considered, eating a meal in advance may be able to suppress the onset of gastrointestinal distress.

不同强度运动抑制糖尿病大鼠肾脏PI3K/AKT/mTOR信号通路改善自噬的比较

背景:2型糖尿病损害肾功能。研究表明运动干预可以保护肾脏;鸢尾素可以通过抑制磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路恢复自噬,保护糖尿病肾病患者的肾功能。目的:探讨运动能否通过抑制肾脏磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路过度激活来恢复自噬,改善肾损伤,以及分析不同方式运动产生影响的差异。方法:将6周龄的SD大鼠随机分为空白对照组(正常大鼠)和糖尿病组,其中糖尿病组大鼠经过高脂高糖喂养加腹腔注射低剂量1%链脲佐菌素(30 mg/kg)建立2型糖尿病模型。造模成功后再将糖尿病组大鼠随机分成糖尿病模型组、中强度持续运动组和高强度间歇运动组。两个运动组大鼠分别进行8周不同强度运动干预。取材后采用葡萄糖氧化酶法检测大鼠空腹血糖,使用试剂盒检测糖化血红蛋白水平,Elisa法检测血清胰岛素浓度,计算胰岛素抵抗指数,RT-PCR检测肾组织磷脂酰肌醇3-激酶、蛋白激酶B、雷帕霉素靶蛋白、Beclin-1、podocin、nephrin的基因表达量,Western Blot检测肾组织雷帕霉素靶蛋白及自噬标记蛋白LC3-1、LC3-2、Beclin-1的蛋白表达量。结果与结论:①2型糖尿病大鼠空腹血糖和糖化血红蛋白水平极显著性升高,胰岛素抵抗水平显著上升,胰岛素水平显著下降;两种运动均能使2型糖尿病大鼠空腹血糖和糖化血红蛋白水平极显著下降,胰岛素抵抗水平显著下降,胰岛素水平显著上升;与中强度持续运动组相比,高强度间歇运动组胰岛素水平显著上升。②2型糖尿病大鼠podocin、nephrin基因表达量显著降低;两种不同形式运动均能显著提高其表达;与高强度间歇运动组相比,中等强度持续性运动组足细胞相关蛋白基因表达有进一步上升趋势,但无显著性差异。③2型糖尿病大鼠肾组织磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及蛋白的表达量显著增加,自噬标志蛋白Beclin-1、LC3-2表达量以及LC3-2/LC3-1显著降低;两种不同形式运动均能使肾组织磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及雷帕霉素靶蛋白蛋白的表达量显著降低,自噬标志蛋白Beclin-1、LC3-2以及LC3-2/LC3-1显著升高;与中等强度持续性运动组相比,高强度间歇运动的磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及雷帕霉素靶蛋白的蛋白表达量有进一步下降的趋势,Beclin-1、LC3-2以及LC3-2/LC3-1有进一步升高的趋势,但仅Beclin-1有显著性差异。④结果说明2型糖尿病肾脏足细胞损伤,自噬受到抑制,与磷脂酰肌醇3-激酶/蛋白激酶B/mTORC1信号通路被异常激活密切相关。高强度间歇运动和中等强度持续性运动可以保护糖尿病肾脏,减少足细胞损伤,促进自噬恢复,这可能与运动抑制磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路过度激活有关。与中等强度持续性运动相比,高强度间歇运动恢复自噬的效果呈更优趋势,但足细胞蛋白表达稍有下降。

间歇经口至食管管饲法联合自创吞咽功能训练在脑卒中吞咽障碍患者的应用研究

目的探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。

不同强度运动干预2型糖尿病大鼠骨骼肌羧酸酯酶1及炎症因子的变化

背景:羧酸酯酶1及炎症因子在调节脂质代谢以及葡萄糖稳态方面起着至关重要的作用,然而有关不同强度运动干预对2型糖尿病大鼠骨骼肌羧酸酯酶1及炎症因子的影响尚待揭示。目的:探究不同强度运动干预对2型糖尿病大鼠骨骼肌羧酸酯酶1及炎症因子的影响。方法:取32只8周龄雄性SD大鼠,适应性喂养1周后随机分为正常对照组(n=12)和造模组(n=20),造模组大鼠利用高脂膳食和一次性注射链脲佐菌素制备2型糖尿病模型,建模成功后随机分为糖尿病对照组(n=6)、中等强度运动组(n=6)和高强度间歇运动组(n=6),后2组适应性跑台运动5 d后分别进行对应强度的跑台运动,每天1次,每次50 min,每周训练5 d。连续运动6周后,检测大鼠血糖与血脂相关指标,苏木精-伊红染色观察骨骼肌组织形态学变化,qRT-PCR检测骨骼肌羧酸酯酶1与炎症因子的mRNA表达,Western-blotting及免疫荧光染色检测骨骼肌中羧酸酯酶1与炎症因子的蛋白表达。结果与结论:①与正常对照组相比,糖尿病对照组大鼠空腹血糖、三酰甘油、低密度脂蛋白胆固醇、胰岛素抵抗指数均升高(P<0.05),胰岛素活性降低(P<0.05),骨骼肌中的羧酸酯酶1、NEK7、白细胞介素18的mRNA与蛋白表达均升高(P<0.05)。②与糖尿病对照组相比,中等强度运动组和高强度间歇运动组大鼠空腹血糖、三酰甘油、低密度脂蛋白胆固醇、胰岛素抵抗指数均降低(P<0.05),胰岛素活性升高(P<0.05);中等强度运动组大鼠骨骼肌中的NEK7 mRNA表达降低(P<0.01),羧酸酯酶1、NEK7、白细胞介素18蛋白表达降低(P<0.05);高强度间歇运动组大鼠骨骼肌中的羧酸酯酶1、NEK7、NLRP3、白细胞介素18 mRNA表达降低(P<0.05),羧酸酯酶1、白细胞介素18蛋白表达降低(P<0.05)。③苏木精-伊红染色显示,相较于糖尿病对照组,中等强度运动组大鼠肌纤维间隙变小,内部空洞减少,细胞结构趋于完整;高强度间歇运动组大鼠肌细胞排列松散,组织形态不规则,肌纤维内部空洞较多。④结果表明,中等强度运动和高强度间歇运动均可降低2型糖尿病大鼠的血糖、血脂、胰岛素抵抗与骨骼肌羧酸酯酶1水平,中等强度运动可明显降低骨骼肌NEK7表达,高强度间歇运动可降低骨骼肌白细胞介素18表达,并且羧酸酯酶1与NEK7、白细胞介素18关系密切。