Effects of exercise training on glucose metabolism indicators and inflammatory markers in obese children and adolescents:A metaanalysis

BACKGROUND Obesity in children and adolescents is a serious problem,and the efficacy of exercise therapy for these patients is controversial.AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers.METHODS The PubMed,Web of Science,and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023.The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children.RESULTS In total,1010 patients from 28 studies were included.Exercise therapy reduced the levels of fasting blood glucose(FBG)[standardized mean difference(SMD):-0.78;95%confidence interval(CI):-1.24 to-0.32,P=0.0008],fasting insulin(FINS)(SMD:-1.55;95%CI:-2.12 to-0.98,P<0.00001),homeostatic model assessment for insulin resistance(HOMA-IR)(SMD:-1.58;95%CI:-2.20 to-0.97,P<0.00001),interleukin-6(IL-6)(SMD:-1.31;95%CI:-2.07 to-0.55,P=0.0007),C-reactive protein(CRP)(SMD:-0.64;95%CI:-1.21 to-0.08,P=0.03),and leptin(SMD:-3.43;95%CI:-5.82 to-1.05,P=0.005)in overweight and obese children.Exercise training increased adiponectin levels(SMD:1.24;95%CI:0.30 to 2.18,P=0.01)but did not improve tumor necrosis factor-alpha(TNF-α)levels(SMD:-0.80;95%CI:-1.77 to 0.18,P=0.11).CONCLUSION In summary,exercise therapy improves glucose metabolism by reducing levels of FBG,FINS,HOMA-IR,as well as improves inflammatory status by reducing levels of IL-6,CRP,leptin,and increasing levels of adiponectin in overweight and obese children.There was no statistically significant effect between exercise training and levels of TNF-α.Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.

Exercise training-induced changes in exerkine concentrations may be relevant to the metabolic control of type 2 diabetes mellitus patients:A systematic review and meta-analysis of randomized controlled trials

Background:This study investigates the effects of exercise training on exerkines in patients with type 2 diabetes mellitus to determine the optimal exercise prescription.Methods:A systematic search for relevant studies was performed in 3 databases.Randomized controlled trials investigating the effects of exercise training on at least one of the following exerkines were included:adiponectin,apelin,brain-derived neurotrophic factor,fetuin-A,fibroblast growth factor-21,follistatin,ghrelin,interleukin(IL)-6,IL-8,IL-10,IL-15,IL-18,leptin,myostatin,omentin,resistin,retinol-binding protein 4,tumor necrosis factor-α,and visfatin.Results:Forty randomized controlled trials were selected for data extraction(n=2160).Exercise training induces changes in adiponectin,fetuin-A,fibroblast growth factor-21,IL-6,IL-10,leptin,resistin,and tumor necrosis factor-a levels but has no significant effects on apelin,IL-18,and ghrelin compared to controls.Physical exercise training favored large and positive changes in pooled exerkines(i.e.,an overall effect size calculated from several exerkine s)(Hedge’s g=1.02,95%confidence interval(95%CI):0.76-1.28),which in turn were related to changes in glycated hemoglobin(mean difference(MD)=-0.81%,95%CI:-0.95%to-0.67%),fasting glucose(MD=-23.43 mg/dL,95%CI:-30.07 mg/dL to-16.80 mg/dL),waist circumference(MD=-3.04 cm,95%CI:-4.02 cm to-2.07 cm),and body mass(MD=-1.93 kg,95%CI:-2.00 kg to-1.86 kg).Slightly stronger effects were observed with aerobic,resistance,or high-intensity interval protocols at moderate-to vigorous-intensity and with programs longer than 24 weeks that comprise at least 3 sessions per week and more than 60 min per session.Conclusion:Exercise training represents an anti-inflammatory therapy and metabolism-improving strategy with minimal side effects for patients with type 2 diabetes mellitus.

Skeletal muscle atrophy,regeneration,and dysfunction in heart failure:Impact of exercise training

This review highlights some established and some more contemporary mechanisms responsible for heart failure(HF)-induced skeletal muscle wasting and weakness.We first describe the effects of HF on the relationship between protein synthesis and degradation rates,which determine muscle mass,the involvement of the satellite cells for continual muscle regeneration,and changes in myofiber calcium homeostasis linked to contractile dysfunction.We then highlight key mechanistic effects of both aerobic and resistance exercise training on skeletal muscle in HF and outline its application as a beneficial treatment.Overall,HF causes multiple impairments related to autophagy,anabolic-catabolic signaling,satellite cell proliferation,and calcium homeostasis,which together promote fiber atrophy,contractile dysfunction,and impaired regeneration.Although both wasting and weakness are partly rescued by aerobic and resistance exercise training in HF,the effects of satellite cell dynamics remain poorly explored.

The resistive range of motion exercise training in Duchenne muscular dystrophy:a case study

Background:To determine the effectiveness of resistive range of motion exercises in improving muscle strength and functional abilities in Duchenne muscular dystrophy.The study was also aimed to determine if resistive range of motion exercises can slow down the progression of the disease.Methods:A seven-year-old male child was diagnosed with Duchenne muscle dystrophy presented to outpatient physiotherapy clinic.The patient was presented with difficulty in stair climbing,sitting up from the floor,fatigue,and muscle weakness specifically weakness in the proximal limb muscles.The progressive resistive range of motion training was implemented for four years to improve muscle strength and functional abilities.The medical research council grading scale,north ambulatory assessment scale,and creatine kinase were used to evaluate muscle strength,functional abilities,and creatine kinase levels.Results:The muscular strength and functional abilities did not improve after four years of exercise training.The creatine kinase levels were decreased over the period of four years.Conclusion:Resistive range of motion exercises are helpful in maintaining the muscular strength and functional abilities in Duchenne muscular dystrophy.

Exercise training in hypertension:Role of microRNAs

Hypertension is a complex disease that constitutes an important public health problem and demands many studies in order to understand the molecular mechanisms involving his pathophysiology. Therefore, an increasing number of studies have been conducted and new therapies are continually being discovered. In this context, exercise training has emerged as an important non-pharmacological therapy to treat hypertensive patients, minimizing the side effects of pharmacological therapies and frequently contributing to allow pharmacotherapy to be suspended. Several mechanisms have been associated with the pathogenesis of hypertension, such as hyperactivity of the sympathetic nervous system and renin-angiotensin aldosterone system,impaired endothelial nitric oxide production, increased oxygen-reactive species, vascular thickening and stiffening, cardiac hypertrophy, impaired angiogenesis, and sometimes genetic predisposition. With the advent of microRNAs(miRNAs), new insights have been added to the perspectives for the treatment of this disease, and exercise training has been shown to be able to modulate the miRNAs associated with it. Elucidation of the relationship between exercise training and miRNAs in the pathogenesis of hypertension is fundamental in order to understand how exercise modulates the cardiovascular system at genetic level. This can be promising even for the development of new drugs. This article is a review of how exercise training acts on hypertension by means of specific miRNAs in the heart, vascular system, and skeletal muscle.

Chronic exercise training versus acute endurance exercise in reducing neurotoxicity in rats exposed to lead acetate

After intraperitoneal injection of 20 mg/kg lead acetate, rats received 8 weeks of treadmill exercise （15-22 m/min, 25-64 minutes） and/or treadmill exercise at 1.6 km/h until exhaustion. The markers related to neurotoxicity were measured by enzyme-linked immunosorbent assay method. 8 weeks of treadmill exercise significantly increased brain-derived neurotrophic factor level in the hippocampus （P = 0.04） and plasma level of total antioxidant capacity of rats exposed to lead acetate （P 〈 0.001）, and significantly decreased plasma level of malondialdehyde （P 〈 0.001）. Acute exercise only decreased the hippocampal malondialdehyde level （P = 0.09） and increased brain-derived neurotrophic factor level in the hippocampus （P = 0.66）. Acute exercise also enhanced the total antioxidant capacity in rats exposed to lead acetate, insignificantly （P = 0.99）, These findings suggest that chronic treadmill exercise can significantly decrease neurotoxicity and alleviate oxidative stress in rats exposed to lead acetate. However, acute endurance exercise was not associated with these beneficial effects.

Effect of exercise training on left ventricular remodeling in patients with myocardial infarction and possible mechanisms

BACKGROUND A growing amount of evidence provides support for the hypothesis that acute myocardial infarction(AMI)patients should go through cardiopulmonary exercise testing(CPET)about 3-5 d after AMI is diagnosed,make reasonable exercising prescription,and conduct exercise training under guidance.AIM To investigate the effect of exercise training(ET)on left ventricular systolic function and left ventricular remodeling(LVRM)and to study the possible mechanisms of LVRM by the changes of matrix metallopeptidase 9(MMP-9)and tissue inhibitor of metalloproteinases 1(TIMP-1)in patients with acute STsegment elevation myocardial infarction(STEMI).METHODS Sixty patients with first STEMI undergoing direct percutaneous coronary intervention from February 2008 to October 2008 were randomly assigned to an exercise group(n=30)and a control group(n=30).The levels of MMP-9 and TIMP-1 were measured in all patients at 1 d,10-14 d,30 d,and 6 mo after admission.Two-dimensional echocardiography and cardiopulmonary exercise testing were done in patients at 10-14 d and 6 mo after admission.RESULTS There was no significant difference in CPET at baseline between the exercise group and the control group.At 6 mo,the time of exercise,peak and anaerobic threshold values of O2 uptake,and metabolic equivalents increased in both groups,but markedly increased in the exercise group.At baseline,there were no significant differences in left ventricular ejection fraction(LVEF)between the two groups.At 6 mo,LVEF increased in the exercise group,but not in the control group.At 6 mo,the percentage of patients with positive result of LVRM was 26.6%in the exercise group and 52.6%in the control group(P<0.05).The levels of plasma MMP-9 and TIMP-1 and the ratio of MMP-9 to TIMP-1 in both groups had no significant difference at 1 d and 10-14 d after AMI,but at 30 d and 6 mo,the levels of plasma MMP-9 and TIMP-1 in the exercise group were significantly lower than those in the control group;the ratio of MMP-9 to TIMP-1 in the exercise group was significantly higher than that in the control group.CONCLUSION ET under supervision based on home condition in early and recovery stage of AMI can improve exercise cardiopulmonary function and prevent the LVRM.Therefore,it may reduce unfavorable remodeling response by decreasing the levels of plasma MMP-9 and TIMP-1 and adjusting the ratio of MMP-9 to TIMP-1 hereafter.

The effects of aerobic exercise training on oxidant-antioxidant balance, neurotrophic factor levels, and blood-brain barrier function in obese and non-obese men

Purpose: The purpose of this study was to investigate the effects of obesity and aerobic exercise training on oxidant-antioxidant balance,neurotrophic factor levels, and blood-brain barrier(BBB) function.Methods: Ten non-obese healthy men(body mass index < 25 kg/m2) and 10 obese men(body mass index ≥ 25 kg/m2) were included in the study.Both groups performed treadmill exercise for 40 min 3 times weekly for 8 weeks at 70% heart rate reserve. Blood samples were collected to examine oxidant-antioxidant balance(reactive oxygen species(ROS) and superoxide dismutase(SOD) activity levels), neurotrophic factors(brain-derived neurotrophic factor(BDNF), nerve growth factor, and glial cell line-derived neurotrophic factor levels), and BBB function(S100βand neuron-specific enolase(NSE) levels) before and after exercise training.Results: The obese group showed significantly greater changes than the non-obese group in serum ROS(-0.46 ± 0.31 mmol/L vs.-0.10 ±0.17 mmol/L,p=0.005),serum S100 p levels(-8.50 ± 5.92 ng/L vs.-0.78 ± 5.45 ng/L,p=0.007),and serum NSE levels(-0.89 ± 0.54 μg/L vs.-0.01 ± 0.74 μg/L,p= 0.007) after training. At baseline,the obese group showed significantly higher serum ROS and S100β levels and significantly lower serum SOD activity and BDNF levels than the non-obese group(p < 0.05). The obese group showed significantly lower serum ROS, S100β,and NSE levels and significantly higher serum SOD activity and BDNF levels after training compared with baseline(p < 0.05).Conclusion: These results suggest that obesity can reduce serum neurotrophic factor levels and can induce BBB dysfunction. On the other hand,aerobic exercise can improve an oxidant-antioxidant imbalance in obese subjects and limit BBB dysfunction.

Exercise training in heart transplantation

Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.

Exercise Training Attenuated Chronic Cigarette Smoking-induced Up-regulation of FIZZ1/RELMα in Lung of Rats

FIZZ/RELM is a new gene family named ＂found in inflammatory zone＂ （FIZZ） or ＂re- sistin-like molecule＂ （RELM）. FIZZ1/RELMct is specifically expressed in lung tissue and associated with pulmonary inflammation. Chronic cigarette smoking up-regulates FIZZ 1/RELMct expression in rat lung tissues, the mechanism of which is related to cigarette smoking-induced airway hyperresponsive- ness. To investigate the effect of exercise training on chronic cigarette smoking-induced airway hyper- responsiveness and up-regulation of FIZZ1/RELMct, rat chronic cigarette smoking model was estab- lished. The rats were treated with regular exercise training and their airway responsiveness was meas- ured. Hematoxylin and eosin （HE） staining, immunohistochemistry and in situ hybridization of lung tissues were performed to detect the expression of FIZZ1/RELMct. Results revealed that proper exercise training decreased airway hyperresponsiveness and pulmonary inflammation in rat chronic cigarette smoking model. Cigarette smoking increased the mRNA and protein levels of FIZZ1/RELMct, which were reversed by the proper exercise. It is concluded that proper exercise training prevents up-regulation of FIZZ1/RELMct induced by cigarette smoking, which may be involved in the mechanism of proper exercise training modulating airway hyperresponsiveness.

Exercise training improves participation in persons with multiple sclerosis:A systematic review and meta-analysis

Background Although previous studies have examined the effects of exercise training on other International Classification of Functioning,Disability and Health(ICF)component levels in persons with multiple sclerosis(MS),the effects of exercise training on participation remain unclear.The objectives of this review were to:(1)characterize systematically the use of outcome measures that capture participation in exercise training studies;(2)quantify the effect of exercise training on participation in persons with MS.Methods A search of 6 electronic databases(CINAHL,SPORTDiscuss,Embase,MEDLINE,Cochrane Central,and Scopus)was conducted to identify controlled and noncontrolled trials involving exercise training and participation in persons with MS.Search strings were built from Medical Subject Headings and CINAHL headings.ICF linking rules were used to identify participation chapters and categories captured.Meta-analysis was used to quantify the effect of exercise training on participation in randomized controlled trials comparing exercise effects to no intervention/usual care.Results We included 49 articles involving controlled and noncontrolled exercise trials in the systematic review of outcome measures.We captured 16 different outcome measures that captured all 9 participation chapters and identified 89 unique participation categories.Across these 16 outcome measures,mobility was the most commonly represented participation chapter,with 108 items.A subsample of 23 randomized controlled trials was included in the meta-analysis.An overall effect of 0.60(standard error=0.12,95%confidence interval:0.36-0.84,z=4.9,p<0.001)was calculated,indicating a moderate,positive effect of exercise training on participation.Conclusion The current review provides information that can be used to guide the selection of outcome measures that capture participation in studies of exercise training in persons with MS.Exercise training has a positive effect on outcomes that capture participation,providing further evidence for the role of exercise training in promoting and maintaining engagement in everyday life.

Physical activity and exercise training in young people with cystic fibrosis:Current recommendations and evidence

Despite the acceptance of physical activity （PA） being integral to a young person＇s health, children with disability often exhibit low levels of PA. In young people with cystic fibrosis （CF） the importance of exercise and daily PA is acknowledged by clinicians and their support teams, however, there is a lack of knowledge related to its prescription. CF is a recessive genetic disorder affecting the lung, pancreas and sweat glands. CF is the most common life shortening genetic disease in the Caucasian population for which there is no cure. In the UK, CF affects over 9000 people, with 4000 under 16 years of age. Only about half of the CF population can expect to live beyond 40 years of age. Besides drug therapies, rehabilitative exercise programmes form an important component of treatment and long term exercise programmes are considered positive treatment strategies, but all lack any detailed prescriptive information. Several reviews and editorials have highlighted the lack of evidence based research in PA and exercise training in young people with CF; but advocate a greater need for understanding the role of exercise in therapeutic interventions. The purpose of this review is to update the reader on the current recommendations and evidence in PA and exercise training for young people with CE These developments have extended our understanding of PA and exercise training in children and adolescents with CF, and its implementation in the management of this chronic disease.

Exercise Training Post Cardiac Resynchronization Therapy Improves Exercise Tolerance and Quality of Life

Background: Cardiac resynchronization therapy (CRT) results in improved morbidity, mortality, symptoms, quality of life (QOL) and exercise capacity, in appropriate chronic heart failure (CHF) patients. Moreover, combined exercise training (ET) and CRT maximize these improvements in these patients. The study evaluated the effect of ET on these patients in terms of QOL, functional class, exercise capacity and left ventricular ejection fraction (LVEF). Results: There were significant improvements in the QOL, functional class, exercise capacity, and LVEF compared with the Control Group. Comparison of both groups confirmed the cumulative effects of ET with CRT. The QOL improved by the end of training in the exercise group (p = 0.001), compared to the Control Group (p = 0.850). NYHA functional class improved significantly in the Exercise Group (p = 0.013). Percent-predicted peak oxygen consumption (VO2 peak) had significantly improved in the trained (p < 0.001) versus the untrained CRT Group (p= 0.596). There was a mean percent rise of the ejection fraction from 39.2 ± 12.86 to 44.40% ± 14.42% in the Exercise Group compared to a non-significant change in the Control Group. Conclusion: ET in resynchronized CHF patients is feasible and further enhances QOL and exercise tolerance in addition to the improvements seen after CRT. The study therefore recommends for the prescription of ET after implantation in order to maximize the expected benefit.

Effects of combined aerobic,resistance and inspiratory training in patients with pulmonary hypertension:A systematic review

BACKGROUND Pulmonary hypertension(PH)is a serious progressive disorder of the modern world,characterized by endothelial dysfunction and impaired vasoreactivity.Patients with PH usually present exercise intolerance from the very early stages and reduced exercise capacity.Exercise training has been shown to have beneficial effects in patients with cardiovascular comorbidities.However,data regarding the effects of combined exercise training programs in patients with PH still remains limited.AIM To investigate the effects of combined exercise training programs on exercise capacity and quality of life in patients with PH.METHODS Our search included all available randomized controlled trials(RCTs)regarding combined aerobic,resistance and inspiratory training programs in patients with PH in 4 databases(Pubmed,PEDro,Embase,CINAHL)from 2012 to 2022.Five RCTs were included in the final analysis.Functional capacity,assessed by peak VO_(2)or 6-min walking test(6MWT),as well as quality of life,assessed by the SF-36 questionnaire,were set as the primary outcomes in our study.RESULTS Peak VO_(2)was measured in 4 out of the 5 RCTs while 6MWT was measured in all RCTs.Both indices of functional capacity were significantly increased in patients with PH who underwent combined exercise training compared to the controls in all of the included RCTs(P<0.05).Quality of life was measured in 4 out of 5 RCTs.Although patients improved their quality of life in each group,however,only 2 RCTs demonstrated further improvement in patients performing combined training compared to controls.CONCLUSION By this systematic review,we have demonstrated that combined aerobic,resistance and inspiratory exercise training is safe and has beneficial effects on aerobic capacity and quality of life in patients with PH.Such exercise training regimen may be part of the therapeutic strategy of the syndrome.

Bone marrow mesenchymal stem cells and exercise restore motor function following spinal cord injury by activating PI3K/AKT/mTOR pathway

Although many therapeutic interventions have shown promise in treating spinal cord injury, focusing on a single aspect of repair cannot achieve successful and functional regeneration in patients following spinal cord injury. In this study, we applied a combinatorial approach for treating spinal cord injury involving neuroprotection and rehabilitation, exploiting cell transplantation and functional sensorimotor training to promote nerve regeneration and functional recovery. Here, we used a mouse model of thoracic contusive spinal cord injury to investigate whether the combination of bone marrow mesenchymal stem cell transplantation and exercise training has a synergistic effect on functional restoration. Locomotor function was evaluated by the Basso Mouse Scale, horizontal ladder test, and footprint analysis. Magnetic resonance imaging, histological examination, transmission electron microscopy observation, immunofluorescence staining, and western blotting were performed 8 weeks after spinal cord injury to further explore the potential mechanism behind the synergistic repair effect. In vivo, the combination of bone marrow mesenchymal stem cell transplantation and exercise showed a better therapeutic effect on motor function than the single treatments. Further investigations revealed that the combination of bone marrow mesenchymal stem cell transplantation and exercise markedly reduced fibrotic scar tissue, protected neurons, and promoted axon and myelin protection. Additionally, the synergistic effects of bone marrow mesenchymal stem cell transplantation and exercise on spinal cord injury recovery occurred via the PI3 K/AKT/mTOR pathway. In vitro, experimental evidence from the PC12 cell line and primary cortical neuron culture also demonstrated that blocking of the PI3 K/AKT/mTOR pathway would aggravate neuronal damage. Thus, bone marrow mesenchymal stem cell transplantation combined with exercise training can effectively restore motor function after spinal cord injury by activating the PI3 K/AKT/mTOR pathway.

Up-regulation of Thioredoxin 1 by aerobic exercise training attenuates endoplasmic reticulum stress and cardiomyocyte apoptosis following myocardial infarction

Exercise training(ET)has been reported to reduce oxidative stress and endoplasmic reticulum(ER)stress in the heart following myocardial infarction(MI).Thioredoxin 1(Trx1)plays a protective role in the infarcted heart.However,whether Trx1 regulates ER stress of the infarcted heart and participates in ET-induced cardiac protective effects are still not well known.In this work,H9c2 cells were treated with hydrogen peroxide(H_(2)O_(2))and recombinant human Trx1 protein(TXN),meanwhile,adult male C57B6L mice were used to establish the MI model,and subjected to a six-week aerobic exercise training(AET)with or without the injection of Trx1 inhibitor,PX-12.Results showed that H_(2)O_(2)significantly increased reactive oxygen species(ROS)level and the expression of TXNIP,CHOP and cleaved caspase12,induced cell apoptosis;TXN intervention reduced ROS level and the expression of CHOP and cleaved caspase12,and inhibited cell apoptosis in H_(2)O_(2)-treated H9c2 cells.Furthermore,AET up-regulated endogenous Trx1 protein expression and down-regulated TXNIP expression,restored ROS level and the expression of ER stress-related proteins,inhibited cell apoptosis as well as improved cardiac fibrosis and heart function in mice after MI.PX-12 partly inhibited the AET-induced beneficial effects in the infarcted heart.This study demonstrates that Trx1 attenuates ER stress-induced cell apoptosis,and AET reduces MI-induced ROS overproduction,ER stress and cell apoptosis partly through up-regulating of Trx1 expression in mice with MI.

Role of exercise training on insulin resistance and TNF-α in high-fat diet rats

This study investigated the effect of exercise training on insulin resistance and serum and adipose TNF-αin high-fat diet-induced insulin-resistant rats.Thirty male Wistar rats were randomly divided into two groups:normal control group(NC;n=8)that accepted normal chow and high-fat diet group(HF;n=22)that fed on high-fat diet to induce insulin resistance model.The HF group was randomly assigned to two subgroups after 18 weeks:sedentary group(SE;n=10)and exercise training group(ET;n=12)that performed swimming exercise training for 6 weeks,while both groups continued high-fat diet.Changes of body weight,lipid profile,and fasting plasma glucose and insulin were measured.The insulin sensitivity index(ISI)was calculated.Serum concentration of TNF-αwas detected by ELISA.The expression of TNF-αmRNA and protein in adipose tissue was examined by using real-timefluorescence quantitative polymerase chain reaction(PCR)and Western blot,respectively.After 18 weeks,compared with the NC group,body weight,blood lipid,glucose,and insulin in the HF group were significantly elevated,while the ISI decreased obviously,which suggested that insulin resistance appeared in the HF group.After exercise training for 6 weeks,compared with the SE group,both ISI and serum TNF-αconcentration in the ET group were decreased significantly;however,the expression levels of TNF-αmRNA and protein in adipose tissue increased by 27.5%and 20.5%,respectively.In conclusion,exercise training ameliorates insulin resis-tance.The reduction of the level of serum TNF-αand the increased expression of TNF-αin adipose tissue by exercise training may be involved in this mechanism.

Exercise Training for the Elderly:Inflammaging and the Central Role for HSP70

Inflammation is a common feature of aging tissues,being involved in most,if not all,age-related diseases.The origin of a low-grade inflammation state in aging(inflammaging)is multifactorial and may involve changes in body composition,immunosenescence,autophagy,microbiota modification and loss of proteostasis.The heat shock response pathway(HSR,and HSP70 expression)plays an important role as a mechanism of resolution of inflammation and proteostasis control.In this review,we sought to discuss the mechanisms that may lead to inflammaging,and the importance of the HSP70 in this process.Besides,we also discuss how physical exercise,particularly resistance training,can improve the HSR and the inflammatory balance of elderly people.

Effectiveness of progressive resistance training in improving muscle strength in myasthenia gravis:a single subject study design

Background:To investigate the effectiveness of the progressive resistance training(PRT)using thera band in improving muscle strength in myasthenia gravis(MG).Methods:In this prospective study,12 MG patients with generalised stable disease performed progressive resistance training with thera band for four times per week for 24 weeks.The isometric muscle force of shoulder abductors,biceps brachii and knee extensors using handheld dynamometer,Myasthenia Gravis Composite(MGC)score,Quantitative myasthenia gravis score(QMG),were assessed before and after the training period.Results:Progressive resistance training was well tolerated,and the isometric muscle strength was significantly improved in shoulder abductors,biceps brachii and knee extensors(P<0.05).The disease course(QMG and MGC)was slowed down and improved(P<0.05).Conclusion:Progressive resistance training is effective in improving muscle strength specifically in most affected muscles in MG.

THE VALUE OF REINFORCED FINE-MOTION EXERCISE IN ADL TRAINING

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