Intervention control of aerobic exercise in maintaining quality of life and pulmonary hypertension in hemodialysis patients

BACKGROUND Pulmonary hypertension is a serious complication in the treatment of maintenance hemodialysis patients,which seriously affects the quality of life of patients and threatens their life safety.Prevention,treatment and improvement of pulmonary hypertension are of great significance to improve the quality of life of patients.AIM To investigate the intervention and control of pedal-powered bicycle in maintaining quality of life and pulmonary hypertension in hemodialysis patients.METHODS 73 patients with maintenance hemadialysis combined with pulmonary arterial hypertension at a hemodialysis center in a certain hospital from May 2021 to May 2022 are selected.Patients are divided into two groups,37 cases in the control group(group C)and 36 cases in the intervention group(group I).Patients are divided into two groups,group C is treated with oral administration of betaglandin sodium combined with routine nursing care.Based on group C,group I conducts power cycling exercises.RESULTS After treatment,group I patients had higher muscle strength,36-Item Short Form Health Survey scores,and Kidney Disease Targets Areas scores;The 6-minute walk distance test index level was higher and the Borg score was lower;The group I had lower systolic blood pressure,greater vital capacity,higher positive emotion,lower systolic pulmonary artery pressure index level,higher arterial partial oxygen pressure level,lower pulmonary vascular resistance index level,and higher blood oxygen saturation level[158.91±11.89 vs 152.56±12.81,1795.01±603.18 vs 1907.20±574.15,24.00(22.00,29.00)vs 24.00(22.00,28.00),P<0.001].CONCLUSION Aerobic exercise combined with Western medicine treatment can effectively improve patients'pulmonary hypertension,alleviate their negative emotions,and enable them to achieve a higher level of quality of life.

An Innovative Approach towards Selecting Aerobic and Coordinative Exercises in Clinical Practice for Children and Young People with ADHD

A growing body of studies and systematic reviews show evidence of the beneficial effects of physical exercise on core symptoms of ADHD. Furthermore, studies indicate that physical exercise as an adjuvant can enhance the effects of medication in the treatment of ADHD. Aerobic and coordinative exercises improve executive functioning through their effect on neurocognitive domains that are implicated in ADHD. It is postulated that through their specific modus operandi, aerobic exercise, by raising cortical arousal levels, improves impaired alerting functions whereas coordinative exercises improve the regulation of inhibitory control through the involvement of a higher variety of frontal-dependent cognitive processes. The increasing use of routine neurocognitive testing with continuous performance tests (CPT), such as the QbTest, at clinical assessments for ADHD allows for an innovative approach to identify the assessment impairments in alerting function and inhibition control that are related to ADHD and accordingly choose aerobic or coordinative physical exercise in a more targeted fashion.

Low-intensity aerobic exercise training attenuates airway inflammation and remodeling in a rat model of steroid-resistant asthma

Background Aerobic exercise can improve symptoms,reduce airway inflammation,and even ameliorate airway remodeling in asthmatic animals and patients.However,previous studies have focused mainly on the effect of aerobic exercise on steroid-sensitive asthma （SSA）.The goals of this study were to determine the effect of low-intensity aerobic exercise training on airway hyperresponsiveness,inflammation,and remodeling in a rat model of steroid-resistant asthma （SRA） and to identify the potential mechanisms underlying these effects.Methods Endotoxin-free ovalbumin with or without lipopolysaccharide were applied to establish rat models of SRA and SSA,respectively.Airway hyperresponsiveness,inflammation,remodeling,expression of interleukin （IL）-25,IL-33,thymic stromal lymphopoietin （TSLP）,high mobility group box-1 （HMGB1）,and IL-17 in bronchoalveolar lavage fluid （BALF）,and the role of dexamethasone （DXM） were compared between these two asthmatic rat models.The effect of low-intensity aerobic exercise training and anti-HMGB1 treatment on airway hyperresponsiveness,inflammation,and remodeling in SRA rats also was evaluated.Results SRA rats developed neutrophil-dominated airway inflammation （（29.5±4.1）％ of the total cell numbers in BALF）,whereas SSA rats developed eosinophil-dominated airway inflammation （（24.0±6.1）％ of the total cell numbers in BALF）.Compared with SSA rats,SRA rats had more severe airway hyperresponsiveness,lower levels of IL-25 （（33.6±10.3） vs.（104.8±24.9） pg/ml）,IL-33 （（87.5±25.0） vs.（226.6±40.7） pg/ml）,and TSLP （（1 933.2±899.5） vs.（7 224.0±992.1） pg/ml）,and higher levels of HMGB1 （（21.2±4.5） vs.（5.4±1.6） ng/ml） and IL-17 （（780.5±261.7） vs.（291.4±76.4） pg/ml） in BALF （all P ＜0.05）.However,there was no significant difference in goblet cell hyperplasia,subepithelial collagen thickness,and airway smooth muscle remodeling between the two groups.Compared with control SSA rats,airway hyperresponsiveness,inflammation,and remodeling in SRA rats were less sensitive to DXM treatment.Anti-HMGB1 treatment attenuated airway hyperresponsiveness,inflammation,and remodeling in SRA rats to a certain extent and was accompanied by lower levels of IL-17 （（369.2±126.7） vs.（780.5±261.7） pg/ml in control SRA rats） in BALF （P ＜0.05）.Low-intensity aerobic exercise training decreased the expression of both HMGB1 （（14.1±2.9） vs.（21.2±4.5） ng/ml in control SRA rats） and IL-17 （（545.3±148.6） vs.（780.5±261.7） pg/ml in control SRA rats） in BALF （all P ＜0.05） and was accompanied by improved airway hyperresponsiveness,inflammation,and remodeling in SRA rats （all P ＜0.05）.Conclusions Low-intensity aerobic exercise training attenuated airway hyperresponsiveness,inflammation,and remodeling in a rat model of SPA.Decreased HMGB1 and IL-17 levels in BALF by aerobic exercise training at least partly contributed to the improvements of SPA.

Effect of Resistance Training,Aerobic Exercise Before Doula-Assisted Delivery on the Psychological Well-Being and Labor Duration of Parturients

Objective:To investigate the impact of resistance training and aerobic exercise before doula-assisted delivery on the psychological well-being and labor duration of parturients.Methods:105 cases of parturients who gave birth in our hospital from February 2021 to April 2023 were included in this study.The patients were divided into a control group of 52 cases and an observation group of 53 cases.The patients in the control group received no particular intervention before delivery and only received doula assistance.The patients in the observation group received resistance training,aerobic exercise,and doula assistance prior to giving birth.After delivery,the mothers were observed for 2 hours in the delivery room and then returned to the maternal and infant ward.The observation indicators of the two groups were compared.Results:In comparison to the control group,the observation group exhibited shorter durations in the first,second,and third stages of labor,as well as the total delivery time.Additionally,the amount of postpartum blood loss at 2 hours was smaller in the observation group.The rate of cesarean section was lower,and the rate of vaginal natural delivery was higher in the observation group.Following the intervention,both groups of postpartum women showed decreased SAS and SDS scores compared to before the intervention.Moreover,the observation group had lower scores than the control group.These differences were all statistically significant(P<0.05).Conclusion:Resistance training and aerobic exercise before doula-assisted delivery can effectively improve the psychological state of parturients,shorten labor duration,increase the rate of natural vaginal delivery,and reduce pain and postpartum hemorrhage.

Exercise training mode effects on myokine expression in healthy adults:A systematic review with meta-analysis

Background:The benefits of exercise are well known;however,many of the underlying molecular mechanisms are not fully understood.Skeletal muscle secretes myokines,which mediate muscleorgan crosstalk.Myokines regulate satellite-cell proliferation and migration,inflammatory cascade,insulin secretion,angiogenesis,fatty oxidation,and cancer suppression.To date,the effects of different exercise modes(namely,aerobic and resistance exercise)on myokine response remain to be elucidated.This is crucial considering the clinical implementation of exercise to enhance general health and wellbeing and as a medical treatment.Methods:A systematic search was undertaken in PubMed,MEDLINE,CINAHL,Embase,SPORTDiscus,andWeb of Science in April 2023.Eligible studies examining the effects of a single bout of exercise on interleukin15(IL-15),irisin,secreted protein acidic and rich in cysteine(SPARC),oncostatinM(OSM),and decorin were included.A random-effects meta-analysis was also undertaken to quantify the magnitude of change.Results:Sixty-two studies were included(n=1193).Overall,exercise appeared to induce small to large increases in myokine expression,with effects observed immediately after to 60 min post-exercise,although these were mostly not statistically significant.Both aerobic and resistance exercise resulted in changes in myokine levels,without any significant difference between training modes,and with the magnitude of change differing across myokines.Myokine levels returned to baseline levels within 180 min to 24 h post-exercise.However,owing to potential sources of heterogeneity,most changes were not statistically significant,indicating that precise conclusions cannot be drawn.Conclusion:Knowledge is limited but expanding with respect to the impact of overall and specific effects of exercise on myokine expression at different time points in the systemic circulation.Further research is required to investigate the effects of different exercise modes at multiple time points on myokine response.

Effect of aerobic and anaerobic exercises on glycemic control in type 1 diabetic youths

AIM:To evaluate the long-term effect of aerobic and/or anaerobic exercise on glycemic control in youths with type 1 diabetes.METHODS:Literature review was performed in spring and summer 2014 using Pub Med/MEDLINE,Google Scholar,Scopus,and Science Direct with the following terms:aerobic,anaerobic,high-intensity,resistance,exercise/training,combined with glycemic/metabolic control,glycated haemoglobin A1c(Hb A1c) and type 1diabetes.Only peer-reviewed articles in English were included published in the last 15 years.It was selected from 1999 to 2014.Glycemic control was measured with Hb A1 c.Studies with an intervention lasting at least 12 wk were included if the Hb A1 c was measured before and after the intervention.RESULTS:A total of nine articles were found,and they were published between the years of 2002-2011.The sample size was 401 diabetic youths(166 males and 235 females) with an age range of 10-19 years except one study,in which the age range was 13-30 years.Study participants were from Australia,Tunisia,Lithuania,Taiwan,Turkey,Brazilia,Belgium,Egypt and France.Four studies were aerobic-based,four were combined aerobic and anaerobic programs,and one compared aerobic exercise to anaerobic one.Available studies had insufficient evidence that any type of exercise or combined training would clearly improve the glycemic control in type 1 diabetic youth.Only three(two aerobic-based and one combined) studies could provide a significant positive change in glycemic control.CONCLUSION:The regular physical exercise has several other valuable physiological and health benefits that justify the inclusion of exercise in pediatric diabetes treatment and care.

Aerobic exercise improves gastrointestinal motility in psychiatric inpatients

AIM: To evaluate the benefit of aerobic exercise on colonic transit time (CTT) for psychiatric inpatients in a closed ward.

Aerobic exercise combined with huwentoxin-I mitigates chronic cerebral ischemia injury

Ca2＋ channel blockers have been shown to protect neurons from ischemia, and aerobic exercise has significant protective effects on a variety of chronic diseases. The present study injected huwentoxin-I （HWTX-I）, a spider peptide toxin that blocks Ca2＋ channels, into the caudal vein of a chronic cerebral ischemia mouse model, once every 2 days, for a total of 15 injections. During this time, a subgroup of mice was subjected to treadmill exercise for 5 weeks. Results showed amelioration of cortical injury and improved neurological function in mice with chronic cerebral ischemia in the HWTX-I ＋ aerobic exercise group. The combined effects of HWTX I and exercise were superior to HWTX-I or aerobic exercise alone. HWTX-I effectively activated the Notch signal transduction pathway in brain tissue. Aerobic exercise up-regulated synaptophysin mRNA expression. These results demonstrated that aerobic exercise, in combination with HWTX-I, effectively relieved neuronal injury induced by chronic cerebral ischemia via the Notch signaling pathway and promoting synaptic regeneration.

Beneficial mechanisms of aerobic exercise on hepatic lipid metabolism in non-alcoholic fatty liver disease

BACKGROUND：Non-alcoholic fatty liver disease（NAFLD）refers to any fatty liver disease that is not due to excessive use of alcohol.NAFLD probably results from abnormal hepatic lipid metabolism and insulin resistance.Aerobic exercise is shown to improve NAFLD.This review aimed to evaluate the molecular mechanisms involved in the beneficial effects of aerobic exercise on NAFLD.DATA SOURCE：We searched articles in English on the role of aerobic exercise in NAFLD therapy in Pub Med.RESULTS： The mechanisms of chronic aerobic exercise in regulating the outcome of NAFLD include： （i） reducing in- trahepatic fat content by down-regulating sterol regulatory element-binding protein-lc and up-regulating peroxisome proliferator-activated receptor y expression levels; （ii） decreas- ing hepatic oxidative stress through modulating the reactive oxygen species, and enhancing antioxidant enzymes such as catalase and glutathione peroxidase; （iii） ameliorating hepatic inflammation via the inhibition of pro-inflammatory media- tors such as tumor necrosis factor-alpha and interleukin-1 beta; （iv） attenuating mitochondrial dependent apoptosis by reducing cytochrome C released from the mitochondria to the cytosol; and （v） inducing hepato-protective autophagy. CONCLUSION： Aerobic exercise, via different mechanisms, significantly decreases the fat content of the liver and improves the outcomes of patients with NAFLD.

Aerobic vs anaerobic exercise training effects on the cardiovascular system

Physical exercise is one of the most effective methods to help prevent cardiovascular(CV) disease and to promote CV health. Aerobic and anaerobic exercises are two types of exercise that differ based on the intensity, interval and types of muscle fibers incorporated. In this article, we aim to further elaborate on these two categories of physical exercise and to help decipher which provides the most effective means of promoting CV health.

Early Aerobic Exercise Promotes Neurological Function Recovery of Rats after Cerebral Ischemia/Reperfusion by Upregulating the Expression of Heat Shock Protein A5

Objective The neuroprotective function of heat shock protein A5(HSPA5)in ischemic stroke has been confirmed.This study aimed to investigate the effects of early aerobic exercise on neurological function recovery from cerebral ischemia/reperfusion and to determine whether these effects are associated with the expression level of HSPA5 in the ischemic penumbra.Methods A total of 72 male Sprague-Dawley rats were randomly assigned to the ischemia and exercise group[middle cerebral artery occlusion(MCAO)-Ex,n=18],ischemia and sedentary group(MCAO-St,n=18),sham-surgery and exercise group(Sham-Ex,n=18),or sham-surgery and sedentary group(Sham-St,n=18).The MCAO-Ex and MCAO-St groups were subjected to MCAO for 60 min,whereas the Sham-Ex and Sham-St groups were subjected to an identical operation without MCAO.Rats in the MCAO-Ex and Sham-Ex groups then ran on a treadmill for 30 min once a day for 5 consecutive days.After reperfusion,the motor function of the rats was scored by the Bederson neurological function test,balance beam test,and screen test.Nissl staining was conducted to assess morphological and structural change of nerve cells in the ischemic penumbra.The reverse transcription-quantitative polymerase chain reaction was applied to detect the mRNA expression of HSPA5.Western blot analysis was conducted to determine the protein expression of HSPA5.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining was carried out in the ischemic penumbra after MCAO.Results Rats receiving early treadmill exercise had lower Bederson neurological function,balance beam,and screen test scores on the 3rd,7th,and 14th days after MCAO;in addition,more neurons survived in the ischemic penumbra after MCAO,and higher mRNA and protein expression of HSPA5 and fewer TUNEL-positive stained cells were observed.Conclusion Our study demonstrated that early aerobic exercise can improve neurological function recovery after ischemia/reperfusion.Furthermore,the increased level of HSPA5 in the ischemic penumbra might be one of the mechanisms of enhanced neurological function recovery.

Effect of aerobic exercise on the contractile function of gastrocnemius myosin heavy chain

Objective To study the effect of 4-6 weeks’ treadmill training of male SD rats on the contractile function of their gastrocnemius myosin heavy chain (MHC). Methods Forty male SD rats were randomly divided into control group and training group. The treadmill training of the training group rats was incessantly performed for 4-6 weeks at an intensity of about 75% VO2max (18.5-24 m/min,gradient of 0°,each training session lasting 50 minutes,twice a day). The content of gastrocnemius MHC mRNA was tested by reverse transcription polymerase chain reaction (RT-PCR),and the changes of muscle fibre and its cross-section area (CSA) were measured using immunohistochemistry. Electric stimulation tests were used to determine the maximal tension of isometric contraction of the post-training gastrocnemius. Results ① After continuous treadmill training for 4-6 weeks,we found that the content of the total MHC,MHC Ⅰ,MHC Ⅱx,MHC Ⅱa mRNAs was 105%,105%,109% and 108% of that in the resting control group,respectively,and the MHC Ⅱb mRNA content did not change significantly. The percentage of MHC Ⅰ mRNA in the total MHC mRNA increased while that of MHC Ⅱ mRNA decreased after aerobic training. ② The slow type of fibre type Ⅰ was the main part of the MHC after training and the CSA of the muscle fibres increased simultaneously. ③ The maximal tension of isometric contraction by pulse stimulation of square wave in the training group increased significantly compared with that in the control group (P<0.01). Conclusion The findings indicate that aerobic exercise may promote an increase in the contractile function of MHC.

Dynamic changes of cardiovascular regulating factors in rats after aerobic exhaustive exercise

Objective To study the changes of cardiovascular regulating factors in rats during recovery of aerobic exhaustive exercise. Methods Sixty male Wistar rats were randomly divided into control group, 1 h-exercise group, 3 h-exercise group, exhausted group, 2 h-recovery group and 12 h-recovery group. The rats were killed at corresponding times for each group after an 8-week-long treadmill training, and the levels of NO, ET, ANP and TXB2 in plasma were measured in each group. Results NO/ET ratio of 1 h-exercise group was significantly higher than that in control group(P<0.01), while it was significantly decreased in 3 h-exercise group and exhausted group(P<0.05). ANP contents in rat plasma were significantly higher in 3 h-exercise group, exhausted group and 2 h-recovery group than that in control group(P<0.05 or P<0.01). The concentration of TXB2 in plasma was significantly increased in 3 h-exercise group, exhausted group and 2 h-recovery group(P<0.05). Conclusion Changes in cardiovascular regulating factors after exhaustive exercise may lead to deficiency of coronary circulation blood/oxygen supply, which may cause exerciseinduced fatigue.

Walking and Aerobic Capacity in Old Adults after Concentric and Eccentric Endurance Exercise at Self-Selected Intensities

Self-selected exercise intensity can be a useful exercise prescription tool for older adults;however, it is not known if it can elicit improvements in walking and aerobic capacity. In older adults, effects of concentric or eccentric endurance exercise at self-selected walking speed were examined on 1-mile indoor walk performance, predicted maximum oxygen uptake and physiological parameters. Twenty-four older adults (67 ± 4 years) completed 3 × 30 min treadmill walks per week for 12-weeks on level (LTW, n = 11, 0%) or downhill (DTW, n = 13, ﹣10%) treadmill gradient at a self- selected speed, which progressed every 4 weeks. Maximal oxygen uptake was predicted using a 1-mile walk at 4-week intervals with physiological responses recorded using a portable metabolic system. One-mile walking speed increased from baseline following 8- and 12-weeks (12 weeks: LTW: 13% ± 6%, DTW: 14% ± 9%,

The therapeutic effect of aerobic exercise with resistance training in elderly men with type 2 diabetes mellitus

Objective: This study was conducted to examine the effects of aerobic exercise alone and aerobic exercise with resistance training on the quality of life in men over the age of 55 years with type 2 diabetes mellitus. Methods: A total of 54 participants were divided into the following three groups so that there were no significant differences in blood chemistry or physical ability indexes among the three groups: control, aerobic exercise, and aerobic exercise with resistance training. The latter two groups exercised for 24 weeks, while the control group performed no exercise. Blood chemistry levels and measures of physical ability in each group members were examined one day before and one day after the exercise regimens. Results: Compared with those before the study, blood glucose, glycated hemoglobin, triglycerides, cholesterol, and low-density lipoprotein levels as well as vital capacity, reaction time, sit-and-reach ability, and balancing while standing on one leg with closed eyes were significantly improved in the aerobic exercise only group(P < 0.05). All these measures as well as high-density lipoprotein levels and grip, back, and leg strength were significantly improved in the combined aerobic and resistance training group(P < 0.05). By contrast, no significant differences before and after the experiment were found in any measure for the control group(P > 0.05). Conclusion: Although both aerobic exercise and aerobic exercise combined with resistance training for 24 weeks effectively improved the quality of life in patients with type 2 diabetes, the effect of the combined training was better than that of aerobic exercise alone. These results suggest that resistance training may be safely added to the rehabilitation training regimen of patients with type 2 diabetes mellitus.

Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria

The following article has been retracted due to the conflicts between the authors. The scientific community takes a very strong view on this matter, and HEALTH treats all unethical behavior seriously. This paper published in Vol.5 No.11, 1796-1802 (2013) has been removed from this site. Title: Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria Authors: Charles Ikechukwu Ezema, Amarachi Akuegbu Onwunali, Sikiru Lamina, Uche Anthonia Ezugwu, Augustine Amaeze Amaeze, Maduabuchukwu Joseph Nwankwo, Florence Ngozi

Impact of community-based exercise program participation on aerobic capacity in women with and without breast cancer

BACKGROUND Evidence for exercise as an efficacious strategy to improve aerobic capacity of breast cancer survivors(BCS)has come largely from intervention studies conducted in laboratory settings.There is an increasing need to translate to community-type settings,but the efficacy of those interventions using gold standard evaluation is not well-established.AIM To investigate whether similar improvement in aerobic capacity(maximal oxygen consumption[VO2])measured with gold standard testing can be achieved through a community-based setting in BCS.METHODS A peak cardiopulmonary exercise test(VO2peak),6-min walk test(6MWT),and timed up and go test(TUG)were assessed pre-and post-16 wk of progressive intensity aerobic and strength training exercise at a community center.RESULTS The sample consisted of 31 early BCS(<1 year since treatment completion)and 15 controls(CTLs).Both groups significantly improved VO2peak(+1.2 mL/kg/min;P=0.030),6MWT(+35 meters;P<0.001),and TUG(-0.44 s;P<0.01)following training.Both groups improved peak cycling power during the cardiopulmonary exercise test with BCS improving by+10 watts more than the CTLs(P=0.020).Average exercise attendance was 71%(34 of 48 possible days),but compliant days averaged only 60%of total days for aerobic,and<40%for strength in both groups.CONCLUSION Community-based exercise programs can be an effective strategy to improve aerobic capacity and physical function for early-stage BCS but potentially not to the same extent observed in laboratory-based randomized controlled trials.Further research is needed to explore barriers and facilitators of exercise engagement in community-based centers to maximize training benefits for adults with cancer.

Effects of Aerobic Exercise on the Intramuscular Lipid and Glycogen Content of Fiber Types in Soleus Muscles of Non-Alcoholic Steatohepatitis Model Rats

We studied the effects of exercise on muscle mitochondria, and lipid and glycogen content in non-alcoholic steatohepatitis (NASH) model rats. Male Sprague-Dawley rats were randomly separated into 3 groups: the control group was fed standard chow;the NASH group was fed a methionine-choline-deficient high-fat diet (MCD);the NASH-exercise group was fed the MCD and exercised three times a week. Exercise training consisted of continuous running for thirty minutes at a 13 m/min, 6° slope on a motor-driven rodent treadmill for 6 weeks. Mitochondria content in NASH group decreased in the both fiber types compared with those of the control group. As compared between the NASH and NASH-exercise groups, however, exercise not only promoted significant improvements in liver fibrosis and cirrhosis and triglyceride (TG) content but also increased mitochondria content in type I muscle fiber in particular. These data suggest that exercise improved hepatic steatosis in NASH model rats and can prevent the progression of NASH.

Acute Response of Heart Rate of Pregnant Women to Aerobic Dance Exercise

This was a Pre-test/Post-test research designed to study the acute heart rate response of pregnant women to aerobic dance exercise. Twenty four (24) pregnant women with no complications participated in this study. HR increased significantly after 30 minutes exercise [7.292, P = 0.004 (P < 0.05)] and then decreased significantly again after 30 minutes rest, post exercise [10.00, P = 0.0001 (P < 0.05)]. The heart rate normalised after 30 minutes rest, showing no significant difference from the pre-exercise value [2.708, P = 0.517 (P > 0.05)]. Moderate intensity Aerobic Dance Exercise may not precipitate adverse acute cardiorespiratory response in pregnant women with no complications.

Effects of Teriparatide and Aerobic Exercise on Lumbar Spine Microstructure in Ovariectomized and Tail-Suspended Rats

Osteoporosis is an increasingly prevalent malady of the elderly that is associated with bone fragility and increased risk of fractures. Osteoporosis treatments focus on restoring bone strength and quality. Teriparatide (TPTD) is a therapeutic agent that has been shown to increase bone strength by improving the volume and connectivity of trabecular bone. Exercise is also known to have pro-osteogenic effects. Here we used a rat model of severe osteoporosis (ovariectomized and tail-suspension) to evaluate the effects of TPTD, exercise and a combination of TPTD and exercise on the microstructure of trabecular bone. TPTD mono-therapy and TPTD combined with exercise treatment significantly increased bone mineral density (BMD) in the whole body. Micro-computed tomography analysis revealed that a combination of exercise and TPTD treatment significantly decreased bone surface to volume and trabecular separation compared with those of the control and exercise groups. Node-strut analysis indicated that exercise or TPTD alone did not affect trabecular bone connectivity. However, the combination of exercise and TPTD treatment significantly decreased measures of trabecular bone connectivity (node number) that are consistent with a transition from rod-like to plate-like of trabecular bone microstructures. The combination treatment with exercise and TPTD improved microstructure of trabecular bone in the OVX and tail-suspended rats. These results indicate that combining exercise with TPTD represents a viable means to improve cancellous bone strength in osteoporosis populations.