Intensive Training for Stroke: Evidence of Safety from Meta-analysis and Systematic Reviews

[Objectives] To investigate the safety of intensive training for stroke recovery. [Methods] A systematic electronic search was conducted up to December 1 st , 2022, and the number of falls and fall-related injuries, as well as other adverse events, were extracted. Odds ratios (ORs) were calculated to assess the two intervention methods, and a 95% confidence interval (95% CI) was calculated for each of them to ensure the statistical accuracy of the results. The heterogeneity of the included studies was also tested. [Results] Five moderate to high quality studies comprising a total of 184 participants were included in this review. All five randomized controlled trials reported adverse events, including falls that did not result in injury, pain in the joints, back, muscle, or chest, and skin injuries such as cuts, bruises, and scrapes. The pooled analysis of these trials showed no statistically significant differences between the intensive training and control groups in terms of falls ( P =0.35) , pain ( P =0.07), or skin injuries ( P =0.90). [Conclusions] This review provides good evidence to suggest that intensive training is safe and feasible as a novel intervention during the stroke recovery.

Effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in type 2 diabetes:A systematic review

BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.

Suppressive effects of exercise-conditioned serum on cancer cells:A narrative review of the influence of exercise mode,volume,and intensity

Cancer is a major cause of morbidity and mortality worldwide,and the incidence is increasing,highlighting the need for effective strategies to treat this disease.Exercise has emerged as fundamental therapeutic medicine in the management of cancer,associated with a lower risk of recur-rence and increased survival.Several avenues of research demonstrate reduction in growth,proliferation,and increased apoptosis of cancer cells,including breast,prostate,colorectal,and lung cancer,when cultured by serum collected after exercise in vitro(i.e.,the cultivation of cancer cell lines in an experimental setting,which simplifies the biological system and provides mechanistic insight into cell responses).The underlying mechanisms of exercise-induced cancer suppressive effects may be attributed to the alteration in circulating factors,such as skeletal muscle-induced cytokines(i.e.,myokines)and hormones.However,exercise-induced tumor suppressive effects and detailed information about training interventions are not well investigated,constraining more precise application of exercise medicine within clinical oncology.To date,it remains unclear what role different training modes(i.e.,resistance and aerobic training)as well as volume and intensity have on exercise-condi-tioned serum and its effects on cancer cells.Nevertheless,the available evidence is that a single bout of aerobic training at moderate to vigorous intensity has cancer suppressive effects,while for chronic training interventions,exercise volume appears to be an influential candidate driving cancer inhibitory effects regardless of training mode.Insights for future research investigating training modes,volume and intensity are provided to further our understanding of the effects of exercise-conditioned serum on cancer cells.

A Study of the English Learning in Language Training Institutions from the Perspective of Dornyei's DMC Theory

This paper will makes a theoretical exploration and explanation about the supporting mental power behind the successful progress the students make in language training institution from the perspective of motivation theory of D?rnyei's DMC theory from the aspect of goal/vision orientedness, a salient facilitative structure, and positive emotionality-the 3 main features of DMC theory. It tries to explore and describe the intense and sustained motivation phenomenon provided by learners who joined some intensive IELTS or TOEFL training courses, hoping to make useful implication and inspiration for future researchers and interested scholars.

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.

Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.

Longitudinal trajectories of athlete burnout among young table tennis players: A 3-wave study

Purpose:The purposes of this study were to examine the trajectories of athlete burnout across a 2-month period characterized by high physical,psychological,and social demands to explore(1)whether several subgroups of athletes representing distinct burnout trajectories emerged from the analyses and(2)whether athlete burnout symptoms(reduced accomplishment,sport devaluation,and exhaustion)developed in tandem or whether some burnout dimensions predicted downstream changes in other dimensions(causal ordering model).Methods:One hundred and fifty-nine table tennis players in intensive training centers completed a self-reported athlete burnout measure across 3 time points within a 2-month period characterized by high demands.Data were analyzed through latent class growth analysis.Results:Results of latent class growth analysis showed 3 distinct trajectories for each athlete burnout dimension,indicating not only linear or quadratic change but also stability in longitudinal athlete burnout perceptions.Results also suggested that the 3 dimensions of athlete burnout did not develop in tandem.Rather,the likelihood of belonging to particular emerging trajectories of sport devaluation and physical/emotional exhaustion was significantly influenced by the athletes’perception of reduced accomplishment assessed at Time 1.Thus,reduced accomplishment predicted downstream changes in the 2 other athlete burnout dimensions.Conclusion:As a whole,these results highlighted that the multinomial heterogeneity in longitudinal athlete burnout symptoms needs to be accounted for in future research.

Producing High Intense Attosecond Pulse Train by Interaction of Three-Color Pulse and Overdense Plasma

Amplifying the attosecond pulse by the chirp pulse amplification method is impossible. Furthermore, the intensity of attosecond pulse is low in the interaction of laser pulse and underdense plasma. This motivates us to propose using a multi-color pulse to produce the high intense attosecond pulse. In the present study, the relativistic interaction of a three-color linearly-polarized laser-pulse with highly overdense plasma is studied. We show that the combination of ω1, ω2 and ω3 frequencies decreases the instance full width at half maximum reflected attosecond pulse train from the overdense plasma surface. Moreover, we show that the three-color pulse increases the intensity of generated harmonics, which is explained by the relativistic oscillating mirror model. The obtained results demonstrate that if the three-color laser pulse interacts with overdense plasma, it will enhance two orders of magnitude of intensity of ultra short attosecond pulses in comparison with monochromatic pulse.

Blood flow restriction during the resting periods of high-intensity resistance training does not alter performance but decreases MIR-1 and MIR-133A levels in human skeletal muscle

Blood flow restriction(BFR)during exercise bouts has been used to induce hypertrophy of skeletal muscle,even with low loads.However,the effects of BFR during the rest periods between sets are not known.We have tested the hypothesis that BFR during rest periods between sets of high-intensity resistance training would enhance performance.Twenty-two young adult male university students were recruited for the current study,with n=11 assigned to BFR and n=11 to a control group.The results revealed that four weeks training at 70%of 1 RM,five sets and 10 repetitions,three times a week with and without BFR,resulted in similar progress in maximal strength and in the number of maximal repetitions.The miR-1 and miR-133a decreased significantly in the vastus lateralis muscle of BFR group compared to the group without BFR,while no significant differences in the levels of miR133b,miR206,miR486,and miR499 were found between groups.In conclusion,it seems that BFR restrictions during rest periods of high-intensity resistance training,do not provide benefit for enhanced performance after a four-week training program.However,BFR-induced downregulation of miR-1 and miR-133a might cause different adaptive responses of skeletal muscle to high intensity resistance training.

High intensity interval training and molecular adaptive response of skeletal muscle

Increased cardiovascular fitness,VO_(2max),is associated with enhanced endurance capacity and a decreased rate of mortality.High intensity interval training(HIIT)is one of the best methods to increase VO_(2max)and endurance capacity for top athletes and for the general public as well.Because of the high intensity of this type of training,the adaptive response is not restricted to Type I fibers,as found for moderate intensity exercise of long duration.Even with a short exercise duration,HIIT can induce activation of AMPK,PGC-1α,SIRT1 and ROS pathway as well as by the modulation of Ca^(2+)homeostasis,leading to enhanced mitochondrial biogenesis,and angiogenesis.The present review summarizes the current knowledge of the adaptive response of HIIT.