Treadmill exercise improves hippocampal neural plasticity and relieves cognitive deficits in a mouse model of epilepsy

Epilepsy frequently leads to cognitive dysfunction and approaches to treatment remain limited.Although regular exercise effectively improves learning and memory functions across multiple neurological diseases,its application in patients with epilepsy remains controversial.Here,we adopted a 14-day treadmill-exercise paradigm in a pilocarpine injection-induced mouse model of epilepsy.Cognitive assays confirmed the improvement of object and spatial memory after endurance training,and electrophysiological studies revealed the maintenance of hippocampal plasticity as a result of physical exercise.Investigations of the mechanisms underlying this effect revealed that exercise protected parvalbumin interneurons,probably via the suppression of neuroinflammation and improved integrity of blood-brain barrier.In summary,this work identified a previously unknown mechanism through which exercise improves cognitive rehabilitation in epilepsy.

Standardization of exercise intensity and consideration of a dose-response is essential.Commentary on "Exercise-linked FNDC5/irisin rescues synaptic plasticity and memory defects in Alzheimer’s models”,by Lourenco et al.,published 2019 in Nature Medicine

Over the past decade,several biochemical pathways have been investigated to understand the underlying mechanisms involved in the beneficial effects of physical exercise on cognition.1,2 Lourenco et al.,3 in an elegant study published in Nature Medicine,examined the relationship between exercise training and hippocampal memory function.Mechanistically,the authors showed that FNDC5/irisin is an important mediator of beneficial effects of physical exercise in a mouse model of Alzheimer's disease.

EEG-Related Changes to Fatigue during Intense Exercise in the Heat in Sedentary Women

Purpose: This study examined the possible causal mechanisms of fatigue during intense exercise in the heat in a group of nine sedentary women. Methods: Two strenuous cycling sessions were performed, at 100% of maximal aerobic power, either in neutral (N-Ex, air temperature: 22°C ± 0.4°C, air humidity: 53% ± 8%) or in heat conditions (H-Ex, air temperature: 35°C ± 0.3°C, air humidity: 59 ± 6). Tympanic temperature (Tty), heart rate (HR), body mass loss (BML), lactate concentration [La] and brain electrical activity (EEG: α and β waves and α/β ratio) were recorded. Results: Tty, HR and [La] increases (p ﹣1) than that during N-Ex (0.08 ± 0.02°C·min﹣1), and time to exhaustion (Time Limit at 100%) was significantly (p β waves decreased (p α/β ratio increased (p < 0.05) significantly immediately before exhaustion. Conclusion: During exercise in the heat, the high rate of core temperature rising might be a critical factor triggering faster brain changes.

Physical exercise and synaptic protection in human and pre-clinical models of multiple sclerosis

In multiple sclerosis,only immunomodulato ry and immunosuppressive drugs are recognized as disease-modifying therapies.Howeve r,in recent years,several data from pre-clinical and clinical studies suggested a possible role of physical exe rcise as disease-modifying therapy in multiple sclerosis.Current evidence is sparse and often conflicting,and the mechanisms underlying the neuroprotective and antinflammatory role of exercise in multiple sclerosis have not been fully elucidated.Data,mainly derived from pre-clinical studies,suggest that exe rcise could enhance longterm potentiation and thus neuroplasticity,could reduce neuroinflammation and synaptopathy,and dampen astrogliosis and microgliosis.In humans,most trials focused on direct clinical and MRI outcomes,as investigating synaptic,neuroinflammato ry,and pathological changes is not straightfo rward compared to animal models.The present review analyzed current evidence and limitations in research concerning the potential disease-modifying therapy effects of exercise in multiple sclerosis in animal models and human studies.

Group dynamics motivation to increase exercise intensity with a virtual partner

Background: The effect of the K?hler group dynamics paradigm(i.e., working together with a more capable partner where one's performance is indispensable to the team outcome) has been shown to increase motivation to exercise longer at a strength task in partnered exercise video games (exergames) using a software-generated partner(SGP). However, the effect on exercise intensity with an SGP has not been investigated. The purpose of this study was to examine the motivation to maintain or increase exercise intensity among healthy, physically active middle-aged adults using an SGP in an aerobic exergame.Methods: Participants(n = 85, mean age = 44.9 years) exercised with an SGP in a 6-day cycle ergometer protocol, randomly assigned to either(a)no partner control,(b) superior SGP who was not a teammate, or(c) superior SGP as a teammate(team score was dependent on the inferior member). The protocol alternated between 30-min continuous and 4-min interval lhigh-intensity session days, during which participants could change cycle power output(watts) from target intensity to alter distance and speed.Results: Mean change in watts from a targeted intensity(75% and 90% maximum heart rate) was the primary dependent variable reflecting motivational effort. Increases in performance over baseline were demonstrated without significant differences between conditions. Self-efficacy and enjoyment were significantly related to effort in the more intense interval sessions.Conclusion: Under these conditions, no K?hler effect was observed. Exercise performance during the higher-intensity interval format is more closely related to enloyment and self-efficacy beliefs compared to the continuous sessions.

Exercise Fatigue Monitoring Based on R-Peak Detection Using UNET-TCN

Moderate exercise contributes to health, but excessive exercise may lead to physicalinjury or even endanger life. It is pressing for a device that can detect the intensity of exercise.Therefore, in order to enable real-time detection of exercise intensity and mitigate the risks of harmfrom excessive exercise, a exercise intensity monitoring system based on the heart rate variability(HRV) from electrocardiogram (ECG) signal and linear features from phonocardiogram (PCG)signal is proposed. The main contributions include: First, accurate analysis of HRV is crucial forsubsequent exercise intensity detection. To enhance HRV analysis, we propose an R-peak detectorbased on encoder-decoder and temporal convolutional network (TCN). Experimental resultsdemonstrate that the proposed R-peak detector achieves an F1 score exceeding 0.99 on real high-intensity exercise ECG datasets. Second, an exercise fatigue monitoring system based on multi-signal feature fusion is proposed. Initially, utilizing the proposed R-peak detector for HRV extractionin exercise intensity detection,which outperforms traditional algorithms, with the system achieving a classification performance of 0.933 sensitivity, 0.802 specificity, and 0.960 accuracy. To further improve the system, we combine HRV with the linear features of PCG. Our exercise intensitydetection system achieves 90.2% specificity, 96.7% recall, and 98.1% accuracy in five-fold cross-validation.

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%,

Physical exercise intensity prescription to improve health and fitness in overweight and obese subjects: A review of the literature

Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. Furthermore, obesity is already responsible for 2% -8% of health costs and 10% -13% of deaths in several industrialized countries. Lifestyle modifications involving changes in exercise, diet and psychological support are effective in reducing the incidence of overweight. Moreover, positive effects of physical activity (PA) for weight loss and prevention of weight regain are well documented. It was recognized that health benefits regarding both psychological and physiological aspects, such as improving cardiorespiratory and muscular fitness and/or decreasing depression symptoms, can be obtained from numerous activities. Public health institutions (American College of Sports Medicine, World Health Organization) provide recommendations for PA (volume, frequency, intensity and type of exercise) to achieve positive effects, at all ages and for many diseases and disorders situations. Although exercise under guidelines can be safely performed by obese subjects, several questions still need to be fully answered. In facts, the exercise program should be tailored according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Thus, this review analyzes the intensity of PA parameters. In the last years, research has been focused on the individualization of the right intensity in which different types of subjects’ condition must undergo to achieve the health goals. Aerobic exercise has been commonly used to reach weight loss goal. Prescription of aerobic exercise in clinical practice is frequently based on the percentage of maximum heart rate (%HRmax), heart rate reserve (%HRreserve), rating of perceived exertion (RPE), maximal oxygen consumption (%VO2max) and for unhealthy subjects, peak oxygen consumption (%VO2peak). It has been shown that unhealthy subjects, such as individuals affected by diabetes, obesity and cardiovascular diseases have a reduced maximal aerobic exercise capacity. For instance, using the formula based on percentage of HRmax or VO2max, it could be prescribed heavy exercises, which would result not appropriated and fully functional for the specific individual goal. To avoid this problem, another approach to individualize aerobic exercise could be to consider the gas exchange parameters such us aerobic gas exchange threshold (AerTGE). AerTGE corresponds to the first increase in blood lactate during incremental exercise. This review offers an overview of the different methods to assess exercise intensity, considering the different subjects health characteristics, in order to choose the right methods to achieve the health goals in obese and overweight subjects.

Effect of exercise training intensity on adipose tissue hormone sensitive lipase gene expression in obese women under weight loss

Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss. Methods:Thirty women(body mass index(BMI) = 33.0±0.7 kg/m^2,age = 58±1 years) completed one of three 20-week interventions: caloric restriction alone(CR only,n = 8),CR plus moderate-intensity exercise(CR + moderate-intensity,45%—50%heart rate reserve(HRR). 3 day/week,n = 9),or CR plus vigorous-intensity exercise(CR + vigorous-intensity,70%—75%HRR,3 day/week,n = 13).Each group had a similar prescribed energy deficit comprised of underfeeding alone(2800 kcal/week for CR only) or underfeeding(2400 kcal/week) plus exercise(400 kcal/week).Body composition and maximal aerobic capacity(VO_2max) were measured,and subcutaneous abdominal adipose tissue samples were collected before and after the interventions.Adipose tissue HSL gene expression was measured by real time reversetranscriptase polymerase chain reaction. Results:All three interventions reduced body weight,fat mass,percent fat.and waist to a similar degree(all p < 0.01).In addition,all interventions did not change absolute VO_2 max,but increased relative VO_2 max(p < 0.05 to P < 0.01).Compared to pre-intervention.neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression,but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression(p < 0.01).The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only(p < 0.05) and CR + moderate-intensity(p < 0.01) groups.In the whole cohort,changes in adipose tissue HSL gene expression correlated positively to changes in absolute(r = 0.55,p < 0.01) and relative(r = 0.32,p = 0.09) VO_2 max. Conclusion:These results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss.

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.

The influence of different exercise intensities on kicking accuracy and velocity in soccer players

Purpose: The aim of this study was to investigate the influence of different exercise intensities induced by a soccer specific protocol on kicking performance in soccer players.Methods: Twelve semi-professional male soccer players participated in this study and performed maximal instep kicks before and after the implementation of an exercise protocol to determine the influence of different intensities upon kicking ball velocity and the target-hitting accuracy.Results: Analysis of variance designs with repeated measures showed that maximal ball velocity was affected only after the most intense circuit(F(6, 66) = 2.3; p = 0.041; η2= 0.18), while accuracy was not affected in the protocol(F(6, 66) = 0.19; p = 0.98; η2= 0.02). Low and moderate intensities did not affect accuracy or kicking ball velocity.Conclusion: These findings suggest that kicking ball velocity is influenced by high-exercise intensities. Low and moderate exercise intensities do not affect the performance of the kick, and intensity does not influence accuracy. Otherwise, it is possible that other mechanisms(not only physiological) may influence players during the exercise.

Lycopene Supplementation Attenuates Oxidative Stress Parameters in the Plasma of Humans with Cad after Intense Exercise

To investigate the effects of moderate and intense exercise (ME,IE) and lycopene (L) supplementation on oxidative stress biomarkers in patients with CAD. Rehabilitation clinic.Thirty-two male volunteers with CAD (55.65 ? 2.27 years, 77.27 ? 3.95 kg, 171.9 ? 2.80 cm) were divided into four groups;ME-Placebo (n = 7), ME + L (n = 8), IE-Placebo (n = 8) and IE-L (n = 9). Blood samples (12 mL) were collected before supplementation (one cereal bars – 15 mg of syn-thetic lycopene) and exercise (45 min plus 15 min of stretching, 3/wk) and after five weeks of supplementation and 72 h after exercise. Nitrite/nitrate concentrations (NOx), lipoperoxidation (TBARS levels), protein carbonylation (PC) and superoxide dismutase (SOD) and catalase (CAT) activity were assessed in plasma. NOx decreased significantly in the ME-P, IE-P and ME-L groups at 72 h after exercise and increased in the IE-L 72 h after the last exercise session. The IE-L group demonstrated decreased TBARS at 72 h after the last exercise session. The level of PC increased only in EI-P at 72 h after the last exercise session, while only the EI-L group presented a reduction. SOD increased signifi-cantly in both placebo groups 72 h after the last exercise session and decreased in the ME-L group 72 h after in rela-tion to placebo groups. CAT increased in ME-P, IE-P and IE-L groups only at 72 h after the last exercise session. The lycopene supplementation attenuates some markers of oxidative stress associated with IE Lycopene also had dissimilar effects on some markers of oxidative stress in subjects undertaking ME versus IE.

Effects of hypoxic training on physiological exercise intensity and recognition of exercise intensity in young men

This study aimed to examine the effects of hypoxic training on physiological exercise intensity and recognition of exercise intensity in young men. The participants included 9 healthy young males (23.2 ± 6.5 years old, 176.2 ±6.7 cm, 74.3 ±16.4 kg). VO2 was measured during running with subjective exercise intensities of “somewhat hard” for 3 min and “fairly light” for 3 min. After the measurements, the participants answered the question “what percentage of your maximal effort was performed during both running exercises.” The exercise intensity recognition for the “fairly light” and “somewhat hard” intensities and the physiological exercise intensity measured by relative VO2 (%) and relative heart rate (HR, %) were then evaluated. The hypoxic training was performed 3 times a week for 4 weeks in a normobaric hypoxic chamber?(oxygen concentration, 15.4% and altitude, 2500 m). The participants ran at an exercise intensity of 60% VO2max for 40 min after a 5 min warm-up and then performed a 5 min cool-down. After training, they sat on a chair in the same room for 30 min. VO2max and HRmax changed significantly after the training. At “fairly light” intensity, the physiological measures were significantly higher than recognition of exercise intensity, with relative VO2 (%) increasing after training. In conclusion, hypoxia training causes an increase in VO2max and physiological exercise intensity during running at a “fairly light” intensity.

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.

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.

Early mobilization for mechanically ventilated patients in the intensive care unit:a systematic review and meta-analysis

Background: Early mobilization(EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation(MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.Methods: A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality.Secondary outcomes were adverse effects and length of stay(LOS) in intensive care unit(ICU) and hospital.Results: Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.Conclusions: This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

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.

Strenuous Exercise—An Unusual Cause of Deranged Liver Enzymes

Liver enzymes and function tests are routinely taken in clinical practice. Deranged liver enzymes however, do not always necessarily imply an underlying liver pathology. The standard liver enzymes measured include alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl-transpeptidase (GGT) and alanine phosphatase (ALP). These enzymes, especially ALT and AST, can be released by other organs in the body. We report an unusual case of a 48-year-old patient with deranged enzymes related exclusively to intensive exercise that resolved on discontinuing such exercise.

Potential Legal Issues and Care Implications during Care-Prevention Gymnastic Exercises for the Elderly Using Pepper in Long Term Health Care Facilities

In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.

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.