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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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.

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

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

延迟性肌肉酸痛与运动性骨骼肌记忆

背景:不习惯的运动使骨骼肌损伤,但可以产生一种减轻肌肉再损伤减轻疼痛的特定训练效果-肌肉记忆。目的:基于延迟性肌肉酸痛的病因,综述延迟性肌肉酸痛中骨骼肌记忆的存在及其可能机制,提出防治延迟性肌肉酸痛的新见解。方法:第一作者以“DOMS,Skeletal muscle memory,Exercise Skeletal muscle adaptation,Repeat turn effect,exercise and autophagy,Autophagy and inflammation”为英文检索词,“延迟性肌肉酸痛,骨骼肌记忆,运动性骨骼肌适应,重复回合效应,运动与自噬,自噬与炎症”为中文检索词,检索PubMed、Embase、Web of Science、中国知网及万方数据库1990年1月至2022年12月发表的相关文献,最终纳入102篇文献进行综述。结果与结论:目前认为延迟性肌肉酸痛是由于代谢紊乱、机械损伤和氧化应激所致的急性期炎症反应,而运动性骨骼肌记忆具有减轻延迟性肌肉酸痛、减轻运动再损伤的作用,当离心训练的持续时间、频率和强度逐渐增加时,损伤症状可以被最小化,甚至可以避免。因此基于运动性骨骼肌记忆机制,寻找防治或减轻延迟性肌肉酸痛及运动性肌肉损伤的方法是未来的研究方向。综述的主要目的:①明确运动性骨骼肌记忆的存在;②探讨运动性骨骼肌记忆的可能机制,并提出该记忆与骨骼肌自噬的关系;③通过改善骨骼肌自噬水平为延迟性肌肉酸痛的防治提供新策略。

经颅重复针刺联合运动疗法治疗卒中后吞咽障碍的临床研究

目的:观察经颅重复针刺联合运动疗法对卒中后吞咽障碍患者吞咽功能和生活质量的影响。方法:符合纳入标准的82例卒中后吞咽障碍患者作为研究对象,将其随机分为观察组和对照组。两组均进行基础治疗,对照组予常规针刺,头项面部穴取天柱、风池、完骨与廉泉,肢体部穴取合谷、手三里、曲池、肩髃、太冲、悬钟、足三里与伏兔,针刺同时嘱患者进行重复吞咽运动,10次/min,共运动5 min;观察组在对照组治疗基础上予经颅重复针刺刺激作用于焦氏头针运动区、足运感区,5 min/次,吞咽运动在此期间进行。两组均留针30 min,治疗1次/d,以治疗6 d休息1 d为1个疗程,共治疗4个疗程。于治疗前、后分别对两组患者的标准吞咽功能评定量表(SSA)评分、吞咽障碍特异性生活质量量表(SWAL-QOL)评分及颏下肌群和舌骨下肌群表面肌电图(sEMG)的变化进行观察。结果:治疗后,两组患者SSA、SWAL-QOL评分及sEMG变化均较治疗前有所改善(P<0.01),且观察组各项评分及sEMG变化均优于对照组(P<0.05或P<0.01)。结论:经颅重复针刺联合运动疗法可缓解卒中后吞咽障碍患者颏下肌群、舌骨下肌群麻痹状态,提高吞咽运动能力,改善生活质量,临床疗效确切。

悬吊训练联合重复经颅磁刺激治疗对痉挛型脑瘫儿童的疗效观察

目的:观察悬吊训练(sling exercise training,SET)联合重复经颅磁刺激对痉挛型脑瘫(以下简称脑瘫)儿童的临床疗效。方法:选取淮安市妇幼保健院儿童康复科门诊、住院部符合纳入及排除标准的48例脑瘫患儿,随机分为常规组、悬吊组、联合组3组,每组各16例。常规组进行常规康复训练,悬吊组在常规康复训练基础上予以悬吊训练,联合组在悬吊组基础上进行重复性经颅磁刺激治疗。观察3组患儿治疗前后在粗大运动功能测试量表(GMFM-88)站立D区及走、跑跳E区评分及Berg平衡量表(BBS)、日常生活活动能力(ADL)评分变化情况。结果:与治疗前相比,3组患儿在GMFM-88 D区、GMFM-88 E区、BBS、ADL评分上均有显著改善(P<0.05)。联合组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS、ADL评分上均优于常规组(P<0.05);悬吊组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS评分上优于常规组(P<0.05),在改善ADL评分上有所提高,差异无统计学意义(P>0.05);联合组在改善患儿GMFM-88 D区、GMFM-88 E区、BBS评分上优于悬吊组(P<0.05),在改善ADL评分上有所提高,但差异无统计学意义(P>0.05)。结论:悬吊训练联合rTMS可显著改善脑瘫患儿平衡、站立、行走等粗大运动功能,有效提高患儿在日常生活活动中的自主性和独立性。

运动疗法配合重复经颅磁刺激对抑郁症患者认知能力和社会功能的影响

目的:观察探讨运动疗法配合重复经颅磁刺激(rTMS)对抑郁症患者认知能力、社会功能的影响。方法:前瞻性选取庆阳市第二人民医院2022年1月—2023年2月接收的抑郁症患者102例,按随机数字表法分为对照组(n=51)、观察组(n=51)。对照组进行rTMS治疗,观察组予以rTMS治疗配合运动疗法。对比两组总有效率、蒙特利尔认知评估量表(MoCA)评分、住院精神病人社会功能评定量表(SSPI)评分、威斯康星卡片分类测验(WCST)、不良反应。结果:观察组总有效率为96.08%,较对照组的78.43%更高,差异有统计学意义(P<0.05)。治疗前,两组MoCA评分、SSPI评分、WCST比较,差异均无统计学意义(P>0.05);治疗后,两组MoCA、SSPI评分均升高,且观察组MoCA、SSPI评分均高于对照组,差异均有统计学意义(P<0.05)。两组完成分类数、应答正确数均高于治疗前,且观察组均高于对照组,持续性错误数、应答错误数均少于治疗前,且观察组均少于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:抑郁症患者进行rTMS治疗的同时配合运动疗法,能够显著提高临床疗效,改善认知能力,增强社会功能、执行功能,且安全性良好。

A Case of Muscle Contraction-Induced Ischemic Limb Hyperemia in a Patient with Peripheral Arterial Disease during Incremental Repeat Isometric Knee Extensor Workloads

Background: To determine whether muscle contraction-induced leg blood flow (LBF) during exercise may be altered in a patient with an ischemic limb due to peripheral arterial disease (PAD) compared with the non-PAD limb. Case Presentation: A 66-year-old male patient with intermittent claudication due to PAD in the right leg (ankle brachial pressure index, 0.69) showed complete obstruction in both common iliac arteries including internal/external segments with collaterals above the femoral artery and popliteal artery with collaterals, and in the healthy left non-PAD-leg (1.06). He attempted unilateral repeat isometric knee extensions at a target contraction rhythm with each leg at incremental contraction intensities (5%, 10%, and 30% of maximum voluntary contraction [MVC] for 3 min at each intensity). Blood velocity/flow (Doppler ultrasound) in the femoral artery, blood pressure, and leg vascular conductance (LVC) were measured. Isometric thigh MVC strength pre-exercise was similar between the PAD-leg (48.0 kg) and non-PAD-leg (48.7 kg). Pre-exercise LBF (ml/min) was also similar between the PAD-leg (316) and non-PAD-leg (327). Blood pressure increases were similar during exercise. Average exercising LBF in ml/min in the last 1 min at each intensity was higher in the PAD-leg than the non-PAD-leg: 1087 vs. 471 at 5%, 2097 vs. 712 at 10%, and 2656 vs. 1517 at 30% MVC with a close positive linear relationship between LBF and %MVC in the non-PAD-leg (r = 0.999, P < 0.01), in agreement with previous findings, but less significant in the PAD-leg (r = 0.879, P = NS), indicating intense vasodilation (increasing LVC) in the PAD-leg compared with the non-PAD-leg. Conclusion: Knee extensor exercising LBF in the femoral artery was dissimilar between the PAD-leg and non-PAD-leg at the same exercise intensity, even though pre-exercising LBF was the same. Further research on the time-course in hemodynamics during leg exercise in PAD might potentially provide insight for the cardiovascular adjustment in severity of arteriosclerosis, stenosis and/or collaterals reserve.

重复离心运动防治代谢性疾病研究进展

通过梳理重复性离心运动(eccentric exercise,ECC)与代谢性疾病防治相关研究,厘清重复性ECC在代谢性疾病防治中的应用成果、适应机制以及应用风险防范。ECC初期,一次不适应的ECC诱发的骨骼肌超微结构损伤和暂时性胰岛素抵抗是机体的代偿性保护机制;重复性ECC可实现在相对较低心血管负担下进行高负荷肌肉运动,在人体代谢、骨骼肌质量与功能、身体成分、心血管功能、炎症、日常生活自理能力、运动依从性等方面产生有益影响,是心血管系统、呼吸系统、运动能力等受限的代谢性疾病患者及其风险人群有效且相对安全可行的理想运动方式。这一代谢性疾病防治效应是机体各系统产生适应的结果。未来研究需进一步针对代谢性疾病患者及其风险人群探究更高依从性且功效更大化的ECC干预方案,并深入探索其机制。

帕金森病非药物非手术治疗进展

帕金森病(PD)是一种神经退行性疾病,临床多使用药物及手术进行治疗,但存在药物异动及手术风险,因此推动了非药物及非手术等疗法的研究,如重复经颅磁刺激治疗、针灸治疗、运动疗法、光照疗法等。本文从PD的上述非药物及非手术疗法的机制及疗效等方面进行综述,并对各疗法现存问题进行分析和展望。

连续运动后延迟性肌肉损伤的适应性研究

采用人体和动物实验观察延迟性肌肉损伤对连续运动的适应性变化。人体研究发现 ,体育系男性大学生一次性运动后即刻身体疲劳感觉 (RPE)达峰值 ,以后逐渐恢复 ;肌肉酸痛感觉、血清肌酸激酶 (CK)活性和肌红蛋白 (Mb)含量运动后第 3天达峰值 ,运动后第 7天恢复到运动前水平。 1周运动后 ,RPE、肌肉酸痛感觉、CK活性和Mb的变化明显 ,但无持续增高的趋势 ,运动后第 4天各种症状和指标均开始恢复。动物实验结果显示 ,一次离心运动导致的骨骼肌超微结构变化在运动后 2 4～ 4 8小时最为明显 ,运动后第 7天损伤程度明显减轻。连续 7天同样强度运动后骨骼肌超微结构的破坏并无积累现象 ,停止运动后第 7天基本恢复。本研究结果提示 。

反复离心运动对大鼠骨骼肌损伤和蛋白质降解机制的影响

目的:探讨连续离心运动训练对骨骼肌中Calpain和Ubiquitin含量的影响及其与骨骼肌损伤之间的关系;方法:雄性SD大鼠29只随机分为对照组、离心训练后即刻组、24h组和7天组。训练组大鼠连续进行7天的下坡跑运动,分别在末次训练后即刻,24h和第7天取股四头肌,测定股四头肌的超微结构、血清LDH和CK活性以及骨骼肌中Calpain-1、Calpain-2和Ubiquitin含量;结果:1)7天离心训练后即刻和24h,股四头肌超微结构的损伤性变化呈渐进性加重,离心训练后24h组出现明显的肌丝坏死。训练后第7天仍不能完全恢复。血清CK和LDH活性的变化与大鼠股四头肌超微结构的变化相一致。2)与对照组相比,末次训练后即刻骨骼肌中Calpain-1、Calpain-2和Ubiquitin含量均显著升高;训练后24h,Calpain-1和Calpain-2含量进一步升高,其中,Calpain-1显著高于对照组和训练后24h组,Calpain-2虽显著高于对照组,但与训练后即刻组相比无显著性差异;而Ubiquitin含量显著低于训练后即刻组。训练后第7天,Calpain-1和Calpain-2含量显著低于训练后24h组,但仍然高于对照组;而Ubiquitin含量虽高于训练后24h组和对照组,但无显著性差异;结论:1)连续的离心运动可能对骨骼肌纤维的损伤产生一定的累加作用;2)短期连续的离心训练后,骨骼肌中Calpain和Ubiquitin的动态变化几乎与骨骼肌超微结构的动态变化相一致。离心运动训练导致骨骼肌中Calpain和Ubiquitin含量的增加,可能是导致骨骼肌累积性损伤的重要机制。

离心运动对大鼠骨骼肌细胞凋亡和增殖的影响

目的:探讨离心运动对骨骼肌细胞凋亡和增殖的时序性影响。方法:50只8周龄SD大鼠随机分为对照组(C)和运动组(B1,B2,B3,B4)(n=10),运动组进行重复3 d的力竭性离心运动,TUNNEL法检测大鼠肱三头肌内侧头不同恢复时相细胞凋亡情况和免疫组化检测其细胞增殖核抗原(PCNA)的表达。结果:①骨骼肌细胞凋亡出现时序性变化,并与运动性骨骼肌微损伤出现了一致性,运动组凋亡指数明显高于对照组(P<0.05),运动后即刻凋亡指数升高,运动后24 h达到峰值,运动后48 h凋亡指数有所下降。②骨骼肌细胞增殖出现时序性,运动组增殖指数明显高于对照组(P<0.05),运动后即刻增殖指数较高,运动后3 h增殖指数有所下降,运动后24 h增殖指数达到峰值,到运动后48 h下降,但还未恢复到对照组。并与细胞凋亡呈中度相关(P<0.05)。结论:①细胞凋亡是诱发骨骼肌再发性损伤的一个因素。②细胞凋亡可能是骨骼肌细胞再生的一个启动因素。