The effects of exercise on non-motor experiences of daily living experienced in Parkinson's Disease: A systematic review and network meta-analysis.

Introduction: Whilst non-motor experiences of daily living (NMeDL) reduce quality of life (QoL) in people with Parkinson's Disease (PD), research dedicated to NMeDL is lacking compared to motor symptoms. The aim of this Network Meta-Analysis (NMA) was to compare and determine the effects of exercise and dual-task training interventions on NMeDL for people with early-to-mid stage PD. Methods: Eight electronic databases were systematically searched, identifying randomised control trials (RCTs) that assessed the effect of interventions on the Movement Disease Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS); Part I scores. A fixed-effect pairwise and NMA were completed and confidence in estimates were assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. Results: Five RCTs involving exercise were identified, involving 218 participants. No dual-tasking studies were suitable. Pairwise comparisons favoured tango and mixed-treadmill training (TT) when compared to control, however 95% Confidence Intervals (CI) crossed the line of no effect (MD = 0). Indirect comparisons revealed tango had clinically meaningful reductions in Part I scores compared to speed-TT and body-weight resistance training, (MD -4.47; 95% CI -8.50 to -0.44 and MD -4.38; 95% CI -7.86 to -0.90), indicating improved NMeDL. Compared to control, low confidence evidence suggests tango and mixed-TT improves NMeDL. Conclusions: Tango and mixed-TT are the most effective exercise interventions for improving NMeDL. Adoption of an exercise program in the early stages of PD, irrespective of modality, may be effective and holds potential clinical importance immediately following a diagnosis of PD.Other: Prospero Registration Number; CRD42022322470.

Sleep restriction between consecutive days of exercise impairs sprint and endurance cycling performance.

The study aim was to determine the effect of sleep restriction (3 h) between consecutive days of exercise on sprint and endurance cycling performance, wellness, and mood. A total of 10 well-trained males performed 2 consecutive-day trials separated by a normal night sleep (control [CONT]; mean [SD] sleep duration 3.0 [0.2] h) or sleep restriction (RES; mean [SD] sleep duration 3.0 [0.2] h). Experimental trials included a 90-min fixed-paced cycling bout and the respective sleep conditions on Day 1, followed by two 6-s peak power (6-s PP) tests, a 4- and 20-min time trial (TT) on Day 2. Profile of Mood States (POMS) and wellness questionnaires were recorded on Day 1 and Day 2. Blood lactate and glucose, heart rate (HR), and rating of perceived exertion were recorded throughout Day 2. Power output (PO) was significantly reduced for RES in the 6-s PP trial (mean [SD] 1159 [127] W for RES versus 1250 [186] W for CONT; p = 0.04) and mean PO during the 20-min TT (mean [SD] 237 [59] W for RES versus 255 [58] W for CONT; p = 0.03). There were no differences for HR, lactate and glucose, or POMS between CONT and RES in all experimental trials (p = 0.05-0.89). Participants reported a reduction in overall wellness prior to exercise on Day 2 following RES (mean [SD] 14.5 [1.6] au) compared to CONT (mean [SD] 16 [3.0] au; p = 0.034). Sleep restriction and the associated reductions in wellness, reduce cycling performance during consecutive days of exercise in a range of cycling tests that are relevant to both track and road cyclists.

Effectiveness and Benefits of Exercise on Older People Living With Mental Illness' Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study.

Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People's Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.

The exercise-induced inflammatory response in inflammatory bowel disease: A systematic review and meta-analysis.

BACKGROUND: This study investigated selected inflammatory responses to acute and chronic exercise in individuals with inflammatory bowel disease (IBD). METHODS: A systematic review and meta-analysis was conducted on all relevant exercise-based intervention publications with IBD participants. The study included articles that utilised a broad range of acute and chronic exercise interventions, with inflammatory biomarkers measured and symptoms documented, both pre- and post-exercise for those with IBD. The search was limited to studies published in English, the use of human participants, and primary studies, with no restrictions on date of publication or participant's age. Articles were retrieved through the electronic databases: PubMed, SPORTDiscus, and Scopus. This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: Six inflammatory markers were included in the meta-analysis which consisted of five studies. Exercise interventions resulted in no significant difference in IL-6 (SMD = -0.09; 95% CI = -0.49, 0.30; P = 0.64), TNF-α (SMD = 0.08; 95% CI = -0.31, 0.48; P = 0.68), CRP (SMD = -0.04; 95% CI = -0.58, 0.50; P = 0.89), IL-17 (SMD = 0.15; 95% CI = -0.45, 0.76; P = 0.62), leukocytes (SMD = 0.40; 95% CI = -0.53, 1.33; P = 0.40) or lymphocytes (SMD = 0.32; 95% CI = -0.33, 0.97; P = 0.33), thus, indicating exercise may have no effect on inflammatory markers in IBD. Bowel symptoms improved following regular moderate exercise that incorporated stress management. CONCLUSION: Heterogeneity among the identified literature may have led to exercise interventions being ineffective in reducing inflammation. Although the limited number of eligible studies may reduce the reliability of results, it emphasises the need for additional research in this domain. Importantly, no adverse symptomatic responses to exercise indicate that exercise is safe for IBD patients.

Metabolic and inflammatory health in SARS-CoV-2 and the potential role for habitual exercise in reducing disease severity.

INTRODUCTION: The rapid emergence and spread of SARS-CoV-2 in late 2019 has infected millions of people worldwide with significant morbidity and mortality with various responses from health authorities to limit the spread of the virus. Although population-wide inoculation is preferred, currently, there is large variation and disparity in the acquisition, development, and deployment of vaccination programs in many countries. Even with availability of a vaccine, achieving herd immunity does not guarantee against reinfection from SARS-CoV-2. Emerging evidence indicates that vaccines do not eliminate infection but protect against severe disease and potential hospitalisation. Therefore, additional strategies which strengthen the immune system should be strongly considered to assist in reducing the overall health care burden and stem the rate of infection. There is now substantial evidence that SARS-CoV-2 disease severity and death are linked to existing comorbidities such as cardiovascular disease, obesity, and metabolic disorders. PURPOSE: In this review, we discuss the potential medium-to-long-term strategy of habitual exercise and its relationship to targeted comorbidities and underlying inflammation as a protective mechanism against SARS-CoV-2 disease severity. CONCLUSION: We conclude that engagement in habitual physical activity and exercise could be a strategy to mitigate the development of comorbidities and improve the response of the immune system, potentially reducing the risk of symptoms and life-threatening complications if infected.

Inflammatory Status and Cardio-metabolic Risk Stratification of Rotational Shift Work.

OBJECTIVES: To investigate the physiological effects of rotational shift work on measures of cardio-metabolic function. METHODS: Sedentary, healthy men (n = 87; age 37 ± 9 years; body mass index: 30.7 ± 5.1 kg m2) were recruited and categorized via occupation. SHIFT group: currently employed in rotational shift work defined by 8-12 h morning, afternoon, and night rotations; or NSHIFT: working fixed daytime hours. Testing procedures included baseline objective sleep assessment and laboratory testing, conducted between 0600 and 0900 h to assess body composition, cardiorespiratory fitness (VO2peak), inflammatory status [C-reactive protein, interleukin (IL)-6, and tumour necrosis factor-alpha (TNF-α)], glucose metabolism, heart rate variability (HRV), and self-reported leisure time physical activity (PA). RESULTS: SHIFT reported significantly less leisure time PA (P = 0.019), reduced VO2peak (P = 0.007), higher body fat percentage (BF%) (P = 0.021), increase response time to oral glucose tolerance test (P = 0.016), and higher IL-6 values (P = 0.008) compared with NSHIFT. A significant difference was observed in actigraphy measured total sleep time, with SHIFT recording reduced sleep following a night shift (P = 0.001). No group difference was observed in HRV or average sleep parameters (P > 0.05). Linear regression identified a significant association between occupation and inflammatory status (P = 0.006). CONCLUSIONS: Rotational shift work is associated with increased risk factors for cardio-metabolic disorders, despite no differences in sleep quality and quantity. The results suggest rotational shift work has a detrimental effect on the health and wellbeing of employees; with homeostatic desynchronization identified as potential pathogenic mechanisms.

Associations between exercise, inflammation and symptom severity in those with mental health disorders.

AIM: This study aimed to investigate the effects of 6-weeks of moderate intensity aerobic exercise on markers of inflammation and symptom severity in those undergoing management of a mental health disorder. METHOD: Twenty six participants were allocated into two groups, those reporting as apparently healthy (AH, n = 13) or those undergoing the management of a mental health disorder (MI, n = 13). Following a baseline testing and familiarization session, participants commenced the 6-week aerobic training intervention, involving stationary cycling at 65% heart rate reserve for 35 min progressing to 70% for 40 min. Measures of aerobic fitness (VO2peak), anthropometric variables, symptom questionnaires and venous blood were collect pre- and post-intervention. Venous blood was assessed for nod-like receptor pyrin containing-3, interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), IL-1ß, C-reactive protein (CRP) and brain-derived neurotropic factor (BDNF). RESULTS: There were no baseline differences between groups, however following the intervention the AH demonstrated lower TNF-α (p = 0.049) than the MI group. Within change was observed for the MI group with an increase in VO2peak (p = 0.049) and declines in symptom severity (p = 0.00-0.005). Significant correlations between variables indicated a positive association between body fat, body fat percentage, CRP and symptom severity (p = 0.01-0.04). Conversely, symptom severity and CRP were inversely associated with VO2peak values (p = 0.02-0.04). CONCLUSION: Six-weeks of moderate intensity aerobic exercise increases VO2peak and reduces symptom severity in those currently undergoing management of a mental health disorder. Further, there may be a physiological link between aerobic capacity, symptom severity, inflammation and adiposity, however greater exploration is required.

The effect of cigarette smoking history on autonomic and cerebral oxygenation responses to an acute exercise bout in smokers.

The extent of smoking history is causally linked to adverse cerebro- and cardiovascular health outcomes, while conversely, exercise decreases this risk and associated mortality. However, the acute cerebro- and cardiovascular responses to exercise in smokers are unknown, and may provide insight to understand chronic adaptation. This study examined the acute heart rate (HR) variability (R-R intervals) and cerebral oxygenation responses to exercise in smokers compared to nonsmokers. Fifty-four males classified as smokers (n = 27) or nonsmokers (n = 27) were allocated into either younger (YSM, YNS) or middle-aged groups (MSM, MNS). Participants completed 40 min of stationary cycle ergometry at 50% of VO2peak. Cerebral oxygenation (near-infrared spectroscopy) and autonomic function (HR variability) were collected before, during, and after exercise at 0, 30 min, 1, and 4 hr postexercise. The nonsmoker cohort (MNS and YNS) demonstrated higher values for the standard deviation (SD) of the R-R interval (SDNN) and the root mean squared of the SD at 1 and 4 hr postexercise versus smokers (p < .05). The low frequency (LF) band in YSM was lower than in YNS at 1 hr (p < .05). However, LF and high frequency were higher for MNS compared to MSM at 1 hr (p < .05). Oxygenated hemoglobin during and following exercise were elevated in NS with values for MSM lower than YSM (p < .05). The findings show smoking history can affect cerebral oxygenation during and following an acute exercise bout. Further, following exercise, smokers may exhibit a delay or inhibition in parasympathetic activity.

Tobacco smoking and acute exercise on immune-inflammatory responses among relative short and longer smoking histories.

This study examined the acute effects of combined tobacco smoking and exercise on immune-inflammatory responses in smoker populations with shorter or longer smoking history. The cohort comprised 14 young male adult (YSM) and 12 middle-aged (MSM) male active cigarette smokers matched for aerobic fitness and smoking behavior. Following an initial familiarization and baseline testing session, participants completed a smoking and exercise protocol. This protocol involved the inhalation of two cigarettes (12 mg tar, 1 mg nicotine) within 15 min, and following a 10 min recovery period, 40 min of cycling at 50% peak aerobic workload. Venous blood was obtained pre- and post-protocol for analysis of interleukin (IL)-6, IL-1receptor antagonist (ra), IL-1beta (ß) and monocyte chemoattractant protein-1 (MCP-1) and total leukocyte count. There was no baseline differences between age groups for IL-6 or MCP-1 (p > 0.05), although higher basal IL-1ra was evident in YSM (p < 0.05). Further, no significant differences existed between groups for post-exercise IL-1ra or IL-6 responses; though MSM demonstrated an elevated MCP-1 at 4 h post (p < 0.05). No between-group differences for total leukocyte count, platelets, neutrophils, lymphocytes or monocytes (p > 0.05) were observed; although higher concentrations of basophils immediately post and 4 h post-exercise, and higher eosinophils at 4 h post-exercise were evident in MSM (p < 0.05). The current study highlights that prolonged elevations in MCP-1, alongside leukocytosis, accompany inhalation of tobacco smoke prior to exercise.