Exergame and/or conventional training-induced neuroplasticity and cognitive improvement by engaging epigenetic and inflammatory modulation in elderly women: A randomized clinical trial.

OBJECTIVE: To evaluate the acute and long-term impact of exergaming (EXE) and conventional therapy (CON) in the peripheral levels of brain-derived neurotrophic factor (BDNF), inflammatory markers (interleukin [IL]-1b, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]) and epigenetic mechanisms (global histone H3 and H4 acetylation levels in mononuclear cells) of healthy elderly women. We also evaluated the effect of intervention on cognitive performance in these individuals. METHODS: Twenty-two elderly women were randomly assigned into two groups: EXE (n = 12) and CON (n = 10). Both interventions were performed twice a week for 6 weeks (12 sessions). Blood samples were obtained before intervention, after the first session, and 1 hour after the last session. Cognitive performance was evaluated before and after intervention. RESULTS: Both EXE and CON interventions ameliorated cognitive performance, improved inflammatory profile, enhanced BDNF levels, and induced histone H4 and H3 hyperacetylation status in elderly women. CONCLUSION: Our study demonstrated that the proposed interventions can be considered important strategies capable of promoting cognitive improvement in healthy elderly women. The acetylation status of histones and inflammatory cytokines are possible molecular mechanisms that mediate this beneficial response, being distinctly modulated by acute and long-term exposure.

Kinesiotherapy With Exergaming as a Potential Modulator of Epigenetic Marks and Clinical Functional Variables of Older Women: Protocol for a Mixed Methods Study.

BACKGROUND: Kinesiotherapy is an option to mitigate worsening neuropsychomotor function due to human aging. Moreover, exergames are beneficial for the practice of physical therapy by older patients. Physical exercise interventions are known to alter the epigenome, but little is known about their association with exergames. OBJECTIVE: We aim to evaluate the effects of kinesiotherapy with exergaming on older women's epigenetic marks and cognitive ability, as well as on their clinical functional variables. Our hypothesis states that this kind of therapy can elicit equal or even better outcomes than conventional therapy. METHODS: We will develop a virtual clinic exergame with 8 types of kinesiotherapy exercises. Afterward, we will conduct a 1:1 randomized clinical trial to compare the practice of kinesiotherapy with exergames (intervention group) against conventional kinesiotherapy (control group). A total of 24 older women will be enrolled for 1-hour sessions performed twice a week, for 6 weeks, totaling 12 sessions. We will assess outcomes using epigenetic blood tests, the Montreal Cognitive Assessment test, the Timed Up and Go test, muscle strength grading in a hydraulic dynamometer, and the Game Experience Questionnaire at various stages. RESULTS: The project was funded in October 2019. Game development took place in 2020. Patient recruitment and a clinical trial are planned for 2021. CONCLUSIONS: Research on this topic is likely to significantly expand the understanding of kinesiotherapy and the impact of exergames. To the best of our knowledge, this may be one of the first studies exploring epigenetic outcomes of exergaming interventions. TRIAL REGISTRATION: Brazilian Clinical Trials Registry/Registro Brasileiro de Ensaios Clínicos (ReBEC) RBR-9tdrmw; https://ensaiosclinicos.gov.br/rg/RBR-9tdrmw. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32729.

Acute exercise and periodized training in different environments affect histone deacetylase activity and interleukin-10 levels in peripheral blood of patients with type 2 diabetes.

AIMS: Our purpose was to investigate the effects of aerobic periodized training in aquatic and land environments on plasma histone deacetylase (HDAC) activity and cytokines levels in peripheral blood of diabetes mellitus type 2 (T2DM) patients. METHODS: The patients underwent 12 weeks of periodized training programs that including walking or running in a swimming pool (aquatic group) or in a track (dry land group). Blood samples were collected immediately before and after both first and last sessions. Plasma cytokine levels and HDAC activity in peripheral blood mononuclear cell (PBMC) was measured. RESULTS: The exercise performed in both environments similarly modulated the evaluated acetylation mark, global HDAC activity. However, a differential profile depending on the evaluated time point was detected, since exercise increased acutely HDAC activity in sedentary and after 12 weeks of training period, while a reduced HDAC activity was observed following periodized training (samples collected before the last session). Additionally, the 12 weeks of periodized exercise in both environments increased IL-10 levels. CONCLUSIONS: Our data support the hypothesis that the modulation of HDAC activity and inflammatory status might be at least partially related to exercise effects on T2DM. The periodized training performed in both aquatic and land environments impacts similarly epigenetic and inflammatory status.

Glucose control can be similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

OBJECTIVES: To compare the effects of two aerobic training methods in water and on dry-land on glycemic, lipid, inflammatory, hormonal, cardiorespiratory, and functional outcomes in patients with type 2 diabetes. DESIGN: Randomized clinical trial. METHODS: Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training interventions had duration of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. RESULTS: Patients were 56.7±7.9 years old. Decreases in glycated hemoglobin were observed in both groups (AT: -0.42±0.28%, DLT: -0.35±1.8%). Total cholesterol, high density lipoprotein, low density lipoprotein levels, plasma renin activity, angiotensin II concentrations, C-reactive protein, systolic blood pressure, resting heart rate, and timed up and go test performed at the usual speed also decreased in both groups in response to both interventions (p<0.05), without between-group differences. Both groups increased the ratio between oxygen uptake at the anaerobic threshold and oxygen uptake of peak (p=0.01). CONCLUSIONS: Aerobic training in an aquatic environment provides effects similar to aerobic training in a dry-land environment in patients with type 2 diabetes.

Balance and coordination training after sciatic nerve injury.

INTRODUCTION: Numerous therapeutic interventions have been tested to enhance functional recovery after peripheral nerve injuries. METHODS: After sciatic nerve crush in rats we tested balance and coordination and motor control training in sensorimotor tests and analyzed nerve and muscle histology. RESULTS: The balance and coordination training group and the sham group had better results than the sedentary and motor control groups in sensorimotor tests. The sham and balance and coordination groups had a significantly larger muscle area than the other groups, and the balance and coordination group showed significantly better values than the sedentary and motor control groups for average myelin sheath thickness and g-ratio of the distal portion of the nerve. CONCLUSIONS: The findings indicate that balance and coordination training improves sciatic nerve regeneration, suggesting that it is possible to revert and/or prevent soleus muscle atrophy and improve performance on sensorimotor tests.

Effect of treadmill exercise on serotonin immunoreactivity in medullary raphe nuclei and spinal cord following sciatic nerve transection in rats.

The serotoninergic system modulates nociceptive and locomotor spinal cord circuits. Exercise improves motor function and changes dopaminergic, noradrenergic, and serotonergic central systems. However, the direct relationship between serotonin, peripheral nerve lesion and aerobic treadmill exercise has not been studied. Using immunohistochemistry and optic densitometry, this study showed that the sciatic nerve transection increased the serotoninergic immunoreactivity in neuronal cytoplasm of the magnus raphe nuclei of trained and sedentary rats. In the dorsal raphe nucleus the increase only occurred in sedentary-sham-operated rats. In the spinal cord of trained, transected rats, the ventral horn showed significant changes, while the change in dorsal horn was insignificant. Von Frey's test indicated analgesia in all exercise-trained rats. The sciatic nerve functional index indicated recovery in the trained group. Thus, both the aerobic treadmill exercise training and the nervous lesion appear to contribute to changes in serotonin immunoreactivity.