Systemic Capillary Responses to Acute Exercise in Hypertensive Seniors: Insights from a Single-Center Pilot Study.

Objective: The aim of this study was to investigate nailfold capillary parameters in community-dwelling individuals aged over 60 years who have hypertension and do not exercise regularly. Furthermore, the study examined the correlations between capillary function and other health-related indicators. DESIGN: This study was a single- center pilot trial. SETTING: The study took place in the Faculty of Health, Tsukuba University of Technology, Japan. PARTICIPANTS: Hypertensive community-dwelling elderly people took part in the study. INTERVENTION: Microcirculation was observed before and 1 min after an arm-curl exercise by means of capillary microscopy of the non-exercised limb. Additionally, we examined other health-related indicators. Methods: We measured the acute effects of reperfusion on nailfold density, flow, and diameters. Secondary outcomes included the correlations between microvascular parameters and other health-related indicators. We hypothesized that brief exercise could enhance microcirculation reperfusion and correlate with other health-related parameters. Results: There were 20 participants with a mean (SD) age of 67.1 (5.8) years. The capillary flow rate changed from 2.3 ± 6.7 to 2.7 ± 0.2 log µm/s (p < 0.01), and the capillary density changed from 0.8 ± 0.2 to 0.9 ± 0.1 log/mm (p < 0.01), which included a significant increase in the non-exercising limb. Significant correlations were observed between the nailfold capillary diameter and body fat mass, the capillary diameter and physical activity, and the capillary density and bone mineral density. Conclusions: The acute effects of exercise on high-risk elderly individuals can be safe, and even 1 of min exercise can potentially improve their nailfold capillary function, despite the brief time, compared to no exercise. The results indicate that capillaries have an impact on the function of the whole body. Thus, they may be a useful diagnostic tool for assessing nailfold capillaries.

Belt Electrode-Skeletal Muscle Electrical Stimulation in Older Hemodialysis Patients with Reduced Physical Activity: A Randomized Controlled Pilot Study.

Background: Although patients receiving hemodialysis are more likely to develop metabolic disorders and muscle weakness at an earlier stage than healthy individuals, many older dialysis patients have difficulty establishing exercise habits to prevent these problems. Therefore, we evaluated the use of belt electrode-skeletal muscle electrical stimulation (B-SES), which can stimulate a wider area than conventional electrical muscle stimulation (EMS), to examine its application and safety in older hemodialysis patients as a means to improve lower extremity function without voluntary effort. Methods: This study was a randomized controlled trial (RCT) involving 20 older dialysis patients (>65 years old) with reduced physical activity. The control group received 12 weeks of routine care only and the intervention group received 12 weeks of B-SES during hemodialysis in addition to routine care. The primary endpoint was the 6 min walk test (6MWT) distance, while the Short Physical Performance Battery (SPPB), body composition, Functional Independence Measure (FIM), biochemistry test, and blood pressure/pulse measurements were used as secondary endpoints. Results: As a result of the 12-week B-SES intervention, no increase in creatine kinase or C-reactive protein levels was observed after the intervention in either group, and no adverse events attributed to the B-SES intervention were observed in the intervention group. Furthermore, the intervention group showed a significant improvement in the 6MWT and SPPB scores after the intervention. Conclusions: The results of this study suggest that a 12-week B-SES intervention during hemodialysis sessions safely improves 6MWT distance and SPPB scores in older patients with a reduced level of physical activity.

Training with an Electric Exercise Bike versus a Conventional Exercise Bike during Hemodialysis for Patients with End-stage Renal Disease: A Randomized Clinical Trial.

OBJECTIVE: Hemodialysis (HD) patients have lower fitness levels than healthy subjects because of various structural, metabolic, and functional abnormalities secondary to uremic changes in skeletal muscles. Aerobic and resistance exercises are beneficial in improving not only physical function, including maximal oxygen uptake and muscle strength, but also anthropometrics, nutritional status, and hematologic indices. The use of electric ergometers that place light loads on patients has been implemented at many dialysis facilities in Japan. However, reports comparing the effects on body function of electric and variable-load ergometers are few. This study aimed to compare electric ergometers and variable-load ergometers in terms of exercise outcomes in HD patients. METHODS: A total of 15 ambulatory HD patients were randomly divided into two groups: the variable-load ergometer group (n=8) and the electric ergometer group (n=7). HD patients exercised at a level based on their physical function three times a week for 12 weeks. RESULTS: After the 12-week intervention period, only the variable-load ergometer group experienced significant increases in lower extremity muscle strength and exercise tolerance. CONCLUSION: This study confirmed that conventional aerobic training and electric bike exercise during HD were efficacious and safe without causing sudden hypotension or any other side effects. However, exercise using a variable-load ergometer may be more effective than exercise using an electric bike in improving the physical function of HD patients. Exercise using a variable-load ergometer elicited specific whole-body and local effects.

Music Attenuated a Decrease in Parasympathetic Nervous System Activity after Exercise.

Music and exercise can both affect autonomic nervous system activity. However, the effects of the combination of music and exercise on autonomic activity are poorly understood. Additionally, it remains unknown whether music affects post-exercise orthostatic tolerance. The aim of this study was to evaluate the effects of music on autonomic nervous system activity in orthostatic tolerance after exercise. Twenty-six healthy graduate students participated in four sessions in a random order on four separate days: a sedentary session, a music session, a bicycling session, and a bicycling with music session. Participants were asked to listen to their favorite music and to exercise on a cycle ergometer. We evaluated autonomic nervous system activity before and after each session using frequency analysis of heart rate variability. High frequency power, an index of parasympathetic nervous system activity, was significantly increased in the music session. Heart rate was increased, and high frequency power was decreased, in the bicycling session. There was no significant difference in high frequency power before and after the bicycling with music session, although heart rate was significantly increased. Additionally, both music and exercise did not significantly affect heart rate, systolic blood pressure or also heart rate variability indices in the orthostatic test. These data suggest that music increased parasympathetic activity and attenuated the exercise-induced decrease in parasympathetic activity without altering the orthostatic tolerance after exercise. Therefore, music may be an effective approach for improving post-exercise parasympathetic reactivation, resulting in a faster recovery and a reduction in cardiac stress after exercise.

High-yield production of vanillin from ferulic acid by a coenzyme-independent decarboxylase/oxygenase two-stage process.

Vanillin is one of the world's most important flavor and fragrance compounds in foods and cosmetics. Recently, we demonstrated that vanillin could be produced from ferulic acid via 4-vinylguaiacol in a coenzyme-independent manner using the decarboxylase Fdc and the oxygenase Cso2. In this study, we investigated a new two-pot bioprocess for vanillin production using the whole-cell catalyst of Escherichia coli expressing Fdc in the first stage and that of E. coli expressing Cso2 in the second stage. We first optimized the second-step Cso2 reaction from 4-vinylguaiacol to vanillin, a rate-determining step for the production of vanillin. Addition of FeCl2 to the cultivation medium enhanced the activity of the resulting E. coli cells expressing Cso2, an iron protein belonging to the carotenoid cleavage oxygenase family. Furthermore, a butyl acetate-water biphasic system was effective in improving the production of vanillin. Under the optimized conditions, we attempted to produce vanillin from ferulic acid by a two-pot bioprocess on a flask scale. In the first stage, E. coli cells expressing Fdc rapidly decarboxylated ferulic acid and completely converted 75 mM of this substrate to 4-vinylguaiacol within 2 h at pH 9.0. After the first-stage reaction, cells were removed from the reaction mixture by centrifugation, and the pH of the resulting supernatant was adjusted to 10.5, the optimal pH for Cso2. This solution was subjected to the second-stage reaction. In the second stage, E. coli cells expressing Cso2 efficiently oxidized 4-vinylguaiacol to vanillin. The concentration of vanillin reached 52 mM (7.8 g L(-1)) in 24 h, which is the highest level attained to date for the biotechnological production of vanillin using recombinant cells.

A coenzyme-independent decarboxylase/oxygenase cascade for the efficient synthesis of vanillin.

Vanillin is one of the most widely used flavor compounds in the world as well as a promising versatile building block. The biotechnological production of vanillin from plant-derived ferulic acid has attracted much attention as a new alternative to chemical synthesis. One limitation of the known metabolic pathway to vanillin is its requirement for expensive coenzymes. Here, we developed a novel route to vanillin from ferulic acid that does not require any coenzymes. This artificial pathway consists of a coenzyme-independent decarboxylase and a coenzyme-independent oxygenase. When Escherichia coli cells harboring the decarboxylase/oxygenase cascade were incubated with ferulic acid, the cells efficiently synthesized vanillin (8.0 mM, 1.2 g L(-1) ) via 4-vinylguaiacol in one pot, without the generation of any detectable aromatic by-products. The efficient method described here might be applicable to the synthesis of other high-value chemicals from plant-derived aromatics.

Electrical stimulation of the abdomen preserves motor performance in the inactive elderly: a randomized controlled trial.

Abdominal muscle strength declines easily with the process of aging and/or disuse, and it is difficult to strengthen weak abdominal muscles in the inactive elderly. In the present study, we applied surface electrical stimulation (ES) to the abdomen of inactive elderly people to investigate its chronic effects. Twenty inactive elderly people (65-89 years) who spent most of the day in their bedroom participated in the study. The subjects were assigned to ES and non-ES groups in a random order. In addition to conventional physical therapy and occupational therapy, ES was applied to both sides of the flank of 10 subjects (ES group) for 8 weeks. For evaluation of the abdominal muscles, the cross-sectional area (CSA) was measured with computed tomography and the electrical muscle activity (iEMG) was measured by electromyography. Functional examinations were performed at 2, 4, and 8 weeks after the beginning of the study with the following parameters: grip strength; maximum walking speed (WS); movement time for sitting up (MSU); number of trunk flexions (NTF); flexibility of the trunk; sit-to-stand time (STS); and Barthel index (BI) score. In the ES group, the NTF and MSU were significantly improved at 4 weeks and thereafter. Furthermore, the STS and WS were also improved significantly after 8 weeks (p < 0.05). The CSA and iEMG both increased significantly (p < 0.05). However, the flexibility of the trunk and BI score did not change. In conclusion, ES to the abdomen has the potential to improve motor function in the inactive elderly.

Functional Changes in the Care-needing Elderly after Surface Electrical Stimulation to the Abdomen.

BACKGROUND: Strength of the trunk muscles is a key component of motor control, but it declines easily with the process of aging and/or disuse. OBJECTIVES: To investigate the effects of surface electrical stimulation (ES) to the abdominal muscles and the motor performance for care-needing elderly. DESIGN: Controlled trial. PARTICIPANTS: Twenty-one elderly people (60-90 years) with care-needing, who were admitted to a nursing home or hospital for daily care and their score of Barthel Index had been stable from 55.3 ± 19.4 to 55.3 ± 19.8 during 3 months before intervention. INTERVENTION: Common physical/occupational therapy was performed for all of the subjects during the study period. ES was applied to the abdomen of 15 subjects (ES group) twice a day for 8 weeks. MEASUREMENTS: Functional measurements were performed before and after beginning of the study with some parameters as follows: grip strength; movement time for sitting up (MSU); maximum walking speed (WS). RESULTS: No significant differences between two groups were noted for characteristics at baseline. In the ES group, MSU (from 21.1 ± 21.4 to 10.4 ± 8.3 sec) significantly improved (p < 0.05) after 8weeks. WS (from 17.7 ± 12.1 to 24.3 ± 15.3 m/min) were also improved (p < 0.05) after 8 weeks. LIMITATIONS: A limitation of this study was the small sample size. CONCLUSIONS: ES to the abdominal area has the potential to improve motor function in the care-needing elderly through reinforcement of the abdominal muscles.