Efficacy of exercise treatments for chronic obstructive pulmonary disease: A systematic review.

OBJECTIVE: To review the efficacy of exercise treatments on chronic obstructive pulmonary disease (COPD). DATA SOURCES: PubMed, Scopus, Science Direct, Ebscohost, SPORTDiscus, ProQuest, Web of Science. REVIEW METHODS: A systematic review was performed to identify the relevant studies published from 2011 to 2023. Studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 5170 articles were retrieved and assessed using the Physiotherapy Evidence Database (PEDro) scale. The risk of bias in individual studies was assessed with the Cochrane risk of bias tool. RESULTS: A total of 38 eligible studies were included. Eight studies evaluated the effects of Tai Chi, followed by Liuzijue (five studies) and yoga (three studies). The duration of the exercise programmes ranged from 8 weeks to 3 years, and the frequency was between 2 and 7 times a week. Exercise sessions lasted between 20 and 90 min. Low-intensity exercise improved lung function after six months. Whole-body exercise improved dyspnea more than local exercise. Water-based exercise improved physical endurance more than land exercise, and quality of life was unaffected by long-term exercise. CONCLUSION: This systematic review highlights the benefit of exercise treatments as a potential adjunct treatment for COPD patients.

Effects of Aerobic Dance Exercise and Honey Supplementation Followed by Their Subsequent Cessation on Bone Metabolism Markers and Antioxidant Status in Young Collegiate Females.

Background: Regular physical activity and proper nutritional intake are crucial for bone health. However, it is unclear if this health benefit is maintained after the removal of these stimuli. This study investigated the combined effects of aerobic dance exercise and honey supplementation, followed by their subsequent cessation on bone metabolism markers and antioxidant status in females. Methods: Forty-eight young female college students were assigned into four groups: i) 16S (16 weeks of sedentary activity); ii) 8E×8S (8 weeks of exercise followed by 8 weeks of sedentary activity); iii) 8H8S (8 weeks of honey supplementation followed by 8 weeks of sedentary activity) and iv) 8E×H8S (8 weeks of combined exercise and honey supplementation followed by 8 weeks of sedentary activity). Blood samples were collected from the participants prior to the intervention, at week 8 and at week 16 for the analysis of bone metabolism markers and antioxidant status. Results: At the mid test, bone speed of sound (SOS) (P < 0.01), serum alkaline phosphatase (ALP) (P < 0.001) and serum osteocalcin (P < 0.01) were significantly higher in the 8E×H8S group as compared to 16S group. After 8 weeks of cessation of exercise and honey supplementation, bone SOS was also significantly higher (P < 0.001) in the 8E×H8S group as compared to 16S group. In addition, the serum total calcium (P < 0.001), serum ALP (P < 0.01), total antioxidant status (TAS) (P < 0.01) and glutathione (GSH) (P < 0.01) in the 8E×H8S group were significantly higher at the post-test as compared to their respective pre-test values. Conclusion: These findings demonstrate that there was improved maintenance of the beneficial effects induced by 8 weeks of combined exercise and honey supplementation on bone properties and the antioxidant status after 8 weeks of cessation of exercise and honey supplementation as compared to exercise and honey supplementation alone.

Bone Health Status, Muscular Strength and Power, and Aerobic and Anaerobic Capacities of Malaysian Male Athletes Involved in Sports with Different Mechanical Loading on Bones.

Background: Physical activity is beneficial for bone health. Bones respond and adapt to applied loads that can vary among physical activity. This study investigated differences in bone health status, muscular performance, and aerobic and anaerobic capacities of young male Malaysian athletes competing at the state level. Methods: A total of 44 participants (age: 17.1 ± 1.6 years old) were randomly divided into sedentary control, weightlifting, cycling or squash groups. The bone speed of sound (SOS), muscular performance, maximal oxygen uptake (VO2max) and anaerobic capacities of the participants were measured. Results: All athletes exhibited significantly higher tibial and radial bone SOS (P < 0.01) values than the sedentary group. Weightlifting athletes showed the highest radial bone SOS value in the arm, whereas cycling athletes exhibited the highest tibial bone SOS value in the leg among the groups. Weightlifting athletes also had significantly higher isokinetic knee extension, shoulder extension and shoulder flexion peak torque (PT) and average power (AVG.P) (P < 0.05) as well as significantly greater anaerobic peak power (P < 0.05) compared to cyclists and squash players. However, the aerobic capacity of cyclists and squash players was significantly higher (P < 0.001) than the weightlifters. The cyclists had significantly higher anaerobic capacity and power (P < 0.001) than weightlifters and squash players. Conclusion: The findings imply that the bone health and physiological profiles of athletes are influenced by the type of sporting activity they undertake.

Histological changes of female reproductive organs subjected to different jumping exercise intensities and honey supplementation in rats.

BACKGROUND: We assessed histopathological changes of ovaries and uterus in female rats subjected to different jumping exercise intensities combined with honey supplementation at one g/kg body weight/day. METHODS: A total of 72 rats were divided into six groups, 12 rats in each: control (C), 20 and 80 jumps (20E, 80E), honey (H), and 20 and 80 jump with honey (20EH, 80EH). RESULTS: The endometrium was significantly thicker in the rats in H, 20EH and 80EH groups compared to C, 20E, and 80E. The myometrium thickness was significantly lower in 80E and significantly higher in 80EH compared to C, respectively. There was significantly higher myometrium thickness in 20EH and 80EH compared to 20E and 80E and H. The number of glands of the uterus in 20E and 80E was significantly lower than C. However, there was a significantly higher number of glands in H, 20EH, and 80EH compared to 20E and 80E. The numbers of uterus vessels were significantly lower in 80E compared to 20E. However, the numbers of vessels were significantly higher in H, 20EH, and 80EH compared to 80E. The number of ovarian haemorregia was significantly lower in 20E, 80E, H, 20EH, and 80EH compared to C. The number of corpora lutea was significantly lower in 80EH, H, 80E, and 20E compared to C. However, the number of corpora lutea was significantly higher in 20EH compared to J20 and H. CONCLUSION: This study suggested that jumping exercises in particularly high-intensity exercise may induce histopathological changes in uterus and ovary in rats, and honey supplementation may ameliorate these effects.

Effects of Eurycoma Longifolia Jack Supplementation Combined with Resistance Training on Isokinetic Muscular Strength and Power, Anaerobic Power, and Urinary Testosterone: Epitestosterone Ratio in Young Males.

INTRODUCTION: This study investigated the effects of resistance training and Eurycoma longifolia Jack supplementation on isokinetic muscular strength and power, Wingate anaerobic power, and testosterone: epitestosterone (T/E) ratio in young males. METHODS: Forty young males were weight-matched and assigned into four groups: control (C), Eurycoma longifolia jack (ElJ), resistance training (RT), and Eurycoma longifolia Jack plus resistance training group (ElJ & RT). Participants in ElJ and ElJ & RT groups consumed 200 mg Eurycoma longifolia Jack daily, whereas participants in the C and RT groups consumed placebo capsules daily for 8 weeks. Resistance training program which consisted of 10 different exercises was conducted three times per week for 8 weeks. Participants' isokinetic muscular strength and power, anaerobic power, and urinary TE ratio were measured before and after the intervention period. This is a randomized placebo-controlled intervention study. Paired t-test and one-way analysis of variance were used for statistical analysis. RESULTS: The mean average power of knee flexion at 300°/s in the RT and ElJ & RT groups was significantly (P < 0.05) higher in the posttest compared with pretest. Wingate relative peak power in the RT group increased significantly (P < 0.05) compared with respective pretest value, whereas peak power in the combined ElJ & RT group was significantly (P < 0.05) higher in posttest compared with pretest. There was no significant difference in T/E ratio between pre- and posttests in all the groups. CONCLUSIONS: The prescribed resistance training program, either with or without ElJ supplementation, improved isokinetic power of the lower limb. Resistance training alone improved relative anaerobic power, whereas combined Eurycoma longifolia Jack and resistance training improved peak power output. ElJ consumption of 200 mg daily for 8 weeks did not affect the urinary T/E ratio.

The effects of combined probiotic ingestion and circuit training on muscular strength and power and cytokine responses in young males.

To our knowledge, the efficacy of combined probiotic supplementation with circuit training has not been evaluated. Thus, we investigated the effects of probiotic supplementation combined with circuit training on isokinetic muscular strength and power and cytokine responses in young males. Forty-eight healthy sedentary young males were recruited and randomised into 4 separate groups: sedentary placebo control, probiotics (P), circuit training with placebo (CT), and circuit training with probiotics (CTP). Participants in the CT and CTP groups performed circuit training 3 times/week with 2 circuits of exercises from weeks 1-8 followed by 3 circuits of exercises from weeks 9-12. Participants in the P and CTP groups consumed multi-strain probiotics containing 3 × 1010 colony-forming units of Lactobacillus acidophilus, L. lactis, L. casei, Bifidobacterium longum, B. bifidum and B. infantis twice daily for 12 weeks. Measurements of body height and weight, blood pressure, resting heart rate, blood samples, and isokinetic muscular strength and power were carried out at pre- and post-tests. Isokinetic knee strength and power in CT and CTP groups were significantly higher (P < 0.05) at post-test. In addition, interleukin (IL)-10 concentration was significantly increased (P < 0.0001) at post-test in P and CT but a trend toward significant increase in CTP (P = 0.09). Nevertheless, there was no significant difference in IL-6. This study suggests that 12 weeks of circuit training alone and the combination of circuit training and probiotic consumption improved muscular performance while circuit training alone and probiotics alone increased IL-10 concentration.

Blood immune function parameters in response to combined aerobic dance exercise and honey supplementation in adult women.

To date, information on the effectiveness of combined aerobic dance exercise with honey supplementation on immune function in women is lacking. The present study investigated the effects of 8 weeks of combined aerobic dance exercise and honey supplementation on blood immune function parameters in adult women. In this study, forty four healthy sedentary women (25-40 year-old) were assigned into four groups with n = 11 per group: sedentary without supplementation control (Con), honey supplementation (H), aerobic dance exercise (D) and combined aerobic dance exercise with honey supplementation (HD) groups. Aerobic dance exercise was carried out for one hour per session, three sessions per week for eight weeks. Honey drink was consumed by H and HD groups, in a dosage of 20 g of honey diluted in 300 ml of plain water, consumed 7 days a week for 8 weeks. In HD group, the participants were required to consume honey drink 30 min before performing exercise. Before and after 8 weeks of experimental period, blood samples were taken to determine the concentrations of immune parameters which include full blood counts and immunophenotyping measurements. It was found that after 8 weeks of experimental period, there were statistically significant increases in T cytotoxic (CD8) (p < 0.05) in HD group. Additionally, the percentages increase in total lymphocyte counts, T helper (CD4), and T cytotoxic (CD8) counts after 8 weeks were the highest in HD group among all the groups. As conclusion, combined aerobic dance and honey supplementation may have potential to enhance immune functions in women.

Combined Effects of Lignosus rhinocerotis Supplementation and Resistance Training on Isokinetic Muscular Strength and Power, Anaerobic and Aerobic Fitness Level, and Immune Parameters in Young Males.

BACKGROUND: This study investigated the effects of Lignosus rhinocerotis (LRS) supplementation and resistance training (RT) on isokinetic muscular strength and power, anaerobic and aerobic fitness, and immune parameters in young males. METHODS: Participants were randomly assigned to four groups: Control (C), LRS, RT, and combined RT-LRS (RT-LRS). Participants in the LRS and RT-LRS groups consumed 500 mg of LRS daily for 8 weeks. RT was conducted 3 times/week for 8 weeks for participants in the RT and RT-LRS groups. The following parameters were measured before and after the intervention period: Anthropometric data, isokinetic muscular strength and power, and anaerobic and aerobic fitness. Blood samples were also collected to determine immune parameters. RESULTS: Isokinetic muscular strength and power were increased (P < 0.05) in participants of both RT and RT-LRS groups. RT-LRS group had shown increases (P < 0.05) in shoulder extension peak torque, shoulder flexion and extension average power, knee flexion peak torque, and knee flexion and extension average power. There were also increases (P < 0.05) in anaerobic power and capacity and aerobic fitness in this group. Similarly, RT group had increases (P < 0.05) in shoulder flexion average power, knee flexion and extension peak torque, and knee flexion and extension average power. In addition, increases (P < 0.05) in anaerobic power and capacity, aerobic fitness, T lymphocytes (CD3 and CD4), and B lymphocytes (CD19) counts were observed in the RT group. CONCLUSIONS: RT elicited increased isokinetic muscular strength and power, anaerobic and aerobic fitness, and immune parameters among young males. However, supplementation with LRS during RT did not provide additive benefits.

Effects of Post-Exercise Honey Drink Ingestion on Blood Glucose and Subsequent Running Performance in the Heat.

BACKGROUND: Glycogen depletion and hypoglycemia have been associated with fatigue and decrement of performance during prolonged exercise. OBJECTIVES: This study investigated the effectiveness of Acacia honey drink as a post-exercise recovery aid on glucose metabolism and subsequent running performance in the heat. PATIENTS AND METHODS: Ten subjects participated in this randomized cross-over study. All subjects performed 2 trials. In each trial, all subjects went through a glycogen depletion phase (Run-1), 2-hour rehydration phase and time trial running phase (Run-2). In Run-1, subjects were required to run on a treadmill at 65% VO2max in the heat (31°C, 70% relative humidity) for 60 min. During 2-hour rehydration phase, subjects drank either plain water (PW) or honey drink (HD) with amount equivalent to 150% of body weight loss in 3 boluses (60%, 50% and 40% subsequently) at 0, 30 and 60 min. In Run-2, the longest distance covered in 20 min was recorded for determining running performance. Two-way repeated measured ANOVA and paired t-test were used for analysis. RESULTS: Running distance in Run-2 covered by the subjects in the honey drink HD trial (3420 ± 350 m) was significantly (P < 0.01) longer compared to plain water PW trial (3120 ± 340 m). In general, plasma glucose, serum insulin and osmolality were significantly (P < 0.05) higher in HD compared to PW during the rehydration phase and Run-2. CONCLUSIONS: These findings indicate that rehydration with honey drink improves running performance and glucose metabolism compared to plain water in the heat. Thus, honey drink can be recommended for rehydration purpose for athletes who compete in the heat.

Bone Mechanical Properties and Mineral Density in Response to Cessation of Jumping Exercise and Honey Supplementation in Young Female Rats.

This study investigated effects of cessation of exercise and honey supplementation on bone properties in young female rats. Eighty-four 12-week-old Sprague-Dawley female rats were divided into 7 groups: 16S, 16J, 16H, 16JH, 8J8S, 8H8S, and 8JH8S (8 = 8 weeks, 16 = 16 weeks, S = sedentary without honey supplementation, H = honey supplementation, and J = jumping exercise). Jumping exercise consisted of 40 jumps/day for 5 days/week. Honey was given to the rats at a dosage of 1 g/kg body weight/rat/day via force feeding for 7 days/week. Jumping exercise and honey supplementation were terminated for 8 weeks in 8J8S, 8H8S, and 8JH8S groups. After 8 weeks of cessation of exercise and honey supplementation, tibial energy, proximal total bone density, midshaft cortical moment of inertia, and cortical area were significantly higher in 8JH8S as compared to 16S. Continuous sixteen weeks of combined jumping and honey resulted in significant greater tibial maximum force, energy, proximal total bone density, proximal trabecular bone density, midshaft cortical bone density, cortical area, and midshaft cortical moment of inertia in 16JH as compared to 16S. These findings showed that the beneficial effects of 8 weeks of combined exercise and honey supplementation still can be observed after 8 weeks of the cessation and exercise and supplementation.

Supplementation of Eurycoma longifolia Jack Extract for 6 Weeks Does Not Affect Urinary Testosterone: Epitestosterone Ratio, Liver and Renal Functions in Male Recreational Athletes.

BACKGROUND: Eurycoma longifolia Jack (ElJ) has been shown to elevate serum testosterone and increased muscle strength in humans. This study investigated the effects of Physta(®) a standardized water extract of ElJ (400 mg/day for 6 weeks) on testosterone: epitestosterone (T:E) ratio, liver and renal functions in male recreational athletes. METHODS: A total of 13 healthy male recreational athletes were recruited in this double blind, placebo-controlled, cross-over study. The participants were required to consume either 400 mg of ElJ or placebo daily for 6 weeks in the first supplementation regimen. Following a 3 week wash-out period, the participants were requested to consume the other supplement for another 6 weeks. Mid-stream urine samples and blood samples were collected prior to and after 6 weeks of supplementation with either ElJ or placebo. The urine samples were subsequently analyzed for T:E ratio while the blood samples were analyzed for liver and renal functions. RESULTS: T:E ratio was not significantly different following 6 weeks supplementation of either ElJ or placebo compared with their respective baseline values. Similarly, there were no significant changes in both the liver and renal functions tests following the supplementation of ElJ. CONCLUSIONS: Supplementation of ElJ i.e. Physta(®) at a dosage of 400 mg/day for 6 weeks did not affect the urinary T:E ratio and hence will not breach any doping policies of the International Olympic Committee for administration of exogenous testosterone or its precursor. In addition, the supplementation of ElJ at this dosage and duration was safe as it did adversely affect the liver and renal functions.

Effects of honey supplementation combined with different jumping exercise intensities on bone mass, serum bone metabolism markers and gonadotropins in female rats.

BACKGROUND: The effects of high and low jumping exercise intensities combined with honey on bone and gonadotrophins were investigated in eighty four 9 week-old female rats. METHODS: The experimental groups were 20 or 80 jumps per day combined with or without honey supplementation (HJ20, HJ80, J20 and J80), honey supplementation (H), sedentary without supplementation control (C), and baseline control (C0) groups. RESULTS: Study results showed that HJ80 elicited greatest beneficial effects on tibial and femoral mass, serum total calcium and alkaline phosphatase concentrations. There were significantly (p < 0.05) lower levels of serum follicle stimulating hormone concentrations in H, J20, J80 compared to C, with exception of HJ20 and HJ80. Serum luteinizing hormone concentrations were significantly (p < 0.05) greater in HJ20, HJ80 and J20 compared to J80. CONCLUSIONS: It appears that high intensity jumping exercise combined with honey supplementation resulted more discernable effects on bone. Meanwhile, honey may protect against the adverse effects induced by jumping exercise on gonadotropins in female rats.

Stress hormone and reproductive system in response to honey supplementation combined with different jumping exercise intensities in female rats.

This study was performed to determine the effects of 8-week honey supplementation combined with different jumping exercise intensities on serum cortisol, progesterone, estradiol, and reproductive organs. Eighty-four 9-week-old female rats were divided into 7 groups: baseline controls (C0), sedentary group (C), 20 and 80 jumps per day (Ex(20J), Ex(80J)), honey (H), and combined honey with 20 and 80 jumps per day (HEx(20J), HEx(80J)) groups. Jumping exercise was performed at 5 days/week and honey was given at a dosage of 1 g/kg body weight/day for 7 days/week. The level of serum cortisol was higher in Ex(20J) and Ex(80J) compared to C. There was significantly lower value of serum cortisol in HEx(20J) compared to Ex(80J). Serum progesterone levels were significantly lower in Ex(20J) and Ex(80J) compared to C. However, serum progesterone levels were significantly higher in HEx(20J) and HEx(80J) compared to Ex(20J) and Ex(80J). Relative uterine weights were significantly greater in HEx(20J) compared to C and HEx(80J), respectively. There was no significant difference in estradiol level and relative ovarian weights among all the groups. Therefore, honey elicited beneficial effects in reducing the increase of cortisol and in increasing the reduce of progesterone levels induced by different intensities jumping exercise in female rats.

Herbs in exercise and sports.

The use of herbs as ergogenic aids in exercise and sport is not novel. Ginseng, caffeine, ma huang (also called 'Chinese ephedra'), ephedrine and a combination of both caffeine and ephedrine are the most popular herbs used in exercise and sports. It is believed that these herbs have an ergogenic effect and thus help to improve physical performance. Numerous studies have been conducted to investigate the effects of these herbs on exercise performance. Recently, researchers have also investigated the effects of Eurycoma longifolia Jack on endurance cycling and running performance. These investigators have reported no significant improvement in either cycling or running endurance after supplementation with this herb. As the number of studies in this area is still small, more studies should be conducted to evaluate and substantiate the effects of this herb on sports and exercise performance. For instance, future research on any herbs should take the following factors into consideration: dosage, supplementation period and a larger sample size.

Changes in bone turnover markers and bone mass with reducing levels of jumping exercise regimens in female rats.

PURPOSE: To date, little is known about the effects of a reduced level of jumping exercise regimens on bone turnover markers and mass. This study investigates the effects of different jumping exercise regimens with varying exercise loads on serum bone turnover markers and bone mass in female rats. METHODS: A total of 144 female rats aged 12 weeks, were divided into 12 groups as follows: no exercise for 8 (8S) or 32 weeks (32S), or 8 weeks of standard training program (8STP) consisting of 200 jumps per week (200J/w), given at 40 jumps per day (40J/d) for 5 days per week (5d/w) (8STP24E), followed by 24 weeks of exercise at loads of either 10J/d or 20J/d or 40J/d, for either 5d/w, or 3d/w, or 1d/w. Serum osteocalcin, alkaline phosphatase, C-terminal telopeptide of type 1 collagen (1CTP) concentrations, and tibial fat free dry weight were measured. RESULTS: Tibial mass was significantly higher in 8STP than 8S. No changes were evident in serum markers of bone turnover parameters after 8STP. Significant increases in tibial mass were observed in rats that continued to exercise at workloads of 30J/w and above after 8STP. Serum alkaline phosphatase concentrations increase whereas serum 1CTP concentrations decrease in rats given workloads of 40J/w and above. CONCLUSIONS: It appears, an exercise load of 30J/w, i.e. 10J/d for 3d/w, was the minimum level of continuous exercise load that was required to maintain the 8STP-induced bone gains. In addition, significant increases in bone mass in young rats following 8STP might not always be reflected by changes in serum levels of osteocalcin, alkaline phosphatase and 1CTP.

Non-uniform decay in jumping exercise-induced bone gains following 12 and 24 weeks of cessation of exercise in rats.

The effects of deconditioning on exercise-induced bone gains in rats were investigated in 12-week-old female WKY rats performing a standard jumping exercise regimen for either 8, 12 or 24 weeks, followed by sedentary periods of either 24, 12 or 0 weeks, respectively. Age-matched controls received no exercise over the same period. At the end of the training/sedentary period, the tibiae were harvested for analyses of bone parameters. Gains in tibial fat-free dry weight decayed within 12 weeks of deconditioning, but gains in tibial ultimate bending force (strength), maximum diameter and cortical area were still present at 12 weeks of deconditioning. With the exception of cortical area, all other exercise-induced bone gains decayed by the 24th week of deconditioning. It appears that the decay in exercise-induced bone gains in strength, physical and morphological properties is not uniform, and that gains in fat-free dry weight seem to decay earlier.