Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial.

This study examined the effectivenss of a balance-focused training program (i.e., Exercise for Balance Improvement Program, ExBP) in improving functional fitness of older nonfallers at risk of falling. Sixty-one participants were randomly assigned to receive 16 weeks of ExBP or Tai Chi (TC) training, or no treatment (CON) with an 8-week follow-up. The Senior Fitness Test battery was applied to assess functional fitness. After the intervention, results revealed significant improvements in all fitness components in the ExBP group. Compared with the CON group, the ExBP group demonstrated more improvements in lower extremity muscle strength, agility and balance, and aerobic endurance. The ExBP group also displayed more improvements in aerobic endurance than the TC group in posttest and follow-up test. Therefore, the balance-focused exercise can be applied as an effective way in improving overall functional fitness among older nonfallers who are at risk of falling.

Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women.

This study compared the effect of prolonged moderate-intensity continuous training (MICT) on reducing abdominal visceral fat in obese young women with that of work-equivalent (300 kJ/training session) high-intensity interval training (HIIT). Forty-three participants received either HIIT (n = 15), MICT (n = 15), or no training (CON, n = 13) for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans preintervention and postintervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Following HIIT and MICT, comparable reductions in AVFA (-9.1, -9.2 cm2), ASFA (-35, -28.3 cm2), and combined AVFA and ASFA (-44.7, -37.5 cm2, p > 0.05) were observed. Similarly, reductions in fat percentage (-2.5%, -2.4%), total fat mass (-2.8, -2.8 kg), and fat mass of the android (-0.3, -0.3 kg), gynoid (-0.5, -0.7 kg), and trunk (-1.6, -1.2 kg, p > 0.05) regions did not differ between HIIT and MICT. No variable changed in CON. In conclusion, MICT consisting of prolonged sessions has no quantitative advantage, compared with that resulting from HIIT, in abdominal visceral fat reduction. HIIT appears to be the predominant strategy for controlling obesity because of its time efficiency.

Sport-specific endurance plank test for evaluation of global core muscle function.

OBJECTIVE: To examine the validity and reliability of a sports-specific endurance plank test for the evaluation of global core muscle function. DESIGN: Repeated-measures study. SETTING: Laboratory environment. PARTICIPANTS: Twenty-eight male and eight female young athletes. MAIN OUTCOME MEASURES: Surface electromyography (sEMG) of selected trunk flexors and extensors, and an intervention of pre-fatigue core workout were applied for test validation. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and the measurement bias ratio */÷ ratio limits of agreement (LOA) were calculated to assess reliability and measurement error. RESULTS: Test validity was shown by the sEMG of selected core muscles, which indicated >50% increase in muscle activation during the test; and the definite discrimination of the ∼30% reduction in global core muscle endurance subsequent to a pre-fatigue core workout. For test-retest reliability, when the first attempt of three repeated trials was considered as familiarisation, the ICC was 0.99 (95% CI: 0.98-0.99), CV was 2.0 ± 1.56% and the measurement bias ratio */÷ ratio LOA was 0.99 */÷ 1.07. CONCLUSION: The findings suggest that the sport-specific endurance plank test is a valid, reliable and practical method for assessing global core muscle endurance in athletes given that at least one familiarisation trial takes place prior to measurement.

Serum oxidant and antioxidant status following an all-out 21-km run in adolescent runners undergoing professional training--a one-year prospective trial.

This study investigated the 1-year longitudinal effect of professional training in adolescent runners on redox balance during intense endurance exercise. Changes in selected serum oxidant and antioxidant status in response to a 21-km running time trial in 10 runners (15.5 ± 1.3 years) undergoing professional training were evaluated twice in 12 months (pre- and post-evaluation). Venous blood samples were collected immediately before and 4-h following the 21-km run for analysis of serum concentrations of thiobarbituric acid-reactive substances (TBARS), xanthine oxidase (XO), catalase (CAT), reduced glutathione (GSH), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC). In pre-evaluation trial, serum TBARS and SOD decreased after the 21-km run (p < 0.05) while XO, GSH, CAT and TAOC were unchanged. In post-evaluation trial, serum TBARS and SOD decreased, whereas XO and CAT increased post-exercise (p < 0.05). Furthermore, pre-exercise serum T-AOC, post-exercise serum XO, CAT, T-AOC (p < 0.05), and GSH (p = 0.057) appeared to be higher than the corresponding pre-evaluation values. The current findings suggest that a professional training regime in adolescent runners is not likely to jeopardize the development of their antioxidant defense. However, uncertainties in the maintenance of redox balance in runners facing increased exercise-induced oxidative stress as a consequence of training-induced enhancement of exercise capacity await further elucidation.

The release of immunosuppressive factor(s) in young males following exercise.

It has been shown that a suppressive protein, acting as an immune suppressor, is generated in animals and humans under particular stresses. However, studies related to immunosuppressive factors in response to the stress resulting from acute exercise are limited. This study compares the effects of pre- and post-exercise human serum on concanavalin A stimulated lymphocyte proliferation of mice. In the present study, blood samples in eight male undergraduates (age 21 ± 0.7 years) were taken before and immediately after ten sets of exercise consisting of 15 free and 30 10-kg loaded squat jumps in each set. The suppression of lymphocyte proliferation was analysed with high pressure liquid chromatography. It was noted from the result of gel chromatography columns that the post-exercise values of the suppression of lymphocyte proliferation, in comparison to corresponding pre-exercise values, were generally greater with significant differences observed in 7.5th-9th min post-exercise eluates (P < 0.05). Such findings suggest that intense eccentric type exercise may lead to generation of immunosuppressive factor(s) in young males.

Serum oxidant and antioxidant status in adolescents undergoing professional endurance sports training.

This study evaluated the impact of professional training on serum oxidant and antioxidant status in adolescent endurance athletes and compared it with that of untrained individuals. Firstly, serum thiobarbituric-acid-reactive substances (TBARSs), xanthine oxidase (XO), catalase (CAT), reduced glutathione (GSH), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC) were measured in 67 male runners, cyclists, and untrained adolescents. Seven-day dietary intakes were also assessed. Secondly, for age- and Tanner-stage-matched comparison, 36 out of the 67 subjects (12 for each group) were then selected and investigated. In cyclists, XO, GSH, and CAT were higher as compared with runners and controls. The CAT in runners, but not GSH and XO, was also higher than in controls. TBARS, T-AOC, and SOD did not differ among the study populations. Regarding the inter-individual relationships among serum redox statuses and dietary nutrient intakes, significant correlations were noted in CAT versus carbohydrates, protein, magnesium, and manganese; GSH versus carbohydrates, protein, fat, selenium, zinc, iron, and magnesium; XO versus cholesterol; CAT versus GSH. These findings suggest that the resting blood redox balance in the professional adolescent athletes was well maintained partly by the increase of individual antioxidant in adaptation to chronic exercise.

Effect of repeated endurance runs on cardiac biomarkers and function in adolescents.

PURPOSE: This study examined the effect of two bouts of prolonged exercise performed on the same day on cardiac biomarkers and left ventricular (LV) function in trained adolescent runners. METHODS: Twelve male adolescent runners (age = 14.5 ± 1.5 yr) performed two 45-min constant-load treadmill runs (RUN1 and RUN2), separated by 255 min of recovery, with intensity set at the running speeds that corresponded to ventilatory threshold. Serum cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were assessed before (PRE1, PRE2), immediately after (POST1, POST2), and 255 min after each run (POST1+4, POST2+4) where PRE2 and POST1+4 were the same sample. LV function was examined echocardiographically before and after each run. RESULTS: cTnT was undetectable at PRE1 and POST1 but was elevated in eight-twelfths (67%) of runners at POST1+4/PRE2 (median (range) = 0.018 (<0.01-0.375 ng·mL(-1))). cTnT decreased progressively thereafter up to POST2+4 (four-twelfths, 33%). Data for NT-pro-BNP were significantly increased at POST1 and POST2 but returned to baseline at POST1+4 and POST2+4. Ejection fraction (EF) was significantly reduced after RUN1 (74% ± 5% to 70% ± 5%, P < 0.05), although still within normal range. There was no evidence of a cumulative drop in EF after RUN2 because the change was similar in magnitude (73% ± 4% to 68% ± 5%, P < 0.05). The decrease in the early-atrial (E:A) diastolic flow velocity ratio was greater after RUN1 (1.91 ± 0.13 to 1.83 ± 0.08, P < 0.05) than after RUN2 (1.86 ± 0.15 to 1.85 ± 0.12, P > 0.05), and thus, changes were not cumulative. CONCLUSIONS: Neither cardiac biomarkers (cTnT or NT-pro-BNP) nor LV function (EF or E:A) demonstrate cumulative changes after two 45-min runs at ventilatory threshold separated by ∼ 4 h of recovery. Adolescent hearts seem to cope well with two prolonged runs performed on the same day.

The effects of time and intensity of exercise on novel and established markers of CVD in adolescent youth.

OBJECTIVES: This article examines the effects of brief, intense exercise in comparison with traditional endurance exercise on both novel and traditional markers of cardiovascular disease (CVD) in youth. METHODS: Forty seven boys and ten girls (16.4 ± 0.7 years of age) were divided into a moderate (MOD), high intensity (HIT), or a control group. The MOD group (12 boys, 4 girls) and HIT group (15 boys, 2 girls) performed three weekly exercise sessions over 7 weeks. Each session consisted of either four to six repeats of maximal sprint running within a 20 m area with 20-30 s recovery (HIT) or 20 min continuous running within a 20 m area at ∼70% maximal oxygen uptake (VO(2) max). RESULTS: Total exercise time commitment over the intervention was 420 min (MOD) and 63 min (HIT). Training volume was 85% lower for the HIT group. Total estimated energy expenditure was ∼907.2 kcal (HIT) and ∼4410 kcal (MOD). Significant improvements (P ≤ 0.05) were found in systolic blood pressure, aerobic fitness, and body mass index (BMI) postintervention (HIT). In the MOD group, significant (P ≤ 0.05) improvements were noted in aerobic fitness, percentage body fat (%BF), BMI, fibrinogen (Fg), plasminogen activator inhibitor-1, and insulin concentrations. CONCLUSIONS: These findings demonstrate that brief, intense exercise is a time efficient means for improving CVD risk factors in adolescents.

Renal function parameters during early and late recovery periods following an all-out 21-km run in trained adolescent runners.

BACKGROUND: This study investigated the changes in biomarkers of renal function and the corresponding estimated glomerular filtration rate (eGFR) in 10 male adolescent (16.2±0.6 years) trained runners during early and late recovery periods after an all-out 21-km run. METHODS: Venous blood samples were taken immediately before, and at 2-h, 4-h, and 24-h following the 21-km run. Samples were analyzed for hemoglobin (Hb) and hematocrit (Hct), and serum urea (U), creatinine (Cr), creatine kinase (CK) and lactate dehydrogenase (LDH). U/Cr ratio, eGFR, and plasma volume change (%ΔPV) were calculated based on the associated measured variables. RESULTS: At 2-h and 4-h, there were increases (26%-146%) in U, Cr, U/Cr, CK, and LDH, and decreases (8%-13%) in Hb and Hct, as compared with the corresponding pre-exercise values. The calculated %ΔPV increased by 17% while the eGFR decreased 20% from the corresponding pre-exercise value, respectively. At 24-h, the changes of the blood variables and renal function parameters observed at early recovery period were sustained. CONCLUSIONS: Taken together, the findings of this study suggest that mild decline in renal function occurred during the early recovery period following the 21-km run. The decline in renal function did not return to normal during the later recovery period.

Temporal association of elevations in serum cardiac troponin T and myocardial oxidative stress after prolonged exercise in rats.

The objective of this study was to determine if prolonged exercise resulted in the appearance of cardiac troponin T (cTnT) in serum and whether this was associated with elevated levels of myocardial oxidative stress. Forty-five male Sprague-Dawley rats were randomized into four groups and killed before (PRE-EX), immediately (0HR), 2 (2HR) and 24 h (24HR) after a 3-h bout of swimming with 5% body weight attached to their tail. In all animals serum cTnT was assayed using 3rd generation electrochemiluminescence. In homogenized heart tissue myocardial malondialdehyde (MDA), a marker of lipid peroxidation, glutathione (GSH), and a non-enzymatic estimate of total antioxidant capacity (T-AOC) were assessed spectrophotometrically. At PRE-EX cTnT was undetectable in all animals. At 0HR (median, range: 0.055, 0.020-0.100) and 2HR post-exercise (0.036, 0.016-2.110) cTnT was detectable in all animals (P < 0.05). At 24HR post-exercise cTnT was undetectable in all animals. An elevation in MDA was observed 0HR (mean ± SD: 1.7 ± 0.2 nmol mgpro(-1)) and 2HR (1.6 ± 0.3 nmol mgpro(-1)) post-exercise compared with PRE-EX (1.3 ± 0.2 nmol mgpro(-1); P < 0.05). The antioxidant response to this challenge was a significant (P < 0.05) decrease in GSH 2HR and 24HR post-exercise. Despite this T-AOC did not alter across the trial (P > 0.05). The results indicated that prolonged and strenuous exercise in rats resulted in an elevation in cTnT, a biomarker of cardiomyocyte damage, in all animals 0HR and 2HR after exercise completion. The time course of cTnT elevation was temporally associated with evidence of increased lipid peroxidation in the rat heart.

Serum oxidant and antioxidant status during early and late recovery periods following an all-out 21-km run in trained adolescent runners.

It is well documented that intense exercise precipitates oxidative stress in adults. However, there is lack of related studies concerning oxidant and antioxidant status during early and late recovery periods in adolescent athletes, following endurance exercise in particular. This study investigated aspects of the serum oxidant and antioxidant status of 12 male adolescent (16.2 ± 0.6 years) trained runners during early and late recovery periods after an all-out 21-km run. Venous blood samples were taken immediately before, 2 and 4 h following (early recovery period), and 24 h following (late recovery period) the 21-km run. Samples were analyzed for serum concentrations of thiobarbituric acid-reactive substances (TBARS), uric acid (UA), reduced glutathione (GSH), and enzymatic activity of xanthine oxidase (XO), superoxide dismutase (SOD), and catalase (CAT). During the early recovery period, there were increases in the 4-h GSH (194.8 ± 10.4 vs. 211.8 ± 11.4 mg l(-1), P < 0.05), 2- and 4-h UA (307.8 ± 68.6 vs. 327.4 ± 63.8; 330.2 ± 65.1 µmol l(-1), P < 0.05), and 2-h CAT (2.05 ± 0.44 vs. 3.07 ± 0.51 U ml(-1), P < 0.05), and decreases in the 2-h XO (11.1 ± 1.5 vs. 10.3 ± 1.2 U l(-1), P < 0.05) compared to the corresponding pre-exercise level, respectively. No change was observed in SOD (P > 0.05). At the late recovery period, there was an increase in CAT (2.80 ± 0.49 U ml(-1), P < 0.05) and TBARS (2.99 ± 0.83 vs. 4.40 ± 1.38 nmol ml(-1), P < 0.05). These data indicate that although the antioxidant capacity of adolescent runners is augmented during the early recovery period following the 21-km run, they were not completely protected from oxidative stress during the later recovery period.

Chronic and acute inspiratory muscle loading augment the effect of a 6-week interval program on tolerance of high-intensity intermittent bouts of running.

This study examined the hypothesis that chronic (training) and acute (warm-up) loaded ventilatory activities applied to the inspiratory muscles (IM) in an integrated manner would augment the training volume of an interval running program. This in turn would result in additional improvement in the maximum performance of the Yo-Yo intermittent recovery test in comparison with interval training alone. Eighteen male nonprofessional athletes were allocated to either an inspiratory muscle loading (IML) group or control group. Both groups participated in a 6-week interval running program consisting of 3-4 workouts (1-3 sets of various repetitions of selected distance [100-2,400 m] per workout) per week. For the IML group, 4-week IM training (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets·d-1, 6 d·wk-1) was applied before the interval program. Specific IM warm-up (2 sets of 30 inspiratory efforts at 40% P0) was performed before each workout of the program. For the control group, neither IML was applied. In comparison with the control group, the interval training volume as indicated by the repeatability of running bouts at high intensity was approximately 27% greater in the IML group. Greater increase in the maximum performance of the Yo-Yo test (control: 16.9 ± 5.5%; IML: 30.7 ± 4.7% baseline value) was also observed after training. The enhanced exercise performance was partly attributable to the greater reductions in the sensation of breathlessness and whole-body metabolic stress during the Yo-Yo test. These findings show that the combination of chronic and acute IML into a high-intensity interval running program is a beneficial training strategy for enhancing the tolerance to high-intensity intermittent bouts of running.

Effect of specific inspiratory muscle warm-up on intense intermittent run to exhaustion.

The effects of inspiratory muscle (IM) warm-up on the maximum dynamic IM function and the maximum repetitions of 20-m shuttle run (Ex) in the Yo-Yo intermittent recovery test were examined. Ten men were recruited to perform identical IM function test and exercise test in three different trials randomly. The control trial was without IM warm-up while the placebo and experimental trials were with IM warm-up by performing two sets of 30 breaths with inspiratory pressure-threshold load equivalent to 15% (IMW(P)) and 40% (IMW) maximum inspiratory mouth pressure, respectively. In IMW, maximum dynamic IM functions including the maximal inspiratory pressure at zero flow (P0) and maximal rate of P0 development (MRPD) were increased compared with control values (P < 0.05). The Ex was also augmented [mean (SD)] [19.5% (12.6)] while the slope of the linear relationship of the increase in rating of perceived breathlessness for every 4th exercise interval (RPB/4i) was reduced (P < 0.05). In IMW(P), although increase in Ex and reduction in RPB/4i were occurred concomitantly in some subjects, the differences in Ex, RPB/4i and dynamic IM functions between control and IMW(P) trials were not statistically significant. For the changes (Delta) in parameters in IMW and IMW(P) (n = 20), negative correlations were found between Delta RPB/4i and Delta Ex (r = -0.92), DeltaP0 and Delta RPB/4i (r = -0.48), and Delta MRPD and Delta RPB/4i (r = -0.54). Such findings suggested that the specific IM warm-up in IMW may entail reduction in breathlessness sensation, partly attributable to the enhancement of dynamic IM functions, in subsequent exhaustive intermittent run and, in turn, improve the exercise tolerance.

Reduced sensations of intensity of breathlessness enhances maintenance of intense intermittent exercise.

To identify the effect of normal breathlessness sensation elicited during intense intermittent exercise at exhaustion on limitation of exercise maintenance (Ex), the contribution of the flow-resistive unloading effect of normoxic helium-oxygen breathing on the breathlessness sensation to the change in the Ex was examined. Seven men repeatedly performed 12-s exercise at 160% maximal aerobic power output followed by passive recovery for 18-s under normal (CON) and unloaded (UL) breathing conditions until exhaustion. In UL, Ex was enhanced [mean (SD) 127.2 (11.8)% CON] concomitantly with reduction in averaged peak inhaled mouth pressure (PPmi) of recorded breathing cycles that reflected approximate true inspiratory muscle force output. At the iso-time point of CON exhaustion, the reduction in PPmi to [75.7(10.2)% CON] in UL was concomitant with the reductions in the rating of perceived breathlessness (RPB) [87.5 (13.1)% CON] and in the slope of time course for RPB (RPB/2-min period) [82.1 (17.2)% CON]. It was also concomitant with increases in ventilation and total oxygen consumption. However, the augmented oxygen consumption did not result in lowering of subjects' metabolic stress that was indicated by accumulations of blood lactate and plasma ammonia and uric acid. Nevertheless, the reductions in the RPB and RPB/2-min period, which reflected the breathlessness intensity, were correlated to the CON Ex enhancement in UL (RPB r=-0.57, RPB/2-min period r=-0.83; P<0.05). These findings implied that the normal noxious breathlessness sensation elicited during intense intermittent exercise at exhaustion might contribute to the limitation of subjects' exercise maintenance.

Increased sensations of intensity of breathlessness impairs maintenance of intense intermittent exercise.

To identify the reserve of an individual's tolerance of the sensation of breathlessness and metabolic stress in maintaining intense intermittent exercise at exhaustion under conditions of normal breathing, the contribution of the effect of modest inspiratory load on these two responses to the change in the exercise sustainability (Ex(sus)) were examined. Seven men repeatedly performed 12 s exercise at 160% maximal aerobic power output followed by passive recovery for 18 s under normal and ventilatory muscle loaded (VML) breathing conditions until exhaustion. In the VML trial, ventilatory muscle work at exhaustion was double that of the normal control. The control Ex(sus) was reduced [mean (SEM)] [31.7 (6.6)%] while the slope of the time course for the rating of the perceived magnitude of breathing effort (RPMBE/Time), which reflected the intensity of breathlessness, was increased [164.8 (32.2)%] from control and the RPMBE at exhaustion was higher than corresponding control value [144.4 (21.8)%]. Moreover, increases in plasma ammonia and uric acid concentrations, which indicated metabolic stress, were increased [168.1 (28.0)% and 251.7 (57.4)%, respectively], with no change in total oxygen uptake from control when the control exercise was repeated with an identical duration of VML exercise. It was found that the reduction in Ex(sus) in the VML trial was correlated to the increase in their sensations of the intensity of breathlessness (RPMBE/Time: r=0.81; RPMBE at exhaustion: r=0.97, P<0.05). The reduction in Ex(sus), however, was not correlated to the increase in metabolite concentrations. These findings implied that there was no substantial reserve of tolerance of the sensation of breathlessness relative to that of metabolic stress in subjects maintaining intense intermittent exercise at exhaustion under normal conditions of breathing.