The effect of exercise rehabilitation with exergames combined with ice therapy in the treatment of obese patients with gout: protocol for a clinical trial.

BACKGROUND: Gout remains a leading cause of inflammatory arthritis worldwide, and the main risk factor for gout is persistent hyperuricemia. The clinical management of gout is mostly drug-based, and other treatment options are often ignored. This research proposal will explore whether exergames combined with ice therapy can help patients with gout to lose weight, relieve pain, improve the range of movement, improve quality of life, decrease uric acid level, decrease kinesiophobia and improve mental health of patients with gout. METHODS: This experiment will use a two-arm randomized controlled design. The study setting is at the Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia (USM). Obese patients with gout (N = 30) will be randomly assigned to the control group (receive an exergames intervention) and intervention group (receive an exergames intervention combined with ice therapy). The outcomes measurement will be conducted before (baseline) and after intervention (4 weeks). Then, it will be followed up at 12 weeks. DISCUSSION: To our knowledge, no study has investigated the effect of exergames and ice therapy among gout patients. This study is expected to demonstrate that exercise rehabilitation facilitated by exergames with ice therapy is more effective in gout management compared to a conventional rehabilitation intervention. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2300070029). Registered on 31 March 2023.

The Efficacy of Ingesting Water on Thermoregulatory Responses and Running Performance in a Warm-Humid Condition.

The understanding that fluid ingestion attenuates thermoregulatory and circulatory stress during exercise in the heat was based on studies conducted in relatively dry (∼50% RH) environments. It remains undetermined whether similar effects occur during exercise in a warm and more humid environment, where evaporative capacity is reduced. Nine well-trained, unacclimatised male runners were randomly assigned to perform four experimental trials where they ran for 60 min at an intensity of 70% VO2max followed by an incremental exercise test until volitional exhaustion. The four trials consisted of non-fluid ingestion (NF) and fluid ingestion (FI) in a warm-dry (WD) and warm-humid condition (WH). Time to exhaustion (TTE), body temperature (Tb), whole body sweat rate, partitional calorimetry measures, heart rate and plasma volume were recorded during exercise. There was no significant difference in Tb following 60 min of exercise in FI and NF trial within both WD (37.3°C ± 0.4 vs. 37.4°C ± 0.3; p > 0.05) and WH conditions (38.0°C ± 0.4 vs. 38.1°C ± 0.4; p > 0.05). The TTE was similar between FI and NF trials in both WH and WD, whereas exercise capacity was significantly shorter in WH than WD (9.1 ± 2.8 min vs. 12.7 ± 2.4 min, respectively; p = 0.01). Fluid ingestion failed to provide any ergogenic benefit in attenuating thermoregulatory and circulatory stress during exercise in the WH and WD conditions. Consequently, exercise performance was not enhanced with fluid ingestion in the warm-humid condition, although the humid environment detrimentally affected exercise endurance.

The influence of angiotensin I-converting enzyme (ACE) I/D gene polymorphism on cardiovascular and muscular adaptations following 8 weeks of isometric handgrip training (IHG) in untrained normotensive males.

We examined the association between the angiotensin I-converting enzyme (ACE) I/D gene polymorphism and isometric handgrip (IHG) training on cardiovascular and muscular responses among normotensive males. Thirty (II = 10, ID = 10, and DD = 10) normotensive untrained males underwent IHG training at 30% of their maximal voluntary contraction 3 days per week for 8 weeks. Cardiovascular and muscular variables were measured before IHG, after a session of IHG and after 8 weeks of IHG. No significant interaction effect was found between ACE I/D genotype and IHG training session on all dependent variables (all p > 0.05). There was a significant main effect of IHG training session on systolic blood pressure (SBP) (p = 0.002), mean arterial pressure (MAP) (p = 0.015) and handgrip strength (HGS) (p = 0.001) scores, while no difference in diastolic blood pressure (DBP), pulse pressure, or heart rate scores was found. A greater improvement in cardiovascular parameters following 8 weeks of IHG training was observed in participants with the D allele than the I allele (SBP reduction: ID+DD genotype group (-5.53 ± 6.2 mmHg) vs. II genotype group (-1.52 ± 5.3 mmHg)); MAP reduction: ID + DD genotype group (-2.80 ± 4.5 mmHg) vs. II genotype group (-1.45 ± 3.5 mmHg). Eight weeks of IHG training improved cardiovascular and muscular performances of normotensive men. Reduction in SBP and MAP scores in D allele carriers compared to I allele carriers indicates that the ACE I/D polymorphism may have an influence on IHG training adaptation in a normotensive population.