Group-based progressive functional, high-intensity training in adolescents and young adults with unilateral cerebral palsy - a tool to improve gross motor function, endurance and gait? - a pilot study.

PURPOSE: This pilot study assessed the safety and effects of progressive functional high-intensity training in a group setting for adolescents with unilateral cerebral palsy (CP) on daily function indicators. METHODS: Nine adolescents (mean age 16.9 years, GMFCS levels I-II) participated in 12 weeks of training (2x/week). Evaluations included 3D gait analysis, the 6-min walking test (6MWT), clinical exams, and the Gross Motor Function Measure-66 (GMFM-66). RESULTS: No adverse events occurred, and GMFM-66 scores significantly improved (p = .031, Δ = 2.19%). Although increases in 6MWT (p = .09, Δ = 29.8 m) performance and propulsion ratio (p = .067, Δ = 5.4%) for the affected leg were observed, they were not statistically significant. DISCUSSION: The study suggests that this training is safe and may enhance gross motor function, endurance, and gait asymmetry in unilateral CP. Future research should include upper limb evaluations and out-of-clinic motion analysis with wearable inertial measurement units (IMUs) to provide a more comprehensive assessment of functional movements.

Effect of whole-body cryotherapy on recovery after high-intensity training in elite rowers.

The purpose of this study was to investigate the effect of whole-body cryotherapy (WBC) on acute recovery after a single high-intensity training day. Twelve elite professional male rowers from the national aquatic training base. They were randomly divided into a WBC group (n = 6) and a control group (CON group, n = 6). They performed a high-intensity training program, with a single session immediately followed by WBC (-110°C, 3 min) or recovered naturally for 3 min (CON group). Rowing performance, skin temperature, heart rate, blood pressure, and blood lactate concentrations were recorded before training, immediately, 5 min, and 15 min after the intervention. Blood samples were collected early in the morning of the day of intervention and that of the following day. The results indicated that 1) the blood lactate concentrations after WBC were significantly lower than pre-training (p < 0.05); 2) the maximum power significantly decreased immediately after WBC compared to pre-training (p < 0.05); 3) a significant main effect of time was observed for average speed, which significantly decreased after WBC (p < 0.05); 4) a significant main effect of time for blood parameters was observed. Specifically, hematocrit, cortisol, and hemoglobin were significantly lower after WBC than pre-intervention, whereas testosterone/cortisol was significantly higher than pre-intervention (p < 0.05). The results of this study showed that a single session of WBC had a positive effect on accelerating the elimination of blood lactate after HIT, but did not significantly change rowing performance and physiological parameters. A single session of WBC was not an effective strategy for elite rowers for acute recovery after HIT.

Exploring the Association Between Physical Fitness (High Intensity and Low Intensity) and the Incidence of Temporomandibular Disorders: A Comparative Study.

BACKGROUND: Temporomandibular joint disorders affect the temporomandibular joint (TMJ), masticatory muscles, and associated structures. Symptoms include TMJ pain, limited jaw movement, muscle tenderness, and referred pain. Physical activity can alleviate musculoskeletal pain. This study explored the link between physical fitness (high and low intensity) and temporomandibular disorder (TMD) incidence. METHODOLOGY: Sixty patients were divided into three groups in this comparative study. Group I underwent 30 minutes of high-intensity aerobic training. Group II had 30 minutes of low-intensity yoga sessions weekly. Group III received health education. TMD was diagnosed using the Fonseca Anamnestic Index (FAI). Pain intensity was measured using the Visual Analogue Scale (VAS) and the Pain Self-Efficacy Questionnaire (PSEQ). RESULTS: Of the participants, 38.1% were males and 61.9% were females. TMD severity was mild (25.0%), moderate (55.0%), and severe (20.0%). High-intensity training groups had higher TMD symptom severity than low-intensity groups (p = 0.001). VAS scores increased in group I and decreased in group II (significant). PSEQ scores decreased in group I and increased significantly in group II. Group III showed no significant differences in PSEQ scores. CONCLUSION: High-intensity training resulted in moderate TMD symptoms. Low-intensity training was beneficial for TMD pain. The study recommends combining low-intensity physical workouts with medications to alleviate TMD.

Effects of High-Intensity Training on Complete Blood Count, Iron Metabolism, Lipid Profile, Liver, and Kidney Function Tests of Professional Water Polo Players.

AIM: Our goal was to examine the effect of high-intensity physical activity on changes in the lipid profile, complete blood count (CBC), iron metabolism, and kidney and liver function tests of professional water polo players. METHODS: This study included twenty professional male water polo players. Blood sampling was carried out at the beginning of the season and during periods of high-intensity training. CBCs were determined with a Siemens Advia 2120i hematology analyzer. A Beckman CoulterAU680 chemistry analyzer was used to determine the serum concentrations/activities of lipid profiles and liver and kidney function test analytes. The lipid athlete scores were also determined. RESULTS: The mean corpuscular volume (p = 0.006), platelet count (p = 0.008), and mean platelet volume (p < 0.001) significantly decreased during the high-intensity period, compared with the beginning of the season. The total iron-binding capacity increased (p = 0.001), and ferritin concentrations significantly declined (p = 0.017). The lipid profiles revealed a significant difference between phases, with slight increases in serum total (p = 0.025) and LDL cholesterol (p = 0.002) levels and a decrease in triglyceride concentrations (p = 0.040) in the high-intensity period. During the high-intensity period, the liver and kidney function tests showed a substantial positive effect on lactate dehydrogenase levels (p < 0.001), aspartate aminotransferase (p = 0.028) serum activity, and total protein concentrations (p = 0.033), compared with the beginning of the season. CONCLUSIONS: Water polo players might exhibit a decrease in some CBC parameters, an increase in LDL cholesterol, and a decrease in liver function biomarkers due to intense training at the peak of the competitive season. Kidney function biomarkers remain unchanged.

High-Intensity Exercise Training Impact on Cardiorespiratory Fitness, Gait Ability, and Balance in Stroke Survivors: A Systematic Review and Meta-Analysis.

Stroke survivors commonly face challenges such as reduced physical activity and cardiorespiratory fitness (CRF) as well as balance and gait impairments, exacerbating their disability. While high-intensity exercise interventions have demonstrated some potential, their effects on these items remain uncertain. Therefore, our study aimed to investigate the impact of high-intensity training protocols on CRF, gait ability, and balance in stroke survivor populations. Two independent investigators systematically searched five databases for relevant RCTs following the PICO model. Through a systematic review of 25 RCTs published up to 31 May 2023, including adult first-stroke survivors, comparing high-intensity exercise training versus low-to-mild or no exercises, we evaluated outcomes such as the Six-Minute Walking Test (6 MWT), peak oxygen uptake (VO2peak), Ten-Meter Walk Test (10 MWT), Berg Balance Scale (BBS), and Timed Up and Go test (TUG). The protocol was registered in PROSPERO (registration number CRD42023456773). Meta-analyses indicated significant enhancements in CRF, as measured by 6 MWT and VO2peak, following high-intensity exercise interventions. However, no significant differences were observed in BBS, 10 MWT, and TUG. Our findings underscore the potential of high-intensity exercise interventions in ameliorating CRF among stroke survivors, although further research involving standardized protocols and long-term follow-ups is imperative to optimize rehabilitation outcomes.

Intensity and Pace Calculation of Ultra Short Race Pace Training (USRPT) in Swimming-Take-Home Messages and Statements for Swimming Coaches.

A recently referenced method known as ultra short race pace training (USRPT), designed to familiarize swimmers with the pace of a swimming event by using high volumes and submaximal intensities, has emerged as an efficient approach, enhancing performance and predicting swimming outcomes. Despite its recognized benefits, particularly its lower physiological burden compared to other training methods, research on USRPT is still in its early stages. There are misunderstandings related to its intensity and the pace of calculation. This systematic review aims to provide valid statements identifying the pros and cons of USRPT as a training stimulus and providing swimming coaches with key messages and advice about this training method. For the analysis, 90,612 studies from PubMed, EBSCO, Science Direct, and Google Scholar databases were screened to research the background, intensity, and pace calculation of the USRPT method, although only four met the inclusion criteria. The final screening of the selected studies was conducted using a PRISMA-P document. USRPT has the potential to become a dominant training stimulus, offering a precise alternative to the often vague training sets that many swimmers use. However, further studies focusing on specific aspects of intensity and pace calculation within USRPT sets are needed for comprehensive understanding. In conclusion, USRPT appears to be a submaximal variation of high-intensity interval training (HIIT) with low blood lactate relevance to swimming events. Also, the pace calculation must be implemented considering the different demands of each point of a swimming event.

Effect of Different Reduced Training Frequencies after 12 Weeks of Concurrent Resistance and Aerobic Training on Muscle Strength and Morphology.

The aim of the study was to investigate the effect of two long-term reduced concurrent training modalities, in which participants performed one training session every either 7 or 14 days, after 12 weeks of systematic concurrent resistance and aerobic training, on lower extremities' muscle strength, power, and morphology in young females. After the 12-week training period, participants were assigned into three groups and performed either one training session every 7 days (G7) or once every 14 days (G14), or detraining (GD), for 12 weeks, followed by 12 additional weeks of detraining. The following were measured before, after the systematic training period, after the end of the reduced training frequency period, and after the end of complete detraining: body composition, leg press 1-RM, countermovement jump, quadriceps cross-sectional area (CSA), vastus lateralis muscle architecture, and maximum aerobic power. Performance and muscle mass increased after the initial 12-week training period. Thereafter, leg press 1-RM, quadriceps CSA, and aerobic power remained unchanged in the G7 group, but decreased in G14 (-4.4 ± 3.5%; -5.9 ± 1.8%; -9.0 ± 7.8%, respectively, p < 0.05), maintaining 95.6 ± 3.5%, 94.1 ± 1.8%, and 91.0 ± 7.8% of the initial training adaptations, respectively. In conclusion, performing one training session every 2 weeks for 3 months may preserve 90 to 95% of the muscle mass/strength and aerobic power adaptations achieved with systematic concurrent training.

How to Equalize High- and Low-Intensity Endurance Exercise Dose.

PURPOSE: Without appropriate standardization of exercise doses, comparing high- (HI) and low-intensity (LI) training outcomes might become a matter of speculation. In athletic preparation, proper quantification ensures an optimized stress-to-recovery ratio. This review aims to compare HI and LI doses by estimating theoretically the conversion ratio, 1:x, between HI and LI: How many minutes, x, of LI are equivalent to 1 minute of HI using various quantification methods? A scrutinized analysis on how the dose increases in relation to duration and intensity was also made. ANALYSIS: An estimation was conducted across 4 categories encompassing 10 different approaches: (1) "arbitrary" methods, (2) physiological and perceptual measurements during exercise, (3) postexercise measurements, and comparison to (4a) acute and (4b) chronic intensity-related maximum dose. The first 2 categories provide the most conservative estimation for the HI:LI ratio (1:1.5-1:10), and the third, slightly higher (1:4-1:11). The category (4a) provides the highest estimation (1:52+) and (4b) suggests 1:10 to 1:20. The exercise dose in the majority of the approaches increase linearly in relation to duration and exponentially in relation to intensity. CONCLUSIONS: As dose estimations provide divergent evaluations of the HI:LI ratio, the choice of metric will have a large impact on the research designs, results, and interpretations. Therefore, researchers should familiarize themselves with the foundations and weaknesses of their metrics and justify their choice. Last, the linear relationship between duration and exercise dose is in many cases assumed rather than thoroughly tested, and its use should be subjected to closer scrutiny.

10-20-30 exercise training improves fitness and health.

Intense interval exercise training has been shown to improve performance and health of untrained and trained people. However, due to the exercise intensity causing high-perceived exertion, the participants often do not wish to continue the training. The 10-20-30 training concept consists of low intensity for 30 s, 20 s at a moderate pace, and then 10 s with high intensity either running or cycling. A 10-20-30 training session consist of two to four 5-min blocks. The 10-20-30 training improved fitness and performance as well as lowered blood pressure and body fat of both untrained and trained individuals even with a significant reduction in the training volume. Similarly, hypertensive, diabetic, and asthmatic patients lowered body fat, improved fitness, and performance during a 10-20-30-training intervention period. In addition, hypertensive patients reduced systolic and diastolic blood pressure markedly with the 10-20-30 training twice a week for 8 weeks. Diabetic patients lowered long-term blood sugar (HbA1c), which did not occur with moderate-intensity exercise training. Furthermore, asthmatic patients improved their control of asthma and asthma-related quality of life with the 10-20-30 training. The adherence for the patient groups was high (>80%), and no adverse events were reported. Thus, the 10-20-30 training seems to be time efficient and feasible for untrained and trained individuals as well as patients and may be used in the prevention and treatment of noncommunicable diseases.

Effects of contrast water therapy on proprioception of the knee joint and degree of fatigue in sprinters after high intensity training.

OBJECTIVE: To investigate the effect of contrast water therapy on proprioception of the knee joint and indicators associated with fatigue in sprinters after high intensity training. METHODS: A total of 40 sprinters were selected and divided into an observation group and a control group. The observation group got 14 minutes of contrast water therapy, while the control group took 14 minutes of sitting rest after training. The knee position sense, muscle force sense, joint reaction angle to release, knee joint function, and indictors associated with fatigue were evaluated before and after exercise at different time points. RESULTS: At 24 h, 48 h, and 72 h after exercise, the active position sense and muscle force sense of the control group were significantly lower than those of the observation group (all P<0.05). At 48 h after exercise, the passive position sense of the control group was significantly lower than that of the observation group (all P<0.05). At 24 h and 48 h after exercise, the joint reaction angle to release of the control group was significantly greater than that of the observation group (all P<0.05). Additionally, the IKDC2000 and Lysholm scores after interference in the observation group were greater than those of the control group (all P<0.05). The indicators associated with fatigue after interference in the observation group were significantly lower than those of the control group (all P<0.05). CONCLUSION: Contrast water therapy can effectively alleviate muscle force sense, promote muscle proprioception, improve knee joint function, and enhance recovery from fatigue.

The Effects of High-Intensity Interval Training and Moderate Alcohol Consumption on Cognitive Performance-A Multidisciplinary Intervention in Young Healthy Adults.

BACKGROUND: The main purpose of this study was to determine the effects of a high-intensity interval training (HIIT) intervention in the context of moderate alcohol consumption on cognitive performance in healthy young adults. METHODS: We conducted a 10-week HIIT program along with four types of beverages with/without alcohol content. A total of 75 healthy adults (18-40 years old; 46% female) were allocated to either a control Non-Training group or an HIIT program group (2 days/week). Using block randomization, participants in the HIIT group were further allocated to an HIIT-Alcohol group (alcohol beer or sparkling water with vodka added, 5.4%) or an HIIT-NonAlcohol group (sparkling water or non-alcohol beer, 0.0%). The control group was instructed to maintain an active lifestyle but did not undergo any regular training. A comprehensive neuropsychological battery was used to evaluate cognitive performance (i.e., memory, working memory, processing speed, inhibitory control, and verbal fluency). Changes from baseline to week 10 were included in the main analyses. RESULTS: All groups improved in all neuropsychological measures (all p ≤ 0.001), independent of sex and alcohol consumption, with no statistical differences between groups (all p > 0.05). Furthermore, larger increases in maximal oxygen uptake were associated with greater improvements in processing speed, inhibitory control, and verbal fluency (all p < 0.050). CONCLUSIONS: Although the improvements found in cognitive performance cannot be attributed to the HIIT intervention, no significant impairments in cognitive functions were noted due to moderate alcohol intake. Furthermore, our results confirmed that exercise-induced physical fitness improvements were associated with cognitive performance enhancements in young healthy adults.

Effects of different exercise methods and intensities on the incidence and prognosis of atrial fibrillation.

Atrial fibrillation (AF), the most common sustained arrhythmia in clinical practice, exhibits a higher risk of cardiovascular adverse events. Exercise plays a crucial role in AF prevention, but the effects of different exercise types and doses are inconclusive. This review aims to comprehensively explore the most recent evidence and possible mechanisms of diverse exercise modalities concerning AF incidence and therapeutic outcomes. Multiple studies underscore the efficacy of moderate-intensity continuous training (MICT) in reducing AF incidence and symptom burden, rendering it the currently favored exercise therapy for AF patients. High-intensity interval training (HIIT) shows promise, potentially surpassing MICT, especially in reducing age-related AF susceptibility and improving symptoms and exercise capacity. Conversely, prolonged high-intensity endurance exercise exacerbates AF risk due to excessive exercise volume, with potential mechanisms encompassing irreversible atrial remodeling, heightened inflammation, and increased vagal tone. In summation, MICT is a secure strategy for populations in mitigating the risk associated with AF incidence and secondary cardiovascular events and should be encouraged. Also, it is recommended to initiate large-scale clinical intervention trials encompassing a variety of exercise types to delineate the optimal exercise prescription for cardiovascular patients, including those afflicted with AF.

Top-class women's soccer performance: peak demands and distribution of the match activities relative to maximal intensities during official matches.

The aims of the current study were to determine the most demanding passages of match play (MDP) and the distribution of match activities relative to maximum intensities during official matches in top-class women soccer players. Twenty-eight women players competing in European championship and international UEFA competitions were monitored during 38 official matches (277 individual samples). Maximum relative (m · min-1) total distance (TD), high-speed running (HSRD), very high-speed running (VHSRD), sprint, acceleration and deceleration distances were calculated across different durations (1-5, 10, 15, 90 min) using a rolling average analysis. Maximum intensities (1-minpeak) were used as the reference value to determine the distribution of relative intensity across the whole-match demands (90-minavg). Time and distance higher than 90-minavg (> 90-minavg) were also calculated. MDP showed moderate to very large [effect size (ES): 0.63/5.20] differences between 1-minpeak vs all durations for each parameter. The relative (m · min-1) 1-minpeak was greater than 90-minavg of about +63% for TD, +358% for HSRD, +969% for VHSRD, +2785% for sprint, +1216% for acceleration, and +768% for deceleration. The total distance covered > 90-minavg was ~66.6% of the total distance covered during the 90-minavg for TD, ~84.8% for HSRD, ~97.4% for VHSRD, ~100% for sprint, ~99.1% for acceleration and ~98.2% for deceleration. The relative distance > 90-minavg was higher (P < 0.05) than the 90-minavg for each metric (ES: 2.22 to 7.58; very large). The present results may help coaches and sport scientists to replicate the peak demands during training routine in top-class women soccer players.

Running with whole-body electromyostimulation improves physiological determinants of endurance performance - a randomized control trial.

BACKGROUND: This study aimed to evaluate the physiological and metabolic adaptations to an eight-week running intervention with whole-body electromyostimulation (wbEMS) compared to running without wbEMS. METHODS: In a randomized controlled trial (RCT), 59 healthy participants (32 female/ 27 male, 41 ± 7 years, rel.V̇O2max 40.2 ± 7.4 ml/min/kg) ran twice weekly à 20 min for eight weeks either with a wbEMS suit (EG) or without wbEMS (control group, CG). Before and after the intervention, (i) rel.V̇O2max, heart rate and time to exhaustion were recorded with an incremental step test with an incremental rate of 1.20 km/h every 3 min. They were interpreted at aerobic and (indirect) anaerobic lactate thresholds as well as at maximum performance. (ii) Resting metabolic rate (RQ) as well as (iii) body composition (%fat) were assessed. RESULTS: Following the intervention, V̇O2max was significantly enhanced for both groups (EG ∆13 ± 3%, CG ∆9 ± 3%). Velocity was elevated at lactate thresholds and maximum running speed (EG ∆3 ± 1%, CG ∆2 ± 1%); HRmax was slightly reduced by -1 beat/min. No significant changes were observed for time until exhaustion and lactate. RQ was significantly enhanced following both trainings by + 7%. %fat was reduced for both groups (EG ∆-11 ± 3%, CG ∆-16 ± 5%), without any changes in body mass. Results did not differ significantly between groups. CONCLUSIONS: Both interventions had a positive impact on aerobic power. The rightward shift of the time-velocity graph points towards improved endurance performance. The effects of wbEMS are comparable to those after high-intensity training and might offer a time-efficient alternative to affect physiological and metabolic effects. TRIAL REGISTRATION: German Clinical Trials Register, ID DRKS00026827, date 10/26/21.

Elevating athletic performance: Maximizing strength and power in long jumpers through combined low-intensity blood flow restriction and high-intensity resistance training.

Purpose: This study aimed to evaluate the effects of low-intensity blood flow restriction (BFR) training and high-intensity resistance training (HI-RT) on the leaping performance of long-jumpers. Materials and methods: Long jump players were divided into two groups; one group (group A) receiving HI-RT (n = 8) and the other group (group B) receiving combined low-intensity BFR training plus HI-RT (n = 8). Muscle power and knee muscle strength was assessed at baseline, 3 weeks and 6 weeks of intervention. Results: 1-RM was found to be significantly different between Group A and Group B at 3 and 6 weeks. Further, IKDQR, IKDHR and IKDQL was significantly improved in group B as compared to group A both at 3 and 6 weeks. There was significant time effect, group effect and time-group interaction in the strength of quadriceps and hamstring of both left and right leg measured through isokinetic device. Post-hoc analysis for 1-RM in group B showed a significant improvement at baseline and 6 weeks and the broad jump was significant at baseline and 3 weeks and at baseline and 6 weeks. Conclusion: The combined effects of low-intensity BFR training and HI-RT is effective in improving the muscle strength and power of lower limbs in long jumpers.

Effects of Aerobic and Speed Training Versus Active Control on Repeated Sprint Ability and Measures of Self-confidence and Anxiety in Highly Trained Male Soccer Players.

BACKGROUND: While there is ample evidence on the effects of single-mode aerobic and speed training on physical fitness in soccer players, less is known on the combined effects of these exercise regimens on physical and psychological factors. AIM: This study aimed to compare the effects of aerobic and speed training with soccer-specific training versus soccer-specific training only on aerobic performance during the YOYO intermittent fitness test level 1 (final velocity, total distance [TD], maximal oxygen consumption [VO2max]), repeated sprint ability (best, total sprint time [RSABT, RSATT], sprint decrement [RSA dec]) performance and somatic anxiety (SA), cognitive anxiety (CA), and self-confidence (SC) adaptations in soccer players. METHODS: Thirty-eight highly trained male athletes aged 18.9 ± 0.5 years were randomly assigned to an aerobic and speed training group (COMB-G; n = 20) or an active control group (CON-G; n = 18). Aerobic training comprised intermittent exercises at 110-120% of the final velocity achieved at the end of the YOYO IL1 test. Speed training involved maximal sprints over 15-20-m with 5-6 sets per session. Aerobic or speed training lasted 20 min per session and replaced parts of the soccer-specific training. CON-G performed the soccer-specific training including technical, tactical drills and small-sided games. Training volume was similar between groups. Pre, post intervention, all participants performed a repeated-sprint ability (RSA) test, the YO-YO IL1 test and the players completed a Competitive Scale Anxiety Inventory (CSAI-2). RESULTS: A two (group: COMB-G, CON-G) by two (time: pre, post) mixed ANOVA (group-by-time) was computed. Significant group-by-time interactions were found for RSATT (F = 117.3; p < 0.001; Pη2 = 1.78), RSABT (F = 82.4; p < 0.001; Pη2 = 1.53), final velocity (F = 85.8; p < 0.001; Pη2 = 1.53), TD (F = 87.1; p < 0.001; Pη2 = 1.56), and VO2max (F = 18.0; p < 0.001; Pη2 = 0.72). In addition, significant group-by-time interactions were observed for SC (F = 90.2; p < 0.001; d = 1.60), SA (F = 60.5; p < 0.001; Pη2 = 1.70), and CA (F = 20.7; p < 0.001; Pη2 = 0.75). Post-hoc analyses indicated significant improvements for all dependent variables from pre- to post-training in favor of COMB-G. CONCLUSION: Aerobic and speed training in combination with soccer-specific training is a safe and effective training method as it exerts positive effects not only for physical fitness but also for self-confidence and the coping of anxiety in male soccer players.

Conceptual development of an intensive exercise program for glioma patients (ActiNO): summary of clinical experience.

PURPOSE: Exercise proved to reduce cancer-related symptoms and prolong survival in some cancer types. However, brain tumor patients are often advised against strenuous exercise. Here, we summarize our experience with a submaximal exercise program for glioma patients: ActiNO (Active in Neuro-Oncology). METHODS: Glioma patients were invited to participate in the program. Since 2011, a sports scientist individualized two one-hour sessions per week adapted to the patients' symptoms. One session consisted of bicycle ergometry (average workload: 75% of maximum heart rate), the other of whole-body resistance training. Both sessions were further complimented by coordinative elements. Cardiorespiratory fitness was assessed using the "Physical Work Capacity" procedure. Patients were followed up regularly to assess adherence to the program and disease activity. RESULTS: Until December 2019, 45 glioma patients, median-aged 49 years (IQR 42-59), were included in the analysis. Most patients suffered from glioblastoma (58%), followed by diffuse lower-grade astrocytoma (29%). In overall 1828 training sessions, two minor epileptic events occurred (1 speech arrest; 1 focal seizure). During fitness assessment, all patients achieved at least 75% of their age-adjusted maximum heart rate. Peak workload averaged 172 W (95% CI 156-187). Median survival of participating glioblastoma patients was 24.1 months (95% CI 8.6-39.5). CONCLUSION: This supervised training program with submaximal exertion was feasible and safe in glioma regardless of WHO grading. Based on these experiences, we initiated a prospective multicenter study to objectify improvements in physical performance and quality of life in patients with glioblastoma.

Effect of acute cardiovascular exercise on cerebral blood flow: A systematic review.

A single bout of cardiovascular exercise can have a cascade of physiological effects, including increased blood flow to the brain. This effect has been documented across multiple modalities, yet studies have reported mixed findings. Here, we systematically review evidence for the acute effect of cardiovascular exercise on cerebral blood flow across a range of neuroimaging techniques and exercise characteristics. Based on 52 studies and a combined sample size of 1,174 individuals, our results indicate that the acute effect of cardiovascular exercise on cerebral blood flow generally follows an inverted U-shaped relationship, whereby blood flow increases early on but eventually decreases as exercise continues. However, we also find that this effect is not uniform across studies, instead varying across a number of key variables including exercise characteristics, brain regions, and neuroimaging modalities. As the most comprehensive synthesis on the topic to date, this systematic review sheds light on the determinants of exercise-induced change in cerebral blood flow, a necessary step toward personalized interventions targeting brain health across a range of populations.

High-Intensity Training for Knee Osteoarthritis: A Narrative Review.

Knee osteoarthritis (OA) is the most common joint disease worldwide. Exercise therapy has been identified as a first-line treatment option in patients suffering from knee OA. High-intensity training (HIT) is an innovative exercise modality with potential in improving various disease-related outcomes. The purpose of this review is to explore the impact of HIT on knee OA symptoms and physical functioning. A comprehensive search of scientific electronic databases was conducted to identify articles on the effects of HIT on knee OA. Thirteen studies were included in this review. Ten compared the effects of HIT with those of low-intensity training, moderate-intensity continuous training, or a control group. Three evaluated the effects of HIT alone. Eight reported a decrease in knee OA symptoms (especially pain), and eight reported an increase in physical functioning. HIT was shown to improve knee OA symptoms and physical functioning, but also aerobic capacity, muscle strength, and quality of life with minimal or no adverse events. However, compared with other exercise modalities, no clear superiority of HIT was found. HIT is a promising exercise strategy in patients with knee OA; nonetheless, the actual quality of evidence remains very low, and more high-quality studies are needed to confirm these promising outcomes.