Circulating soluble intercellular adhesion molecule-1 (sICAM-1) after exercise-induced muscular damage: Does the use of whole-body cryostimulation influence its concentration in blood?

As soluble intercellular adhesion molecule-1 (sICAM-1) was recently hypothesized to be a key player in the mechanisms involved in exercise-induced muscular damage (EIMD), we investigated its circulating concentration changes in athletes before and after EIMD with and without the use of whole-body cryostimulation (WBC; 3 min at -110 °C) at the exercise end and repeated once a day during 4 days. We previously characterized plasma specimens from 11 endurance athletes who performed twice (randomized crossover design) strenuous running leading to EIMD, followed by passive recovery or WBC. Muscle soreness and inflammatory response were observed in both cases but the use of WBC induced a significant reduction in these responses (PlosOne 2011; 6:e22748). We now found that sICAM-1 concentration slightly increased in both circumstances and remained elevated for 24 h (p < 0.01). However, no significant WBC effect was observed concerning sICAM-1 changes indicating that this compound is not a major player both in EIMD and WBC physiological impacts.

Whole-body cryostimulation (cryotherapy) provides benefits for fatigue and functional status in multiple sclerosis patients. A case-control study.

OBJECTIVES: To study the effects of whole-body cryostimulation (WBC) on fatigue and functional status in multiple sclerosis (MS) patients with different levels of fatigue. SUBJECTS AND METHODS: Two groups of 24 MS patients with fatigue were studied. At the beginning of the study, the first group presented a Fatigue Severity Scale (FSS) score between 38 and 42 (low-fatigue (LF) group), and the second group had an FSS score between 48 and 52 (high-fatigue (HF) group). Both groups were matched for age and sex. All patients were exposed to 10.3-min session of WBC (one exposure per day at -110°C or lower). Functional status was assessed before and after the series of WBC exposures using the Rivermead Motor Assessment (RMA), the Multiple Sclerosis Impact Scale (MSIS-29), and the Expanded Disability Status Scale (EDSS). The RMA was estimated in three sections: gross function (RMA1), leg and trunk (RMA2), and arm (RMA3). MSIS-29 consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) status. RESULTS: In both groups, the WBC sessions induced a significant improvement in the functional status and in the feeling of fatigue. However, the changes observed in HF patients were significantly greater than those observed in LF patients, especially in the MSIS-29-PHYS, MSIS-29-PSYCH, RMA1, and RMA3. The changes observed in the EDSS, RMA2, and FSS were similar in both groups. CONCLUSIONS: WBC appears to be effective in improving functional status and the feeling of fatigue in patients with MS and especially in those who are the most fatigued.

The "Stroop Walking Task": An innovative dual-task for the early detection of executive function impairment.

AIMS OF THE STUDY: To evaluate a dual-task named the "Stroop Walking Task", which is similar to the task of making a decision of whether to cross a street based on a pedestrian traffic light. PATIENTS AND METHODS: Fifty-one subjects (15 young adults, 21 subjectively healthy old subjects and 15 old subjects with mild cognitive impairment) had to respond to a visual signal (pictogram) with an appropriate motor response (walk or stop). We used an electronic walkway system to record the gait parameters and performed a cluster analysis on the obtained data. RESULTS: This dual-task enables the early detection of executive function impairment with 89% sensitivity and 87% specificity. CONCLUSION: The use of a dual-task that is inspired by an everyday event as an evaluation tool seems to facilitate the detection of ageing subjects' cognitive impairment, which is not detectable with traditional psychometric tests.

Concomitant changes in clinical and posturographic data in elderly fallers during the course of an in-home anti-falling multimodal program--a preliminary investigation.

AIM OF THE STUDY: The objective of this preliminary study was to evaluate the effectiveness, in terms of fall reduction, of an in-home strategy that we have developed for elderly fallers. We also aimed at finding links between the expected changes in the data obtained in static posturography and in clinical balance tests through our program. PATIENTS AND METHODS: Twelve elderly patients living at home who were diagnosed as fallers (5 males and 7 females; 77.9±4.1 years) participated in the study. Our multimodal intervention lasted 6 months. Before this period, and one year later, an evaluation was conducted using cognitive (MMSE), clinical balance tests (i.e. Berg Balance Scale, Balance One leg, Timed Up and Go, and Functional Reach tests) and static posturography (where the area of body sway, velocity and medio-lateral and antero-posterior amplitudes were recorded twice, first with eyes open and then with eyes closed). RESULTS: Among the 12 patients who were diagnosed as fallers, eight became non-fallers. When comparing data obtained after the intervention with those obtained beforehand, we found significant changes in all of the clinical balance tests and in the posturographic-derived variables indicating improvements in the balance control in our group of subjects. We also found significant correlations between the changes in the Berg Balance Scale scores and the changes in the area of body sway data, in antero-posterior amplitude both with eyes open and with eyes closed, and also in the medio-lateral amplitude in the eyes closed condition. CONCLUSIONS: We prospectively demonstrated the relevance of our anti-falling intervention at home and of the use of posturography for clinical follow-up.

Oral contraception but not menstrual cycle phase is associated with increased free cortisol levels and low hypothalamo-pituitary-adrenal axis reactivity.

BACKGROUND: In females, estrogen is a potential modulator of cortisol response to stressors. The aim of this study was to determine the influence of menstrual cycle phase, oral contraception (OC) use and exercise training on hypothalamo-pituitary-adrenal (HPA) axis activity and reactivity after physical stress. AIM: We investigated the effects of the menstrual cycle and OC use on exhaustive exerciseinduced changes in free salivary cortisol concentrations and free urinary cortisol/cortisone excretion in healthy young women. MATERIALS AND SUBJECTS: Twenty-eight women were allocated to an untrained group (no.=16) or a trained group (no.=12), depending on their physical training background. The untrained group was composed of nine OC users (UNTOC+) and seven eumenorrheic women (UNT-OC-) tested in the follicular and luteal phases, while the trained group was entirely composed of OC+ subjects (T-OC+). METHODS: Three laboratory sessions were conducted in a randomised order: a prolonged exercise test, a short-term exercise test, and a control session. For each session, urine and saliva specimens were collected at rest (09:00 h) and then, 30, 60 and 90 min later. RESULTS: Estradiol fluctuation during the menstrual cycle phase did not alter free cortisol baseline values and responses to exercise. OC use was associated with increased free resting salivary concentrations and urinary cortisol excretion with blunted salivary cortisol response to prolonged exercise stimulation. No training effect was noted. CONCLUSIONS: OC but not menstrual cycle phase is associated with increased free cortisol levels and low HPA axis reactivity.

Could home be an appropriate location for performing posturographic assessments in elderly subjects?

INTRODUCTION: Posturographic measurements are often performed in hospital in the context of assessing fall risks in elderly subjects. These hospital visits may generate different kinds of stimuli that could influence test outcomes. STUDY AIM: The aim was to investigate whether posturographic measurements performed both at home and in hospital in a randomized order provide similar data. METHODS: Thirty-five healthy elderly subjects (average age 72.5 ± 3.7 years) were assigned to two postural evaluations performed in a random order: one at home and one at the hospital. Before the first evaluation, subject's levels of anxiety, depression and stress were assessed. Then, the area of body sway, velocity and medial-lateral and antero-posterior amplitudes were recorded twice, first with the subject's eyes opened and then with eyes closed. RESULTS AND DISCUSSION: The posturographic data obtained in hospital and at home were quite similar. However, when the group that was first evaluated in hospital was compared with the group first evaluated at home, the medio-lateral amplitude was observed to significantly decrease in the second evaluation compared with the data obtained in the first trial (P<0.05), and this decrease was significantly higher in the first group (P<0.05). For the eyes-opened condition, we found significant correlations between anxiety and the area of body sway, stress and the area of body sway, and anxiety and the medial-lateral amplitude. CONCLUSIONS: Psychological factors may influence some posturographic data, and carrying out posturographic evaluations at home for elderly subjects could be a reasonable strategy.

Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics.

CONTEXT: The multifactorial nature of falls among elderly people is well-known. Identifying the social-demographic characteristics of elderly people who fall would enable us to define the typical profile of the elderly who are at risk of falling. OBJECTIVE: We aimed to isolate studies in which the social-demographic risk factors for falls among the elderly have been evaluated and to carry out a meta-analysis by combining the results of all of these selected studies. METHOD: We did a systematic literature review using the key words "accidental fall / numerical data" and "risk factors." Inclusion criteria entailed the selection of articles with the following characteristics: population of subjects aged 60 years or over, falls that took place in everyday life, and social-demographic risk factors for falls. RESULTS: 3,747 indexed articles published between 1981 and 2007 were identified, and 177 studies with available data were included, of which 129 had data on social-demographic risk factors for falls. Difficulties in activities of daily living (ADL) or in instrumental activities of daily living (IADL) double the risk of falling: The OR and 95% Cl were 2.26 (2.09, 2.45) for disturbance ADL and 2.10 (1.68, 2.64) for IADL. The OR and 95% Cl for Caucasians were 1.68 (0.98 - 2.88) and 0.64 (0.51 - 0.80) for Hispanics. In the subgroup of patients older than eighty, being married protected people from falling with an OR and 95% Cl =0.68 (0.53 - 0.87). CONCLUSION: Defining factors that create a risk of falling and protect elderly people from falls using social-demographic characteristics lets us focus on an "at risk" population for which a specific program could be developed.

Exercise rehabilitation restores physiological cardiovascular responses to short-term head-out water immersion in patients with chronic heart failure.

PURPOSE: Rehabilitation programs increasingly involve immersed exercising, including inpatients suffering from severe cardiovascular diseases such as coronary artery disease (CAD) or chronic heart failure (CHF). The hemodynamic responses to short-term head-out water immersion are not well defined in these diseases. This study was aimed at evaluating (1) the cardiac and peripheral hemodynamic responses to short-term head-out water immersion in patients with CHF (n = 12) and CAD (n = 12) and (2) the effect of a rehabilitation program on these responses. METHODS: Wrist arterial tonometry was performed in the upright posture before and during immersion (1.30-m depth) once before and once after a 3-week rehabilitation program including gymnic water exercises. RESULTS: In patients with CAD, water immersion triggered a significant increase in stroke volume, cardiac output, and pulse pressure and a significant decrease in pulse rate, diastolic blood pressure, and systemic vascular resistances, both before and after the rehabilitation program. In patients with CHF, no significant immersion-linked changes in cardiovascular variables were observed before rehabilitation. However, after completion of the rehabilitation program, it was found that water immersion caused significant increases in stroke volume, cardiac output, and pulse pressure. CONCLUSION: In patients with CHF, this 3-week rehabilitation program restored the usual central responses to head-out water immersion (increase in stroke volume and cardiac output). In both patients with CHF and CAD, acute water immersion did not change arterial compliance.

(1)H NMR-based metabolomics approach for exploring urinary metabolome modifications after acute and chronic physical exercise.

Metabolomics is a comprehensive method for metabolite assessment that involves measuring the overall metabolic signature of biological samples. We used this approach to investigate biochemical changes due to acute and chronic physical exercise. Twenty-two women using identical oral contraceptives were segregated into an untrained (n = 10) or trained (n = 12) group depending on their physical training background. The subjects performed two exercises in a randomized order: a prolonged exercise test (75% of their VO(2 max) until exhaustion) and a short-term, intensive exercise test (short-term, intensive exercise anaerobic test). Urine specimens were collected before and 30 min after each test. The samples were analyzed by (1)H NMR spectroscopy, and multivariate statistical techniques were utilized to process the data. Distinguishing characteristics were observed only in the urine profiles of specimens collected before vs. 30 min after the short-term, intensive exercise test. The metabolites responsible for such changes were creatinine, lactate, pyruvate, alanine, beta-hydroxybutyrate, acetate, and hypoxanthine. In both groups, the excretion of lactate, pyruvate, alanine, beta-hydroxybutyrate, and hypoxanthine increased similarly after the completion of the short-term, intensive exercise test (p < 0.03). However, acetate excretion increased to a lesser extent in trained than in untrained subjects (p < 0.05). In conclusion, metabolomics is a promising tool in order to gain insight into physiological status and to clarify the changes induced by short-term, intense physical exercise.

Nandrolone excretion in sedentary vs physically trained young women.

We investigated the effects of the menstrual cycle, oral contraception and physical training on exhaustive exercise-induced changes in the excretion of nandrolone metabolites [19-norandrosterone (19-NA), and 19-noretiocholanolone (19-NE)] in young women. Twenty-eight women were allocated to an untrained group (n=16) or a trained group (n=12), depending on their physical training background. The untrained group was composed of nine oral contraceptive users (OC+) and seven eumenorrheic women (OC-), while the trained group was entirely composed of OC+ subjects. Three laboratory sessions were conducted in a randomized order: a prolonged exercise test, a short-term exercise test and a control session. Urine specimens were collected before and 30, 60 and 90 min after the exercise test and at the same times of the day during the control session. Urinary concentrations of nandrolone metabolites were determined by gas chromatography coupled to mass spectrometry. Urinary concentrations of 19-NA and 19-NE ranged from undetectable levels to 1.14 and 0.47 ng/mL, respectively. Nandrolone excretion was not affected by the menstrual cycle phase (early follicular vs mid-luteal), prior physical training, oral contraception or acute physical exercise. Therefore, a urinary concentration of 2 ng/mL of 19-NA appears to be fair as the upper acceptable limit in doping control tests for female athletes.

Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics

CONTEXT: The multifactorial nature of falls among elderly people is well-known. Identifying the social-demographic characteristics of elderly people who fall would enable us to define the typical profile of the elderly who are at risk of falling. OBJECTIVE: We aimed to isolate studies in which the social-demographic risk factors for falls among the elderly have been evaluated and to carry out a meta-analysis by combining the results of all of these selected studies. METHOD: We did a systematic literature review using the key words "accidental fall / numerical data" and "risk factors." Inclusion criteria entailed the selection of articles with the following characteristics: population of subjects aged 60 years or over, falls that took place in everyday life, and social-demographic risk factors for falls. RESULTS: 3,747 indexed articles published between 1981 and 2007 were identified, and 177 studies with available data were included, of which 129 had data on social-demographic risk factors for falls. Difficulties in activities of daily living (ADL) or in instrumental activities of daily living (IADL) double the risk of falling: The OR and 95 percent Cl were 2.26 (2.09, 2.45) for disturbance ADL and 2.10 (1.68, 2.64) for IADL. The OR and 95 percent Cl for Caucasians were 1.68 (0.98 - 2.88) and 0.64 (0.51 - 0.80) for Hispanics. In the subgroup of patients older than eighty, being married protected people from falling with an OR and 95 percent Cl =0.68 (0.53 - 0.87). CONCLUSION: Defining factors that create a risk of falling and protect elderly people from falls using social-demographic characteristics lets us focus on an "at risk" population for which a specific program could be developed.

Effects of menstrual cycle, oral contraception, and training on exercise-induced changes in circulating DHEA-sulphate and testosterone in young women.

The objective of this study was to ascertain the effects of menstrual cycle, oral contraception, and training status on the exercise-induced changes in circulating DHEA-sulphate and testosterone in young women. Twenty-eight healthy women were assigned to an untrained group (n = 16) or a trained group (n = 12) depending on their training background. The untrained group was composed of nine oral contraceptive users (OC+) and seven eumenorrheic women (OC-). The trained group was composed of OC+ subjects only. All the OC+ subjects were taking the same low-dose oral contraception. Three laboratory sessions were organised in a randomised order: a prolonged exercise test until exhaustion, a short-term exhaustive exercise test, and a control session. Blood specimens were collected before, during and after the exercise tests and at the same time of the day during the control session. Basal circulating testosterone was significantly lower in trained as compared to untrained subjects. In all subjects, the prolonged exhaustive exercise induced a significant increase in circulating DHEA-s and testosterone. The short-term exercise induced a significant increase in circulating DHEA-s in untrained eumenorrheic and in trained OC users only. Menstrual phases in OC- did not influence the responses. It was found that exhaustive physical exercise induced an increase in circulating DHEA-s and testosterone in young women. Oral contraception may limit short-term exercise-induced changes.

Impressive anaerobic adaptations in elite karate athletes due to few intensive intermittent sessions added to regular karate training.

The aim of this study was to investigate the effects of adding a high-intensity intermittent session twice a week during a 7-week karate training (KT) on markers of aerobic and anaerobic metabolisms in elite class karate athletes. Two groups were studied: a KT group (n=8, age 20.1+/-0.9 years, 70.0+/-8.8 kg) that followed traditional KT, and a group that followed combined traditional karate and a high-intensity intermittent training (HIT group, n=9, age 24.4+/-3.1 years, 67.0+/-7.8 kg). The subjects undertook a supramaximal exercise and a maximal oxygen uptake test before and after the training. Blood lactate, pH and plasma ammonia were determined at rest, immediately at the end of the supramaximal exercise and during the recovery period at 2, 4, 6, 8, 10 and 15 min. After the training period, no changes occurred in the KT group. However, in the HIT group, the time to exhaustion, MAOD and in the maximal oxygen uptake test were significantly improved by 23.6%, 10.3% and 4.6%, respectively. A clear-cut discrepancy was observed in the time course of lactate and pH in the supramaximal test after the training in the HIT group. We observed a significantly higher peak for lactate and a lower extreme value for pH with a shorter delay of appearance. At the end of the test, the lactate concentration increased significantly (+53.7%) and pH declined significantly, when compared with the values obtained after the same test before the training period. Ammonia was not influenced. The addition of high-intensity intermittent sessions twice per week during the period of KT induced beneficial physiological adaptations in athletes, allowing improvement in the duration of intense physical exercise before a state of fatigue is reached.

Quantitative analysis of DHEA and androsterone in female urine: investigating the effects of menstrual cycle, oral contraception and training on exercise-induced changes in young women.

Dehydroepiandrosterone (DHEA) and its metabolite androsterone (A) are natural steroids secreted in high quantities in human body. To assess the influence of oral contraceptives, menstrual cycle phase, and also physical exercise (acute and chronic such as training) on these metabolites excretions, a collection of 28 female urine specimens was organized. A three-extraction-step method was developed, and the analyses were performed by gas chromatography-mass spectrometry using deuterated 19-noretiocholanolone as the internal standard. Sample hydration state was found to be of great importance for kinetic studies, as it directly influenced the concentrations. No influence of menstrual cycle and training was found for androsterone and DHEA. However, oral contraceptive intake lowered DHEA excretion in urine and A seems to be slightly affected by exercise.

Biological factors and the determination of androgens in female subjects.

The idea of the presence of androgens in females may sound peculiar as androgens generally refer to male hormones. Although produced in small amounts in women, androgens have direct and significant effects on many aspects of female physiology. Moreover, androgens are precursors to estrogens, which are the predominant female sex hormones. The measurement of androgens in blood is important in the diagnosis of both gonadal and adrenal functional disturbances, as well as monitoring subsequent treatments. The accuracy of such measurements is crucial in sports medicine and doping control. Therefore, the concentration of androgens in female subjects is frequently measured. Analysing such compounds with accuracy is especially difficult, costly and time consuming. Therefore, laboratories widely use direct radioimmunoassay kits, which are often insensitive and inaccurate. It is especially complicated to determine the level of androgens in women, as the concentration is much lower compared to the concentration found in males. Additionally, the amount of androgens in fluids tends to decrease with aging. Analyses of hormone concentrations are influenced by a myriad of factors. The factors influencing the outcome of these tests can be divided into in vivo preanalytical factors (e.g., aging, chronobiological rhythms, diet, menstrual cycle, physical exercise, etc.), in vitro preanalytical factors (e.g., specimen collection, equipment, transport, storage, etc.) and as mentioned before, analytical factors. To improve the value of these tests, the strongly influencing factors must be controlled. This can be accomplished using standardised assays and specimen collection procedures. In general, sufficient attention is not given to the preanalytical (biological) factors, especially in the measurement of androgens in females. Biological factors (non-pathological factors) that may influence the outcome of these tests in female subjects have received little attention and are the topic of the present review.

Effects of long-term whole-body cold exposures on plasma concentrations of ACTH, beta-endorphin, cortisol, catecholamines and cytokines in healthy females.

OBJECTIVE: Cold therapy is used to relieve pain and inflammatory symptoms. The present study was designed to determine the influence of long-term regular exposure to acute cold temperature. Two types of exposure were studied: winter swimming in ice-cold water and whole-body cryotherapy. The outcome was investigated on humoral factors that may account for pain alleviation related to the exposures. MATERIAL AND METHODS: During the course of 12 weeks, 3 times a week, a group of healthy females (n = 10) was exposed to winter swimming (water 0-2 degrees C) for 20 s and another group (n = 10) to whole-body cryotherapy (air -110 degrees C) for 2 min in a special chamber. Blood specimens were drawn in weeks 1, 2, 4, 8 and 12, on a day when no cold exposure occurred (control specimens) and on a day of cold exposures (cold specimens) before the exposures (0 min), and thereafter at 5 and 35 min. RESULTS: Plasma ACTH and cortisol in weeks 4-12 on time-points 35 min were significantly lower than in week 1, probably due to habituation, suggesting that neither winter swimming nor whole-body cryotherapy stimulated the pituitary-adrenal cortex axis. Plasma epinephrine was unchanged during both experiments, but norepinephrine showed significant 2-fold to 3-fold increases each time for 12 weeks after both cold exposures. Plasma IL-1-beta, IL-6 or TNF alpha did not show any changes after cold exposure. CONCLUSIONS: The main finding was the sustained cold-induced stimulation of norepinephrine, which was remarkably similar between exposures. The frequent increase in norepinephrine might have a role in pain alleviation in whole-body cryotherapy and winter swimming.

[Isokinetic profile of knee flexors and extensors in a population of rugby players]. / Profil isocinétique des muscles fléchisseurs et extenseurs du genou chez une population de rugbymen.

OBJECTIVE: We aimed to assess the isokinetic profile of the flexor and extensor muscles of the knee within a population of rugby players. METHODS AND POPULATION: This was a descriptive study. The rugby players underwent bilateral isokinetic assessment of knee flexion and extension on a CON-TREX MJ isokinetic dynamometer functioning at four angular frequencies - 90, 120, 180 and 240 degrees/s - in a concentric manner. The isokinetic parameters were peak torque, mean power, and mean work in relation to weight and femoral bicep: quadriceps ratio. The population included 16 "Federal 1" (semi-professional) rugby players with mean age 25 years (range 20-33 years). The players were divided into two groups: "forward" players (props, hookers, second line, third line) and "back" players (scrum, inside, center, wing, tail). RESULTS: The values of the isokinetic parameters did not reveal use of a preferred limb. Consequently, peak torque and mean power were higher in forward players than back players, whereas back players showed a higher relative power throughout the isokinetic test. CONCLUSION: Among rugby players, forward and back players showed differences in several isokinetic parameters. Accurate knowledge of the equilibrium between the knee's effector muscles is important for stability of the joint, to not only minimize articular accidents but also pinpoint force imbalances, thereby preventing muscular lesions during the sports season.

Lung function after acute and repeated exposures to extremely cold air (-110 degrees C) during whole-body cryotherapy.

Whole-body cryotherapy (WBC) is one mode of cold therapy, during which rheumatic patients are exposed to very cold air (-110 degrees C) in minimal clothing. It is also proposed to have a bronchodilatory effect. The aim was to examine the effects of WBC on lung function in healthy humans after acute and repeated exposures. Twenty-five healthy, non-smoking subjects participated in the study. They were exposed to WBC for 2 min three times per week for 12 weeks. The peak expiratory flow rate (PEF) and forced expiratory volume in 1 s (FEV1) were measured before and after (at 2 and 30 min) the first WBC, and then similarly at 4, 8 and 12 weeks. At all time points, after 30 min of the WBC the PEF values were slightly lower compared with values before the WBC, and the reductions reached statistical significance at 1 month (5.1 +/- 1.2%), and at 3 months (3.2 +/- 1.7%). After 30 min of the first WBC, the FEV1 was significantly reduced by 2.3 +/- 0.8%, but no other changes were observed during the study. In conclusion, the WBC induced minor bronchoconstriction in healthy humans instead of proposed bronchodilatation. The WBC seems not to be harmful for lung function, but should be used with caution in susceptible individuals.