Topical cooling (icing) delays recovery from eccentric exercise-induced muscle damage.

It is generally thought that topical cooling can interfere with blood perfusion and may have positive effects on recovery from a traumatic challenge. This study examined the influence of topical cooling on muscle damage markers and hemodynamic changes during recovery from eccentric exercise. Eleven male subjects (age 20.2 ± 0.3 years) performed 6 sets of elbow extension at 85% maximum voluntary load and randomly assigned to topical cooling or sham groups during recovery in a randomized crossover fashion. Cold packs were applied to exercised muscle for 15 minutes at 0, 3, 24, 48, and 72 hours after exercise. The exercise significantly elevated circulating creatine kinase-MB isoform (CK-MB) and myoglobin levels. Unexpectedly, greater elevations in circulating CK-MB and myoglobin above the control level were noted in the cooling trial during 48-72 hours of the post-exercise recovery period. Subjective fatigue feeling was greater at 72 hours after topical cooling compared with controls. Removal of the cold pack also led to a protracted rebound in muscle hemoglobin concentration compared with controls. Measures of interleukin (IL)-8, IL-10, IL-1ß, and muscle strength during recovery were not influenced by cooling. A peak shift in IL-12p70 was noted during recovery with topical cooling. These data suggest that topical cooling, a commonly used clinical intervention, seems to not improve but rather delay recovery from eccentric exercise-induced muscle damage.

A simple method for increasing levels of high-density lipoprotein cholesterol: a pilot study of combination aerobic- and resistance-exercise training.

Evidence suggests that physical activity has a beneficial effect of elevated high-density lipoprotein cholesterol (HDL-C) on reducing coronary artery risk. However, previous studies show contrasting results for this association between different types of exercise training (i.e., aerobic, resistance, or combined aerobic and resistance training). The aim of this study was to determine which type of exercise training is more effective in increasing HDL-C levels. Forty obese men, age 18-29 yr, were randomized into 4 groups: an aerobic-training group (n = 10), a resistance-training group (n = 10), a combined-exercise-training group (n = 10), and a control group (n = 10). After a 12-wk exercise program, anthropometrics, blood biochemical variables, and physical-fitness components were compared with the data obtained at the baseline. Multiple-regression analysis was used to evaluate the association between different types of exercise training and changes in HDL-C while adjusting for potential confounders. The results showed that with the control group as the comparator, the effects of combined-exercise training (ß = 4.17, p < .0001), aerobic training (ß = 3.65, p < .0001), and resistance training (ß = 2.10, p = .0001) were positively associated with increase in HDL-C after adjusting for potential confounders. Our findings suggested that a short-term exercise program can play an important role in increasing HDL-C levels; either aerobic or resistance training alone significantly increases the HDL-C levels, but the improvements are greatest with combined aerobic and resistance training.

Immediate effects of ischemic compression on neck function in patients with cervicogenic cephalic syndrome.

OBJECTIVE: Cervicogenic cephalic syndrome (CCS), a group of diseases, consists of cervicogenic headache and dizziness. These symptoms may cause loss of physical function compared with other headache and dizziness disorders. The purpose of this case-control study was to assess the clinical effects of ischemic compression (IC) in patients with CCS. METHODS: Twenty-seven subjects with chronic neck pain (persisting for >3 months) and 26 healthy volunteers were examined. Subjects with organic lesion of the ear, nose, throat, eye, or central nervous system were excluded. The CCS group received IC over the maximal tender points of the origin of the posterior nuchal muscle. Sensory organization test (SOT) scores, cervical range of motion (ROM), and isometric strength of neck were measured before IC and after IC. RESULTS: The ROM of the cervical spine increased in all directions after IC (P < .0083) in the CCS group, and isometric strength in the CCS group rose in all directions after IC (P = .000). There was a significant difference in ankle strategy score under the sway-referenced vision and fixed support condition (P = .003) between the control group and CCS before IC. The ankle strategy score of the CCS group improved substantially after IC under eyes closed and sway-referenced support conditions (P = .003). The visual and vestibular ratios in the CCS group also increased after IC (P = .006 and P = .002, respectively). CONCLUSIONS: The findings of this study showed that ROM of the cervical spine and isometric strength increased in all directions, and the SOT scores showed increased postural stability under conditions with swayed reference support after IC in the CCS group. The ratios for vestibular and visual function also increased after IC in the CCS group.

Cell type specificity of female lung cancer associated with sulfur dioxide from air pollutants in Taiwan: an ecological study.

BACKGROUND: Many studies have examined the association between air pollutants (including sulfur dioxide [SO2], carbon monoxide [CO], nitrogen dioxide [NO2], nitric oxide [NO], ozone [O3], and particulate matter < 10 µm [PM10]) and lung cancer. However, data from previous studies on pathological cell types were limited, especially for SO2 exposure. We aimed to explore the association between SO2 exposure from outdoor air pollutants and female lung cancer incidence by cell type specificity. METHODS: We conducted an ecological study and calculated annual average concentration of 6 air pollutants (SO2, CO, NO2, NO, O3, and PM10) using data from Taiwan Environmental Protection Administration air quality monitoring stations. The Poisson regression models were used to evaluate the association between SO2 and age-standardized incidence rate of female lung cancer by two major pathological types (adenocarcinoma [AC] and squamous cell carcinoma [SCC]). In order to understand whether there is a dose-response relationship between SO2 and two major pathological types, we analyzed 4 levels of exposure based on quartiles of concentration of SO2. RESULTS: The Poisson regression results showed that with the first quartile of SO2 concentration as the baseline, the relative risks for AC/SCC type cancer among females were 1.20 (95% confidence interval [CI], 1.04-1.37)/1.39 (95% CI, 0.96-2.01) for the second, 1.22 (95% CI, 1.04-1.43)/1.58 (95% CI, 1.06-2.37) for the third, and 1.27 (95% CI, 1.06-1.52)/1.80 (95% CI, 1.15-2.84) for the fourth quartile of SO2 concentration. The tests for trend were statistically significant for both AC and SCC at P = 0.0272 and 0.0145, respectively. CONCLUSION: The current study suggests that SO2 exposure as an air pollutant may increase female lung cancer incidence and the associations with female lung cancer is much stronger for SCC than for AC. The findings of this study warrant further investigation on the role of SO2 in the etiology of SCC.

A Simple Method for Increasing High-Density Lipoprotein Cholesterol Levels: A Pilot Study of Combination Aerobic and Resistance Exercise Training.

Evidence suggests that physical activity has a beneficial effect of elevated high-density lipoprotein cholesterol (HDL-C) on reducing coronary artery risk. However, previous studies show contrasting results for this association between different types of exercise training (i.e., aerobic, resistance or combined aerobic and resistance training).The aim of this study was to determine which type of exercise training is more effective in increasing HDL-C levels. A total of 40 obese males, aged 18-29 years old, were randomized into four groups: an aerobic training group (n= 10), a resistance training group (n= 10), a combined exercise training group (n= 10), and a control group(n= 10). After 12-week of exercise program, anthropometrics, blood biochemical variables and physical fitness components were compared with the data obtained at the baseline. The multiple regression analysis was used to evaluate the association between different types of exercise training and changes in HDL-C while adjusting for potential confounders. The results showed that with the control group as the comparator, the effects of combined exercise training group (ß= 4.17, P< 0.0001), aerobic training group (ß= 3.65, P< 0.0001) and resistance training group (ß= 2.10, P=0.0001) were positively associated with increase in HDL-C after adjusting for potential confounders. Our findings suggested that a short-term exercise program can play an important role in increasing the HDL-C level, either aerobic or resistance training alone increase significantly the HDL-C levels, but the improvements are greatest with combined aerobic and resistance training.

Waist-to-hip ratio is a better anthropometric index than body mass index for predicting the risk of type 2 diabetes in Taiwanese population.

Body mass index (BMI) has been reported to be related to the risk of type 2 diabetes and hypertension. However, waist circumference or waist-to-hip ratio (WHR) can better reflect the accumulation of intra-abdominal fat and might be a better predictor than BMI of the risk of type 2 diabetes and hypertension. We hypothesized that other anthropometric indices rather than BMI could more accurately predict the risk of type 2 diabetes and hypertension. The purpose of this study was to determine which anthropometric index can be a better predictor for forecasting the risk of type 2 diabetes and hypertension in the Taiwanese population. We conducted a cross-sectional study and reviewed data derived from the Nutrition and Health Survey in Taiwan, 1993-1996. The subjects were 2545 men and 2562 women, aged 18 to 96 years. Receiver operating characteristic curve analysis was used to measure the predictive diabetic and hypertensive performance of each anthropometric measurement based on the area under the curve (AUC). Among 5 anthropometric indices, WHR had a significantly adjusted odds ratio (OR) and the highest AUC (0.72 for men and 0.80 for women) to predict the risk of type 2 diabetes. Although BMI had a significantly adjusted OR, the AUC was not the highest among the 5 anthropometric indices used to predict the risk of hypertension. Our findings suggested that WHR is a better anthropometric index for predicting the risk of type 2 diabetes, and the optimal cutoff values of WHR are considered as 0.89 for men and 0.82 for women in the Taiwanese population.

Optimal cutoff value of high-density lipoprotein cholesterol for predicting coronary artery disease in Taiwanese population.

The aim of this study was to determine if an optimal cutoff value for high-density lipoprotein cholesterol (HDL-C) can be obtained for predicting the risk of coronary artery disease (CAD) in Taiwanese population. We conducted a hospital-based case-control study. Patients identified by cardiac catheterization as having at least 70% stenosis of one major coronary artery and without diabetes were assigned to the case group (n = 184). The control group (n = 516) was composed of healthy individuals with normal blood biochemical values. The multiple logistic regression analysis was used to evaluate linear association between low-density lipoprotein cholesterol (LDL-C), HDL-C, or LDL-C/HDL-C ratio and CAD while adjusting for confounders. Furthermore, receiver operating characteristic curve analyses were constructed. Individuals with an HDL-C value less than or equal to 60 mg/dL had the significantly highest odds ratio (7.72; 95% confidence interval, 2.70-22.07) after adjusting for LDL-C, LDL-C/HDL-C ratio, and other potential confounders. The areas under the curves were 0.85 and 0.61 for HDL-C and LDL-C, respectively. The optimal cutoff value of HDL-C for predicting the presence of CAD was 46 mg/dL. Sensitivity and specificity using this cutoff value were 71.74% and 81.40%, respectively. Our findings suggest that subjects with lower levels of HDL-C have a much higher risk of CAD than those with higher levels of LDL-C. The optimal cutoff value for HDL-C in predicting the risk of CAD is considered as 46 mg/dL in the Taiwanese population.

Clinical assessment of patients with cervicogenic headache: a preliminary study.

BACKGROUND: The traditional diagnostic criteria of cervicogenic headache (CEH) are mainly subjective symptoms, thus making its differential diagnosis difficult. This study aimed to evaluate the diagnostic validity of functional plain radiograms, based on the clinical diagnostic criteria of CEH. METHODS: Twenty-two patients with subjectively diagnosed cervicogenic headache, including 7 with a traceable history of neck trauma, and 14 healthy subjects as controls from rehabilitation clinics were evaluated. All of them received plain cervical radiographic examination, including lateral views in the flexion, neutral, and extension positions. The degree of localized kinking was measured to define the level of cervical malalignment. Subjective symptoms elicited by a questionnaire were categorized by involved regions. RESULTS: The numbers of localized kinking segments in the lower cervical spine were significantly different between the study and control groups (p < 0.05). The study group had more involved segments than the control group. On the questionnaire, clinical symptoms involving the nasal regions were one of the most common clinical manifestations (36.4%) among cephalic syndrome. CONCLUSIONS: For cervicogenic headache, functional plain radiogram may help in clinical diagnosis. Abnormal nociceptive afferents due to malalignment may be responsible for the nasal symptoms.

[The effect of yoga exercise intervention on health related physical fitness in school-age asthmatic children].

The purpose of this study was to investigate the effect of yoga exercise on the health-related physical fitness of school-age children with asthma. The study employed a quasi-experimental research design in which 31 voluntary children (exercise group 16; control group15) aged 7 to 12 years were purposively sampled from one public elementary school in Taipei County. The yoga exercise program was practiced by the exercise group three times per week for a consecutive 7 week period. Each 60-minute yoga session included 10 minutes of warm-up and breathing exercises, 40 minutes of yoga postures, and 10 minutes of cool down exercises. Fitness scores were assessed at pre-exercise (baseline) and at the seventh and ninth week after intervention completion. A total of 30 subjects (exercise group 16; control group 14) completed follow-up. Results included: 1. Compared with children in the general population, the study subjects (n = 30) all fell below the 50th percentile in all five physical fitness items of interest. There was no significant difference in scores between the two groups at baseline (i.e., pre-exercise) for all five fitness items. 2. Research found a positive association between exercise habit after school and muscular strength and endurance among asthmatic children. 3. Compared to the control group, the exercise group showed favorable outcomes in terms of flexibility and muscular endurance. Such favorable outcomes remained evident even after adjusting for age, duration of disease and steroid use, values for which were unequally distributed between the two groups at baseline. 4. There was a tendency for all item-specific fitness scores to increase over time in the exercise group. The GEE analysis showed that yoga exercise indeed improved BMI, flexibility, and muscular endurance. After 2 weeks of self-practice at home, yoga exercise continued to improve BMI, flexibility, muscular strength, and cardiopulmonary fitness.

Motor control in patients with incomplete spinal cord injuries and various voluntary movement capabilities.

BACKGROUND: In this study, we attempted to verify the hypothesis that further improvements in volitional movement of patients with a spinal cord injury would diminish and ultimately suppress the segmental responses, while enhancing the supraspinal inhibitory influence. METHODS: Eleven patients with an incomplete spinal cord injury and partial preservation of motor function (ASIS grades C and D) were recruited. Their lower limbs were evaluated using polyelectromyography (PEMG) during voluntary movements, reinforcement maneuvers, tonic vibratory reflex, passive stretch reflex, irradiation of the passive stretch reflex (PSRirrad), and plantar reflex suppression. RESULTS: The reinforcement maneuver response, tonic vibratory response, passive stretch reflex, and PSRirrad were most active in limbs with partially preserved volitional movement, but for which patients were still incapable of lifting their heel off the examination table. In contrast, plantar reflex suppression was strongest in limbs with partially preserved volitional movement, for which patients were capable of lifting the heel off the examination table. CONCLUSIONS: Supraspinal inhibitory effects were most active in those limbs which were capable of lifting the heel off the examination table, compared to limbs with partially preserved volitional activity but without visible movement or which were incapable of lifting the heel off the examination table. The capability for volitional activity paralleled the supraspinal inhibitory effects.

Starting position and stretching velocity effects on the reflex threshold angle of stretch reflex in the soleus muscle of normal and spastic subjects.

BACKGROUND AND PURPOSE: Although both starting position and stretching velocity play an important role in reflex response, their interaction with stretch reflexes has not been thoroughly investigated. This study examined the interaction effect of starting position and stretching velocity on the reflex threshold angle (RTA) of the stretch reflex in the soleus muscle of normal and spastic subjects. METHODS: The spastic group included 11 ankles from 7 subjects with a history of upper motor neuron lesions. Their ages ranged from 22 to 40 years. Another 10 healthy subjects served as the control group. RTAs of the stretch reflex in the soleus muscle were measured for a matrix of starting positions and stretching velocities. The matrix design enabled the use of a 2-way analysis model to investigate the effect of starting position and stretching velocity on the RTA. RESULTS: No interaction effect was found in either the phasic stretch reflex (PSR) or the tonic stretch reflex (TSR) in the spastic group, or in the PSR in the normal group. The RTA of the PSR in both spastic and normal groups was significantly affected by starting position but not by stretching velocity. In contrast, the RTA of the TSR in the spastic group was affected by both starting position and stretching velocity. Stretching velocity and starting position played independent roles in determining the RTA of both the PSR and the TSR of the spastic group and in the PSR of the normal group. CONCLUSIONS: The lack of interaction between length-sensitive and velocity-sensitive muscle spindles in both normal and spastic subjects supports the hypothesis that they independently modulate the stretch reflex. Results for the RTA of the TSR demonstrated that spasticity results in disinhibition of motoneuron excitability with different thresholds.

Characteristics of glycemic control in elite power and endurance athletes.

A previous study has shown that former elite power athletes exhibited significantly greater relative risk in diabetes than that of former elite endurance athletes. It is unknown whether insulin sensitivity in elite young healthy power athletes is lower than that in elite young endurance athletes. This study includes two parts, part I and part II. In the part I of this study, an oral glucose tolerance test was performed in all of the elite juvenile track athlete subjects, specializing either in short-distance racing (jSD, N = 13, aged 12.5 +/- 0.37 years) or in long-distance racing (jLD, N = 13, aged 12.6 +/- 0.42 years). In the part II of this study, we recruited elite adult swimmers and divided them into two groups according to their specialty in swimming race distance: long-distance (aLD, N = 10, age 20.3 +/- 1.32) and short-distance groups (aSD, N = 10, age 20.2 +/- 1.31). Insulin sensitivity was significantly lower in the jSD group than that in the jLD group, as indicated by the area under the curves of insulin and glucose following a 75-g oral glucose load. Fasting plasma LDL-C and total cholesterol levels in the jSD group were significantly greater than those in the jLD group. The result of the part II of this study, similar to the result of the part I, shows that insulin sensitivity in aSD swimmers was significantly lower than that in aLD swimmers. LDL-C, total cholesterol, and triglyceride levels were also found higher in aSD swimmers than in those of aLD swimmers. These new findings implicate that the genetic makeup associated with exceptional power or endurance performance of elite athletes could also reflect on their metabolic characteristics; elite power athletes appear to be more insulin resistant than elite endurance athletes.