Effects of meditation on pain intensity, physical function, quality of life and depression in adults with low back pain - A systematic review with meta-analysis.

BACKGROUND: Low back pain (LBP) is a common biopsychosocial health problem. Meditation may provide a complementary treatment option for LBP patients. OBJECTIVES: The aim of this systematic review with meta-analysis was to examine the effects of meditation on pain intensity, functional disability, quality of life, and depression in LBP populations. METHODS: This systematic review was conducted according to the PRISMA Guidelines. PubMed, Web of Science, CENTRAL, CamQuest and PubPsych were searched up to a publication date of June 2020. Inclusion criteria were RCTs or non-RCTs with LBP patients, aged at least 18 years, the application of a specific meditation technique, and pain intensity and/or functional disability as outcomes. Pooled SMDs were calculated at post-treatment and follow up. The Cochrane risk-of-bias tool was used to estimate risk of bias. The overall quality of evidence was assessed using the GRADE approach. RESULTS: 12 studies with a total of 1005 participants were included in this review. Compared to controls, meditation solely showed a significant positive effect on pain intensity (SMD = -0.27 [CI -0.43; -0.11]; p = 0.001; based on 10 studies with 934 participants) and physical quality of life (SMD = 0.21 [CI 0.07; 0.36]; p = 0.005; based on 5 studies with 756 participants) at post-treatment. At follow up (mean 20 weeks, range 4-52) there were no significant effects anymore. The quality of the evidence was moderate due to study limitations and imprecision. CONCLUSIONS: Meditation seems to be promising with regard to reducing short-term pain intensity in patients with LBP. However, additional well-designed and large trials are required in order to draw more reliable conclusions.

An ergonomic welding torch reduces physical load response and improves welding quality in novices: a pilot study.

Objectives. This crossover pilot study aimed to compare the physical load response of an ergonomically improved welding torch versus a conventional torch. Methods. Ten inexperienced volunteers performed an experimental augmented virtual welding trial at chest height (ASME code 1G) and overhead (ASME code 4G) with both welding torches in random order. Skeletal muscle load and fatigue were assessed by surface electromyography and changes in isometric peak force. The sensation of pain, perceived exertion and welding execution quality were defined as further outcome parameters. Results. The muscle load response in three out of eight muscles was lower in favour of the ergonomic welding torch, which went along with a lower sensation of pain and a higher working accuracy. Conclusions. An ergonomically improved welding torch reduces the acute physical load response and sensation of pain, which ultimately allows performing better, and might contribute to prevention of musculoskeletal diseases in the long term.

Excessive Accumulation of Intracellular Ca2+ After Acute Exercise Potentiated Impairment of T-cell Function.

Ca2+ is an important intracellular second messenger known to regulate several cellular functions. This research aimed to investigate the mechanisms of exercise-induced immunosuppression by measuring intracellular calcium levels, Ca2+-regulating gene expression, and agonist-evoked proliferation of murine splenic T lymphocytes. Mice were randomly assigned to the control, sedentary group (C), and three experimental groups, which performed a single bout of intensive and exhaustive treadmill exercise. Murine splenic lymphocytes were separated by density-gradient centrifugation immediately (E0), 3h (E3), and 24h after exercise (E24). Fura-2/AM was used to monitor cytoplasmic free Ca2+ concentration in living cells. The combined method of carboxyfluorescein diacetate succinimidyl ester (CFSE) labeling and flow cytometry was used for the detection of T cell proliferation. The transcriptional level of Ca2+-regulating genes was quantified by using qPCR. Both basal intracellular Ca2+ levels and agonist (ConA, OKT3, or thapsigargin)-induced Ca2+ transients were significantly elevated at E3 group (p<0.05 vs. control). However, mitogen-induced cell proliferation was significantly decreased at E3 group (p<0.05 vs. control). In parallel, the transcriptional level of plasma membrane Ca2+-ATPases (PMCA), sarco/endoplasmic reticulum Ca2+-ATPases (SERCA), TRPC1, and P2X7 was significantly downregulated, and the transcriptional level of IP3R2 and RyR2 was significantly upregulated in E3 (p<0.01 vs. control). In summary, this study demonstrated that acute exercise affected intracellular calcium homeostasis, most likely by enhancing transmembrane Ca2+ influx into cells and by reducing expression of Ca2+-ATPases such as PMCA and SERCA. However, altered Ca2+ signals were not transduced into an enhanced T cell proliferation suggesting other pathways to be responsible for the transient exercise-associated immunosuppression.

Exercise training reduces workload, improves physical performance, and promotes overall health in welders.

OBJECTIVES: Welders demonstrate a significant prevalence of work-related musculoskeletal disorders as indicated by high rates of illness-related absenteeism. The aim of the study was to investigate the effects of a 24-week exercise program on workload, physical performance, and overall health in welders. METHODS: Seventy-seven professional welders were assigned to either a control group (CG), an endurance training group (ETG), or a strength training group (STG). Both groups conducted a 24-week, standardized and progressive endurance or resistance exercise training program. Before (TP1) and after training (TP2) all participants performed an experimental welding task (EWT) in order to test the hypothesis that training would reduce the relative load (%MVC) of eight skeletal muscles measured by surface electromyography. Secondary outcome measures included further EWT-induced stress parameters and a series of health-related outcome measures. RESULTS: Results revealed a lower muscle load in participants of the ETG and STG for trapezius muscle at TP2 compared to T1 (P < .05 vs CG). Rate of perceived exertion and visual analogue scale were decreased, while increase of maximum EWT duration was found in participants of the ETG and STG after training (P < .05 vs CG). At T2, body fat (%) decreased and physical performance (bicycle exercise test, isometric strength of core muscles) increased in ETG and STG (P < .05). CONCLUSION: Both regular endurance and strength training represent effective strategies for reducing workload and improving physical performance of welders. The results emphasize the importance of physical fitness for welders and might motivate health professionals in steel-industry to offer access to exercise training programs.

Effects of exercise training on pulmonary hemodynamics, functional capacity and inflammation in pulmonary hypertension.

Pulmonary hypertension (PH) is characterized by severe exercise limitation mainly attributed to the impairment of right ventricular function resulting from a concomitant elevation of pulmonary vascular resistance and pressure. The unquestioned cornerstone in the management of patients with pulmonary arterial hypertension (PAH) is specific vasoactive medical therapy to improve pulmonary hemodynamics and strengthen right ventricular function. Nevertheless, evidence for a beneficial effect of exercise training (ET) on pulmonary hemodynamics and functional capacity in patients with PH has been growing during the past decade. Beneficial effects of ET on regulating factors, inflammation, and metabolism have also been described. Small case-control studies and randomized clinical trials in larger populations of patients with PH demonstrated substantial improvements in functional capacity after ET. These findings were accompanied by several studies that suggested an effect of ET on inflammation, although a direct link between this effect and the therapeutic benefit of ET in PH has not yet been demonstrated. On this background, the aim of the present review is to describe current concepts regarding the effects of exercise on the pulmonary circulation and pathophysiological limitations, as well as the clinical and mechanistic effects of exercise in patients with PH.

Effects of Traumeel (Tr14) on recovery and inflammatory immune response after repeated bouts of exercise: a double-blind RCT.

PURPOSE: The purpose of this double-blind, randomized, placebo-controlled clinical trial was to investigate the effects of the natural combination medicine Traumeel (Tr14) consisting of 14 diluted biological and mineral components on the inflammatory immune response and recovery up to 72 h after repetitive bouts of bicycle tests. METHODS: Antigen-stimulated IL-1ra and IL-6 were defined as primary outcome measures. Moreover, various immunological and serum muscle damage markers were investigated. The evaluation was performed using the score of the area under the curve with respect to increase (AUCi) for 24 and 72 h after the second exercise test (EX2). RESULTS: The Tr14 group indicated a lower decrease of lymphocytes by tendency (p = 0.06) and a lower activation of lymphocyte activation markers (CD62L absolute: p = 0.04; CD69: p = 0.01 and CD69 absolute: p = 0.05) in the period 24 h after EX2. In addition, the Tr14 group indicated a higher expression of antigen-stimulated CCL3 (p = 0.01), CCL4 (p = 0.07) and serum CCL2 (p = 0.05) in the period 24 h after EX2. There was a tendentially lower decrease of monocytes (p = 0.09) and a lower expression of antigen-stimulated MMP-3 (p = 0.01) in the Tr14 group in the period 72 h after EX2. However, antigen-stimulated IL-1ra and IL-6 showed no group differences. CONCLUSION: In line with the previous results, it was shown that Tr14 attenuates the adaptive immune response partially. Furthermore, the results indicate that Tr14 is able to stimulate the innate immune system via an increased production of pro-inflammatory chemokines. It is speculated that the higher expression of chemokines might play a role in the regeneration and recovery after exercise.

Exercise Affects T-Cell Function by Modifying Intracellular Calcium Homeostasis.

PURPOSE: The study aimed to investigate the effects of chronic moderate exercise on regulation of intracellular calcium signaling as an important link to proliferation capacity in murine splenic T lymphocytes. METHODS: Male CD1 Swiss mice were randomly assigned either to a control group (CG) or an exercise training group (EG). EG mice performed voluntary exercise for 3 months. Lymphocytes were isolated from murine spleens and intracellular calcium was determined by using Fura-2(AM) and fluorescence spectrometry. The combination of flow cytometry and carboxy-fluorescein succinimidyl ester labeling technique was used for determination of cell proliferation. The expression levels of Ca-regulating genes were determined by quantitative polymerase chain reaction (qPCR) analysis. RESULTS: Basal [Ca]i was significantly higher in mice from the EG compared with mice of the CG (P < 0.001, n = 6). Similarly, [Ca]i transients after stimulation with phytohemagglutinin, concanavalin A, and the anti-CD3 antibody induced were significantly increased in mice from the EG (P < 0.05, n = 5). However, no differences were found after stimulation with thapsigargin (P < 0.05, n = 5). CD3 T cells from EG showed higher mitogen-induced proliferation levels than from CG (P < 0.05/0.01, n = 5). The mRNA expression of cellular Ca-regulating genes, such as STIM1, Cav2.3, TRPV4, IP3R2, ORAI1, MCU, TRPM5, and TRPC1, were significantly downregulated (P < 0.05/0.01, n = 5). CONCLUSION: This study suggests that chronic moderate exercise improves intracellular Ca signaling in murine splenic lymphocytes. The enhanced availability of the second messenger Ca is followed by an improved cellular function such as cell proliferation. The downregulation of Ca homeostasis-related factor expression might be considered as a self-protective mechanism against elevated intracellular Ca signals.

Effects of Traumeel (Tr14) on Exercise-Induced Muscle Damage Response in Healthy Subjects: A Double-Blind RCT.

The present double-blind, randomized, placebo-controlled clinical trial intended to test whether ingestion of a natural combination medicine (Tr14 tablets) affects serum muscle damage and inflammatory immune response after downhill running. 96 male subjects received Tr14 tablets, which consist of 14 diluted biological and mineral components, or a placebo for 72 h after the exercise test, respectively. Changes in postexercise levels of various serum muscle damage and immunological markers were investigated. The area under the curve with respect to the increase (AUCi) of perceived pain score and creatine kinase (CK) were defined as primary outcome measures. While for CK the p value of the difference between the two groups is borderline, the pain score and muscle strength were not statistically significant. However, a trend towards lower levels of muscle damage (CK, p = 0.05; LDH, p = 0.06) in the Tr14 group was shown. Less pronounced lymphopenia (p = 0.02), a trend towards a lower expression of CD69 count (p = 0.07), and antigen-stimulated ICAM-1 (p = 0.01) were found in the verum group. The Tr14 group showed a tendentially lower increase of neutrophils (p = 0.10), BDNF (p = 0.03), stem cell factor (p = 0.09), and GM-CSF (p = 0.09) to higher levels. The results of the current study indicate that Tr14 seems to limit exercise-induced muscle damage most likely via attenuation of both innate and adaptive immune responses. This study was registered with ClinicalTrials.gov (NCT01912469).

Effects of Acute Endurance Exercise on Plasma Protein Profiles of Endurance-Trained and Untrained Individuals over Time.

Acute physical exercise and repeated exercise stimuli affect whole-body metabolic and immunologic homeostasis. The aim of this study was to determine plasma protein profiles of trained (EET, n = 19) and untrained (SED, n = 17) individuals at rest and in response to an acute bout of endurance exercise. Participants completed a bicycle exercise test at an intensity corresponding to 80% of their VO2max. Plasma samples were taken before, directly after, and three hours after exercise and analyzed using multiplex immunoassays. Seventy-eight plasma variables were included in the final analysis. Twenty-nine variables displayed significant acute exercise effects in both groups. Seven proteins differed between groups, without being affected by acute exercise. Among these A2Macro and IL-5 were higher in EET individuals while leptin showed elevated levels in SED individuals. Fifteen variables revealed group and time differences with elevated levels for IL-3, IL-7, IL-10, and TNFR2 in EET individuals. An interaction effect could be observed for nine variables including IL-6, MMP-2, MMP-3, and muscle damage markers. The proteins that differ between groups indicate a long-term exercise effect on plasma protein concentrations. These findings might be of importance in the development of exercise-based strategies in the prevention and therapy of chronic metabolic and inflammatory diseases and for training monitoring.

The Immunomodulatory Effects of Physical Activity.

BACKGROUND: An individual's level of physical activity is one of a set of lifestyle and behavioral factors that can affect immune function and health. METHODS: The purpose of this review is to summarize the current knowledge in this research field and to review the recent developments in exercise immunology. RESULTS: Most studies show that regular exercise training increases immune competence and reduces the risk of infection compared to a sedentary lifestyle. In contrast, acute prolonged bouts of exercise and periods of intensified training are followed by a temporary increase in the risk of infection. These observations have been attributed to differential exercise-induced changes of a series of humoral and cellular immune system parameters. Furthermore, regular exercise training is a countermeasure against a persistent systemic inflammatory state which is a typical feature of cardiovascular and metabolic diseases is by lowering levels of pro-inflammatory cytokines. It is supposed that these effects are mediated by a modification of metabolic signals and innate immune regulation, the release of anti-inflammatory cytokines from muscle, the release of stress hormones, and a process known as browning of adipose tissue. CONCLUSION: The effects of physical activity on the immune system strongly depend on the mode and intensity of exercise or training. Thereby, considerable knowledge has accumulated concerning the significance of exercise as an important lifestyle factor for prevention and therapy of major chronic diseases.

Preventive strength training improves working ergonomics during welding.

To investigate the effect of a preventive strength training program on cardiovascular, metabolic and muscular strains during welding. Welders are one of the occupation groups which typically have to work in extended forced postures which are known to be an important reason for musculoskeletal disorders. Subjects (exercise group) accomplished a 12-week strength training program, while another group served as controls (control group). Pre and post training examinations included the measurements of the one repetition maximum and an experimental welding test. Local muscle activities were analysed by surface electromyography. Furthermore, heart rate, blood pressure, lactate and rating of perceived exertion were examined. In the exercise group, strength training lead to a significant increase of one repetition maximum in all examined muscles (p<.05). During the experimental welding test muscle activities of trunk and shoulder muscles and arm muscles were significantly reduced in the exercise group after intervention (p<.05). While no changes of neither cardiovascular nor metabolic parameters were found, subjects of the exercise group rated a significantly decreased rate of perceived exertion welding (p<.05). Effects of strength training can be translated in an improved working ergonomics and tolerance against the exposure to high physical demands at work.

Structural and functional prevention of hypoxia-induced pulmonary hypertension by individualized exercise training in mice.

Pulmonary hypertension (PH) is a disease with a poor prognosis characterized by a vascular remodeling process and an increase in pulmonary vascular resistance. While a variety of reports demonstrated that exercise training exerts beneficial effects on exercise performance and quality of life in PH patients, it is not known how physical exercise affects vascular remodeling processes occurring in hypoxia-induced PH. Therefore, we investigated the effect of individualized exercise training on the development of hypoxia-induced PH in mice. Training effects were compared with pharmacological treatment with the phosphodiesterase 5 inhibitor Sildenafil or a combination of training plus Sildenafil. Trained mice who received Sildenafil showed a significantly improved walking distance (from 88.9 ± 8.1 to 146.4 ± 13.1 m) and maximum oxygen consumption (from 93.3 ± 2.9 to 105.5 ± 2.2% in combination with Sildenafil, to 102.2 ± 3.0% with placebo) compared with sedentary controls. Right ventricular systolic pressure, measured by telemetry, was at the level of healthy normoxic animals, whereas right heart hypertrophy did not benefit from training. Most interestingly, the increase in small pulmonary vessel muscularization was prevented by training. Respective counterregulatory processes were detected for the nitric oxide-soluble guanylate cyclase-phosphodiesterase system. We conclude that individualized daily exercise can prevent vascular remodeling in hypoxia-induced PH.

Physical performance profile of handball players is related to playing position and playing class.

The purpose of the study was to compare anthropometric data and physical performance characteristics between different playing positions in professional team handball. Furthermore, a comparison between performance profiles of first and second division players was made. Thirty-four male professional handball players were recruited. Measurement of heart rates (HRs) during official games anthropometric data, sprint ability, jumping performance, throwing velocity, and endurance performance were determined and analyzed with respect to playing position. In a further step, additional 31 players from German second division were recruited to compare their profile on each position with profile of the first division players. Players of wings and backs positions had highest average HRs during game, best times in 30-m sprint tests, best jumping performance, and best anaerobic endurance performance. Similarly, backs and wings reached highest throwing velocities. Regarding anthropometric characteristics, wings were players with lowest body height and weight, whereas pivots were heaviest players and players with highest body mass index (BMI). We further found that wings from first division had a better sprint performance compared with wings from second division. Furthermore, pivots from first division had higher BMI and drop jump performance. Our data demonstrated a close relationship of anthropometric data, physical performance characteristic, and the playing position of handball. These information might be helpful for the assessment and evaluation of talents and may help to develop and optimize position-specific training regimes and identification of talents.