Psychological responses to acute resistance exercise in men and women who are obese

The purpose of the study was to investigate the psychological response to the very first session of resistance exercise on positive well-being (PWB), psychological distress (PD), and perception of fatigue in untrained men and women who are obese. Forty-five (male = 22, female = 23) untrained, middle-aged volunteers (mean ± SEM, 51.0 ± 1.0; range, 40-69 years) participated in the study. Participants were divided into 4 groups according to sex and obesity level (i.e., men who are obese, men who are nonobese, women who are obese, women who are nonobese). The threshold for obesity was defined as waist circumference ≥94 cm for men and 80 cm for women. Measures included body composition, aerobic power, muscle strength, and quality of life (Short Form 36, SF-36). Before and after resistance exercise, participants completed the Subjective Exercise Experience Scale (SEES). Paired sample t-tests were used to assess changes in SEES scores within group pre- and post-exercise and repeated-measures analysis of variance were used to assess changes in SEES scores between groups. Exercise increased the perception of PWB in both women who are obese and nonobese, without changes in PD or fatigue. In women, the change in PWB after exercise was negatively correlated with most scales of the SF-36, particularly with the mental health dimension (r = -0.55, p < 0.01). No significant changes in PWB, PD, or fatigue were found in men who are obese. Acute resistance exercise improved PWB in women who are obese and nonobese and those with lower self-perceived quality of life scores at the start improved the most. In addition, resistance exercise did not increase feelings of distress in either women or men who are obese.

Insulin sensitivity not modulated 24 to 78 h after acute resistance exercise in type 2 diabetes patients

Background
The aim of this study was to describe the clinical characteristics, causative pathogens, clinical management and outcomes of patients presenting to a tertiary adult Australian intensive care unit (ICU) with a diagnosis of necrotizing fasciitis (NF).
Methods
This retrospective observational study was conducted in a 19-bed, level III, adult ICU in a 450-bed tertiary, regional hospital. Clinical databases were accessed for patients diagnosed with NF and admitted to The Geelong Hospital ICU between 1 February 2000 and 1 June 2011. Information on severity of sepsis, surgical procedures and microbiological results were collected.
Results
Twenty patients with NF were identified. The median age was 52.5 years and 38% were female. The overall mortality rate was 8.3%. Common co-morbidities were diabetes (21%) and heart failure (17%), although 50% of patients had no co-morbidities. Group A Streptococcus was the identified pathogen in 11 (46%) patients, and Streptococcus milleri group in 5 (21%) patients. Hyperbaric oxygen therapy was not used in the majority of patients. The initial antibiotics administered were active against subsequently cultured bacteria in 83% of patients. Median time to surgical debridement was 20 h. Diagnosis and management was delayed in the nosocomial group.
Conclusions
This study reports physiological data, aetiology and therapeutic interventions in NF for an adult tertiary hospital. We demonstrate one of the lowest reported mortality rates, with early surgical debridement being achieved in the majority of patients. The main delay was found to be in the diagnosis of NF.

Acute resistance exercise increases the expression of chemotactic factors within skeletal muscle.

Intense resistance exercise causes mechanical loading of skeletal muscle, followed by muscle adaptation. Chemotactic factors likely play an important role in these processes.

Corticomotor excitability is increased following an acute bout of blood flow restriction resistance exercise

We used transcranial magnetic stimulation (TMS) to investigate whether an acute bout of resistance exercise with blood flow restriction (BFR) stimulated changes in corticomotor excitability (motor evoked potential, MEP) and short-interval intracortical inhibition (SICI), and compared the responses to two traditional resistance exercise methods. Ten males completed four unilateral elbow flexion exercise trials in a balanced, randomized crossover design: (1) heavy-load (HL: 80% one-repetition maximum [1-RM]); (2) light-load (LL; 20% 1-RM) and two other light-load trials with BFR applied; (3) continuously at 80% resting systolic blood pressure (BFR-C); or (4) intermittently at 130% resting systolic blood pressure (BFR-I). MEP amplitude and SICI were measured using TMS at baseline, and at four time-points over a 60 min post-exercise period. MEP amplitude increased rapidly (within 5 min post-exercise) for BFR-C and remained elevated for 60 min post-exercise compared with all other trials. MEP amplitudes increased for up to 20 and 40 min for LL and BFR-I, respectively. These findings provide evidence that BFR resistance exercise can modulate corticomotor excitability, possibly due to altered sensory feedback via group III and IV afferents. This response may be an acute indication of neuromuscular adaptations that underpin changes in muscle strength following a BFR resistance training programme.

The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: systematic review update and meta-analysis

RATIONALE: Smoking cessation is associated with cigarette cravings and tobacco withdrawal symptoms (TWS), and exercise appears to ameliorate many of these negative effects. A number of studies have examined the relationships between exercise, cigarette cravings, and TWS. OBJECTIVES: The objectives of this study were (a) to review and update the literature examining the effects of short bouts of exercise on cigarette cravings, TWS, affect, and smoking behaviour and (b) to conduct meta-analyses of the effect of exercise on cigarette cravings. METHODS: A systematic review of all studies published between January 2006 and June 2011 was conducted. RESULTS: Fifteen new studies were identified, 12 of which found a positive effect of exercise on cigarette cravings. The magnitude of statistically significant effect sizes for 'desire to smoke' and 'strength of desire to smoke' ranged from 0.4 to 1.98 in favour of exercise compared to passive control conditions, and peaked either during or soon after treatment. Effects were found up to 30 min post-exercise. Cigarette cravings were reduced following exercise with a wide range of intensities from isometric exercise and yoga to activity as high as 80-85 % heart rate reserve. Meta-analyses revealed weighted mean differences of -1.90 and -2.41 in 'desire to smoke' and 'strength of desire to smoke' outcomes, respectively. Measures of TWS and negative affect were reduced following light-moderate intensity exercise, but increased during vigorous exercise. CONCLUSIONS: Exercise can have a positive effect on cigarette cravings and TWS. However, the most effective exercise intensity to reduce cravings and the underlying mechanisms associated with this effect remain unclear.

Effect of an acute bout of plyometric exercise on neuromuscular fatigue and recovery in recreational athletes

Although plyometric training is widely used by sports coaches as a method of improving explosive power in athletes, many prescribe volumes in excess of the National Strength and Conditioning Association recommendations. The purpose of this study was to assess voluntary and evoked muscle characteristics to assess the neuromuscular impact of a high-volume bout of plyometric exercise that was non-exhaustive. Ten athletes who did not have plyometric training experience and were in their competitive season for club-level sport volunteered for the study. After at least 2 days without high-intensity activity, subjects were assessed on maximal twitch torque, time to peak torque, rate of twitch torque development, twitch half-relaxation time, rate of twitch relaxation, and voluntary activation by the interpolated twitch technique before, immediately after, and 2 hours after a high-volume plyometric training program (212 ground contacts). Data were analyzed by repeated-measures analysis of variance and described as mean +/- SD and Cohen d. Statistically significant decrements appeared immediately after the training protocol in the total torque generated by maximal voluntary contractions (p < 0.05, d = -0.51) and twitch (p < 0.01, d = -0.92), rate of twitch torque development (p < 0.01, d = -0.77), and rate of relaxation (p < 0.01, d = -0.73). However, we did not observe any differences that remained statistically different after 2 hours. There were no significant differences observed at any time point in time to peak twitch, half-relaxation time, or voluntary activation. We conclude that high-volume plyometric training results primarily in peripheral fatigue that substantially impairs force and rate of force development. We recommend that coaches carefully monitor the volume of plyometric training sessions to avoid neuromuscular impairments that can result in suboptimal training.

Resistance exercise with blood flow restriction: An examination of the acute and chronic neuromuscular, haemodynamic, and perceptual responses

 This thesis provides evidence of central nervous system adaptations as well as reduced exercising haemodynamics and perceptual responses when light-load resistance exercise/training is performed with blood flow restriction. In addition, this type of training appears beneficial in order to target gains in strength and muscle mass in healthy young populations.

Exercise increases nuclear AMPK α2 in human skeletal muscle

An acute bout of exercise increases skeletal muscle glucose uptake, improves glucose homeostasis and insulin sensitivity, and enhances muscle oxidative capacity. Recent studies have shown an association between these adaptations and the energy-sensing 5' AMP-activated protein kinase (AMPK), the activity of which is increased in response to exercise. Activation of AMPK has been associated with enhanced expression of key metabolic proteins such as GLUT-4, hexokinase II (HKII), and mitochondrial enzymes, similar to exercise. It has been hypothesized that AMPK might regulate gene and protein expression through direct interaction with the nucleus. The purpose of this study was to determine if nuclear AMPK α₂ content in human skeletal muscle was increased by exercise. Following 60 min of cycling at 72 +/- 1% of V_O2peak in six male volunteers (20.6 +/- 2.1 years; 72.9 +/- 2.1 kg; V_O2peak = 3.62 +/- 0.18 l/min), nuclear AMPK α₂ content was increased 1.9 +/- 0.4-fold (P = 0.024). There was no change in whole-cell AMPK α₂ content or AMPK α₂ mRNA abundance. These results suggest that nuclear translocation of AMPK might mediate the effects of exercise on skeletal muscle gene and protein expression.

Insulin-stimulated insulin recetor substrate-2-associated phosphatidylinositol 3-kinase activity is enhanced in human skeletal muscle after exercise.

Exercise increases skeletal muscle insulin action but the underlying mechanisms mediating this are equivocal. In mouse skeletal muscle, prior exercise enhances insulin-stimulated insulin receptor substrate-2 (IRS-2) signaling (Diabetes 2002;51:479-83), but it is unknown if this also occurs in humans. Hyperinsulinemic-euglycemic clamps were performed on 7 untrained males at rest and immediately after 60 minutes of cycling exercise at ~75% Vo_2peak. Muscle biopsies were obtained at basal, immediately after exercise, and at 30 and 120 minutes of hyperinsulinemia. Insulin infusion increased (P < .05) insulin receptor tyrosine phosphorylation similarly in both the rest and exercise trials. Under resting conditions, insulin infusion resulted in a small, but non–statistically significant increase in IRS-2–associated phosphatidylinositol 3 (PI 3)–kinase activity over basal levels. Exercise per se decreased (P < .05) IRS-2–associated PI 3–kinase activity. After exercise, insulin-stimulated IRS-2–associated PI 3–kinase activity tended to increase at 30 minutes and further increased (P < .05) at 120 minutes when compared with the resting trial. Insulin increased (P < .05) Akt Ser⁴⁷³ and GSK-3α/β Ser²¹/Ser⁹ phosphorylation in both trials, with the response tending to be higher in the exercise trial. In conclusion, in the immediate period after an acute bout of exercise, insulin-stimulated IRS-2 signaling is enhanced in human skeletal muscle.

Reduced plasma free fatty acid availability during exercise: effect on gene expression

Endurance exercise transiently increases the mRNA of key regulatory proteins involved in skeletal muscle metabolism. During prolonged exercise and subsequent recovery, circulating plasma fatty acid (FA) concentrations are elevated. The present study therefore aimed to determine the sensitivity of key metabolic genes to FA exposure, assessed in vitro using L6 myocytes and secondly, to measure the expression of these same set of genes in vivo, following a single exercise bout when the post-exercise rise in plasma FA is abolished by acipimox. Initial studies using L6 myotubes demonstrated dose responsive sensitivity for both PDK4 and PGC-1α mRNA to acute FA exposure in vitro. Nine active males performed two trials consisting of 2 h exercise, followed by 2 h of recovery. In one trial, plasma FA availability was reduced by the administration of acipimox (LFA), a pharmacological inhibitor of adipose tissue lipolysis, and in the second trial a placebo was provided (CON). During the exercise bout and during recovery, the rise in plasma FA and glycerol was abolished by acipimox treatment. Following exercise the mRNA abundance of PDK4 and PGC-1α were elevated and unaffected by either acipimox or placebo. Further analysis of skeletal muscle gene expression demonstrated that the CPT I gene was suppressed in both trials, whilst UCP-3 gene was only modestly regulated by exercise alone. Acipimox ingestion did not alter the response for both CPT I and UCP-3. Thus, this study demonstrates that the normal increase in circulating concentrations of FA during the later stages of exercise and subsequent recovery is not required to induce skeletal muscle mRNA expression of several proteins involved in regulating substrate metabolism.

The effect of exercise and training status on platelet activation: do cocoa polyphenols play a role?

Sedentary and trained men respond differently to the same intensity of exercise, this is probably related to their platelet reactivity and antioxidant capacity. There is growing interest in the utilization of antioxidant-rich plant extracts as dietary food supplements. The aim of this study was to investigate the effect of an acute bout of sub maximal exercise on platelet count and differential response of platelet activation in trained and sedentary subjects and to observe if cocoa polyphenols reverse the effect of exercise on platelet function. The practical significance of this study was that many sedentary people engage in occasional strenuous exercise that may predispose them to risk of heart disease. Fasting blood samples were collected from 16 male subjects, pre and post 1-h cycling exercise at 70% of maximal aerobic power (VO2max) before and after consumption of cocoa or placebo. Agonist stimulated citrated whole blood was utilized for measuring platelet aggregation, adenosine triphosphate (ATP) release and platelet activation. Baseline platelet count (221 ± 33 times 109/L) and ATP release (1.4 ± 0.6 nmol) increased significantly (P < 0.05) after exercise in all subjects. Baseline platelet numbers in the trained were higher (P < 0.05) than in the sedentary (235 ± 37 vs. 208 ± 34 times 109/L), where as platelet activation in trained was lower (P < 0.05) than sedentary (51 ± 6 vs. 59 ± 5%). Seven days of cocoa polyphenol supplementation had little effect on any of the parameters measured. We conclude that trained subjects show decreased activation of stimulated platelets when compared to the sedentary subjects and short-term cocoa polyphenol supplementation did not decrease platelet activity in response to exercise independent of prior training status.

The effects of a simplified tai-chi exercise program (STEP) on the physical health of older adults living in long-term care facilities : a single group design with multiple time points

Background
Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred.
Objective
To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities.
Design
A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started.
Settings
Two 300–400 bed veteran homes in Taiwan.
Participants
The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded.
Methods
The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization.
Results
A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038).
Conclusions
Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.