Walking trials in postmenopausal women: effect of one vs two daily bouts on aerobic fitness

We compared the effects of one vs two daily bouts of walking on aerobic fitness and body composition in postmenopausal women. One hundred and thirty-four subjects were randomized into exercise groups or a control group and 130 completed the study. The subjects walked 5 d/week for 15 weeks at 65% of their maximal aerobic power expending 300 kcal (1255 kJ) in exercise in one (Group S1) or two daily sessions (Group S2). VO(2max) was measured in a direct maximal treadmill test. Body mass index (BMI) was calculated and the percentage of body fat (fat%) estimated using skinfold measurements. The net change in the VO(2max) was 2.5 mL min/kg (95% CI 1.5, 3.5) (8.7%) in Group S1 and 2.5 mL min/kg (95% CI 1.5, 3.5) (8.8%) in Group S2. The net change in body mass was -1.2 kg (95% CI-1.9, -0.5) in Group S1 and -1.1 kg (95% CI -1.8, -0.4) in Group S2. The net fat% change was -2.1% (95% CI-2.7, -1.4) in Group S1 and -1.7% (95% CI-2.3, -1.0) in Group S2. Exercise improved the maximal aerobic power and body composition equally when walking was performed in one or two daily bouts.     

The effect of hormone replacement therapy and exercise on cardiovascular disease risk factors in postmenopausal women

Following menopause, women show an increased risk of heart disease to a level equal that of men. This elevated risk is thought to be due, at least partly, to changes in blood lipid and fibrinogen levels. The purpose of this article is to review the published research on the relationship between both exercise and hormone replacement with regards to common cardiovascular disease (CVD) risk factors and the relative importance of each. Menopause is associated with increased total serum cholesterol, triglycerides and fibrinogen, and a decrease in high density lipoprotein (HDL) cholesterol levels. The major reason for these changes following menopause is believed to be a result of fluctuations in hormonal status, primarily a deficiency in estrogen. Intervention may be justified since estrogen replacement therapy has been shown to decrease the risk of developing CVD and to have a significant impact on many of the CVD risk factors. The results vary from study to study, but generally estrogen replacement has been found to decrease total cholesterol and fibrinogen, while increasing HDL cholesterol and triglycerides. All of these changes, other than the increase in triglycerides, are seen as positive. The addition of progestogen to estrogen may negate some of the beneficial changes of estrogen, most notably the increase in HDL cholesterol levels. However, progestogen has also been reported to offset the increase in triglycerides seen with unopposed estrogen replacement. Thus, there are contradictory effects (both positive and negative) of hormone replacement on CVD risk factors in women. Regular aerobic exercise and resulting improvements in cardiorespiratory fitness have consistently been shown as preventive of CVD. This decreased CVD risk is in part because of the impact of exercise on blood lipids and fibrinogen. Increased aerobic exercise is thought to improve the risk profile, mainly through an increase in HDL cholesterol levels and decreases in triglycerides and fibrinogen. Unfortunately, the majority of research supporting the effects of exercise on CVD risk factors has been done on men. Even when research has included women, very few studies have focused on postmenopausal women. However, the research done on postmenopausal women points to a significantly improved CVD risk factor profile with regular cardiorespiratory exercise.     

游泳训练对血压、血脂等心血管疾病危险因素影响的Meta分析

 目的 系统评价游泳训练对于血压、血脂等心血管疾病危险因素的影响。方法 计算机检索Cochrane图书馆、Pubmed、EMbase、SCI、中国生物医学文献数据库、中国期刊全文数据库、维普数据库、万方数据库,纳入关于游泳训练对于心血管系统功能获益的随机对照试验,对纳入研究进行偏倚风险分析,并对同质性结果进行Meta 分析。结果 共纳入11项研究,合计410例研究对象。Meta分析结果显示,游泳训练降低收缩压[MD＝-6.07, 95％CI(-10.19,-1.95),P<0.01]、舒张压[MD＝-2.77,95％CI(-5.09,-0.45),P<0.01]、静息心率[MD＝-4.63,95％CI(-5.21,-4.04),P<0.01]、总胆固醇[MD＝-9.05,95％CI(-11.32,-6.77),P<0.01]、低密度脂蛋白[MD＝-4.08,95％CI(-5.69,-2.48),P<0.01]、三酰甘油[MD＝-8.16,95％CI(-12.33,-4.00),P<0.05]的效果显著优于对照组,差异有统计学意义。结论 游泳训练可以使患者在心血管系统健康,包括血压、血脂等方面显著获益。     

持续气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征合并高血压患者降压效果的Meta分析

目的 系统评价持续气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的疗效.方法 计算机检索PubMed、Cochrane Library、中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)和万方数据库,搜集在常规降压药物基础上采用持续气道正压通气与单纯采用降压药物治疗OSAHS合并高血压疗效比较的随机对照研究(RCTs),检索时限均为建库至2015年10月.由两位研究者独立进行文献筛选、资料提取和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入16个RCTs,包括2101例患者.Meta分析结果显示,在随访小于12周时,持续气道正压通气治疗组日间收缩压[MD=-12.60,95％CI(-17.68,-7.52),P＜0.00001],夜间收缩压[MD=-21.90,95％CI(-25.94,-17.86),P＜0.00001],夜间舒张压[MD=-11.90,95％CI(-15.44,-8.36),P＜0.00001]降低程度明显大于对照组,但日间舒张压、24h平均收缩压、24h平均舒张压与对照组差异无统计学意义(P＞0.05).在随访大于等于12周时,持续气道正压通气治疗组24h平均收缩压[MD=-7.88,95％CI(-12.09,-3.66),P=0.00002]、24h平均舒张压[[MD=-5.14,95％CI(-6.00,-4.28),P＜0.00001]、日间收缩压[MD=-5.89,95％CI(-8.79,-2.98),P＜0.0001]、日间舒张压[MD=-4.34,95％CI(-6.32,-2.36),P＜0.0001]、夜间收缩压[MD=-7.06,95％CI(-11.12,-2.99),P=0.0007]、夜间舒张压[MD=-4.49,95％CI(-7.39,-1.58),P=0.006]降低程度均明显大于对照组.结论 在常规降压药物治疗的基础上采用持续气道正压通气治疗,可有效降低OSAHS合并高血压患者长期随访时的收缩压和舒张压,但短期随访时其降压效果不明显.受纳入研究质量限制,本研究结论尚需进一步开展多中心、大样本、高质量的随机对照双盲试验加以验证.     

Effect of block‐periodized exercise training on bone and coronary heart disease risk factors in early post‐menopausal women: a randomized controlled study

The purpose of this 12 month randomized exercise intervention was to determine the effect of a block‐periodized multipurpose exercise program on bone mineral density (BMD) and parameters of the metabolic syndrome (MetS) in early post‐menopausal women. Eighty‐five subjects (52.3 ± 2.4 years) living in the area of Erlangen (Germany) were randomly assigned into an exercise (EG, n=43) or a wellness‐control group (CG: n=42). The EG performed a periodized multipurpose exercise program with 4–6‐week blocks of high‐intensity bone‐specific exercise intermitted by 10–12 weeks of exercise dedicated to increase endurance and reduce cardiac and metabolic risk factors. The CG performed a low‐volume/low‐intensity “wellness” program to increase well‐being. After 12 months, significant exercise effects were observed for the lumbar spine (LS) BMD as assessed by quantitative computed tomography [total BMD (EG: ?0.3 ± 2.1% vs CG: ?2.1 ± 2.2%, P=0.015); trabecular BMD (EG: ?0.7 ± 3.4% vs CG: ?4.7 ± 4.9%, P=0.001) and dual‐energy x‐ray absorptiometry (DXA) (EG: ?0.1 ± 2.2% vs CG: ?2.0 ± 2.0%, P=0.002)]. However, no significant effects were observed for total hip BMD as assessed by DXA (P=0.152). Although all MetS parameters were favorably affected among the EG, only the effect for waist circumference was significant. In summary, short periods of bone‐specific intervention embedded in longer periods of exercises dedicated to improve cardiovascular and metabolic risk factors positively affected BMD at the LS.     

The effect of interval sprinting exercise on vascular function and aerobic fitness of post-menopausal women

Menopausal transition accelerates an age-associated decrease in vascular function and a decline in aerobic fitness. The purpose of this study was to examine the effect of 8 weeks of interval sprinting cycle ergometer exercise on arterial stiffness, basal forearm blood flow, and aerobic fitness of post-menopausal women. Sixty overweight post-menopausal women were randomized into either exercise (Ex, n = 30) or control (C, n = 30) groups. Ex participants completed 24 interval sprinting exercise (ISE) sessions over 8 weeks. Each 20-minute ISE session comprised of alternating 8 seconds sprints and 12 seconds of light pedaling. Arterial stiffness assessed through ankle-brachial pulse wave velocity (baPWV) and augmentation index (AIx), basal forearm blood flow (FBF) assessed using venous occlusion, and aerobic fitness were assessed before and after the intervention. baPWV was significantly decreased in the Ex group by 7.2%, P = .03, whereas AIx demonstrated a 10% decrease, P = .002. No changes were found in basal FBF. Aerobic fitness was significantly increased, P = .002, in the Ex group (14%) with no change occurring in the control group.ISE training, despite minimal exercise commitment time (8 hours over 8 weeks), significantly lowered the arterial stiffness and increased the aerobic fitness of post-menopausal women. These results suggest that ISE positively influences the negative change in arterial stiffness and aerobic fitness that typically accompanies menopause.     

Commuter cycling: effect on physical performance in untrained men and women in Flanders: minimum dose to improve indexes of fitness

The purpose was to examine (1) the effect of cycling to work on physical performance; (2) the minimum weekly energy expenditure needed for fitness improvement based on the dose–response relationship between total caloric expenditure and fitness changes. Healthy, untrained men and women, who did not cycle to work, participated in a 1-year intervention study. Sixty-five subjects were asked to cycle to work at least three times a week. Fifteen subjects were asked not to change their living habits. All measurements were performed on three consecutive occasions, with 6 months in between. Maximal external power ( P _max), heart rate, respiratory exchange ratio and peak oxygen uptake (VO_2peak) were assessed. Cycling characteristics and leisure time physical activities were reported in a dairy. A significant change over time between both groups was seen for VO_2peak (/kg) in the total group and the women and for P _max in the total group. Correlations were found between VO_2peak (/kg) ( r ≥0.40) and kcal/week and min/week. Preliminary results indicate that the minimum expended energy needed for the improvement of indexes of fitness is higher for men compared with women.     

Mean arterial pressure following prolonged exercise in the heat: Influence of training status and fluid replacement

Prolonged exercise in the heat without fluid replacement represents a significant challenge to the regulation of mean arterial pressure (MAP). It is unknown, however, if MAP is equally challenged during the post‐exercise period, and whether regular endurance exercise training can provide any benefit to its regulation. We examined MAP (Finometer) in eight trained (T) and eight untrained (UT) individuals prior to, and following, 120 min of cycling at 42 °C with (HYD) and without (DEHY) fluid replacement. Exercise during DEHY induced significant hyperthermia (T: 39.20 ± 0.52 °C vs UT: 38.70 ± 0.36 °C, P = 0.941) and body weight losses (T: 3.4 ± 1.2% vs UT: 2.7 ± 0.9%, P = 0.332), which did not differ between groups. Although MAP was equally reduced 5 min into the post‐exercise period of DEHY (T: ?20 ± 11 mmHg vs UT: ?22 ± 13 mmHg, P = 0.800), its subsequent recovery was significantly different between groups (P = 0.037). While MAP returned to pre‐exercise values in UT (?1 ± 3 mmHg), it remained reduced in T (?9 ± 3 mmHg, P = 0.028). No differences in MAP post‐exercise were observed between groups during HYD. These data suggest that trained men exhibit a greater level of post‐exercise hypotension following prolonged exercise in the heat without fluid replacement. Furthermore, fluid replacement reverses the sustained post‐exercise hypotension observed in trained individuals.     

Effects of strength and endurance training on metabolic risk factors in healthy 40–65‐year‐old men

This study compared 21 weeks of combined high‐intensity strength and endurance training with endurance or strength training only on metabolic risk factors in 40–65‐year‐old men. The healthy men (n=63) were randomized into endurance (E), strength (S), combined strength and endurance training (SE) and control (C) groups. S and E trained two times a week and SE 2+2 times a week. Systolic (SBP) and diastolic blood pressure decreased significantly both in E (?6±8 and ?4±6 mmHg) and in S (?9±8 and ?5±7 mmHg), but not in SE or C (P=0.003 for the difference in the changes of SBP between the groups). The changes in serum glucose and insulin during an oral glucose tolerance test did not differ between the groups. Only E decreased serum fasting insulin levels (?17±27%, P=0.013). Minor changes were observed in blood lipids and lipoproteins in all groups. Both endurance and strength training can modestly improve metabolic health even in relatively lean older men with normal glucose tolerance. Combined strength and endurance training did not produce complementary benefits on metabolic risk factors. Combined training is effective in improving body composition and cardiorespiratory and muscular fitness, however, which is likely to decrease the risk of future metabolic and cardiovascular disease.     

Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus

BackgroundNo reliable evidence has confirmed whether plantar intrinsic foot muscle strengthening exercises improve static and dynamic foot kinematics in individuals with pes planus.Research questionDoes the short-foot exercise affect static foot alignment and foot kinematics during gait in individuals with pes planus?MethodsThis was a randomized controlled single-blind trial involving 20 participants with pes planus who were randomly allocated to a short-foot exercise group (exercise) or a control group (controls). Exercise patients performed a progressive short-foot exercise three times per week for 8 weeks; controls received no intervention. Before and after the 8-week intervention, foot kinematics during gait, including dynamic navicular drop—the difference between navicular height at heel strike and the minimum value—and the time at which navicular height reached its minimum value were assessed, using three-dimensional motion analysis. We assessed static foot alignment by foot posture index and navicular drop test, and the thickness of the intrinsic and extrinsic foot muscles using ultrasound. All measurements were performed by one investigator (KO) blinded to the participants' allocation.ResultsAfter the 8-week intervention in the exercise group, foot posture index scores with regard to calcaneal inversion/eversion improved significantly (p < 0.05). Moreover, the time required for navicular height to reach the minimum value decreased significantly (p < 0.01).SignificanceFor individuals with pes planus, the short-foot exercise effectively corrected static foot alignment and temporal parameters of foot kinematics during gait. This temporal change, which shortens the time for navicular height to reach its minimum value, indicates an improved windlass mechanism. Therefore, short-foot exercise might effectively prevent or treat injuries related to the pes planus alignment.     

准备运动与放松运动对剧烈运动中及运动后颈总动脉血流速度的影响

８名男性大学生参加了下列３组实验：（１）单纯５分钟的剧烈运动（大于９０％ｏｆＶＯ２ｍａｘ）;（２）５分钟的准备运动（５０％ｏｆＶＯ２ｍａｘ）后再进行上述剧烈运动;（３）上述剧烈运动后再进行５分钟的放松运动（５５％ｏｆＶＯ２ｍａｘ）。在上述实验的同时,检测了每位被试者的颈总动脉血流平均速度（平均ＶＣＣＡ）、心率（ｆｃ）、左肱动脉平均血压（Ｐｍ）,并根据血流速度参数计算出反映脑血流阻力的指标———阻抗指数（ＲＩ）。结果显示：在５分钟的剧烈运动中,不论有否准备运动,上述４种参数均明显增加。在准备运动中,平均ＶＣＣＡ和ｆｃ均有所增加,ＲＩ的增加几乎达到了剧烈运动时的水平。剧烈运动后,Ｐｍ和ｆｃ很快恢复,放松运动中这两个指标有所恢复。但是平均ＶＣＣＡ和ＲＩ在放松运动中保持着剧烈运动时的高水平。准备运动中阻抗指数明显增加提示脑血流阻力增加,这可防止由于颈总动脉平均血流速度和心率的增加而引起脑血流的过多增加（尤其是对那些有脑血管缺陷的人）,有利于机体接着进行剧烈的运动。本研究中的放松运动可减缓颈总动脉血流平均速度等几种生理指标在剧烈运动后的恢复速度,使剧烈运动后机体（尤其是心脑血管调节功能差的人）的生理功能逐渐得到恢复,?     

Dose–response effect of exercise frequency on bone mineral density in post‐menopausal,osteopenic women

The purpose of this study was to determine the long‐term dose–response relationship of exercise frequency on areal bone mineral density (aBMD) in early post‐menopausal women with osteopenia. Based on the 12‐year results of the consequently supervised exercise group (EG) of the Erlangen Fitness and Osteoporosis Prevention Study, we retrospectively structured two exercise groups according to the overall exercise frequency. Changes in aBMD at lumbar spine and proximal femur as assessed by dual‐energy x‐ray absorptiometry technique were compared between a low‐frequency exercise group (LEF‐EG, n = 16) with 1.5–<2 sessions/week and a high‐frequency exercise group (HEF‐EG, n = 25) with ≥2–3.5 sessions/week. Changes in aBMD at the lumbar spine and proximal femur were significantly more favorable in the HEF‐EG compared with the LEF‐EG; lumbar spine: (mean value ± standard deviation) 1.1 ± 4.7% vs ?4.1 ± 3.0%; P = 0.001, ES: d' = 1.26; total hip: ?4.4 ± 3.9% vs ?6.7 ± 3.5%, P = 0.045, ES: d' = 0.70). BMD results of the LEF‐EG did not significantly differ from the data of the non‐training control group (lumbar spine: ?4.4 ± 5.2%, total hip: ?6.9 ± 5.0%). Although this result might not be generalizable across all exercise types and cohorts, it indicates that to impact bone, an overall exercise frequency of at least 2 sessions/week may be crucial, even if exercise is applied with high intensity/impact.     

Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents

To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5–17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24‐h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high‐density lipoprotein cholesterol (HDL‐C) levels and total cholesterol (TC)/HDL‐C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL‐C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet.