Effects of different protocols of high intensity interval training for VO2max improvements in adults: A meta-analysis of randomised controlled trials

ObjectivesTo examine the effects of different protocols of high-intensity interval training (HIIT) on VO₂max improvements in healthy, overweight/obese and athletic adults, based on the classifications of work intervals, session volumes and training periods.DesignSystematic review and meta-analysis.MethodsPubMed, Scopus, Medline, and Web of Science databases were searched up to April 2018. Inclusion criteria were randomised controlled trials; healthy, overweight/obese or athletic adults; examined pre- and post-training VO₂max/peak; HIIT in comparison to control or moderate intensity continuous training (MICT) groups.ResultsFifty-three studies met the eligibility criteria. Overall, the degree of change in VO₂max induced by HIIT varied by populations (SMD = 0.41–1.81, p < 0.05). When compared to control groups, even short-intervals (≤30 s), low-volume (≤5 min) and short-term HIIT (≤4 weeks) elicited clear beneficial effects (SMD = 0.79–1.65, p < 0.05) on VO₂max/peak. However, long-interval (≥2 min), high-volume (≥15 min) and moderate to long-term (≥4–12 weeks) HIIT displayed significantly larger effects on VO₂max (SMD = 0.50–2.48, p < 0.05). When compared to MICT, only long-interval (≥2 min), high-volume (≥15 min) and moderate to long-term (≥4–12 weeks) HIIT showed beneficial effects (SMD = 0.65–1.07, p < 0.05).ConclusionsShort-intervals (≤30 s), low-volume (≤5 min) and short-term (≤4 weeks) HIIT represent effective and time-efficient strategies for developing VO₂max, especially for the general population. To maximize the training effects on VO₂max, long-interval (≥2 min), high-volume (≥15 min) and moderate to long-term (≥4–12 weeks) HIIT are recommended.     

Different cognitive functions discriminate gait performance in younger and older women: A pilot study

AimCognitive dysfunction is associated with slower gait speed in older women, but whether cognitive function affects gait performance earlier in life has yet to be investigated. Thus, the objective of this study was to test the hypothesis that cognitive function will discriminate gait performance in healthy younger women.MethodsFast-pace and dual-task gait speed were measured in 30 young to middle-aged (30–45 y) and 26 older (61–80 y) women without mild cognitive impairment. Visuoperceptual ability, working memory, executive function, and learning ability were assessed using neuropsychological tests. Within each age group, women were divided by the median into lower and higher cognitive function groups to compare gait performance.ResultsYounger women with higher visuoperceptual ability had faster fast-pace (2.25 ± 0.30 vs. 1.98 ± 0.18 m/s, p ≤ 0.01) and dual-task gait speed (2.02 ± 0.27 vs. 1.69 ± 0.25 m/s, p ≤ 0.01) than women with lower visuoperceptual ability. The difference in dual-task gait speed remained significant (p = 0.02) after adjusting for age, years of education, and other covariates. Dividing younger women based on other cognitive domains showed no difference in gait performance. In contrast, working memory and executive function discriminated dual-task gait speed (p < 0.05) in older women after adjusting for age and education.ConclusionTo our knowledge, this is the first study to show that poorer cognitive function even at a relatively young age can negatively impact mobility. Different cognitive functions discriminated gait performance based on age, highlighting a possible influence of aging in the relationship between cognitive function and mobility in women.     

Combined aerobic and resistance training in breast cancer survivors: A randomized, controlled pilot trial

The purpose of this pilot study was to examine the effects of a combined cardiorespiratory and resistance exercise training program of short duration on the cardiorespiratory fitness, strength endurance, task specific functional muscle capacity, body composition and quality of life (QOL) in women breast cancer survivors. Sixteen subjects were randomly assigned to either a training (n = 8; age: 50 +/- 5 yrs) or control non-exercising group (n = 8; age: 51 +/- 10 yrs). The training group followed an 8-week exercise program consisting of 3 weekly sessions of 90-min duration, supervised by an experienced investigator and divided into resistance exercises and aerobic training. Before and after the intervention period, all of the subjects performed a cardiorespiratory test to measure peak oxygen uptake (VO2peak), a dynamic strength endurance test (maximum number of repetitions for chest and leg press exercise at 30 - 35 % and 100 - 110 % of body mass, respectively) and a sit-stand test. Quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC-C30) questionnaire. In response to training, QOL, VO2peak (mean 3.9 ml/kg/min; 95 % CI, 0.93, 6.90) performance in leg press (17.9 kg; 95 % CI, 12.8, 22.4) and sit-stand test (- 0.67 s; 95 % CI, - 0.52, - 1.2) improved (p < or = 0.05). We observed no significant changes in the control group. Combined cardiorespiratory and resistance training, even of very brief duration, improves the QOL and the overall physical fitness of women breast cancer survivors.     

Effects of sprint interval training on VO2max and aerobic exercise performance: A systematic review and meta‐analysis

Recently, several studies have examined whether low‐volume sprint interval training (SIT) may improve aerobic and metabolic function. The objective of this study was to systematically review the existing literature regarding the aerobic and metabolic effects of SIT in healthy sedentary or recreationally active adults. A systematic literature search was performed (Bibliotek.dk, SPORTDiscus, Embase, PEDro, SveMed+, and Pubmed). Meta‐analytical procedures were applied evaluating effects on maximal oxygen consumption (VO_2max). Nineteen unique studies [four randomized controlled trials (RCTs), nine matched‐controlled trials and six noncontrolled studies] were identified, evaluating SIT interventions lasting 2–8 weeks. Strong evidence support improvements of aerobic exercise performance and VO_2max following SIT. A meta‐analysis across 13 studies evaluating effects of SIT on VO_2max showed a weighted mean effects size of g = 0.63 95% CI (0.39; 0.87) and VO_2max increases of 4.2–13.4%. Solid evidence support peripheral adaptations known to increase the oxidative potential of the muscle following SIT, whereas evidence regarding central adaptations was limited and equivocal. Some evidence indicated changes in substrate oxidation at rest and during exercise as well as improved glycemic control and insulin sensitivity following SIT. In conclusion, strong evidence support improvement of aerobic exercise performance and VO_2max following SIT, which coincides with peripheral muscular adaptations. Future RCTs on long‐term SIT and underlying mechanisms are warranted.     

Physical fitness and psychological health in overweight/obese children: A cross-sectional study from the ActiveBrains project

Objectives

To examine the associations of physical fitness (i.e. cardiorespiratory fitness, muscular strength, and speed/agility) with psychological distress and psychological well-being in overweight/obese pre-adolescent children.

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.     

A true screening environment for review of interval breast cancers: pilot study to reduce bias

PURPOSE: To retrospectively assess the feasibility of an uninformed review process to evaluate interval breast cancers and to compare the number of false-negative cancers detected at uninformed review with the number detected at standard informed review. MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective study, and informed consent was waived. Mammograms showing interval cancer were included in the daily work of radiologists in a high-volume screening center. Each of three experienced radiologists read studies in the normal screening environment, without knowledge that identifiers had been changed to conceal the fact that studies were not current (ie, uninformed review). Results were compared with the standard review procedure, in which mammograms showing interval cancers were mixed with normal mammograms and read in a panel of 17-20 interval cancers per 80 normal studies by radiologists who were aware that they were participating in a review process (ie, informed review). RESULTS: Of 21 interval cancers, six (29%) were interpreted as positive more often by the informed radiologists than by the uninformed radiologists. For 14 (67%) cancers, there was no difference in detection rate between the two groups, and one cancer (5%) was seen by one of the uninformed radiologists but by none of the informed radiologists. The screening environment review process was found to be feasible at the low volumes tested. CONCLUSION: The number of false-negative cancers was higher in the informed review than in the uninformed review. This result suggests that bias exists with the informed review process.     

Resistance training enhances delayed memory in healthy middle-aged and older adults: A randomised controlled trial

ObjectivesHigh-intensity exercise is a potential therapeutic tool to postpone or prevent the onset of cognitive decline. However, there is a lack of sufficient evidence regarding the longitudinal effects of structured resistance training on cognitive function in healthy adults. The purpose of this study was to investigate the effect of two ecologically valid, intense 12-week resistance training programs on cognitive function in late middle-aged adults.DesignSingle-site parallel randomised controlled trial at the Department of Exercise Science strength and conditioning laboratory. Groups allocated by minimisation randomisation.MethodsForty-five healthy adults (age range = 41–69 years) were enrolled and randomised into (A) high-load, long rest resistance training (n = 14), or (B) moderate-load, short rest resistance training (n = 15) twice per week for 12 weeks, or a non-exercising control (n = 16). Follow-up within seven days. Data were collected September 2016–December 2017. Cognitive function assessed using the CogState computerised battery. Assessors were blinded to participant group allocation. Secondary outcomes were maximal muscle strength and body composition.ResultsForty-four participants were analysed in 2018. Delayed verbal memory performance was improved (p = 0.02) in resistance training groups (g = 0.67–0.79) when compared to the control group, with no differences between training groups. Likewise, increases in maximal muscle strength were observed (p < 0.01) in resistance training groups when compared to the control group, with no differences between training groups. No differences in body composition were observed. There were no adverse events or side-effects of the intervention.Conclusions12 weeks of intense resistance training improves delayed verbal memory irrespective of training design (i.e., high-load vs. moderate-load).Trial registrationThis study is registered at www.anzctr.org.au ACTRN12616000690459.     

Efficacy and feasibility of HIIT training for university students: The Uni-HIIT RCT

Objectives

The primary aim of this study was to evaluate the preliminary efficacy and feasibility of an 8-week high-intensity interval training program (Uni-HIIT) for young adult students in a university setting.

The effect of high Intensity interval training versus moderate intensity continuous training on arterial stiffness and 24 h blood pressure responses: A systematic review and meta-analysis

Objectives

Greater arterial stiffness and poor 24 h blood pressure (BP) are recognized as indicators of poor cardiovascular health. Evidence has shown that high intensity interval training (HIIT) may be a superior alternative to moderate intensity continuous training (MICT) for improving cardiovascular disease risk factors such as cardiorespiratory fitness and vascular function. However, there are limited data comparing the effect of HIIT to MICT on central arterial stiffness and/or 24 h BP response. The purpose of this study was to compare HIIT versus MICT on central arterial stiffness and 24 h BP outcomes by systematic review and meta-analysis.

Image and pathological changes after microwave ablation of breast cancer: A pilot study

Purpose

To prospectively assess MR imaging evaluation of the ablation zone and pathological changes after microwave ablation (MWA) in breast cancer.

Materials and methods

Twelve enrolled patients, diagnosed with non-operable locally advanced breast cancer (LABC), were treated by MWA and then neoadjuvant chemotherapy, followed by surgery. MR imaging was applied to evaluate the effect of MWA. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were applied to analyze the ablated area.

Results

All MWA procedures were performed successfully under local anesthesia. For a mean duration of 2.15 min, the mean largest, middle and smallest diameters in the ablated zone 24-h post-ablation in MR imaging were 2.98 cm ± 0.53, 2.51 cm ± 0.41 and 2.23 cm ± 0.41, respectively. The general shape of the ablation zone was close to a sphere. The ablated area became gradually smaller in MR imaging. No adverse effects related to MWA were noted in all 12 patients during and after MWA. HE staining could confirm the effect about 3 months after MWA, which was confirmed by TEM.

Conclusions

2 min MWA can cause an ablation zone with three diameters larger than 2 cm in breast cancer, which may be suitable for the local treatment of breast cancer up to 2 cm in largest diameter. However, the long-term effect of MWA in the treatment of small breast cancer should be determined in the future.     

Inhospital exercise benefits in childhood cancer: A prospective cohort study

Childhood cancer patients are at risk of developing important adverse effects, mortality and disease relapse after treatments, which has a substantial economic impact on healthcare systems. The objective of this study was to determine the effects of supervised inhospital exercise on clinical endpoints during childhood cancer treatment. 169 children with a new diagnosis of cancer were divided into an exercise intervention (n = 68, 11 ± 4 years) or a control group (n = 101, 11 ± 3 years). The cohort was followed up from the start of treatment for up to five years. Supervised inhospital exercise intervention was performed during the neoadjuvant (for solid tumors) or intensive chemotherapy treatment period (for leukemias). The median duration of the intervention was 22 (interquartile range, 14-28) weeks. We assessed survival, risk of disease relapse or metastasis, and days of hospitalization (primary outcomes), and cardiovascular function, anthropometry and blood variables (secondary outcomes). No exercise-related adverse events were noted. The exercise group had significantly less days of hospitalization than the control group (P = .031), resulting in a lower (~−17%) mean total economic cost of hospitalization in the former. Moreover, echocardiography-determined left ventricular function (ejection fraction and fractional shortening) was significantly impaired in the control group after treatment compared with baseline, whereas it was maintained in the exercise group (P = .024 and .021 for the between-group differences, respectively). In conclusion, supervised inhospital exercise intervention is safe and plays a cardioprotective role, at least in the short term, in children with cancer, also reducing hospitalization time, and therefore alleviating the economic burden.     

Effect of exercise on key pharmacokinetic parameters related to metformin absorption in healthy humans: A pilot study

Exercise is widely accepted as having therapeutic effects; thus, it is important to know whether it interacts with medications. The aim of the present pilot study was to examine the effect of high-intensity interval exercise (known to have antidiabetic action) on key pharmacokinetic parameters related to absorption of metformin (the first-line medication against type 2 diabetes). Ten healthy men participated in two sessions, spaced one to two weeks apart in random, counterbalanced order. In both sessions, participants received 1000 mg of metformin orally, 1-1.5 hours after breakfast. Then, they either ran for 60 minutes at alternating intensity, starting at 40 minutes after metformin administration, and rested without food consumption over the next 3 hours or they rested without food consumption during the entire testing period. Venous blood samples were collected before and at 0.5, 2, 2.5, 3, 3.5, 4, and 4.5 hours after metformin administration for metformin determination by liquid chromatography-mass spectrometry. Capillary blood samples were also collected for lactate and glucose measurements. Data from the two sessions were compared through Wilcoxon or Student's t test, as appropriate. Maximum plasma concentration of metformin (C_max) was higher at exercise compared to rest (P = .059). Time to reach C_max (T_max) decreased with exercise (P = .009), and the area under the metformin concentration vs time curve was higher at exercise (P = .047). The addition of exercise to metformin administration did not cause hypoglycemia or lactic acidosis. In conclusion, our results provide the first evidence that pharmacokinetic values related to metformin absorption are affected by exercise.     

Simultaneous whole-body 18F-FDG PET-MRI in primary staging of breast cancer: A pilot study

PurposeAccurate initial staging in breast carcinoma is important for treatment planning and for establishing the likely prognosis. The purpose of this study was to assess the utility of whole body simultaneous ¹⁸F-FDG PET-MRI in initial staging of breast carcinoma.Methods36 patients with histologically confirmed invasive ductal carcinoma underwent simultaneous whole body ¹⁸F-FDG PET-MRI on integrated 3 T PET-MR scanner (Siemens Biograph mMR) for primary staging. Primary lesion, nodes and metastases were evaluated on PET, MRI and PET-MRI for lesion count and diagnostic confidence (DC). Kappa co relation analysis was done to assess agreement between the satellite, nodal and metastatic lesions detected by PET and MRI. Histopathology, clinical/imaging follow-up served as the reference standard.Results36 patients with 37 histopathologically proven index breast cancer were retrospectively studied. Of 36 patients, 25 patients underwent surgery and 11 patients received systemic therapy. All index cancers were seen on PET and MR. Fused PET-MRI showed highest diagnostic confidence score of 5 as compared to PET (median 4; range 3–5) and MRI (median 4; range 4–5) alone. 2/36 (5.5%) patients were detected to have unsuspected contralateral synchronous cancer. 47 satellite lesions were detected on DCE MRI of which 23 were FDG avid with multifocality and multicentricity in 21 (58%) patients. Kappa co relation analysis revealed fair agreement for satellite lesion detection by the two modalities (κ = 0.303; P = 0.003).The study showed a sensitivity of 60% and 93.3% on PET and MRI respectively for detection of axillary lymph nodes with a specificity of 91% for both and a false negative rate of 6.7% on MRI and 40% on PET. Kappa co relation analysis between PET and MRI for all the lymph nodes detected revealed fair agreement by the two modalities (κ = 0.337; P = 0.000). Combined PET-MRI increased diagnostic confidence for nodal involvement (median DC 5, range 4–5; P < 0.05).Distant metastases were found in 8/36 (22%) patients at the time of diagnosis with a total of 91 metastatic lesions on PET (DC ≥ 4) and 105 on MRI (DC ≥ 4), the difference being statistically significant (P = 0.001) while Kappa co relation analysis showed significant agreement between the two modalities (κ = 0.667; P = 0.000). Overall PET-MRI led to a change in management in 12 (33.3%) patients.ConclusionIn this pilot study, simultaneous ¹⁸F-FDG PET-MR, has been found to be useful in whole-body initial staging of breast cancer patients.