Difference in muscle activation patterns during high-speed versus standard-speed yoga: A randomized sequence crossover study

ObjectivesTo compare the difference in muscle activation between high-speed yoga and standard-speed yoga and to compare muscle activation of the transitions between poses and the held phases of a yoga pose.DesignRandomized sequence crossover trialSettingA laboratory of neuromuscular research and active aging Interventions: Eight minutes of continuous Sun Salutation B was performed, at a high speed versus a standard-speed, separately. Electromyography was used to quantify normalized muscle activation patterns of eight upper and lower body muscles (pectoralis major, medial deltoids, lateral head of the triceps, middle fibers of the trapezius, vastus medialis, medial gastrocnemius, thoracic extensor spinae, and external obliques) during the high-speed and standard-speed yoga protocols. Main Outcome Measures: Difference in normalized muscle activation between high-speed yoga and standard-speed yoga.ResultsNormalized muscle activity signals were significantly higher in all eight muscles during the transition phases of poses compared to the held phases (p < 0.01). There was no significant interaction between speed × phase; however, greater normalized muscle activity was seen for highspeed yoga across the entire session.ConclusionsOur results show that transitions from one held phase of a pose to another produces higher normalized muscle activity than the held phases of the poses and that overall activity is greater during highspeed yoga than standard-speed yoga. Therefore, the transition speed and associated number of poses should be considered when targeting specific improvements in performance.     

A brief yoga intervention implemented during chemotherapy: A randomized controlled pilot study

ObjectivesFatigue and other treatment-related symptoms (e.g., sleep disturbance) are critical targets for improving quality of life in patients undergoing chemotherapy. Yoga may reduce the burden of such symptoms. This study investigated the feasibility of conducting a randomized controlled study of a brief yoga intervention during chemotherapy for colorectal cancer.DesignWe randomized adults with colorectal cancer to a brief Yoga Skills Training (YST) or an attention control (AC; empathic attention and recorded education).SettingThe interventions and assessments were implemented individually in the clinic while patients were in the chair receiving chemotherapy.InterventionsBoth interventions consisted of three sessions and recommended home practice.Main outcome measuresThe primary outcome was feasibility (accrual, retention, adherence, data collection). Self-reported outcomes (i.e., fatigue, sleep disturbance, quality of life) and inflammatory biomarkers were also described to inform future studies.ResultsOf 52 patients initially identified, 28 were approached, and 15 enrolled (age Mean = 57.5 years; 80% White; 60% Male). Reasons for declining participation were: not interested (n = 6), did not perceive a need (n = 2), and other (n = 5). Two participants were lost to follow-up in each group due to treatment changes. Thus, 75% of participants were retained in the YST and 71% in the AC arm. Participants retained in the study adhered to 97% of the in-person intervention sessions and completed all questionnaires.ConclusionsThis study demonstrated the feasibility of conducting a larger randomized controlled trial to assess YST among patients receiving chemotherapy for colorectal cancer. Data collected and challenges encountered will inform future research.     

Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial

BACKGROUND: Numerous studies have explored the effectiveness of complementary and alternative medicine in the treatment of migraine but there is no documented investigation of the effectiveness of yoga therapy for migraine management. OBJECTIVES: To investigate the effectiveness of holistic approach of yoga therapy for migraine treatment compared to self-care. DESIGN: A randomized controlled trial. METHODS: Seventy-two patients with migraine without aura were randomly assigned to yoga therapy or self-care group for 3 months. Primary outcomes were headache frequency (headache diary), severity of migraine (0-10 numerical scale) and pain component (McGill pain questionnaire). Secondary outcomes were anxiety and depression (Hospital anxiety depression scale), medication score. RESULTS: After adjustment for baseline values, the subjects' complaints related to headache intensity (P < .001), frequency (P < .001), pain rating index (P < .001), affective pain rating index (P < .001), total pain rating index (P < .001), anxiety and depression scores (P < .001), symptomatic medication use (P < .001) were significantly lower in the yoga group compared to the self-care group. CONCLUSION: The study demonstrated a significant reduction in migraine headache frequency and associated clinical features, in patients treated with yoga over a period of 3 months. Further study of this therapeutic intervention appears to be warranted.     

Validity of wearable actimeter computation of total energy expenditure during walking in post-stroke individuals

BackgroundRecent studies reported that wearable sensor devices show low validity for assessing the amount of energy expenditure in individuals after stroke.ObjectiveWe aimed to evaluate the validity of energy expenditure calculation based on the product of energy cost and walked distance estimated by wearable devices in individuals after hemispheric stroke.MethodsWe recruited individuals with hemispheric stroke sequelae who were able to walk without human assistance. The participants wore a tri-axial accelerometer (Actigraph GT3x) and a pedometer (ONStep 400) on the unaffected hip in addition to a respiratory gas exchange analyzer (METAMAX 3B) during 6 min of walking at their self-selected walking speed and mode. The energy expenditure was calculated from the product of energy cost measured by the METAMAX 3B and the distance estimated by wearable devices. It was compared to the energy expenditure measured by the METAMAX 3B and the energy expenditure values recorded by the devices according to the manufacturer's algorithms. The validity was investigated by Bland-Altman analysis (mean bias [MB], root mean square error [RMSE], limits of agreement [95%LoA]), and Pearson correlation analysis (r).ResultsWe included 26 participants (mean [SD] age 64.6 [14.8] years). With the pedometer, the energy expenditure calculated from the product of energy cost and walked distance showed high accuracy and agreement with METAMAX 3B values (MB = −1.6 kcal; RMSE = 4.1 kcal; 95%LoA = −9.9; 6.6 kcal; r = 0.87, P < 0.01) but low accuracy and agreement with Actigraph GT3x values (MB = 15.7 kcal; RMSE = 8.7 kcal; 95%LoA = −1.3; 32.6 kcal; r = 0.44, P = 0.02) because of poorer estimation of walked distance. With the pedometer, this new method of calculation strongly increased the validity parameter values for estimating energy expenditure as compared with the manufacturer's algorithm.ConclusionsThis new method based on the energy cost and distance estimated by wearable devices provided better energy expenditure estimates for the pedometer than did the manufacturer's algorithm. The validity of this method depended on the accuracy of the sensor to measure the distance walked by an individual after stroke.     

间接测热法与传统能量估算法测定重症监护病房患者能量消耗的比较

目的 比较间接测热法测定能量消耗值(MEE)与传统方法得到估计能量消耗值(EEE)的差异,为危重患者的能量补充提供依据.方法 采用自身前后对照研究方法,对57例重症监护病房(ICU)患者使用间接测热法得到MEE,使用传统能量估算法如HB公式法、HB系数法和体重法得到EEE,其中低体重者[体质指数(BMI)<18.4 kg/m2]使用理想体重表计算,并以EEE与MEE的比值来评价估算能量的准确性.结果 HB公式法、HB系数法和实际体重法得到的EEE与间接测热法得到MEE比较差异均有统计学意义[(6335±1004)kJ、(9125±1795)kJ、(7188±1029)kJ比(7753±1439)kJ,P<0.05或P<0.01].HB系数法与实际体重法比较差异也有统计学意义(P<0.01),且后者的结果更接近实际测定值.用HB公式法估计能量会造成多数患者营养不足[低体重者占100%(4/4);体重正常者(BMI 18.5～23.9 kg/m2)占73.59%(39/53)].低体重者使用理想体重估算能量均能在营养充足范围内[100%(4/4)];体重正常者使用HB系数法和实际体重法可造成大量的营养不足[分别占39.62%(21/53)和43.39%(23/53)]及营养过度(分别占24.53%(13/53)和13.22%(7/53)].结论 对于危重病患者,各种传统公式估算能量消耗都很不精确,容易造成大量的营养不足和营养过度,最好使用间接测热法测定目标能量;在没有间接能量测定仪的情况下,低体重者使用理想体重,而体重正常者使用实际体重的估算法似乎较为合理.

Abstract：

Objective To compare measurement of energy expenditure(MEE)by indirect calorimetry (IC)with traditional estimation of energy expenditure(EEE),to provide a basis for energy supplementary for critically ill patients.Methods Using self-controlled study,the energy expenditure of 57 intensive care nnit(ICU)patients was measured by IC.Meanwhile,EEE was also calculated using the following equations:Harris-Benedict(HB),HB×factor,or 104.6 kJ/kg.Body weight were calculated using actual body weight(ABW)or ideal body weight(IBW).If body mass index(BMI)<18.4 kg/m2 it was considered as underweight,and the IBW was selected from the IBW table.The potential adequacy of estimated energy was assayed by ratio of EEE/MEE.Results There was significant difference in MEE by IC and EEE by HB,HB×factor and 104.6 kJ/kg [(6335±1004)kJ,(9125±1795)kJ,(7188±1029)kJ vs.(7753±1439)kJ,P<0.05 or P<0.01].There was significant difference between EEE by HB × factor and 104.6 kJ/kg(P<0.01),and EEE by 104.6 kJ/kg×ABW,and the latter was closer to MEE.Underfeeding would occur in most ICU patients if HB equation was used [100%(4/4)in underweight patients and 73.59%(39/53)in normal weight(BMI 18.5-23.9 kg/m2)].EEE as calculated by 104.6 kJ/kg ×IBW was reasonable in the underweight patients 100%(4/4),but EEE in the patients with normal weight by using HB×factor or 104.6 kJ/kg × ABW resulted in significant underfeeding[39.62%(21/53)and 43.39%(23/53)]or overfeeding[24.53%(13/53)and 13.22%(7/53)].Conclusion EEE derived from the equations was extremely inaccurate and may result in significant underfeeding or overfeeding in individuals.On the basis of this study we would recommend IC for measuring energy expenditure in ICU patients.Otherwise,the equations of 104.6 kJ/kg × IBW in underweight and 104.6 kJ/kg × ABW in normal weight patients may be reasonable.     

Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials

ObjectiveTo determine whether the odds of positive conclusions in randomized controlled trials (RCTs) of yoga, differ between yoga styles.DesignSystematic review of yoga RCTs. Medline/PubMed, Scopus, the Cochrane Library, IndMED and the tables of content of specialist yoga journals, not listed in medical databases, were screened up to 12 February, 2014 for RCTs comparing yoga interventions to non-yoga interventions. The RCTs’ conclusions were classified as positive (yoga is helpful for a respective condition) or not positive; and these were compared between different yoga styles using the Chi squared test and multiple logistic regression analysis.ResultsA total of 306 RCTs were included. These applied 52 different yoga styles, the most commonly used of which were: hatha yoga (36 RCTs), Iyengar yoga (31 RCTs), pranayama (26 RCTs), and the integrated approach to yoga therapy (15 RCTs). Positive conclusions were reached in 277 RCTs (91%); the proportion of positive conclusions did not differ between yoga styles (p = 0.191).ConclusionRCTs with different yoga styles do not differ in their odds of reaching positive conclusions. Given that most RCTs were positive, the choice of an individual yoga style can be based on personal preferences and availability.     

Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial

IntroductionConstipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly.Materials and methodsNinety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0–2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants.ResultsEighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls.DiscussionThe results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.     

Effects of prenatal yoga on women’s stress and immune function across pregnancy: A randomized controlled trial

ObjectiveThe effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks’ gestation between women receiving prenatal yoga and those receiving routine prenatal care.DesignFor this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks’ gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n = 48) or control (n = 46) groups using Clinstat block randomization.InterventionThe 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care.Main outcome measuresIn both groups, participants’ salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks’ gestation.ResultsThe intervention group had lower salivary cortisol (p < 0.001) and higher immunoglobulin A (p < 0.001) levels immediately after yoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p = 0.018), and infants born to women in the intervention group weighed more than those born to the control group (p < 0.001).ConclusionPrenatal yoga significantly reduced pregnant women’s stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function.     

A yoga & exercise randomized controlled trial for vasomotor symptoms: Effects on heart rate variability

ObjectivesHeart rate variability (HRV) reflects the integration of the parasympathetic nervous system with the rest of the body. Studies on the effects of yoga and exercise on HRV have been mixed but suggest that exercise increases HRV. We conducted a secondary analysis of the effect of yoga and exercise on HRV based on a randomized clinical trial of treatments for vasomotor symptoms in peri/post-menopausal women.DesignRandomized clinical trial of behavioral interventions in women with vasomotor symptoms (n = 335), 40–62 years old from three clinical study sites.Interventions12-weeks of a yoga program, designed specifically for mid-life women, or a supervised aerobic exercise-training program with specific intensity and energy expenditure goals, compared to a usual activity group.Main outcome measuresTime and frequency domain HRV measured at baseline and at 12 weeks for 15 min using Holter monitors.ResultsWomen had a median of 7.6 vasomotor symptoms per 24 h. Time and frequency domain HRV measures did not change significantly in either of the intervention groups compared to the change in the usual activity group. HRV results did not differ when the analyses were restricted to post-menopausal women.ConclusionsAlthough yoga and exercise have been shown to increase parasympathetic-mediated HRV in other populations, neither intervention increased HRV in middle-aged women with vasomotor symptoms. Mixed results in previous research may be due to sample differences. Yoga and exercise likely improve short-term health in middle-aged women through mechanisms other than HRV.     

High-flow nasal oxygen vs high-flow face mask: A randomized crossover trial in extubated patients

Purpose

Oxygen delivery after extubation is critical to maintain adequate oxygenation and to avoid reintubation. The delivery of oxygen in such situations is usually by high-flow face mask (HFFM). Yet, this may be uncomfortable for some patients. A recent advance in oxygen delivery technology is high-flow nasal prongs (HFNP). There are no randomized trials comparing these 2 modes.

Methods

Patients were randomized to either protocol A (n = 25; HFFM followed by HFNP) or protocol B (n = 25; HFNP followed by HFFM) after a stabilization period of 30 minutes after extubation. The primary objective was to compare the efficacy of HFNP to HFFM in maintaining gas exchange as measured by arterial blood gas. Secondary objective was to compare the relative effects on heart rate, blood pressure, respiratory rate, comfort, and tolerance.

Results

Patients in both protocols were comparable in terms of age, demographic, and physiologic variables including arterial blood gas, blood pressure, heart rate, respiratory rate, Glasgow Coma Score, sedation, and Acute Physiology and Chronic Health Evaluation (APACHE) III scores. There was no significant difference in gas exchange, respiratory rate, or hemodynamics. There was a significant difference (P = .01) in tolerance, with nasal prongs being well tolerated. There was a trend (P = .09) toward better patient comfort with HFNP.

Conclusions

High-flow nasal prongs are as effective as HFFM in delivering oxygen to extubated patients who require high-flow oxygen. The tolerance of HFNP was significantly better than in HFFM.     

Day-to-day variation in oxygen consumption and energy expenditure during submaximal treadmill walking in female adolescents

The day-to-day variation in oxygen consumption (V˙O ₂) and energy expenditure (EE) during horizontal treadmill walking was measured using indirect calorimetry in 20 female adolescents (mean age 17·3 years). Two different walking speeds were used: 5 km h^?1 and an individually convenient speed of 3·0 km h^?1 (mean). The two sets of measurements were performed on 2 consecutive days, and great care was taken to minimize possible disturbing factors. The mean V˙O ₂ was 919 ml min^?1 at 5 km h^?1 and 622 ml min^?1 at the individual speed, and the mean values of EE were 4·5 kcal min^?1 and 3·1 kcal min^?1 respectively. The individual day-to-day variation in V˙O ₂ (at 5 km h^?1) was between ?11·7% and +12·6% of the mean V˙O ₂. The coefficient of variation (CV) was 6·4% when values were calculated in ml min^?1 kg^?1. The energy expenditure varied somewhat less between the 2 days (CV = 5·7%). The corresponding value for EE when walking at the individual speed was 7·2%, and the mean day-to day variation in V˙O ₂ was 7·5% (CV). The rate of perceived exertion according to Borg's scale was lower on day 2 (11·9) compared with day 1 (13·0) when walking at 5 km h^?1. There was no difference in heart rate between the 2 days. It is concluded that EE varies somewhat less than V˙O ₂ on successive days, probably because of an interchangeable relationship between breathing gases, depending on which substrate is used for combustion. When using V˙O ₂ and EE for evaluation of physical capacity, the day-to-day variation in the measurements must be taken into consideration.     

The effects of Baduanjin and yoga exercise programs on physical and mental health in patients with Multiple Sclerosis: A randomized controlled trial

ObjectiveTo discuss whether Baduanjin and yoga exercise interventions improve motor function, posture control, and relieving fatigue and depression in MS patients. And to explore whether practicing Baduanjin benefits MS patients more than yoga.DesignA prospective, randomized, controlled, three-arm trial comparing BDJ (n = 30), yoga (n = 30) and control group (n = 20).SettingJiangsu Provincial Corps Hospital.InterventionEligible participants were randomized to a 24-week Baduanjin or yoga intervention, or a usual activity control group. Balance, posture control and trunk movement were measured with the Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS). Fatigue was measured using the Fatigue Severity Scale (FSS) and depressive symptoms via the Zung Self-Rating Depression Scale (SDS).ResultsFor BBS and TIS, there were significant changes pre- to post- exercise in two exercise groups (P < 0.05), with greater increases in the Baduanjin exercise group (BDJ group). For the FSS, there were significant changes pre- to post- exercise in both the BDJ (P = 0.0292) and yoga groups (P = 0.0150). For the SDS, the pre- and post-exercise difference of the BDJ group was larger than the yoga group (P < 0.0001). On the other hand, we could not find any changes of the BBS, TIS, FSS, and SDS scores in the control group (p > 0.05).ConclusionThe results suggest that practicing Baduanjin was more effective than yoga and that it is suitable for the MS patients.     

Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial

Background

Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults.

Objective

To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status.

Design

Cluster randomized trial.

Settings

Eight senior activity centers, southern Taiwan.

Participants

A sample of 139 participants was recruited, and 128 of them completed the study. Inclusion criteria: (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 ± 6.23 years, and the average number of chronic illness was 0.83 ± 0.90. The average BI score of the participants was 99.92 ± 0.62, and the mean SPMSQ score was 9.90 ± 0.30.

Methods

Participants were randomly assigned into either the experimental (n = 62) or the control (n = 66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group.

Results

Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p < .05).

Conclusions

After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.     

Automated versus manual blood pressure measurement: a randomized crossover trial

This study evaluated the accuracy and reliability of the Dinamap 8100 automated blood pressure machine against three internationally recognized criteria. Systolic and diastolic blood pressures were taken concurrently by two nurses using the automated machine and a manual sphygmomanometer. Results demonstrated agreement between automated and manual readings on one set of criteria for both systolic and diastolic pressures, and support for systolic readings only on one other criterion. Comparison of mean differences between automated and manual measures showed the automated machine consistently under-read both systolic and diastolic blood pressures. The conclusion from this study was that the Dinamap 8100 machine can be used with some degree of confidence to assess systolic blood pressures in a general population of adult hospital inpatients, but with caution when taking diastolic readings.     

Comparison of measured and predicted energy expenditure in mechanically ventilated children

Objective: To determine the energy requirements in mechanically ventilated pediatric patients using indirect calorimetry and to compare the results with the predicted metabolic rate. Design: In 50 mechanically ventilated children with a moderate severity of illness, energy expenditure was measured by indirect calorimetry. Daily caloric intake was recorded for all patients. Total urinary nitrogen excretion was determined in 31 patients. Results: Although there was a close correlation between the measured total energy expenditure (mTEE) and the predicted basal metabolic rate (pBMR) (r = 0.93, p < 0.001), Bland–Altman analysis showed lack of agreement between individual mTEE and pBMR values. The ratio of caloric intake/mTEE was significantly higher in the patients with a positive nitrogen balance (1.4 ± 0.07) compared with those with a negative nitrogen balance (0.8 ± 0.1; p < 0.001). Conclusions: Standard prediction equations are not appropriate to calculate the energy needs of critically ill, mechanically ventilated children. Individual measurements of energy expenditure and respiratory quotient by means of indirect calorimetry in combination with nitrogen balance are necessary for matching adequate nutritional support. Received: 27 June 1997 Accepted: 12 February 1998     

Increased serum brain-derived neurotrophic factor with high-intensity interval training in stroke patients: A randomized controlled trial

BackgroundPhysiological adaptations of stroke patients after high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) remain unclear.ObjectiveThis study determined the HIIT and MICT effects on aerobic capacity, cerebral oxygenation, peak cardiac output (CO), and serum brain-derived neurotrophic factor (BDNF) in stroke patients.MethodsWe included 23 stroke patients with age about 55 years and stroke duration > 24 months; participants completed 36 sessions of exercise training for 30 min; 13 were randomly assigned to perform MICT at 60% of peak oxygen consumption (VO_2peak) and 10 to perform HIIT at alternating 80% (3 min) and 40% (3 min) VO_2peak. Before and after interventions, we evaluated VO_2peak, peak CO, arteriovenous oxygen difference (AV O_2diff), bilateral frontal cortex oxygenation (relative changes of oxyhemoglobin Δ[O₂Hb], deoxyhemoglobin Δ[HHb], and total hemoglobin Δ[THb] levels), serum brain-derived neurotrophic factor (BDNF) level, and fluorescent cell staining for neuron morphology and percentage of cell-bearing neurites (% neurites).ResultsHIIT induced significant increases in VO_2peak (P = 0.008), CO (P = 0.038), Δ[HHb] (P = 0.046), Δ[THb] (P = 0.046), and serum BDNF level (P = 0.012). The improvement in VO_2peak was significantly greater with HIIT than MICT (20.7% vs. 9.8%, P = 0.031), as was AV O_2diff (P = 0.041), Δ[HHb] (P = 0.027), and serum BDNF level (P < 0.001). HIIT facilitated neuron dendritic protrusions (greater % neurites, P = 0.012) with prominent redistribution of mitochondria.ConclusionAs compared with MICT, HIIT-improved aerobic capacity by increasing systemic tissue O₂ extraction in stroke patients. Increased cerebral O₂ utilization in the involved hemisphere was also identified after HIIT. These physiological adaptations may be associated with increased serum BDNF level. In vitro dendritic growth in neurons treated with serum from HIIT participants may imply significant effects on neuron activities as compared with MICT.ClinicalTrials.gov identifierNCT04135391.     

Validity of the accelerometer and smartphone application in estimating energy expenditure in individuals with chronic stroke

ObjectiveTo examine the concurrent validity of the GT3X^® ActiGraph accelerometer and Google Fit^® smartphone application in estimating energy expenditure in people who had suffered a stroke, during fast overground walking.MethodsThirty community-dwelling stroke individuals walked on a 10-meter hallway over 5 min at their fastest speeds, wearing a Cortex Metamax 3B^® ergoespirometer, a GT3X^® ActiGraph accelerometer, and a smartphone with the Google Fit^® application. Pearson correlation coefficients were calculated to verify the associations between measures of energy expenditure, in kilocalories (kcal), estimated by both devices and those obtained with the Cortex Metamax 3B^® ergoespirometer (gold-standard measure).ResultsFair association was found between the energy expenditure values estimated from the combined formula of the ActiGraph GT3X^® and those obtained with the gold-standard measure (r = 0.37; p = 0.04). No significant associations were found between the energy expenditure values estimated by the Google Fit^® application and those provided by the gold-standard measure.ConclusionsThe findings demonstrated that both the GT3X^®ActiGraph accelerometer and the Google Fit^® smartphone application do not provide valid measures of energy expenditure in chronic stroke individuals during fast overground walking.