Evaluation of the Lactate Threshold during Downhill Running in Rats

[Purpose] The purpose of the present study was to investigate if lactate thresholds in rats could be accurately determined during downhill running in rats. [Subjects] Twenty-four female Wistar rats were used in this study. Rats were randomly divided into two groups: the level running group and downhill running group. [Methods] Catheters were inserted into the right external jugular veins of the rats. Two days after the operation, the rats performed incremental exercise tests. The level running group ran on a treadmill at a 0° incline; the downhill running group ran on a treadmill at a −16° incline. The lactate threshold was determined using the 2-line combination that minimizes the total sum of squares for fitting all data. [Results] Maximal running speeds and running speeds at the lactate threshold for the downhill running group were significantly higher than those for the level running group. [Conclusion] In this study, it was possible to accurately determine the lactate threshold during downhill running. These findings suggest that when the treadmill speed is the same, downhill running can be done at lower metabolic intensity than level running.Key words: Lactate threshold, Downhill running, Eccentric contraction     

The Effects of Aerobic Exercise and Strengthening Exercise on Pain Pressure Thresholds

[Purpose] We assessed the effects of aerobic exercise and strengthening exercise on pain pressure thresholds (PPTs) over time. [Subjects and Methods] Fifteen healthy participants were recruited and randomly divided into 3 groups: aerobic exercise, strengthening exercise, and control. The subjects in the aerobic group walked on a treadmill for 40 min at 6.5 km/h. The subjects in the strength group performed circuit training that included bench press, lat pull down, biceps curl, triceps extension, and shoulder press based on the perceived exertion for 40 min. The subjects in the control group rested without any exercise in a quiet room for 40 min. The PPTs of 5 potential muscle trigger points before exercise, and immediately after 10 and 40 min of exercise or rest were measured using an electronic algometer (JTECH Medical, USA). The Friedman’s, Kruskal-Wallis, and Mann-Whitney tests were performed using SPSS 18.0 (IBM, Korea). [Results] The PPTs of all subjects decreased after 10 min of exercise, but the difference was not statistically significant. The PPTs of the control group decreased after 40 min. Furthermore, the PPTs of 3 muscles increased after 40 min of aerobic exercise and of 6 muscles after 40 min of strengthening exercise. No significant difference in PPTs was noted among the groups. [Conclusion] The results show that 40 min is a more appropriate exercise time, although the efficacy of controlling pain did not differ between strengthening exercise and aerobic exercise.Key words: Aerobic exercise, Strengthening exercise, Pain pressure thresholds     

The Effects of Antecedent Exercise on Motor Function Recovery and Brain-derived Neurotrophic Factor Expression after Focal Cerebral Ischemia in Rats

[Purpose] In the present study, we investigated the effect of antecedent exercise on functional recovery and brain-derived neurotrophic factor (BDNF) expression following focal cerebral ischemia injury. [Subjects] The rat middle cerebral artery occlusion (MCAO) model was employed. Adult male Sprague-Dawley rats were randomly divided into 4 groups. Group I included untreated normal rats (n=10); Group II included untreated rats with focal cerebral ischemia (n=10); Group III included rats that performed treadmill exercise (20 m/min) training after focal cerebral ischemia (n=10); and Group IV included rats that performed antecedent treadmill exercise (20 m/min) training before focal cerebral ischemia (n=10) as well as treadmill exercise after ischemia. At different time points (1, 7, 14, and 21 days) Garcia’s score, and the hippocampal expressions level of BDNF were examined. [Results] In the antecedent exercise group, improvements in the motor behavior index (Garcia’s score) were observed and hippocampal BDNF protein expression levels increased. [Conclusion] These results indicate that antecedent treadmill exercise, before permanent brain ischemia exerts a neuroprotective effect against ischemia brain injury by improving motor performance and increasing the level of BDNF expression. Furthermore, the antecedent treadmill exercise of appropriate intensity is critical for post-stroke rehabilitation.Key words: Antecedent exercise, Brain-derived neurotrophic factor, Cerebral ischemia     

Comparison of Abdominal Muscle Thickness with Vaginal Pressure Changes in Healthy Women

[Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5 years and that of Group II was 49.69 years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH₂O in Group I, and at 20 cmH₂O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles.Key words: Pelvic floor muscle contraction, Vaginal pressure, Abdominis muscle     

Effect of Skin Resection on the Improvement of Joint Contractures in Rats

The effect of skin resection on joint contracture was determined by comparing the first measurement of range of motion after cast removal and the second measurement after the skin resection. This study aimed to verify that both the joint movement during the measurement and skin affect range of motion. [Subjects] Twelve female Wistar rats were used. [Methods] The right hind limb ankle of each rat was immobilized in complete plantar flexion in a cast. In the resection group (n = 6), the skin of the right hind limb ankle was removed surgically, but not in the non-resection group (n = 6). In the resection group, the first measurement of the dorsiflexion angle was obtained after the cast was removed, and the second measurement was obtained after skin resection. In the non-resection group, both measurements of the dorsiflexion angle were obtained soon after the cast was removed. [Results] Compared with the non-resection group, the resection group showed a significant increase between the first and second measurements of range of motion. [Conclusion] These results show that range of motion is substantially affected by skin, in addition to joint movement, during measurement.Key words: Joint contracture, Skin, Rat     

The Effects of Lower Extremity Angle According to Heel-height Changes in Young Ladies in Their 20s during Gait

[Purpose] The purpose of this study was to compare the effects of heel-height changes on the low joint angles of the lower extremities of women in their 20s during gait. [Subjects and Methods] Qualisys Track Manager Software ver. 2.8 (Qualisys, Sweden) was used to perform measurements on 14 female university students in their 20s. To measure movements, the subjects were asked to walk while wearing high-heeled shoes and reflective stickers on their hip joints, knee joints, and ankle joints, the changes in joint angles were measured at heel strike, foot flat, and toe off. [Results] Analysis of the amount of change according to heel height changes during gait showed that the angle of the hip joints was reduced with an increase in heel-height. Although the changes were not significant, the angle of the knee joints was reduced during heel strike, foot flat, and midstance, and it was increased during toe off. In contrast, the angle of the ankle joints was increased by a significant amount during heel strike, foot flat, midstance, and toe off. [Conclusions] During gait with high heels, the movements of the lower extremities of women in their 20s were reduced significantly with an increase in heel height. Therefore, it is concluded that the restrictions on gait can only be reduced by wearing low-heeled shoes.Key words: Heel height, Gait, Low extremity     

Difference in the Effect of Outpatient Pulmonary Rehabilitation Due to Variation in the Intervention Frequency: Intervention Centering on Home-based Exercise

[Purpose] The purpose of this study was to investigate differences in effects caused by variation in the intervention frequency of outpatient pulmonary rehabilitation, in terms of the pulmonary function, lower-limb muscle strength, exercise tolerance, and quality of life (QOL). [Subjects and Methods] A total of 36 patients with mild to severe chronic obstructive pulmonary disease (COPD) were studied. These patients were all men over the age of 40 who did not require assistance for activities of daily living (ADL). Groups undergoing intervention once a month (M1 group) and once a week (W1 group) were compared in terms of the effects of outpatient pulmonary rehabilitation for a period of 12 weeks. Intervention during this time included supervised and home-based exercise. [Results] Comparison of before and after intervention revealed that the rate of change in the W1 group was significantly higher than that in the M1 group in terms of the QOL, lower-extremity muscle strength, and 6-minute walking distance. [Conclusion] Outpatient pulmonary rehabilitation programs yielded greater improvements in the W1 group than in the M1 group in terms of the QOL and exercise tolerance.Key words: COPD, Pulmonary rehabilitation as outpatient, Frequency of intervention     

压疮大鼠骨骼肌组织形态学变化研究

目的研究压疮大鼠缺血再灌注不同时间点骨骼肌的形态学变化。方法54只Wistar大鼠随机分为9组：对照组、缺血再灌注组（IR组）：IR0h组、IR4h组、IR12h组、IR24h组、IR3d组、IR1周组、IR2周组、IR4周组,每组6只。观察受压部位骨骼肌的大体形态及HE染色光镜下观察其病理改变。结果实验组大鼠骨骼肌结构发生进行性损伤,肌纤维出现溶解、断裂、空泡变、水肿、骨骼肌横纹消失、毛细血管扩张充血,间质水肿等病理改变。在施压后24h损伤最严重,施压后4周,仍未完全修复。结论压疮形成过程中受压部位骨骼肌的损伤是一个渐进的过程,在受压后不同时间损伤的表现不同。     

Strength deficits of the shoulder complex during isokinetic testing in people with chronic stroke

OBJECTIVES:

To examine the strength deficits of the shoulder complex after stroke and to characterize the pattern of weakness according to type of movement and type of isokinetic parameter.

METHOD:

Twelve chronic stroke survivors and 12 age-matched healthy controls had their shoulder strength measured using a Biodex isokinetic dynamometer. Concentric measures of peak torque and work during shoulder movements were obtained in random order at speeds of 60°/s for both groups and sides. Type of movement was defined as scapulothoracic (protraction and retraction), glenohumeral (shoulder internal and external rotation) or combined (shoulder flexion and extension). Type of isokinetic parameter was defined as maximum (peak torque) or sustained (work). Strength deficits were calculated using the control group as reference.

RESULTS:

The average strength deficit for the paretic upper limb was 52% for peak torque and 56% for work. Decreases observed in the non-paretic shoulder were 21% and 22%, respectively. Strength deficit of the scapulothoracic muscles was similar to the glenohumeral muscles, with a mean difference of 6% (95% CI -5 to 17). Ability to sustain torque throughout a given range of motion was decreased as much as the peak torque, with a mean difference of 4% (95% CI -2 to 10).

CONCLUSIONS:

The findings suggest that people after stroke might benefit from strengthening exercises directed at the paretic scapulothoracic muscles in addition to exercises of arm elevation. Clinicians should also prescribe different exercises to improve the ability to generate force and the ability to sustain the torque during a specific range of motion.     

Effect of Exercise Intervention on Changes in Free Fatty Acid Levels and Metabolic Risk Factors in Stroke Patients

[Purpose] The present study investigated the effects of regular exercise on the improvement of free fatty acid (FFA) levels and metabolic risk factors of stroke patients. [Methods] The subjects were 20 male patients aged 47−59 years who were diagnosed as having hemiplegia resulting from stroke. Exercise was conducted using a stationary bicycle, a rehabilitative exercise machine. The exercise program utilized the heart rate reserve (HRR) method to create an exercise intensity amounting to 50−70% of the target heart rate (THR). The program lasted for 30 minutes and was conducted 5 times per week for a total of 12 weeks. [Results] In stroke patients, 12 weeks of exercise training yielded a significant interaction effect with weight, body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). There were also significant differences in triglycerides (TG) according to the time of measurement, and an interaction effect was observed for triglycerides (TC). High-density lipoprotein cholesterol (HDLC), an important marker of improvement in metabolic risk factors, showed a significant interaction effect with exercise training. In addition, free fatty acids (FFA) showed a significant difference based on the time of measurement and showed a significant negative correlation with HDLC (r = −0.77). [Conclusion] The results of the present study suggest that regular exercise by stroke patients reduces their risk of metabolic complications and stroke recurrence by reducing obesity indices, improving serum lipid and FFA levels, and increasing HDLC levels.Key words: Stroke patient, Metabolic risk factors, Free fatty acids (FFA)     

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Weakening of trunk muscles in stroke patients hinders functional ability, safety and balance. To confirm whether strengthening trunk muscles could facilitate rehabilitation of stroke patients, we investigated the effectiveness of sling exercise therapy (SET) using closed kinetic chain exercises to activate trunk muscles and improve balance in stroke patients. [Subjects and Methods] Twenty stroke patients with chronic hemiplegia were equally divided into 2 groups, a SET group and a control group that performed regular exercises on a mat with the assistance of a table. Patients in both groups exercised for 30 min, three times per week for 4 weeks. Trunk muscle activity was measured using surface electromyography, whereas balance was measured using the Berg Balance Scale, Frailty and Injuries Cooperative Studies of Intervention Technique, Timed Up & Go test, and BioRescue before and after the 4-week experimental period. [Results] Trunk muscle activity and balance before and after intervention in both groups were significantly different. However, no significant differences were observed between the 2 groups. [Conclusion] Although SET was not more effective than regular exercise, significant improvement was observed before and after SET. Therefore, SET can be considered effective in strengthening trunk muscles in stroke patients with chronic hemiplegia.Key words: Chronic stroke patients, Sling exercise therapy, Trunk muscles     

Effects of the CORE Exercise Program on Pain and Active Range of Motion in Patients with Chronic Low Back Pain

[Purpose] This study aimed to identify the effects of the CORE exercise program on pain and active range of motion (AROM) in patients with chronic low back pain. [Subjects and Methods] Thirty subjects with chronic low back pain were randomly allocated to two groups: the CORE group (n = 15) and the control group (n = 15). The CORE group performed the CORE exercise program for 30 minutes a day, 3 times a week, for 4 weeks, while the control group did not perform any exercise. The visual analog scale (VAS) and an algometer were used to measure pain, and pain-free AROM in the trunk was measured before and after the intervention. [Results] The CORE group showed significantly decreased VAS scores at rest and during movement and had a significantly increased pressure pain threshold in the quadratus lumborum and AROM in the trunk compared with those in the control group. [Conclusion] This study demonstrated that the CORE exercise program is effective in decreasing pain and increasing AROM in patients with chronic low back pain. Thus, the CORE exercise program can be used to manage pain and AROM in patients with chronic low back pain.Key words: CORE exercise program, Chronic low back pain (CLBP), Active range of motion (AROM)     

Study of Treadmill Exercise Effect on Rats with Osteoarthritis Using Proteomic Analysis

[Purpose] To investigate the correlation between the effect treadmill exercise and change in serum proteins in rats with osteoarthritis, a study of proteins was carried out using a mass spectrometer. [Subjects and Methods] Rats were randomly divided into five groups. After 4 weeks of treadmill training, serum from each rat was analyzed by Liquid chromatography-electrospray ionization tandem mass spectrometry. Complementary component 9 (C9) was discovered to be downregulated in the serum of the exercise groups, and this was validated by Western blot. [Results] Seventeen proteins were discovered to be elevated in the monosodium iodoacetate injection osteoarthritis group samples by more than 1.5 fold compared with the control group. One of the proteins upregulated, C9 protein, was validated, and it was found to decrease in the middle-intensity exercise group. [Conclusion] We showed that the serum level of C9, an inflammatory-related protein, decreased after treadmill exercise. Therefore, treadmill exercise with an appropriate intensity might be recommended for OA patients.Key words: Treadmill, Serum protein, Proteomics     

Effects of Intervention with To-balance Exercise on the Elderly Requiring Assistance and Lower Levels of Care

[Purpose] To examine the effects of intervention combining individualized and group rhythm (To-balance) exercises on the mental and physical functions of the elderly requiring low level care. [Subjects] A total of 29 elderly persons requiring level 2 assistance to level 2 who were and using outpatient care services participated in this study. [Methods] The participants were randomly allocated to 2 groups: To-balance, and Sitting. The former group performed individualized and To-balance group exercises, while the latter group performed individualized exercise, as well as group exercise while sitting on a chair. The effects were evaluated through somatometric, physical fitness, and mental function measurements before and 3, 6, and 9 months after the initiation of the intervention. [Results] The lower-limb muscle strength and mental function significantly improved in both groups. Particularly, in the To-balance group, early improvement in balance and gait ability were observed. [Conclusion] The To-balance exercise may be useful for quickly improving the elderly’s static balance ability.Key words: Elderly persons, Rhythm exercises, Balance ability     

Spontaneous Wheel Running Exercise Induces Brain Recovery via Neurotrophin-3 Expression Following Experimental Traumatic Brain Injury in Rats

[Purpose] The aim of the present study was to investigate the expression of neurotrophin-3 (NT-3) after applying spontaneous wheel running exercises (SWR) after experimental traumatic brain injury (TBI). [Subjects and Methods] Thirty male Sprague-Dawley rats were divided into 3 groups; 20 rats were subjected to controlled cortical impact for TBI, and then, animals were randomly collected from the SWR group and subjected to wheel running exercise for 3 weeks. Ten rats were not subjected to any injury or running exercise to compare with the effect of TBI and SWR. Immunohistochemistry, Western blotting, skilled ladder rung walking test, and 2,3,5-triphenyltetrazolium chloride staining analysis for the evaluation of NT-3 expression were used to assess brain damage and recovery. [Results] The TBI-induced decrease in NT-3 expression was recovered by wheel running exercise. Moreover, decreased ischemic volume and progressive neurobehavioral outcome were observed in the SWR group. [Conclusion] Spontaneous running exercise promotes brain recovery and motor function through an increase in expression of NT-3.Key words: Neurotrophin-3, Traumatic brain injury, Wheel running exercise     

Evaluation of the Effectiveness of an Aerobic Exercise Program and the Personality Characteristics of Patients with Fibromyalgia Syndrome: A Pilot Study

[Purpose] The aim of this study was to assess the effectiveness of a 6-week aerobic exercise program on pain, physical function, and psychological status, and to evaluate the personality characteristics of fibromyalgia syndrome (FMS) patients. [Subjects and Methods] Fourteen women with FMS were enrolled. They were trained for a 6-week home-based aerobic exercise program. The Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, the visual analog scale of pain and sleep quality were measured at baseline and at the end of week 6. The personality profiles were evaluated using the Minnesota Multiphasic Personality Inventory (MMPI). [Results] After the exercise program, significant improvements were determined in pain, sleep quality, physical function, depression and FMS symptoms compared to baseline. In addition, the hysteria item (71.21±8.84) of the MMPI was significantly higher in FMS. [Conclusion] Our findings indicate that home-based aerobic exercise may be a useful treatment in the management of FMS. Personality characteristics should be considered during the planning process of the treatment of FMS. Personality is a filter between life events and psychological responses. It is defined to be the integration of effective and behavioral patterns. Long-term studies involving larger clinical samples are needed to define the role of personality characteristics in FMS.Key words: Fibromyalgia syndrome, Aerobic exercise, Personality characteristics     

The Effects of 12 Weeks Regular Aerobic Exercise on Brain-derived Neurotrophic Factor and Inflammatory Factors in Juvenile Obesity and Type 2 Diabetes Mellitus

[Purpose] The purpose of this study was to investigate the effects of 12 weeks regular aerobic exercise on brain-derived neurotrophic factor (BDNF) and inflammatory factors in juvenile obesity and type 2 diabetes mellitus (T2DM). Obesity and T2DM, typically common among adults, have recently become more prevalent in the Korean juvenile population, affecting not only their lipid profiles and oxidant stress levels, but also their BDNF and inflammatory factor levels. [Subjects] This study enrolled 26 juveniles (boys = 15, girls = 9) who were assigned to a control group (CG, n = 11), obesity group (OG, n = 8), or T2DM group (TG, n = 7). [Methods] The outcome of a 40–60-minute aerobic exercise session that took place three times per week for 12 weeks at a maximum oxygen intake (VO_2max) of 50~60% was investigated. [Results] The exercise resulted in a significant reduction in the resting serum BDNF and TrkB levels (baseline) among juveniles in the OG and TG as compared to those in the CG. Additionally, the 12 weeks of regular aerobic exercise led to significant reductions in body weight, body fat percentage, and body mass index in the OG and a significant increase of VO_2max in the OG and TG. However, no significant differences in serum NGF or inflammatory factors were found among the three groups. There was a significant increase in resting serum BDNF levels following the 12 weeks regular exercise only in the OG. [Conclusion] While 12 weeks of regular aerobic exercise had a positive effect on body composition, and increased BDNF levels of juveniles in the OG, it did not affect the inflammatory factor levels and had no effect on the TG.Key words: Obesity, T2DM, BDNF     

Analysis of the Applicability of an Ankle-Foot Orthosis during Gait in Poststroke Patients

[Purpose] The aim of this study was to develop and assess the applicability of an experimental ankle-foot orthosis during gait in patients with hemiparesis. [Subjects and Methods] This was a noncontrolled cross-sectional study. Ten adult patients with hemiparesis but who were capable of independent gait were included in the study. Gait assessment was performed using two platforms (EMG System do Brasil), an electromyograph (EMG System do Brasil), and a video camera. The experimental orthosis consisted of a single piece that fit over the foot and 1/3 of the distal tibia and had a steel spring. [Results] There was greater activation of the rectus femoris and vastus lateralis muscles in the stance and mid-stance phases with the use of the experimental ankle-foot orthosis in comparison with the use of a polypropylene ankle-foot orthosis and no orthosis. Regarding spatial and temporal gait parameters, the individuals achieved an increase in stride length with the use of the experimental ankle-foot orthosis in comparison with the use of a polypropylene ankle-foot orthosis. [Conclusion] The results of the present study demonstrate that individuals with hemiparesis achieved an improvement in the stance and mid-stance phases of gait with the use of the experimental ankle-foot orthosis.Key words: Orthosis, Hemiparesis, Gait     

Physiological predictors of survival during high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome

Introduction

Data that provide clinical criteria for the identification of patients likely to respond to high-frequency oscillatory ventilation (HFOV) are scarce. Our aim was to describe physiological predictors of survival during HFOV in adults with severe acute respiratory distress syndrome (ARDS) admitted to a respiratory failure center in the United Kingdom.

Methods

Electronic records of 102 adults treated with HFOV were reviewed retrospectively. We used logistic regression and receiving-operator characteristics curve to test associations with oxygenation and mortality.

Results

Patients had severe ARDS with a mean (SD) Murray''s score of 2.98 (0.7). Partial pressure of oxygen in arterial blood to fraction of inspired oxygen (PaO₂/FiO₂) ratio and oxygenation index improved only in survivors. The earliest time point at which the two groups differed was at three hours after commencing HFOV. An improvement of >38% in PaO₂/FiO₂ occurring at any time within the first 72 hours, was the best predictor of survival at 30 days (area under the curve (AUC) of 0.83, sensitivity 93%, specificity 78% and a positive likelihood ratio (LR) of 4.3). These patients also had a 3.5 fold greater reduction in partial pressure of carbon dioxide in arterial blood (PaCO₂). Multivariate analysis showed that HFOV was more effective in younger patients, when instituted early, and in patients with milder respiratory acidosis.

Conclusions

HFOV is effective in improving oxygenation in adults with ARDS, particularly when instituted early. Changes in PaO₂/FiO₂ during the first three hours of HFOV can identify those patients more likely to survive.