抑郁症的1H-MRS研究

目的:探讨抑郁症患者1H-MRS的表现.方法:对33例抑郁症患者及18例健康对照组行MRI、1H-MRS扫描,兴趣区为双侧海马,双侧扣带回前部(anterior cingulate cortex, ACC),双侧背外侧前额叶皮层(dorsolateral prefrontal cortex, DLPFC).结果:抑郁症患者显示脑沟、脑池增宽,脑内未见异常信号灶;双侧海马NAA/Cr明显减低,与对照组相比有显著性差异(P<0.01),双侧背外侧前额叶皮层NAA/Cr明显减低,与对照组相比,有显著性差异(L: P<0.01,R: P<0.01);抑郁症患者背外侧前额叶皮层Cho/Cr比对照组明显增高(L: P<0.01,R: P<0.01).结论:1H-MRS能够揭示抑郁症时海马及背外侧前额叶皮层存在着神经元的丢失和细胞膜磷脂代谢的异常.     

Effects of short-term endurance training on aortic distensibility in young males

BACKGROUND: Short-term endurance exercise training can increase aortic distensibility. The effect of exercise on arterial distensibility, however, may not last long term. PURPOSE: We evaluated the effects of short-term exercise training and detraining on aortic distensibility in 10 sedentary young males (21.0 +/- 0.6 yr, mean +/- SE; range 19-24 yr). METHODS: The subjects underwent 8 wk of endurance training on a cycle ergometer at 70% of maximal oxygen consumption (VO(2max)), for 60 min at a time and on alternate days (3-4 d.wk(-1). The detraining period consisted of a return to sedentary days for 8 wk. The aortic pulse wave velocity (APWV) was measured before and immediately after training and during the detraining period. RESULTS: The VO(2max) was significantly increased after training (pre: 2240.0 +/- 71.4 mL, after: 2728.8 +/- 82.5 mL, mean +/- SE, P < 0.0001) and remained at increased levels during the detraining period (after 4 wk: 2671.2 +/- 73.6 mL, P < 0.001; after 8 wk: 2628.0 +/- 85.0 mL, P < 0.001). The APWV was significantly decreased after training (pre: 5.80 +/- 0.15 m.s(-1), after: 5.50 +/- 0.21 m.s(-1), P < 0.01) but returned close to the baseline after detraining for 4 wk (5.66 +/- 0.13 m.s, P < 0.18). CONCLUSION: Our data suggest that short-term exercise training can improve aortic distensibility, but the effect cannot be maintained without continuing physical exercise.     

Influence of short-term endurance exercise training on heart rate variability

PURPOSE: To examine the influence of 2 wk (eight sessions) of endurance training on cardiac autonomic modulation, as measured by heart rate variability (HRV). METHODS: Twenty-four males (mean age: 23.1 yr) were randomized to an exercise (EX; N = 12) or control group (CT; N = 12). EX trained for eight sessions (4x wk-1, 40 min, 80-85% HRreserve) on a cycle ergometer. ECG tracings were collected during 5 min of paced breathing (12 breaths x min-1 (PB)), 5 min of spontaneous breathing (SB1), 5 min of 70 degrees head-up tilt (TILT), and a second 5-min period of spontaneous breathing (SB2). Data were collected before (test 1), during (tests 2-4), and 48 h after (test 5) the 2-wk period. HRV was reported as the standard deviation of RR intervals, and as natural logarithm of the normalized units (NU) of high- and low-frequency power (lnHF and lnLF). RESULTS: EX exhibited a significant increase in peak oxygen consumption (8%). During PB and TILT conditions, ANOVA revealed a group x time interaction such that EX exhibited lower lnLFNU and lnLF/lnHF during test 5 compared with test 1. CONCLUSION: These data suggest that eight endurance exercise-training sessions performed over 2 wk enhance the relative vagal modulation of the heart during PB and TILT, but not during SB.     

Eccentric overload training for patients with chronic Achilles tendon pain--a randomised controlled study with reliability testing of the evaluation methods

The purpose was to examine the reliability of measurement techniques and evaluate the effect of a treatment protocol including eccentric overload for patients with chronic pain from the Achilles tendon. Thirty-two patients with proximal achillodynia (44 involved Achilles tendons) participated in tests for reliability measures. No significant differences and strong (r=0.56-0.72) or very strong (r=0.90-0.93) correlations were found between pre-tests, except for the documentation of pain at rest (P<0.008, r=0.45). To evaluate the effect of a 12-week treatment protocol for patients with chronic proximal achillodynia (pain longer than three months) 40 patients (57 involved Achilles tendons) with a mean age of 45 years (range 19-77) were randomised into an experiment group (n=22) and a control group (n=18). Evaluations were performed after six weeks of treatment and after three and six months. The evaluations (including the pre-tests), performed by a physical therapist unaware of the group the patients belonged to, consisted of a questionnaire, a range of motion test, a jumping test, a toe-raise test, a pain on palpation test and pain evaluation during jumping, toe-raises and at rest. A follow-up was also performed after one year. There were no significant differences between groups at any of the evaluations, except that the experiment group jumped significantly lower than the control group at the six-week evaluation. There was, however, an overall better result for the experiment group with significant improvements in plantar flexion, and reduction in pain on palpation, number of patients having pain during walking, having periods when asymptomatic and having swollen Achilles tendon. The controls did not show such changes. Furthermore, at the one-year follow-up there were significantly more patients in the experiment group, compared with the control group, that were satisfied with their present physical activity level, considered themselves fully recovered, and had no pain during or after physical activity. The measurement techniques and the treatment protocol with eccentric overload used in the present study can be recommended for patients with chronic pain from the Achilles tendon.     

Effects of short-term endurance training on muscle deoxygenation trends using NIRS

PURPOSE: This study examined changes in cardiorespiratory responses and muscle deoxygenation trends to test the hypothesis that both central and peripheral adaptations would contribute to the improvements in VO(2max) and simulated cycling performance after short-term high-intensity training. METHODS: Eight male cyclists performed an incremental cycle ergometer test to voluntary exhaustion, and a simulated 20-km time trial (20TT) on wind-loaded rollers before and after training (60 min x 5 d x wk(-1) x 3 wk at 85-90% VO(2max). Near-infrared spectroscopy (NIRS) was used to evaluate the trend in vastus medialis hemoglobin/myoglobin deoxygenation (Hb/Mb-O(2) during both tests pre- and post-training. RESULTS: Training induced significant increases (P 0.05) in the VO(2) (4.02 +/- 0.52 to 4.04 +/- 0.51), heart rate (176 +/- 9 to 173 +/- 8 beats x min ) or O pulse (22.4 +/- 3.2 to 23.5 +/- 2.8 mL O(2) x beat(-1)). However, mean muscle deoxygenation during the 20TT was significantly lower after training (-550 +/- 292 to -707 +/- 227 mV, P 相似文献   

Transfer effects of endurance training with the arms and legs

The purpose of this study was to examine whether endurance training in the form of arm or leg cycling resulted in significant transfer effects when exercise was performed with the untrained muscle group. Sixteen middle-aged male volunteers completed 24 training sessions over 8 wk on either an arm cycle ergometer (AG, N = 8, mean age = 35.2 +/- 6.6 yr) or a leg cycle ergometer (LG, N = 8, mean age = 41.0 +/- 4.7 yr). The two groups were initially equated for their pre-training peak oxygen uptake (pVO2) determined during leg cycling (44.5 +/- 5.0 and 43.8 +/- 7.7 ml.kg-1.min-1 for the AG and LG, respectively). Training was performed at an intensity that was mid-way between the pre-training ventilatory threshold (VT) and the pVO2 for both cycling methods. Significant increases (P less than .05) were observed in the relative values of the oxygen uptake at the VT and the pVO2 as a result of both these methods of training, but these elevations were specific to the muscle groups that were trained. This specificity of training was also evident in the cardiorespiratory and metabolic measurements obtained during submaximal steady state exercise performed at the power output corresponding to the pre-training VT during arm and leg exercise. Hence, it was concluded that improvements in exercise performance resulting from short-term aerobic training with the arms or legs in middle-aged males with relatively high aerobic powers are due primarily to peripheral adaptations in the trained muscles.     

Benefits from aerobic exercise in patients with major depression: a pilot study

BACKGROUND: Several reports indicate that physical activity can reduce the severity of symptoms in depressed patients. Some data suggest that even a single exercise bout may result in a substantial mood improvement. OBJECTIVE: To evaluate the short term effects of a training programme on patients with moderate to severe major depression. METHODS: Twelve patients (mean (SD) age 49 (10) years; five men, seven women) with a major depressive episode according to the Diagnostic and Statistical Manual of the American Society of Psychiatry (DSM IV) criteria participated. The mean (SD) duration of the depressive episode was 35 (21) weeks (range 12--96). Training consisted of walking on a treadmill following an interval training pattern and was carried out for 30 minutes a day for 10 days. RESULTS: At the end of the training programme, there was a clinically relevant and statistically significant reduction in depression scores (Hamilton Rating Scale for Depression: before, 19.5 (3.3); after, 13 (5.5); p = 0.002. Self assessed intensity of symptoms: before, 23.2 (7); after, 17.7 (8.1); p = 0.006. Values are mean (SD)). Subjective and objective changes in depression scores correlated strongly (r = 0.66, p = 0.01). CONCLUSIONS: Aerobic exercise can produce substantial improvement in mood in patients with major depressive disorders in a short time.     

A randomized controlled trial on an aerobic exercise programme for depression outpatients

Objectives

There were limitations in the conventional treatments for depression. This study investigated if an aerobic exercise programme would be a beneficial adjunct for outpatients on treatment for depression in Hong Kong.

Methods

We performed a single blind randomized controlled trial on 34 adult patients (between 18 and 65) suffering from major depressive disorder. Their Hamilton Depression Rating Scale (HAM-D) scores were at least 14. They were randomly assigned to receive a 12-week aerobic exercise programme in addition to usual psychiatric care (intervention), or to continue with usual psychiatric care alone (control). The outcomes included depression severity, sleep quality, somatic symptoms distress level, and anxiety level.

Results

Seventeen participants were randomly allocated to each group. There was statistically significant reduction in the mean HAM-D scores in both intervention (18.5–9.8) and control (19.5–14.5) groups. There were statistically significant main effects for time, for group, and for time*group interaction. On the sleep quality measures, there was statistically significant improvement in the global Pittsburg Sleep Quality Index in the intervention group only (from 12.0 to 9.0).

Conclusion

This study provided suggestive evidence that aerobic exercise might be a beneficial adjunct treatment for depression.

     

Pre-surgical sensorimotor training for patients undergoing total hip replacement: a randomised controlled trial

The aim of this study was to investigate whether pre-operative, sensorimotor training results in improved physical function, quality of life, sensorimotor function and reduced disability in total hip replacement patients. 80 subjects awaiting total hip replacement at a Swiss hospital were recruited for this randomised controlled trial. The intervention group participated in a pre-operative home exercise sensorimotor training programme; the control group received no therapy. Primary outcome measure was physical function, secondary outcome measures were quality of life, disability and sensorimotor function. Outcomes were measured using generic and disease-specific questionnaires as well as objectively assessed balance ability. Measurements were taken one day before surgery and 10 days, 4 and 12 months after surgery. The intervention showed improved quality of life and sensorimotor function before surgery. These effects were lost following surgery. The intervention group experienced more disability at 4 months than the control group. At one year follow-up group-membership influenced quality of life scores depending on the measurement-time-point. It can be concluded that no useful effect was identified for a pre-operative sensory-motor training-programme. The psychological aspects following total hip replacement need to be considered in order to facilitate coping-strategies, reduce unrealistic expectations and increase satisfaction.     

Resistive training effects on strength and cardiovascular endurance in cardiac and coronary prone patients

Resistive training using heavy loads with few repetitions increases strength but does little to improve cardiovascular endurance. Circuit weight training, a form of resistive training using moderate loads with frequent repetitions, is used to improve both cardiovascular and strength fitness. Studies of circuit weight training in healthy adults and athletes have shown increases of 20-45% and cardiovascular improvement from 0 to 15%. An increasing number of exercise programs for cardiac and coronary prone populations have introduced circuit weight training. The few reported studies have shown that high risk patients can attain increases in fitness similar to those seen in healthy populations. Furthermore, the hemodynamic responses to circuit weight training suggest that it is a clinically safe and acceptable form of exercise.     

Increased training intensity effects on plasma lactate, ventilatory threshold, and endurance

The purpose of this study was to determine the effects of increased training intensity (ITI) on VO2max, plasma lactate accumulation, ventilatory threshold (VT), and performance in trained distance runners. Seven trained male distance runners increased their training intensity three d.wk-1 at 90-95% HRmax for eight wk. ITI did not alter VO2max (65.3 +/- 2.3 vs 65.8 +/- 2.4 ml.kg-1.min-1) but improved 10 km race time (means = 63 s decrease) and increased run time to exhaustion on the treadmill at the same speed and grade (means = 3.88 min). Significant decreases in plasma lactate concentration at 85 and 90% of VO2max were observed after ITI. No differences were found in plasma lactate at 65, 70, 75 or 80% of VO2max or VT following ITI. Significant correlations were obtained between 10 km race times and changes in plasma lactate at 85 and 90% of VO2max (r = 0.69 and 0.73, respectively). Lactate accumulation at both 2.5 and 4.0 mM were at a significantly greater percent of VO2max after ITI. Additionally, the changes in plasma lactate were dissociated from alterations in VT after ITI. These data indicate that previously trained runners can increase training intensity to improve endurance performance by lowering lactate at the intensity at which they trained despite no changes in VO2max and VT.     

Evaluation of fitness level by the oxygen uptake efficiency slope after a short-term intermittent endurance training

Several indicators are used as indices of cardiorespiratory reserve. Among them, oxygen uptake (VO(2)) at peak and ventilatory threshold (VAT) levels are the most common used. In the present study, endurance training was used to evaluate and compare the usefulness of a new index, the Oxygen Uptake Efficiency Slope (OUES) as an alternative to the previous ones. Fifteen physical education student women participated in the study (8 as a trained group [T: age (mean +/- SD) 21.9 +/- 3.3 y, height 165.1 +/- 5.5 cm, weight 60.4 +/- 3.3 kg] and 7 as a control group [C: age 21.7 +/- 1.9 y, height 165.4 +/- 7.2 cm, weight 59.6 +/- 8.6 kg]). Before and after 6 weeks of the Square-Wave Endurance Exercise Test (SWEET) training program or daily activities, they performed an incremental test (30 W/3 min) on a cycle ergometer to determined VO(2), power output and parameters associated with breathing efficiency (the respiratory equivalents, and the ventilatory dead space to tidal volume ratio [Vd/Vt]) at peak- and VAT-levels. The slope of the relationship between ventilation and carbon dioxide production was also calculated. OUES, derived from the logarithmic relationship between VO(2) and minute ventilation (V(E)), was determined at 75 % (OUES75), 90 % (OUES90) and 100 % (OUES100) of exercise duration. After endurance training in T, VO(2) and power output were significantly improved at peak- and VAT-levels while all breathing efficiency indices remained unchanged. No changes were observed in C after 6 weeks. Despite significant correlation between OUES values and VO(2) at peak- and VAT-levels, OUES75, OUES90 and OUES100 did not significantly change after endurance training. While VO(2) and power output at peak- and VAT-levels increased in all T, training-induced changes in OUES appeared more variable. We concluded that OUES was not sufficiently sensitive to highlight improvement of cardiorespiratory reserve after endurance training whereas VO(2) at peak and VAT levels did.     

Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis

In a previous uncontrolled pilot study we demonstrated very good clinical results with eccentric calf muscle training on patients with painful chronic Achilles tendinosis located at the 2-6 cm level in the tendon. In the present prospective multicenter study (Sundsvall and Ume?) patients with painful chronic Achilles tendinosis at the 2-6 cm level in the tendon were randomized to treatment with either an eccentric or a concentric training regimen for the calf muscles. The study included 44 patients, with 22 patients (12 men, 10 women; mean age 48 years) in each treatment group. The amount of pain during activity (jogging or walking) was recorded by the patients on a visual analogue scale, and patient satisfaction was assessed before and after treatment. The patients were instructed to perform their eccentric or concentric training regimen on a daily basis for 12 weeks. In both types of treatment regimen the patients were told to do their exercises despite experiencing pain or discomfort in the tendon during exercise. The results showed that after the eccentric training regimen 82% of the patients (18/22) were satisfied and had resumed their previous activity level (before injury), compared to 36% of the patients (8/22) who were treated with the concentric training regimen. The results after treatment with eccentric training was significantly better (P<0.002) than after concentric training. The good clinical results previously demonstrated in the pilot study with eccentric calf muscle training on patients with chronic Achilles tendinosis, were thus reproduced in this multicenter, showing superior results to treatment with concentric training.     

Effect of endurance training on lung function: a one year study

Objective: To identify in a follow up study airway changes occurring during the course of a sport season in healthy endurance athletes training in a Mediterranean region. Methods: Respiratory pattern and function were analysed in 13 healthy endurance trained athletes, either during a maximal exercise test, or at rest and during recovery through respiratory manoeuvres (spirometry and closing volume tests). The exercise test was conducted on three different occasions: during basic endurance training and then during the precompetition and competitive periods. Results: During the competitive period, a slight but non-clinically significant decrease was found in forced vital capacity (–3.5%, p = 0.0001) and an increase in slope of phase III (+25%, p = 0.0029), both at rest and after exercise. No concomitant reduction in expiratory flow rates was noticed. During maximal exercise there was a tachypnoeic shift over the course of the year (mean (SEM) breathing frequency and tidal volume were respectively 50 (2) cycles/min and 3.13 (0.09) litres during basic endurance training v 55 (3) cycles/min and 2.98 (0.10) litres during the competitive period; p<0.05). Conclusions: This study does not provide significant evidence of lung function impairment in healthy Mediterranean athletes after one year of endurance training.