The Impact of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training on Vascular Function: a Systematic Review and Meta-Analysis

Effect of submaximal and maximal training on serum levels of asprosin, metabolic parameters and body composition in overweight and obese women

Objectives

This study evaluated the effects of maximal and submaximal exercise training on serum levels of Asprosin, insulin resistance, and body composition in overweight and obese women.

Methods

30 overweight/obese women voluntarily participated in the study and were then randomly divided into control, submaximal, and maximal groups. A treadmill high-intensity exercise protocol was applied to MG non-consecutive three days a week for 8 weeks, in four 4-min intervals with an intensity of 70 to 95% of maximum heart rate (HRmax) with 3-min active recovery intervals. SMG performed a moderate-intensity exercise protocol of approximately 25 to 35 min at the treadmill at 50-70% of HRmax non-consecutive days three days per week for 8 weeks. The CG continued their daily routine activities. Anthropometric and body composition measurements such as body weight, height, BMI, and waist-hip ratio (WHR) were performed before and after the 8-week training period. Fasting blood glucose (FGB), insulin, insulin resistance (HOMA-IR), and serum asprosin levels were also measured.

Results

Post-training, there were significant main effects of time and a group-by-time interaction for all body composition and performance variables (p < 0.001). Post hoc analysis revealed that body mass, BMI, WHR, FBG, insulin, HOMA-IR, and serum asprosin were significantly reduced after 8 8-week training program.

Conclusions

The present study showed that maximal and submaximal exercise protocols effectively improved body composition, insulin sensitivity, resistance, and reduced asprosin level. It has been concluded that these effects are more pronounced, especially after maximal exercise protocols.

High-Intensity Intervallic Exercise (HIIE) Is Superior to Isocaloric Moderate-Intensity Continuous Exercise (MICE) at Reducing Postprandial Hyperglycemia

PURPOSE

We investigated if a bout of high-intensity intervallic exercise (HIIE) is more efficacious at reducing postprandial hyperglycemia than an isocaloric bout of moderate-intensity continuous exercise (MICE).

METHODS

Nineteen healthy physically active individuals (21% women) completed three trials in a randomized order: i ) HIIE cycling consisting of five bouts of 4 min at 83 ± 9% of subjects' maximal oxygen consumption ( O 2MAX ) with active recoveries at 53 ± 8%, for a total of 50 min; ii ) MICE cycling at 65 ± 8% of O 2max for 50 min; and iii ) CONTROL no exercise. All trials were followed by a standard oral glucose tolerance test (OGTT) ingesting 74 g of glucose traced with 1 g of uniformly labeled [ 13 C]-glucose. Plasma glucose and insulin concentrations, and plasma glucose kinetics ([6,6 2 H 2 ] glucose infusion) were measured before exercise, during exercise, and during the OGTT. Insulin sensitivity was estimated by the Matsuda index (ISI). Energy expenditure and carbohydrate oxidation (CHOxid) were monitored.

RESULTS

At rest, blood glucose, insulin concentrations, and CHOxid were similar in all three trials. During exercise, energy expenditure was similar in HIIE versus MICE (548 ± 131 vs 560 ± 125 kcal; P = 0.340). However, CHOxid, plasma glucose concentration, and its rates of appearance in plasma (Ra) were higher in HIIE versus MICE (Ra glucose 34.3 ± 9.8 vs 28.9 ± 6.8 μmol·kg -1 ·min -1 ; P = 0.021). During the OGTT, plasma glucose and insulin concentrations were lower, and insulin sensitivity was higher in HIIE versus CONTROL (ISI MATSUDA ; 12.4 ± 4.7 vs 10.8 ± 4.7 au; P = 0.007). Exercise delayed blood incorporation of [ 13 C]-glucose into blood ( P = 0.023). Early during the OGTT, glucose clearance rates were higher in HIIE versus CONTROL (7.1 ± 3.1 vs 5.5 ± 3.0 mL·kg -1 ·min -1 ; P = 0.015).

CONCLUSIONS

HIIE is more effective than MICE to reduce hyperglycemia and hyperinsulinemia after glucose ingestion. HIIE improves glycemic control by increasing splanchnic glucose retention and glucose clearance rates.

Moderate intensity continuous training, combined moderate-intensity continuous training vs combined high-intensity interval training in adults with hypertension: Randomized controlled trial

BACKGROUND AND PURPOSE

Despite all efforts to treat hypertension, it is still responsible for 10.8 million deaths annually. The aim of this study was to compare the effects of continuous moderate-intensity training, strength training combined with continuous moderate-intensity training and strength training combined with high-intensity interval training in adults with high blood pressure.

METHODS

A 12-week randomized control trial was performed. A total of 100 volunteers, 51 women and 49 men with hypertension participated. The sample was randomly assigned into three intervention groups and one control group.

RESULTS

All intervention groups significantly improved their hemodynamic parameters, body composition, lipid profile, glucose, and physical fitness as compared to the control group. Both combined training groups showed greater improvements than the moderate-intensity continuous training group. However, the strength group combined with the moderate-intensity continuous group showed the greatest benefits in systolic, diastolic and mean arterial pressure, of -13.4 mmHg, -6.8 mmHg and -8.9 mmHg respectively, abdominal circumference, upper and lower limb strength and VO₂peak, versus the continuous moderate-intensity group; it also achieved greater reductions in systolic and mean blood pressure, up to -6.8 mmHg and 4.3 mmHg respectively, than the strength group combined with the high intensity interval group.

CONCLUSION

Performing a strength training program combined with continuous moderate intensity training, 2 days per week for 12 weeks, produces significant improvements in cardiometabolic biomarkers, body composition, and physical condition of adults with hypertension, with these adaptations being superior to those produced by continuous moderate-intensity training and strength training combined with high-intensity intervallic training.

Optimal amount of vigorous-intensity physical activity for lowering incidence of microvascular diseases: A prospective cohort study from the UK Biobank

AIMS

To explore the amount-response associations between the duration of physical activity (PA) at different intensities and the risks of microvascular diseases (MVDs), with a particular focus on identifying the optimal amount of vigorous-intensity PA (VPA).

METHODS

In this prospective cohort study, PA of different intensities were measured using wrist-worn accelerometers. MVDs, including nephropathy, neuropathy, and retinopathy, were identified from hospital inpatient records. Cox models and restricted cubic splines were used to evaluate the associations.

RESULTS

This prospective study included 92,275 participants (40,256 males and 52,019 females) with a mean (SD) age of 61.7 (7.8) years. During a median follow-up of 7.9 years, a total of 5,201 individuals were diagnosed with MVDs, including 2,385 with nephropathy, 512 with neuropathy, and 2,666 with retinopathy. An L-shaped amount-response association for VPA and overall MVDs was observed (P value for non-linearity < 0.001), with the optimal amount of 38 (95 % CI: 34, 44) minutes/week, corresponding to an HR of 0.71 (95 % CI: 0.64, 0.77).

CONCLUSION

VPA of 34-44 min/week were associated with 23 %-36 % lower risks of overall MVDs, with a less pronounced decline in risk thereafter. These findings may have implications for the future revision of physical activity recommendations to better improve microvascular health.

Narrative Review of High-Intensity Interval Training: Positive Impacts on Cardiovascular Health and Disease Prevention

BACKGROUND

High-intensity interval training (HIIT) has gained recognition for its positive impacts on cardiovascular (CV) health, metabolic outcomes, mental health, and quality of life (QoL). This narrative review aims to comprehensively evaluate the efficacy of HIIT in enhancing CV health and preventing CV disease (CVD).

METHODS

A comprehensive search of PubMed identified 257 articles, of which 39 studies met predefined inclusion and exclusion criteria for quality assessment. Key metrics evaluated included blood pressure, vascular function, lipid profiles, body composition, and CRF.

RESULTS

HIIT significantly improved vascular function, evidenced by reductions in systolic and diastolic blood pressure and enhanced flow-mediated dilation. Improvements in cardiac function were observed through increased cardiac output and heart rate variability. Additionally, HIIT positively influenced lipid profiles, decreasing low-density lipoprotein and triglycerides while increasing high-density lipoprotein. Significant reductions in body fat and improvements in VO2peak were noted, contributing to enhanced CRF. HIIT also positively impacted mental health and QoL, reducing anxiety and depressive symptoms. Importantly, HIIT was safely and effectively applied to high-risk populations-individuals with obesity, metabolic syndrome, CVD, and cancer survivors-with a low incidence of adverse effects.

CONCLUSIONS

This review highlights HIIT as an effective and safe exercise modality for improving CV health, metabolic indicators, mental health, and QoL. Future research should focus on developing tailored HIIT protocols to optimize adherence and efficacy across diverse populations, considering variations in age, sex, health status, and underlying medical conditions.

Protein-enriched intermittent meal replacement combined with moderate-intensity training for weight loss and body composition in overweight women

The global rise in overweight and obesity has been exacerbated by sedentary lifestyles and suboptimal dietary habits. Traditional weight loss methods often struggle with adherence due to restrictive diets and metabolic adaptations. Intermittent meal replacement (IMR), incorporating formulated protein-enriched nutritional shakes, has emerged as a potential strategy for weight management. However, its combined effects with moderate-intensity continuous training (MICT) remain underexplored. This study aimed to evaluate the impact of a weight loss method incorporating formulated protein-enriched nutritional shake IMR in conjunction with MICT workout for overweight female adults. This 8-week parallel randomized controlled trial investigated the impact of protein-enriched IMR combined with MICT on weight loss and body composition in overweight female adults. Participants were randomly assigned to either the MICT group or MICT + IMR group. Body composition, hematological, and urinary biomarkers were assessed pre- and post-intervention. The MICT + IMR Group achieved a greater reduction in body weight (-3.70 kg vs. -1.17 kg, p < 0.001) and body fat mass (-2.25 kg vs. -1.19 kg, p < 0.001) compared to the MICT group. Additionally, fasting blood glucose and insulin levels significantly improved in the MICT + IMR Group, suggesting enhanced metabolic regulation. IMR, when combined with MICT, is a viable strategy for short-term weight loss in overweight women, offering improved fat reduction and metabolic benefits compared to exercise alone.Trial registration: Chinese Clinical Trail Registry, ChiCTR2300076750. Registered 17 October 2023, https://www.chictr.org.cn/bin/project/edit?pid=197611 .

Effects of aerobic training on brachial artery flow-mediated dilation in healthy adults: a meta-analysis of inter-individual response differences in randomized controlled trials

BACKGROUND

This study aimed to investigate: (a) the effects of aerobic training (AT) on brachial artery endothelial function, measured by flow-mediated dilatation (baFMD) and whether changes in baFMD are associated with changes in other cardiovascular health markers in healthy adults; (b) whether intra-individual response differences (IIRD) in baFMD improvement exist following AT; and (c) the association between participants' baseline characteristics and exercise-induced changes in baFMD.

METHODS

The search conducted across six databases (PubMed, Web of Science, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials, and EBSCOhost) identified 12 eligible studies. We conducted both traditional meta-analyses identifying the effects of the intervention and IIRD. IIRD meta-analysis was performed to assess if true IIRD between AT and the control group exists for baFMD. The methodological quality of included studies was assessed by the PEDro scale, while GRADE assessment was used for certainty of evidence evaluation.

RESULTS

In total, 12 studies with 385 participants (51% male, 46.3 ± 17.3 [years]) were included in the current review. Meta-analysis revealed improvement in baFMD post-AT (small MD = 1.92%, 95% CI 0.90 to 2.94, p = 0.001). The standard deviation of change scores in the intervention and control groups suggests that most of the variation in the observed change from pre-to-post intervention is due to other factors (e.g., measurement error, biological variability etc.) unrelated to the intervention itself. However, subgroup meta-analysis revealed that significantly trivial IIRD exists following AT in prehypertensive individuals.

CONCLUSIONS

The study found small improvements in baFMD, suggesting an average 19.2% reduction in cardiovascular disease (CVD) risk, with some individuals-such as prehypertensive individuals-potentially experiencing even greater benefits from AT. However, a meta-analysis based on IIRD suggests that factors unrelated to AT predominantly explain baFMD changes. Further research is needed to better understand response variability in individuals with cardiovascular risk factors, and longer studies are required to assess IIRD in the general population.

Customizing intense interval exercise training prescription using the "frequency, intensity, time, and type of exercise" (FITT) principle

Intense interval exercise training induces various physiological and metabolic adaptations related to performance and health. For designing a program, the F.I.T.T. principle, referring to frequency, intensity, time, and type of exercise, can be used to manipulate the level of physiological stress in the body, leading to various adaptations. Modifying these four parameters results in a wide range of interval protocols that are safe and effective for different populations including athletes and individuals with chronic diseases. In this review, we present how the manipulation of the F.I.T.T. components can alter the acute and chronic cardiorespiratory, metabolic, perceptual, and affective responses and adaptations to intense interval exercise training. From this evidence, it appears that the duration of the exercise bout and recovery interval are critical parameters for the manipulation of almost all acute responses, enabling periodization of intense interval exercise training, and promoting optimal adaptations and exercise adherence. In addition, a considerable level of adaptations may be achieved with training frequencies as low as once or twice per week and with lower than maximal intensities, adding to the feasibility of this exercise mode. Overall, by varying these parameters, the design of an intense interval exercise training program can be tailored according to the needs and abilities of each individual, and an optimized training prescription may be achieved.

High-intensity interval training improves insulin sensitivity in individuals with prediabetes

OBJECTIVE

To examine the separate and combined effects of low-volume high-intensity interval training (HIIT) and walking compared with no training on insulin sensitivity and skeletal metabolic capacity in individuals with prediabetes.

DESIGN

Individuals were randomized to: (1) control (no exercise), (2) HIIT (3 × 20 s's cycle sprint 3 times weekly), (3) HIIT + walking (walking >10 000 steps/day), or (4) walking for 12 weeks.

METHODS

Insulin sensitivity was assessed by an oral glucose tolerance test at baseline and end-of-trial. Additionally, proteins important for mitochondria capacity and insulin sensitivity were measured in the vastus lateralis muscle.

RESULTS

Seventy sedentary individuals with prediabetes (women n = 36; age: 60.8 ± 11.3 years (mean ± SD); body mass index: 31.6 ± 4.4 kg/m2; fasting plasma glucose: 6.6 ± 0.8 mmol/L; glycated hemoglobin A1c 5.7 ± 0.4% (39.0 ± 4.3 mmol/mol) were included. Compared with control, peripheral insulin sensitivity (measured by the Cederholm index) was significantly improved with HIIT (estimated treatment difference [ETD]: 18.5% [95% confidence interval (CI): 7.4; 28.3%] and HIIT + walking [ETD: 15.7% (95% CI: 4.4; 25.6%)]), but not with walking alone (ETD: 9.4% [95% CI: -2.5; 19.9%]). Whole-body insulin sensitivity (measured by the Matsuda index) was significantly increased with HIIT + walking (ETD: 28.0% [95% CI: 10.3; 42.3%]) and walking alone (ETD: 42.3% [95% CI: 28.3; 53.5%]), but not with HIIT alone (ETD: 17.0% [95% CI: -4.0; 33.7%]). Protein expression of proteins involved in mitochondrial capacity in skeletal muscle and glucose uptake were most improved with HIIT + walking, and no significant effects were observed with walking alone.

CONCLUSIONS

Twelve weeks of low-volume HIIT training can improve glucose control and induces adaptations in skeletal muscle important for metabolic health in individuals with prediabetes.

Effects of high-intensity interval training on physical morphology, cardiopulmonary function, and metabolic indicators in older adults: a systematic review and meta-analysis

Background

Despite the growing attention towards the efficacy of high-intensity interval training (HIIT) on older adult health, a consensus regarding the pleiotropic effects of HIIT in this population is yet to be reached. Previous studies have predominantly focused on specific outcomes or particular groups, lacking comprehensive analysis.

Objective

We aimed to conduct a systematic evaluation of the impact of HIIT on body composition, cardiopulmonary function, and metabolic parameters in older adults.

Methods

The databases searched included PubMed, Web of Science, Cochrane Library, Scopus, WanFang, and other relevant sources from the inception of the database until July 2023. Randomized controlled trials (RCTs) on the effects of HIIT on body shape, cardiopulmonary function, and metabolic parameters in the older adult were searched.

Results

A total of 87 RCTs meeting the criteria were included, involving 4,213 older adult people. Meta-analysis results showed that HIIT significantly improved body fat percentage (BF%) [MD: -1.63%, p = 0.005], maximal oxygen uptake (VO2max) [MD: 2.46 mL min-1 kg-1, p < 0.00001], maximal heart rate (HRmax) [MD: 2.83 beats min-1, p = 0.02], and high-density lipoprotein (HDL) levels [MD: 0.04 mmol L-1, p = 0.002]. However, for systolic blood pressure (SBP) [MD: 0.49 mmHg, p = 0.60], resting heart rate (HRrest) [MD: -0.95 BPM -1, p = 0.24], triglycerides (TG) [tendency for MD: -0.02 mmol L-1, p = 0.61], low-density lipoprotein (LDL) [MD: -0.04 mmol L-1, p = 0.27] had no significant effect. Sensitivity analysis found that HIIT significantly improved waist circumference (WC) [MD: -1.89 cm, p = 0.17], diastolic blood pressure (DBP) [MD: -0.63 mmHg, p = 0.23], respiratory exchange rate (RER) [MD: 0.01, p = 0.20], total cholesterol (TC) [MD: 0.10 mmol L-1, p = 0.14], and fasting plasma glucose (FPG) [MD:-0.20 mmol L-1, p = 0.08], but the results lacked robustness. There was no significant improvement in DBP [MD: -0.63 mmHg, p = 0.23] and body mass index (BMI) [MD: -0.36 kg m-2, p = 0.06].

Conclusions

HIIT has shown certain potential and advantages in improving the physical health of the older adult, especially in cardiopulmonary function. However, more high-quality studies are needed to confirm the effects of HIIT on the physical health of the older adult in the future. It also provides a reference for the clinical practice and family health management of HIIT in the older adult and the development of HIIT guidelines.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/myprospero, identifier CRD42023460252.

Home-based exercise and PHysical activity maintenance interventiOn after livEr traNsplantation: Impact of eXercise intensity (PHOENIX-Liver)

Liver transplant recipients experience comorbidities, including impaired physical fitness, which could be managed by exercise and physical activity interventions. This study aims to evaluate the feasibility, clinical effectiveness and cost-effectiveness of a 6-month exercise intervention, followed by a 15-month tailored physical activity maintenance intervention, in de novo liver transplant recipients. This single-centre, randomised, controlled, single-blinded trial will recruit 147 adult liver transplant recipients at 3-5 months post-transplant. Participants will be randomised into (1) 6 months of enhanced usual care, not followed by a physical activity intervention (control (CON) group, n=49), (2) 6 months of moderate-intensity exercise training, followed by a physical activity intervention (moderate-intensity training (MIT) group; n=49) or (3) consecutively 3 months of moderate-intensity exercise training, 3 months of high-intensity interval training and a physical activity intervention (moderate and high-intensity training (MHIT) group; n=49). Exercise training will consist of home-based stationary bicycling and muscle-strengthening exercises, partially supervised by participants' local physiotherapists. The physical activity intervention includes an array of behaviour change techniques. Primary hypothesis: after the exercise intervention, peak oxygen uptake (V̇O2peak) will be higher in MHIT versus CON (α-level 0.05). Secondary hypotheses: after the exercise intervention, V̇O2peak will be higher in MIT versus CON and MHIT versus MIT (α-level 0.025). Secondary outcomes, assessed up to 2 years post-transplant, include physical fitness, cardiovascular and graft health, quality of life, physical activity and implementation outcomes. Trial registration number NCT06302205.

Exercise-based cardiac rehabilitation in patients with left ventricular assist devices: an updated systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Data on the efficacy and safety of exercise-based cardiac rehabilitation (EBCR) in patients with left ventricular assist devices (LVAD) remains limited. This study aims to pool evidence on EBCR's efficacy and safety in LVAD patients and compare high-intensity (HIIT) versus moderate-intensity (MIIT) regimens.

METHODS

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Embase, Cochrane, Scopus, and Web of Science up to January 2024. A fixed-effects model reported dichotomous outcomes using risk ratio (RR) and continuous outcomes using standardized mean difference (SMD) with a 95% confidence interval (CI). The study was registered in PROSPERO under the identifier 'CRD42024506485.'

RESULTS

Six RCTs with 160 patients were included. No significant difference was found between EBCR and usual care for peak VO2 change [p = 0.22] and six-minute walk distance (6-MWD) change [p = 0.16]. Similarly, no significant difference was observed between HIIT and MICT for peak VO2 change [p = 0.52] and 6-MWD change [p = 0.61]. Moreover, there was no significant difference between EBCR and usual care regarding the incidence of adverse events [p = 0.09], and between HIIT and MICT exercise [p = 0.71].

CONCLUSION

The evidence suggests EBCR does not improve functional capacity, measured by peak VO2 or 6-MWD, in LVAD patients. However, EBCR is safe, with similar adverse event rates compared to usual care.

Comparative effectiveness of exercise interventions on arterial stiffness in individuals at risk for cardiovascular disease: a systematic review and network meta-analysis

Background

Previous studies have shown that exercise can improve arterial stiffness (AS). However, it remains unclear which type of exercise is most effective for managing AS, particularly in individuals at high risk for cardiovascular diseases (CVD). This review aims to evaluate the effects of various exercises on AS and related variables in individuals at high risk for CVD.

Methods

A comprehensive search strategy was employed to systematically explore MEDLINE (PubMed), Embase, Cochrane Library, EBSCOhost, and Web of Science to identify relevant studies. Inclusion criteria were: (1) randomized controlled trials; (2) participants with known CVD risk factors as per the American College of Sports Medicine guidelines; (3) interventions including interval training (INT), aerobic exercise (AE), resistance exercise, and combined exercise (CT); (4) control groups engaging in no intervention, routine care, or health education; (5) outcome measures of pulse wave velocity (PWV), systolic blood pressure (SBP), and diastolic blood pressure; and (6) studies published in English. Studies were assessed using the Cochrane risk of bias tool and analyzed with a random-effects network meta-analysis.

Results

The review included 2,034 participants from 43 studies. Both CT [standardized mean difference (SMD) = -0.98, p < 0.001, I 2 = 84%] and INT (SMD = -0.77, p < 0.001, I 2 = 61%) significantly reduced PWV, but both showed considerable heterogeneity. INT (SMD = -0.382, p < 0.001, I 2 = 45%) and AE (SMD = -0.369, p < 0.001, I 2 = 43%) significantly reduced SBP. Surface under the cumulative ranking curve (SUCRA) showed that CT (SUCRA = 87.2) was the most effective for lowering PWV, while INT (SUCRA = 81.3) was the most effective for lowering SBP.

Conclusion

In high-risk populations for CVD, CT was most effective in improving AS, while INT demonstrated the greatest reduction in SBP. AE showed greater benefits at moderate to low intensities. Due to significant heterogeneity in CT, its results should be interpreted with caution. Further research with larger sample sizes is needed to confirm these findings.

Physiological adaptations and performance enhancement with combined blood flow restricted and interval training: A systematic review with meta-analysis

OBJECTIVES

We aimed to determine: (a) the chronic effects of interval training (IT) combined with blood flow restriction (BFR) on physiological adaptations (aerobic/anaerobic capacity and muscle responses) and performance enhancement (endurance and sprints), and (b) the influence of participant characteristics and intervention protocols on these effects.

METHODS

Searches were conducted in PubMed, Web of Science (Core Collection), Cochrane Library (Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform), and Chinese National Knowledge Infrastructure on April 2, with updates on October 17, 2024. Pooled effects for each outcome were summarized using Hedge's g (g) through meta-analysis-based random effects models, and subgroup and regression analyses were used to explore moderators.

RESULTS

A total of 24 studies with 621 participants were included. IT combined with BFR (IT+BFR) significantly improved maximal oxygen uptake (VO2max) (g = 0.63, I2 = 63%), mean power during the Wingate 30-s test (g = 0.70, I2 = 47%), muscle strength (g = 0.88, I2 = 64%), muscle endurance (g = 0.43, I2 = 0%), time to fatigue (g = 1.26, I2 = 86%), and maximal aerobic speed (g = 0.74, I2 = 0%) compared to IT alone. Subgroup analysis indicated that participant characteristics including training status, IT intensity, and IT modes significantly moderated VO2max (subgroup differences: p < 0.05). Specifically, IT+BFR showed significantly superior improvements in VO2max compared to IT alone in trained individuals (g = 0.76) at supra-maximal intensity (g = 1.29) and moderate intensity (g = 1.08) as well as in walking (g = 1.64) and running (g = 0.63) modes. Meta-regression analysis showed cuff width (β = 0.14) was significantly associated with VO2max change, identifying 8.23 cm as the minimum threshold required for significant improvement. Subgroup analyses regarding muscle strength did not reveal any significant moderators.

CONCLUSION

IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance, with moderators including training status, IT protocol (intensity, mode, and type), and cuff width. This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.

High Intensity Interval Training and Arterial Hypertension: Quality of Reporting

The benefits of exercise have been well described for the treatment of hypertension. Poor reporting quality impairs quality appraisal and replicability. High intensity interval training (HIIT) has been shown to be an effective alternative to traditional aerobic exercise in patients with hypertension. We evaluated the completeness of reporting of randomized controlled trials (RCTs) with HIIT for hypertension and to compare both exercise modes in reporting quality. RCTs of HIIT with a minimum duration of 6 weeks in adults with at least high normal blood pressure (≥130 mmHg/≥85 mmHg) were evaluated using the Consensus on Exercise Reporting Template (CERT). Nine RCTs conducting HIIT in hypertensive patients (N=718; 51.8 years) were evaluated. A mean of 62.6% of items were sufficiently described, compared with 49.2% in moderate intensity training interventions. Exercise dose was adequately reported in 8 out of 9 studies. Only one study reported information on adverse events. In a small sample of RCTs with HIIT in patients with hypertension we found a better reporting quality than in moderate intensity training interventions. However, reporting completeness is not optimal for a good replicability in clinical practice. The lack of reporting of adverse events in interventions using high intensities is particularly unfavourable.

A comparison of the acute effects of high intensity interval training and moderate intensity continuous training on working memory and emotional state in adolescent women with subthreshold depression

Objective

Various guidelines emphasize the cognitive and emotional benefits of physical activity. However, it is not yet clear what kind of exercise intensity is suitable for individuals with subthreshold depression. Therefore, this study aims to examine the effects of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on the working memory and emotional state.

Methods

Forty-nine female students with subthreshold depression (mean age 16.3 ± 0.5 yrs) completed 20-min group of sit (SIT), MICT, and HIIT on separate days in a counterbalanced order. The modified n-back task was employed to evaluate working memory. Emotional state was assessed using the Feeling Scale (FS) and Felt Arousal Scale (FAS).

Results

Regarding working memory, for accuracy, SIT (82.41 ± 13.79%), MICT (81.79 ± 13.19%) and HIIT (82.06 ± 11.36%) have no significant difference (all p > 0.05). However, for reaction time, MICT (459.86 ± 131.47 ms) is significantly faster than HIIT (491.16 ± 115.68 ms) (p = 0.046), and there is no significant difference between MICT and SIT (462.71 ± 120.64 ms) (p > 0.05). Concerning emotional state, for arousal, FAS scores significantly increased after both HIIT (2.39 ± 1.30 to 3.76 ± 1.12, p < 0.001) and MICT (2.55 ± 0.88 to 3.94 ± 1.08, p < 0.001) compared to pre-exercise, and the increase caused by them was significantly higher than that of SIT (HIIT: p = 0.011; MICT: p < 0.01). For pleasure, the increase in FS score after MICT (-0.27 ± 1.13 to 1.06 ± 1.79) was significantly higher than that of SIT (0.32 ± 1.38 to 0.58 ± 1.53) (p < 0.01).

Conclusion

Acute MICT can enhance working memory and improve the emotional state of adolescent women with subthreshold depression, while HIIT may decrease working memory and pleasure in this particular population.

Changes in the reactive hyperemia index after continuous and interval exercise

INTRODUCTION

High-intensity interval exercise (HIIE) is more effective than moderate-intensity interval exercise (MICE) for improving macrovascular function (e.g., flow-mediated dilation), but less is known regarding the effect of HIIE on microvascular function. We used peripheral artery tonometry to measure the reactive hyperemia index (RHI) and examine the acute effects of HIIE and MICE on microvascular function.

METHODS

Ten healthy participants (50% men, age: 26 ± 5 years, mass: 75.6 ± 15.1 kg, height: 170 ± 10 cm, body mass index: 26.0 ± 3.1 kg∙m-2) performed single bouts of HIIE and MICE cycling on separate occasions. The MICE protocol was 20 min at 60% of maximum power output. The HIIE protocol was a 12-min warm up at 50% of maximum power output immediately followed by an 8-min Tabata protocol where participants alternated between cycling at ⩾ 100% max power (20 sec) and rest (10 sec). The RHI was measured before, immediately after, and 1 h after exercise and compared by two-way repeated measures analysis of variance (condition [MICE, HIIE] and time [pre-, post-, and 1-h postexercise]).

RESULTS

Compared to baseline, RHI increased 1 h after MICE only (p = 0.02). Heart rate was higher during MICE at 5 and 10 min (p = 0.02) and higher during HIIE at min 20 (p < 0.01).

CONCLUSION

Within a sample of healthy adults, the RHI was improved 1 h after a single session of MICE but not HIIE. Future research is needed to determine the significance of the differential effects of exercise regimens on the macro- and microvasculature.

Exercise type and settings, quality of life, and mental health in coronary artery disease: a network meta-analysis

BACKGROUND AND AIMS

Individuals with coronary artery disease have poorer mental health, health-related quality of life (HR-QoL), and cognition compared with (age-matched) controls. Exercise training may attenuate these effects. The aim is to systematically review and meta-analyse the effects of different exercise types and settings on brain structure/function, cognition, HR-QoL, mental health (e.g. depression, anxiety), and sleep in patients with coronary artery disease.

METHODS

A systematic search was conducted and a network meta-analysis compared (i) exercise types, high-intensity interval training (HIIT), HIIT + resistance (HIIT + R), moderate-intensity training (MIT), MIT + R and stretching-toning-balance training, and (ii) exercise settings, in-person and home-based.

RESULTS

A total of 42 randomized controlled trials with a parallel group design were identified, of which 36 were included in the meta-analysis. Few studies included cognition (n = 2), sleep (n = 2), and none brain structure/function (n = 0). Most studies examined HR-QoL (n = 30), depression (n = 15), and anxiety (n = 9), in which outcomes were meta-analysed. HIIT + R, HIIT, and MIT were associated with improved HR-QoL vs. no exercise (i.e. usual care) [standardized mean difference, SMD: 1.53 (95% confidence interval 0.83; 2.24), 0.44 (0.15; 0.73), and 0.44 (0.20; 0.67), respectively]. In-person exercise was associated with larger and significant improvements [HR-QoL SMD: 0.51 (0.28; 0.74), depressive SMD: -0.55 (-1.03; -0.07), and anxiety symptoms SMD: -1.16 (-2.05; -0.26)] compared with no exercise, whereas home-based programmes were not significantly associated with improvements in these outcomes. Findings were robust in secondary (i.e. intervention duration and volume) and sensitivity analyses excluding high risk of bias studies.

CONCLUSIONS

Exercise training, especially in-person sessions, was associated with improved HR-QoL, depression and anxiety, independently of exercise type. However, this study raises concern about the effectiveness of home-based programmes in improving these outcomes.Study protocol was registered in PROSPERO (ID: CRD42023402569).

Exercise snacks and physical fitness in sedentary populations

Physical inactivity remains a pressing global public health concern. Prolonged periods of sedentary behavior have been linked to heightened risks of non-communicable diseases such as cardiovascular diseases and type 2 diabetes, while engaging in any form of physical activity can elicit favorable effects on health. Nevertheless, epidemiological research indicates that people often struggle to meet recommended physical activity guidelines, citing time constraints, lack of exercise equipment, and environmental limitations as common barriers. Exercise snacks represents a time-efficient approach with the potential to improve physical activity levels in sedentary populations, cultivate exercise routines, and enhance the perception of the health benefits associated with physical activity. We review the existing literature on exercise snacks, and examine the effects of exercise snacks on physical function and exercise capacity, while also delving into the potential underlying mechanisms. The objective is to establish a solid theoretical foundation for the application of exercise snacks as a viable strategy for promoting physical activity and enhancing overall health, particularly in vulnerable populations who are unable to exercise routinely.

Acute high-intensity interval exercise is superior to moderate-intensity continuous exercise in enhancing endothelial function and its associated biomarkers in sedentary young individuals: the possible involvement of lactate

Objectives

Our study investigated the effects of acute high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on endothelial function and its associated biomarkers in sedentary young individuals.

Methods

Fifteen subjects (10M / 5F; 22 ± 2 years; BMI: 23.07 ± 4.12 kg/m2) participated in a crossover trial including three experimental conditions: HIIE, MICE, and a control session of rest (CON) in random order separated by a 7-day washout period. Endothelial function was assessed using flow-mediated dilation (FMD), mean shear rate (MSR), and circulating levels of blood lactate, VEGF, IGF-1, and irisin.

Results

Both HIIE and MICE significantly enhanced FMD% (both P < 0.001 and P < 0.01, respectively), lactate (both P < 0.001), VEGF (P < 0.001 and P < 0.01, respectively), IGF-1 (both P < 0.001), and irisin (P < 0.001 and P < 0.05, respectively), with a greater extent after HIIE compared to MICE in FMD% (P < 0.001), MSR (P < 0.05), lactate (P < 0.001), VEGF (P < 0.05), and IGF-1 (P < 0.05). Additionally, change (post-pre) in FMD% was positively correlated with changes in MSR, lactate, and VEGF in both HIIE and MICE conditions. Change in MSR was positively associated with changes in lactate and VEGF in both HIIE and MICE conditions. Furthermore, enhancement in lactate was correlated with enhancements in VEGF in both HIIE and MICE conditions.

Conclusions

Acute HIIE is a more effective method than MICE at improving endothelial function in sedentary young individuals and increases in lactate and its mediated VEGF release, attributed to increase in shear rate after exercise, are involved in regulatory mechanisms.

Effects of High-Intensity Interval Training on Blood Pressure Levels in Hypertensive Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

OBJECTIVE

This systematic review and meta-analysis aimed to (I) evaluate the evidence on the effects of high-intensity interval training (HIIT) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive patients; (II) determine whether HIIT impacts SBP and DBP differently; and (III) assess the clinical relevance of these effects.

METHODS

A comprehensive search was conducted across multiple electronic databases, resulting in the inclusion of seven randomized clinical trials in the meta-analysis. The outcomes were analyzed using random-effects models to compute mean differences (MD) and standardized mean differences (SMD) for SBP and DBP.

RESULTS

A small reduction in SBP was observed with HIIT interventions (MD -3.00; 95% CI -4.61 to -1.39; p < 0.0001; SMD -0.28; 95% CI -0.42 to -0.13; p = 0.0003). However, no statistically significant reductions were detected for DBP (MD -0.70; 95% CI -1.80 to 0.39; p = 0.21; SMD -0.07; 95% CI -0.22 to 0.08; p = 0.35). Despite demonstrating statistical significance for SBP, the effects did not reach clinical relevance.

CONCLUSIONS

HIIT interventions yield small reductions in SBP, with minimal impact on DBP. These findings suggest limited clinical relevance in the management of hypertension. Further randomized controlled trials are necessary to standardize HIIT protocols, with specific emphasis on intensity control and manipulation, to better understand their potential role in hypertensive populations.

VascuFit: Aerobic exercise improves endothelial function independent of cardiovascular risk: A randomized-controlled trial

BACKGROUND AND AIMS

Endothelial dysfunction predicts elevated cardiovascular (CV) risk in healthy individuals. Aerobic exercise reduces endothelial dysfunction in part by improving CV risk factors. Yet, this explains less than 50 % of the effect and a direct influence of exercise training on the endothelium is discussed as possible contributor. The VascuFit study applied non-linear periodized aerobic exercise (NLPE) training to assess its multilevel effects on endothelial function including potential epigenetic endothelial modifications by circulating micro-ribonucleic acids (endomiRs).

METHODS

Sedentary adults with elevated CV risk between 40 and 60 years were randomized 2:1 and engaged in an eight-week ergometer-based NLPE training (n = 30) or received standard exercise recommendations (n = 14). Macro-, microvascular, cellular and molecular adaptations were assessed via brachial-arterial flow-mediated dilation (baFMD), static retinal vessel analysis (SVA), flow cytometry, and endomiRs regulating key pathways of endothelial function. Statistics included ANCOVA, Principal Component Analysis (PCA), and regression analyses.

RESULTS

baFMD improved by 2.38 % (CI:0.70-4.06, p = 0.007) independent of CV risk, whereas SVA parameters and circulating endothelial (progenitor) cells did not significantly change in the NLPE group. The mean distance between baseline and follow-up PCA loadings of the endomiR dataset explaining 44.2 % of dataset variability was higher in the NLPE-group compared to the control group (2.71 ± 2.02 vs. 1.65 ± 0.93). However, regression analyses showed no evidence of endomiRs explaining the improvement of baFMD.

CONCLUSIONS

The improvement of macrovascular endothelial function by aerobic exercise training was independent from CV risk factors. Increased heterogeneity among endomiRs did not explain this effect, but suggests an adaptive response to the exercise stimulus on the epigenetic level.

High-Intensity Interval Training vs. Medium-Intensity Continuous Training in Cardiac Rehabilitation Programs: A Narrative Review

Exercise-based cardiac rehabilitation (ExCR) programs are essential for patients diagnosed with cardiac diseases. Studies have shown that they aid in the rehabilitation process and may even facilitate a return to previous cardiorespiratory fitness. Also, patients who enroll and follow such programs have shown a lower rate of complications and mortality in the long run. The results vary depending on the type of program followed and the degree of debilitation the disease has caused. Therefore, in order to obtain optimal results, it is ideal to tailor each ExCR program to the individual profile of each patient. At the moment, the two most studied and employed training types are medium-intensity continuous training (MICT) and high-intensity interval training (HIIT). For most of the time, MICT was the first-choice program for patients with cardiovascular disease. In recent years, however, more and more studies have pointed towards the benefits of HIIT and how it better aids patients in recovering their cardiovascular fitness. Generally, MICT is more suited for patients with a severe degradation in functional capacity and who require a higher degree of safety (e.g., elderly, with a high number of comorbidities). On the other hand, while HIIT is more demanding, it appears to offer better outcomes. Therefore, this review aimed to summarize information from different publications on both types of training regimens in ExCR and assess their utility in current clinical practice.

Effect of different running protocols on bone morphology and microarchitecture of the forelimbs in a male Wistar rat model

BACKGROUND

It is accepted that the metabolic response of bone tissue depends on the intensity of the mechanical loads, but also on the type and frequency of stress applied to it. Physical exercise such as running involves stresses which, under certain conditions, have been shown to have the best osteogenic effects. However, at high intensity, it can be deleterious for bone tissue. Consequently, there is no clear consensus as to which running modality would have the best osteogenic effects.

AIM

Our objective was to compare the effects of three running modalities on morphological and micro-architectural parameters on forelimb bones.

METHODS

Forty male Wistar rats were randomly divided into four groups: high intensity interval training (HIIT), continuous running, combined running ((alternating HIIT and continuous modalities) and sedentary (control). The morphometry, trabecular microarchitecture and cortical porosity of the ulna, radius and humerus were analyzed using micro-tomography.

RESULTS

All three running modalities resulted in bone adaptation, with an increase in the diaphyseal diameter of all three bones. The combined running protocol had positive effects on the trabecular thickness in the distal ulna. The HIIT protocol resulted in an increase in both medio-lateral diameter and cortical bone area over total area (Ct.Ar/Tt.Ar) at the ulnar shaft compared with sedentary condition. Moreover, the HIIT protocol decreased the mean surface area of the medulla (Ma.Ar) according to sedentary condition at the ulnar shaft.

CONCLUSION

This study has shown that HIIT resulted in a decrease in trabecular bone fraction in favor of cortical bone area at the ulna.

Aquatic High-Intensity Interval Deep Water Running Influence on Cardiometabolic Health and Cognitive Psychological Responses in Women

PURPOSE

To investigate the effects of an 8-wk AHIIT-DWR intervention compared with land-based HIT training (LHIIT) on cardiometabolic health, cognitive, and psychological outcomes in inactive elderly women.

METHODS

Seventy inactive elderly women aged 60 yr or above were randomly assigned into two groups: AHIIT-DWR and LHIIT. The AHIIT-DWR group engaged in DWR sessions comprising 30 min of interval training, consisting of ten 2-min exercise bouts at 80%-90% of their maximal heart rate (HR max ), with 1-min active recovery at 70% HR max between bouts, for two sessions per week, for 8 wk. The LHIIT group performed treadmill running at the same intensity.

RESULTS

Both groups showed similar cardiovascular fitness, maximal aerobic capacity (V̇O 2max ), HR max , and RER improvement ( P > 0.05), whereas AHIIT-DWR showed a significant improvement in aerobic capacity minute ventilation (V̇E), metabolic equivalents (METs), and O 2 pulse ( P < 0.05) over the 8-wk intervention. Both AHIIT-DWR and LHIIT significantly decreased triglycerides, total cholesterol, HDL, and LDL postintervention ( P < 0.05). No significant group differences were observed for cognitive function assessed by MMSE and MOCA ( P > 0.05). Both groups showed similar enjoyment levels, self-efficacy scores, and high adherence rates (>90%).

CONCLUSIONS

Our study suggests that AHIIT-DWR can elicit a similar improvement in cardiorespiratory health, metabolic blood markers, cognitive function assessed by MMSE and MOCA, and psychological responses as LHIIT in inactive elderly women.

Effects of high-intensity interval training versus moderate-intensity continuous training on vascular function among individuals with overweight and obesity-a systematic review

BACKGROUND

The study aimed to investigate and systematically review the evidence relating to the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on vascular function such as arterial diameter, arterial stiffness, pulse wave velocity, blood flow, etc. in individuals with overweight and obesity.

METHODS

The entire content of PubMed (MEDLINE), Scopus, SPORT Discus® (via EBSCO host), CINAHL, and Web of Science were searched. Only experimental research studies conducted in adult participants aged ≥18 years, published in English before January 2023 were included.

RESULTS

A total of 5397 studies were reviewed for the title and abstract with 11 studies being included for data extraction. The review resulted in a total of 346 individuals with overweight and obesity with body mass index (BMI) ranging between 25-36 kg/m2. HIIT and MICT intensities resulted in 85%-95% and 60%-70% maximal heart rate (MHR) respectively. Seven out of 11 studies showed some concerns about the overall risk of bias. Six of 11 studies reported improving vascular function following HIIT than MICT.

CONCLUSION

HIIT is a more effective and time-efficient exercise for enhancing vascular functions in individuals with overweight and obesity, leading to improvements in flow-mediated dilation by 3.9% and arterial diameter by 4.8%, compared to MICT.

The causes of pulmonary hypertension and the benefits of aerobic exercise for pulmonary hypertension from an integrated perspective

Pulmonary hypertension is a progressive disease of the pulmonary arteries that begins with increased pulmonary artery pressure, driven by progressive remodeling of the small pulmonary arteries, and ultimately leads to right heart failure and death. Vascular remodeling is the main pathological feature of pulmonary hypertension, but treatments for pulmonary hypertension are lacking. Determining the process of vascular proliferation and dysfunction may be a way to decipher the pathogenesis of pulmonary hypertension. In this review, we summarize the important pathways of pulmonary hypertension pathogenesis. We show how these processes are integrated and emphasize the benign role of aerobic exercise, which, as an adjunctive therapy, may be able to modify vascular remodeling in pulmonary hypertension.

Eight weeks of high-intensity interval training versus stretching do not change the psychoneuroendocrine response to a social stress test in emotionally impulsive humans

PURPOSE

Research supports physical activity as a method to heighten stress resistance and resilience through positive metabolic alterations mostly affecting the neuroendocrine system. High-intensity interval training (HIIT) has been proposed as a highly effective time-saving method to induce those changes. However, existing literature relies heavily on cross-sectional analyses, with few randomised controlled trials highlighting the necessity for more exercise interventions. Thus, this study aims to investigate the effects of HIIT versus an active control group on the stress response to an acute psychosocial stressor in emotionally impulsive humans (suggested as being strong stress responders).

METHODS

The study protocol was registered online (DRKS00016589) before data collection. Sedentary, emotionally impulsive adults (30.69 ± 8.20 y) were recruited for a supervised intervention of 8 weeks and randomly allocated to either a HIIT (n = 25) or a stretching group (n = 19, acting as active controls). Participants were submitted to a test battery, including saliva samples, questionnaires (self-efficacy- and perceived stress-related), visual analogue scales (physical exercise- and stress-related), and resting electroencephalography and electrocardiography assessing their reaction to an acute psychological stressor (Trier Social Stress Test) before and after the exercise intervention.

RESULTS

HIIT increased aerobic fitness in all participants, whereas stretching did not. Participants from the HIIT group reported perceiving exercising more intensively than those from the active control group (ƞp2 = 0.108, p = 0.038). No further group differences were detected. Both interventions largely increased levels of joy post-TSST (ƞp2 = 0.209, p = 0.003) whilst decreasing tension (ƞp2 = 0.262, p < 0.001) and worries (ƞp2 = 0.113, p = 0.037). Finally, both interventions largely increased perceived levels of general self-efficacy (ƞp2 = 0.120, p = 0.029).

CONCLUSION

This study suggests that 8 weeks of HIIT does not change the psychoneuroendocrine response to an acute psychological stress test compared to an active control group in emotionally impulsive humans. Further replications of supervised exercise studies highly powered with active and passive controls are warranted.

Keys to the switch of fat burning: stimuli that trigger the uncoupling protein 1 (UCP1) activation in adipose tissue

As one of the main pathogenic factors of cardiovascular and cerebrovascular diseases, the incidence of metabolic diseases such as adiposity and metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing annually. It is urgent and crucial to find more therapeutic targets to treat these diseases. Mainly expressed in brown adipocytes, mitochondrial uncoupling protein 1 (UCP1) is key to the thermogenesis of classical brown adipose tissue (BAT). Furthermore, white adipose tissue (WAT) is likely to express more UCP1 and subsequently acquire the ability to undergo thermogenesis under certain stimuli. Therefore, targeting and activating UCP1 to promote increased BAT thermogenesis and browning of WAT are helpful in treating metabolic diseases, such as adiposity and MASLD. In this case, the stimuli that activate UCP1 are emerging. Therefore, we summarize the thermogenic stimuli that have activated UCP1 in recent decades, among which cold exposure is one of the stimuli first discovered to activate BAT thermogenesis. As a convenient and efficient therapy with few side effects and good metabolic benefits, physical exercise can also activate the expression of UCP1 in adipose tissue. Notably, for the first time, we have summarized and demonstrated the stimuli of traditional Chinese medicines that can activate UCP1, such as acupuncture, Chinese herbal formulas, and Chinese medicinal herbs. Moreover, pharmacological agents, functional foods, food ingredients, and the gut microbiota are also commonly associated with regulating and activating UCP1. The identification and analysis of UCP1 stimuli can greatly facilitate our understanding of adipose tissue thermogenesis, including the browning of WAT. Thus, it is more conducive to further research and therapy for glucose and lipid metabolism disorders.

Effects of aquatic and land high-intensity interval trainings on selected bio- and physiological variables among obese adolescents

Background

Obesity among adolescents have become a global public health problem. Exercises can effectively improve the bio-physiological factors of obese adolescents. High-intensive interval training (HIIT) has been applied to obese adolescents. Studies have reported that the Aquatic environment may bring the same or more positive exercise effects as the land environment. Therefore, the purpose of this study was to examine the effects of aquatic and land interventions on selected bio-and physiological variables among obese adolescences.

Methods

Twenty-eight obese adolescents who met the requirements participated in and completed this study. The participants were randomly assigned to Aquatic HIIT group (n=17) or Land HIIT group (n=11) for a four-week exercise intervention, 3 time/week. Each Intervention program was one-hour long, including 20 minutes of warm-up, 30 minutes of HIIT and 10 minutes of stretching and relaxation. Bio- and physiological variables including Anthropometry and body composition, Physical Function and blood pressure, and Lipid metabolism indexes were collected before and after the Aquatic and Land interventions.

Results

After four weeks of exercise interventions, the body mass, BMI, body fat rate, waist circumference, hip circumference and body water content were significantly reduced (p<0.05), and the lean body mass were significantly increased (p<0.05) in both groups. Both group exhibited significant effects in decreasing, systolic blood pressure (p<0.05), diastolic blood pressure (p<0.01), and increasing vital capacity and total energy consumption (p<0.05). The Aquatic HIIT group showed significant effects on reducing Rest heart rate (p<0.05), but no significant changes in Rest heart rate in Land HIIT group (p=0.364). The low-density lipoprotein cholesterol in both groups was significantly decreased (p<0.05). Moreover, the Aquatic HIIT group had significant better improvements (p<0.05) in lean body mass, waist circumference, waist-to-hip ratio, vital capacity and total energy consumption than Land HIIT group did.

Conclusions

The results of the present study demonstrated that in a short-term (4 weeks) both Aquatic and Land HIIT interventions may improve the body composition, physical function, blood pressure and low-density lipoprotein cholesterol (LDL-C) of overweight and obese adolescents. Furthermore, the Aquatic HIIT may be superior than the Land HIIT in weight control among the obese adolescents.

Effect of low-volume combined aerobic and resistance high-intensity interval training on vascular health in people with type 2 diabetes: a randomised controlled trial

PURPOSE

We compared the effects of low-volume combined aerobic and resistance high-intensity interval training (C-HIIT), combined moderate-intensity continuous training (C-MICT) and waitlist control (CON) on vascular health after 8-weeks of supervised training, and an additional 10-months of self-directed training, in adults with type 2 diabetes (T2D).

METHODS

Sixty-nine low active adults with T2D were randomised to 8-weeks of supervised C-HIIT (3 times/week, 78-min/week), C-MICT (current exercise guidelines, 4 times/week, 210-min/week) or CON. CON underwent usual care for 8-weeks before being re-randomised to C-HIIT or C-MICT. This was followed by 10-months of self-directed training for participants in C-HIIT and C-MICT. Vascular outcomes were evaluated at baseline, 8-weeks, and 12-months.

RESULTS

After 8-weeks, supervised C-HIIT significantly improved relative flow-mediated dilation (FMD) compared with CON (mean difference [MD] 0.8% [0.1, 1.4], p = 0.025). Although not significantly different from CON, the magnitude of change in relative FMD following 8-weeks of supervised C-MICT was similar (MD 0.8% [-0.1, 1.7], p = 0.080). There were no differences in haemodynamic indices, carotid-femoral pulse wave velocity (cfPWV), or aortic reservoir pressure between groups at 8-weeks. After 12-months, there was a significant reduction in haemodynamic indices (time effect, p < 0.05) for both C-HIIT and C-MICT, with no between-group difference. The reduction in cfPWV over 12-months was significantly greater in C-MICT than C-HIIT (group × time effect, p = 0.018). There was no difference in FMD over time or between groups at 12-months.

CONCLUSIONS

Short-term supervised C-HIIT and C-MICT both increased brachial artery FMD compared with CON. Long-term C-HIIT and C-MICT were beneficial for improving haemodynamic indices, but not brachial artery FMD. C-MICT was superior to C-HIIT for improving cfPWV at 12-months.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry Identifier ACTRN12615000475549.

High-intensity interval versus moderate-intensity continuous cycling training in Parkinson's disease: a randomized trial

Exercise training is recommended to improve the quality of life in those living with Parkinson's disease (PD); however, the optimal prescription to improve cardiorespiratory fitness and disease-related motor symptoms remains unknown. Twenty-nine participants with PD were randomly allocated to either 10 wk of high-intensity interval training (HIIT) (n = 15; 6 female) or moderate-intensity continuous training (MICT) (n = 14; 5 female). The primary outcome was the change in maximal oxygen consumption (V̇o2peak). Secondary outcomes included changes in the Unified Parkinson's Disease Rating Scale (UPDRS) Part III motor score, Parkinson's Fatigue Scale (PFS)-16, resting and exercise cardiovascular measures, gait, balance, and knee extensor strength and fatigability. Exercise training increased V̇o2peak (main effect of time, P < 0.01), with a clinically meaningful difference in the change following HIIT versus MICT (Δ3.7 ± 3.7 vs. 1.7 ± 3.2 mL·kg-1·min-1, P = 0.099). The UPDRS motor score improved over time (P < 0.001) but without any differences between HIIT versus MICT (Δ-9.7 ± 1.3 vs. -8.4 ± 1.4, P = 0.51). Self-reported subjective fatigue (PFS-16) decreased over time (P < 0.01) but was similar between HIIT and MICT groups (P = 0.6). Gait, balance, blood pressure (BP), and heart rate (HR) were unchanged with training (all P > 0.09). Knee extensor strength increased over time (P = 0.03) but did not differ between HIIT versus MICT (Δ8.2 ± 5.9 vs. 11.7 ± 6.2 Nm, P = 0.69). HIIT alone increased the muscular endurance of the knee extensors during an isotonic fatigue task to failure (P = 0.04). In participants with PD, HIIT and MICT both increased V̇o2peak and led to improvements in motor symptoms and perceived fatigue; HIIT may offer the potential for larger changes in V̇o2peak and reduced knee extensor fatigability.NEW & NOTEWORTHY The optimal exercise prescription to improve cardiorespiratory fitness and disease-related motor symptoms in adults with Parkinson's disease remains unknown. In a single-center randomized trial consisting of either 10 wk of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT), we found that both training modes increased V̇o2peak, with a larger clinically meaningful difference following HIIT. Both exercise modes improved motor symptoms and subjective fatigue, whereas HIIT increased the muscular endurance of the knee extensors.

Effects of high-intensity interval and continuous moderate aerobic training on fitness and health markers of older adults: A systematic review and meta-analysis

BACKGROUND

High-intensity interval training (HIIT) promotes similar or superior gains in physical fitness and health compared to continuous moderate-intensity training (MICT) in young individuals. However, the effectiveness of HIIT in older adults is uncertain.

OBJECTIVE

This meta-analysis compared the effects of HIIT and MICT on cardiorespiratory fitness, body composition, vascular, metabolic, and hormonal variables, cognitive function, and quality of life in older adults.

METHODS

PubMed, Embase, Cochrane, Web of Science, Scopus, and SportDiscus databases were searched from inception until December 2023. Trials included adults ≥ 60 y. Hedge's effect sizes (g) were calculated and study quality and features of training interventions were tested as moderators.

RESULTS

Twenty-nine trials including 1,227 subjects (65.4 ± 3.3 y). HIIT and MICT elicited significant (p < 0.021) and similar (p > 0.156) 'gs' for VO2max (0.722 vs. 0.490), maximal workload/peak power output ratio (0.290 vs. 0.372),% fat (-0.297 vs. -0.262), glycemia (-0.273 vs. -0.334), systolic (-0.465 vs. -0.341), and diastolic blood pressure (-0.566 vs. -2.311). HIIT (p < 0.04) but not MICT (p > 0.170) produced significant 'gs' for fat mass (-0.245 vs. -0.103), waist circumference (-0.239 vs. -0.116), testosterone (0.339 vs. 0.170), and complex Stroop test (-0.595 vs. -0.250). Increases in the VO2max occurred only in controlled trials after HIIT but not MICT (Q = 6.286, p = 0.012; HITT-g = 1.068, p < 0.0001 vs. MICT-g = 0.109, p= 0.596).

CONCLUSION

HIIT and MICT produced similar changes in most of the investigated variables. In trials with greater quality (controlled vs. non-controlled trials), cardiorespiratory gains were higher in HIIT vs. MICT. These findings suggest that HIIT might be suitable for improving fitness and health in older adults.

Impact of aging on maximal oxygen uptake in female runners and sedentary controls

The present study aimed to compare V̇O2max (absolute, adjusted to total body mass, and adjusted to lean mass) in recreational runners and sedentary women < and > 50 yr and verify the effect of aging and physical activity level on the three types of V̇O2 max expression. The study included 147 women:85 runners (45.7 ± 14.1 yr) and 62 sedentary controls (48.8 ± 9.8 yr). They were subjected to cardiopulmonary exercise testing for V̇O2 max measurement and a body composition test by dual-emission X-ray absorptiometry system. V̇O2max were expressed as absolute values (L/min), relative to total body mass values (mL/kg/min), and relative to lean mass values (mL/kgLM/min). The two-way analysis of variance revealed a significant interaction [F(2,131) = 4.43, p < 0.001] and effects of age group [F(2,131) = 32.79, p < 0.001] and physical activity group [F(2,131) = 55.64, p < 0.001] on V̇O2max (mL/min). V̇O2max (mL/kg/min) and V̇O2 max (mL/kgLM/min) were significantly influenced by age and physical activity levels. The multiple regression model explains 76.2 % of the dependent variable V̇O2max (mL/kg/min), age (β = -0.335, t = -7.841, p < 0.001), and physical activity group (β = -0.784, t = -18.351, p < 0.001). In conclusion, female runners had higher V̇O2 max values than sedentary women at all ages, even though aging has a greater impact on V̇O2 max in the runners group. In addition to cardiorespiratory fitness, women's metabolic lean mass function, as measured by V̇O2max adjusted by lean mass, is significantly influenced by aging. Finally, physical activity has a greater impact on V̇O2 max levels than aging.

Genome-wide association study of exercise-induced skeletal muscle hypertrophy and the construction of predictive model

The aim of the current study was to investigate interindividual differences in muscle thickness of the rectus femoris (MTRF) following 12 wk of resistance training (RT) or high-intensity interval training (HIIT) to explore the genetic architecture underlying skeletal muscle hypertrophy and to construct predictive models. We conducted musculoskeletal ultrasound assessments of the MTRF response in 440 physically inactive adults after the 12-wk exercise period. A genome-wide association study was used to identify variants associated with the MTRF response, separately for RT and HIIT. Using the polygenic predictor score (PPS), we estimated the genetic contribution to exercise-induced hypertrophy. Predictive models for the MTRF response were constructed using random forest (RF), support vector mac (SVM), and generalized linear model (GLM) in 10 cross-validated approaches. MTRF increased significantly after both RT (8.8%, P < 0.05) and HIIT (5.3%, P < 0.05), but with considerable interindividual differences (RT: -13.5 to 38.4%, HIIT: -14.2 to 30.7%). Eleven lead single-nucleotide polymorphisms in RT and eight lead single-nucleotide polymorphisms in HIIT were identified at a significance level of P < 1 × 10-5. The PPS was associated with the MTRF response, explaining 47.2% of the variation in response to RT and 38.3% of the variation in response to HIIT. Notably, the GLM and SVM predictive models exhibited superior performance compared with RF models (P < 0.05), and the GLM demonstrated optimal performance with an area under curve of 0.809 (95% confidence interval: 0.669-0.949). Factors such as PPS, baseline MTRF, and exercise protocol exerted influence on the MTRF response to exercise, with PPS being the primary contributor. The GLM and SVM predictive model, incorporating both genetic and phenotypic factors, emerged as promising tools for predicting exercise-induced skeletal muscle hypertrophy.NEW & NOTEWORTHY The interindividual variability induced muscle hypertrophy by resistance training (RT) or high-intensity interval training (HIIT) and the associated genetic architecture remain uncertain. We identified genetic variants that underlie RT- or HIIT-induced muscle hypertrophy and established them as pivotal factors influencing the response regardless of the training type. The genetic-phenotype predictive model developed has the potential to identify nonresponders or individuals with low responsiveness before engaging in exercise training.

Effect of high-intensity interval training on cardiometabolic component risks in persons with paraplegia: Results of a randomized controlled trial

The aim of this work is to determine the effect of upper-body high intensity interval training (HIIT) on cardiometabolic risks in individuals with chronic paraplegia. Twenty-seven individuals (14 females, 13 males, mean ± SD age: 46 ± 9 years) with chronic paraplegia (spinal cord injury between T2 and L5 >1-year post-injury) took part in a randomized controlled trial and were included in the final analysis. Participants in the HIIT group (n = 18) performed ∼30 min of arm crank exercise (60 s intervals at 80%-90% peak heart rate) four times per week, for 6 weeks. Participants in the control (CON) group (n = 9) were asked to maintain their habitual diet and physical activity patterns over the study period. Outcome measures were taken at baseline and follow-up. The primary outcome measures were fasting insulin, peak power output (PPO) and peak aerobic capacity (V ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ ). Secondary outcome measures included body composition, postprandial glycaemic control, fasting blood lipids, inflammatory biomarkers and resting blood pressure. Differences between groups were assessed by ANCOVA, using baseline values as a covariate. PPO was higher in the HIIT (101 W, 97-106) compared to the CON (90 W, 83-96) group at follow-up (P = 0.006). There were no differences in fasting insulin (P = 0.415) or relativeV ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ (P = 0.417). Postprandial Matsuda insulin sensitivity index (ISIMatsuda) was higher in the HIIT (5.42, 4.69-6.15) compared to the CON (3.75, 2.46-5.04) group at follow-up (P = 0.036). Six weeks of upper-body HIIT increased PPO and ISIMatsuda, with no other beneficial effect on cardiometabolic component risks in persons with chronic paraplegia. HIGHLIGHTS: What is the central question of this study? What is the effect of upper-body high intensity interval training (HIIT) on cardiometabolic component risks in individuals with chronic paraplegia? What is the main finding and its importance? Six weeks of upper-body HIIT increased PPO and improved insulin sensitivity, but had no beneficial effect on other cardiometabolic component risks in persons with chronic paraplegia. The large effect size observed for insulin sensitivity may be important in terms of reducing the risk of type-2 diabetes in this population.

MICT ameliorates hypertensive nephropathy by inhibiting TLR4/NF-κB pathway and down-regulating NLRC4 inflammasome

BACKGROUND

Hypertensive nephropathy (HN) is one of the main causes of end-stage renal disease (ESRD), leading to serious morbidity and mortality in hypertensive patients. However, existing treatment for hypertensive nephropathy are still very limited. It has been demonstrated that aerobic exercise has beneficial effects on the treatment of hypertension. However, the underlying mechanisms of exercise in HN remain unclear.

METHODS

The spontaneously hypertensive rats (SHR) were trained for 8 weeks on a treadmill with different exercise prescriptions. We detected the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on inflammatory response, renal function, and renal fibrosis in SHR. We further investigated the relationship between TLR4 and the NLRC4 inflammasome in vitro HN model.

RESULTS

MICT improved renal fibrosis and renal injury, attenuating the inflammatory response by inhibiting TLR4/NF-κB pathway and the activation of NLRC4 inflammasome. However, these changes were not observed in the HIIT group. Additionally, repression of TLR4/NF-κB pathway by TAK-242 inhibited activation of NLRC4 inflammasome and alleviated the fibrosis in Ang II-induced HK-2 cells.

CONCLUSION

MICT ameliorated renal damage, inflammatory response, and renal fibrosis via repressing TLR4/NF-κB pathway and the activation of NLRC4 inflammasome. This study might provide new references for exercise prescriptions of hypertension.

Comparative effects of high-intensity interval training and moderate-intensity continuous training on weight and metabolic health in college students with obesity

The purpose of this study was to compare the effects of High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) on weight, body composition, blood lipid indicators, and metabolic status in college students living with obesity. The study focused on a sample of 40 college students living with obesity, including 20 males and 20 females, aged between 18 and 25. Participants were randomly assigned to either the HIIT group or the MICT group. Both groups underwent an 8-week intervention, consisting of three sessions per week with alternate-day training. The MICT group's training consisted of continuous aerobic exercise for 35 min at 60-70% of maximum heart rate. The HIIT group engaged in 28 min of alternating high-intensity and low-intensity exercise, where the high-intensity phase was at 85-90% of maximum heart rate for 4 min, followed by a 3-min recovery period at 50-60% of maximum heart rate, repeated four times. Both groups underwent heart rate monitoring before and after the training sessions to ensure the accuracy of the training intensity. Within each group, further distinctions were made based on gender, resulting in the following subgroups: Male HIIT group (n = 10), Female HIIT group (n = 10), Male MICT group (n = 10), and Female MICT group (n = 10). Differences in anthropometric and biochemical indicators among the groups were analyzed, and the different effects of the two intervention strategies on the obese college student population were comprehensively evaluated. Compared to the baseline assessment, the HIIT group showed a more favorable declining trend than the MICT group in terms of body morphology and body composition, particularly in the aspect of body fat percentage (BF%). The male HIIT group, female HIIT group, male MICT group, and female MICT group respectively reduced by - 23.71%, - 26.76%, - 9.81%, - 7.16%. Male and female HIIT group experienced a more pronounced decrease compared to the MICT group, with the female HIIT group reducing an additional 3.75% more than the male HIIT group. Regarding intergroup differences, BF% significant differences were shown between male MICT group and the HIIT group (P < 0.05), and female MICT group and the HIIT group (P < 0.01). In terms of biochemical indicators, the HIIT group also presented a more favorable declining trend compared to the MICT group, with male HIIT participants showing more reduction than female HIIT participants, especially in total cholesterol (TC) (10.64%), low-density lipoprotein cholesterol (LDL-C) (11.73%), alanine aminotransferase (ALT) (11.99%), and uric acid (UA) (11.76%). Regarding triglycerides (TG), significant intergroup differences were observed between male MICT and HIIT groups (P < 0.01) and female MICT and HIIT groups (P < 0.01). Concerning ALT, a significant difference was shown between female MICT and HIIT groups (P < 0.01), while no significant difference was observed among male participants. Overall, for college students living with obesity, both HIIT and MICT have shown positive effects. Among these, HIIT demonstrates greater effectiveness compared to MICT in BF% and biochemical markers.

Effects of aquatic and land high intensity interval training on hemodynamics and vascular function of middle-aged men

Objective: To investigate the effects of 8-week aquatic and land high intensity interval training (HIIT) on hemodynamics and vascular function in middle-aged men. Methods: Thirty middle-aged men with low physical activity were selected and divided into 15 men (52.43 ± 4.11) in aquatic group and 15 men (52.74 ± 5.62) in land group by random number table. They performed HIIT exercise in aquatic and land 3 times a week for 8 weeks. Pre-test, inter-test and post-test respectively measure hemodynamics and blood vessel function. Results: (1) Body composition: After 8 weeks of exercise, weight, body mass index (BMI) and body fat rate (BF) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of BF in the aquatic group was better than that in the land group (p < 0.05); (2) Cardiac function: After 8 weeks of exercise, stroke volume (SV), left ventricular end-diastolic volume (EDV), cardiac output (CO), and left ventricular fractional shortening (FS), were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05), heart rate (HR) and left ventricular end-systolic volume (ESV) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SV, HR, EDV, ESV, CO and FS in the aquatic group was better than that in the land group (p < 0.05); (3) Hemodynamics: After 8 weeks of exercise, systolic blood pressure (SBP), diastolic blood pressure (DBP) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05), wall shear stress (WSS) and peak systolic velocity (PSV) were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SBP, WSS and PSV in the aquatic group was better than that in the land group (p < 0.05); (4) Vascular function: basal diameter and brachial artery flow-mediated dilatation (FMD) level in aquatic group and land group was higher than before exercise, pulse wave velocity (PWV) level was lower than before exercise (aquatic and land group: p < 0.05). The improvement of FMD in the aquatic group was better than that in the land group. Conclusion: The body composition, hemodynamics and vascular function of middle-aged men were improved by 8-week aquatic and land HIIT. Aquatic HIIT has better effect on body fat rate, hemodynamics and vascular endothelial function in middle-aged men due to the effect of aquatic pressure and temperature.

Impact of Endurance Exercise Training on Biomarkers of Aortic Endothelial Damage in Diabetic Rats

Given the heightened risk of diabetes-related cardiovascular events associated with inactivity, this study investigates the molecular mechanisms of vascular damage in streptozotocin (STZ)-induced diabetic rats. The aim is to elucidate the impact of different exercises (interval and continuous training) and metformin on biochemical parameters, aortic injury, oxidative stress, and inflammation to provide insights into potential therapeutic interventions for diabetes-associated vascular complications. Male Wistar rats were administered a single dose of STZ (60 mg/kg) to induce diabetes. Diabetic rats underwent either interval training or continuous training (40 min/day, 5 days/week, 6 weeks), received metformin (300 mg/kg), or a combination of metformin and exercise. After 6 weeks, biochemical parameters in serum and oxidative stress markers and mRNA expression of endothelial nitric oxide synthase (eNOS), lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), and intercellular adhesion molecule-1 (ICAM-1) in aorta tissue were assessed. Serum levels of fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), TG/HDL, TC/HDL, and LDL/HDL ratios were significantly reduced in all treatment groups compared to the diabetes group. Both types of exercises, metformin, and exercise+metformin combinations, significantly reduced oxidative stress by decreasing malondialdehyde (MDA) and enhancing the antioxidant status in the aortic tissue compared to the diabetic group. In addition, in exercise groups, metformin, and combination groups, the expression of eNOS was significantly elevated, while LOX-1 and ICAM-1 expression significantly decreased compared to the diabetic group. In most cases, the combination of exercise and metformin (especially interval training) was more effective than exercise alone. It seems that exercise along with taking metformin can be considered as a therapeutic method by improving hyperglycemia and hyperlipidemia and reducing oxidative stress and vascular inflammatory responses, leading to ameliorating biomarkers function related to endothelial damage in experimental diabetes conditions.

Effects of different exercise interventions on cardiopulmonary function in male tobacco-dependent college students

This study investigated the effects of different exercise interventions on cardiopulmonary function in male tobacco-dependent college students. Forty-five male tobacco-dependent college students were recruited as the tobacco-dependent (TB) group, and 45 non-tobacco-dependent college students were recruited as the control group. The TB group was randomly assigned to three subgroups: non-exercise (NE), high-intensity interval training (HIIT), and moderate-intensity continuous training (MICT). The HIIT and MICT groups underwent a 10-week exercise training, while the NE group received no intervention. Cardiac parameters, including maximal oxygen uptake (VO2max), heart rate max (HRmax), and heart rate reserve (HRR), and pulmonary indicators, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), vital capacity (VC), maximum ventilation volume (MVV), and peak expiratory flow (PEF) were investigated. The results showed that the TB group had significantly lower cardiopulmonary function than the control group. The degree of tobacco dependence was negatively correlated with VO2max, FVC, FEV1, FEV1/FVC, and MVV. Furthermore, both HIIT and MICT training improved cardiopulmonary function. HIIT training exhibited superior efficacy compared to MICT in improving HRmax, HRR, FVC, FEV1, FEV1/FVC, and PEF. In conclusion, tobacco dependence adversely affects cardiopulmonary function in male college students. Both HIIT and MICT effectively improved cardiopulmonary function, with HIIT showing superior efficacy.

Effectiveness of traditional chinese medicine (TCM) exercise therapy intervention on the cognitive function in the elderly: A systematic review and meta-analysis

OBJECTIVES

There exists a deficiency in a distinct understanding of the intervention effects of Traditional Chinese Medicine (TCM) exercise therapies (Tai Chi, Yi Jin Jing, Ba Duan Jin, Liu Zi Jue, Qigong, Wu Qin Xi etc.) on cognitive function and its moderating variables in the elderly. This study aims to systematically evaluate the effects of TCM exercise therapies on the cognitive function of the elderly and further propose the best exercise intervention programme to delay the cognitive decline of the elderly.

METHODS

PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies.

RESULTS

A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes.

CONCLUSION

TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.

The PAD-adapted 30-20-10 during Nordic walking: A new exercise training session in patients with symptomatic peripheral artery disease

This study aimed to investigate the feasibility of a peripheral artery disease (PAD)-adapted 30-20-10 Nordic walking session in patients with symptomatic PAD and to compare the cardiovascular response of this new training session to a traditional walking (TW) and 4 × 4 minutes Nordic walking session. This is a prospective observational study. Patients with Fontaine stage II PAD were included. Patients participated in Nordic walking sessions, which were randomly assigned as TW, 4 × 4 minute intervals, and peripheral artery disease adapted 30-20-10 exercise session (PAD-adapted 30-20-10 sessions). PAD-adapted 30-20-10 and 4 × 4 minutes sessions consisted of 4 repetitions of 4 minutes of effort followed by 3 minutes of passive recovery. PAD-adapted 30-20-10 session was characterized by 4 continuous 1-min repetitions at 3 different walking speeds [high (30 seconds), moderate (20 seconds) and low (10 seconds)]. During the 4 × 4 minutes session, patients were asked to cover the maximal distance at a constant speed. During TW session, patients were asked to walk at a speed inducing moderate-to-severe claudication pain. Heart rate, rating of perceived exertion (RPE) and claudication pain intensity using a visual analog scale were assessed. The perceived enjoyment of each session was assessed using a visual analog scale ranging from 0 (not enjoyable) to 10 (very enjoyable). Eleven patients with chronic symptomatic PAD were included (62 ± 13 years; 54% women). The mean heart rate during the time of effort was significantly higher in PAD-adapted 30-20-10 group than in 4 × 4 minutes and TW groups (127 ± 12, 122 ± 12, 114 ± 11 bpm, respectively; P ≤ .001). The mean rating of perceived exertion (16 ± 1, 15 ± 1, 13 ± 1; P ≤ .001) and claudication pain intensity (8 ± 1, 7 ± 1; 7 ± 1 mm; P ≤ .019) were significantly higher during PAD-adapted 30-20-10 sessions than during 4 × 4 minutes and TW sessions. The perceived enjoyment was similar among sessions (8.7 ± 1.6 for TW, 8.6 ± 1.7 for 4 × 4 minutes, and 8.8 ± 1.8 mm for PAD-adapted 30-20-10 sessions; P = .935). The PAD-adapted 30-20-10 session is feasible and induces higher cardiovascular stimulation and claudication pain than 4 × 4 minutes and TW procedures in patients with symptomatic PAD. Despite these different responses, a similar perceived enjoyment among the sessions has been shown. Future investigations are needed to examine the effects of this new training session in these patients.

Strategies for Improving Firefighter Health On-Shift: A Review

The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.

Shenqi Fuzheng injection facilitates skeletal muscle mitophagy mediated by the ubiquitination of HIF-1α to ameliorate cancer-associated fatigue

Cancer-related fatigue (CRF) significantly impacts the quality of life of cancer patients. This study investigates the therapeutic potential of Shenqi Fuzheng injection (SFI) in managing CRF, focusing on its mechanistic action in skeletal muscle. We utilized a CRF mouse model to examine the effects of SFI on physical endurance, monitoring activity levels, swimming times and rest periods. Proteomic analysis of the gastrocnemius muscle was performed using isobaric tags and liquid chromatography-tandem mass spectrometry to map the muscle proteome changes post-SFI treatment. Mitochondrial function in skeletal muscle was assessed via ATP bioluminescence assay. Furthermore, the regulatory role of the hypoxia inducible factor 1 subunit alpha (HIF-1α) signalling pathway in mediating SFI's effects was explored through western blotting. In CRF-induced C2C12 myoblasts, we evaluated cell viability (CCK-8 assay), apoptosis (flow cytometry) and mitophagy (electron microscopy). The study also employed pulldown, luciferase and chromatin immunoprecipitation assays to elucidate the molecular mechanisms underlying SFI's action, particularly focusing on the transcriptional regulation of PINK1 through HIF-1α binding at the PINK1 promoter region. Our findings reveal that SFI enhances physical mobility, reduces fatigue symptoms and exerts protective effects on skeletal muscles by mitigating mitochondrial damage and augmenting antioxidative responses. SFI promotes cell viability and induces mitophagy while decreasing apoptosis, primarily through the modulation of HIF-1α, PINK1 and p62 proteins. These results underscore SFI's efficacy in enhancing mitochondrial autophagy, thereby offering a promising approach for ameliorating CRF. The study not only provides insight into SFI's potential therapeutic mechanisms but also establishes a foundation for further exploration of SFI interventions in CRF management.

Physical Activity Intensity and Risk of Dementia

INTRODUCTION

Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity.

METHODS

This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0%-30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022.

RESULTS

Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%-30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA.

CONCLUSIONS

These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia.

Isometric Exercise Training and Arterial Hypertension: An Updated Review

Hypertension is recognised as a leading attributable risk factor for cardiovascular disease and premature mortality. Global initiatives towards the prevention and treatment of arterial hypertension are centred around non-pharmacological lifestyle modification. Exercise recommendations differ between professional and scientific organisations, but are generally unanimous on the primary role of traditional aerobic and dynamic resistance exercise. In recent years, isometric exercise training (IET) has emerged as an effective novel exercise intervention with consistent evidence of reductions in blood pressure (BP) superior to that reported from traditional guideline-recommended exercise modes. Despite a wealth of emerging new data and endorsement by select governing bodies, IET remains underutilised and is not widely prescribed in clinical practice. This expert-informed review critically examines the role of IET as a potential adjuvant tool in the future clinical management of BP. We explore the efficacy, prescription protocols, evidence quality and certainty, acute cardiovascular stimulus, and physiological mechanisms underpinning its anti-hypertensive effects. We end the review with take-home suggestions regarding the direction of future IET research.

Lowering blood pressure by exercise: investigating the effect of sweating

High blood pressure (hypertension), is a common medical condition, affecting millions of people and is associated with significant health risks. Exercise has been suggested to manage hypertension by inducing sweating and the corresponding loss of sodium and water from the body.Thus, a variety of epidemiological and clinical studies have been conducted to investigate the relationship between sweating and exercise-induced blood pressure reduction and its impacts on hypertension. The mechanisms underlying exercise-induced blood pressure reduction are complex and still not fully understood. However, several pathways have been suggested, including the loss of sodium and water through sweat, a decrease in peripheral resistance, and an improvement in endothelial function in the blood vessels. The decrease in sodium and water content in the body associated with sweating may result in a reduction in blood volume and thus a decrease in blood pressure. Moreover, the reduction in peripheral resistance is thought to be mediated by the activation of the nitric oxide synthase pathway and the release of vasodilators such as prostacyclin and bradykinin, which lead to vasodilation and, thus, a reduction in blood pressure. In conclusion, exercise-induced sweating and consequent sodium and water loss appear to be a reliable biological link to the blood pressure-reducing effects of exercise in hypertensive individuals. Additionally, the mechanisms underlying exercise-induced blood pressure reduction are complex and involve several biological pathways in the cardiovascular system. Therefore, understanding the role of sweat production in blood pressure management is important for developing effective exercise interventions to prevent and manage hypertension.

Home-Based Aerobic Interval Training Combined with Resistance Training Improved Daytime Dysfunction in Adults with Obesity and Sleep-Disordered Breathing

Introduction  There have been many barriers to exercising at a gym due to the coronavirus disease 2019 (COVID-19) pandemic worldwide. Home-based aerobic interval training (AIT) combined with resistance training (RT) may be helpful for obese adults with sleep-disordered breathing (SDB) to overcome those barriers and improve their subjective sleep disorders. Thus, the present study aimed to examine the effects of home-based AIT combined with RT on subjective sleep disorders in obese adults with SDB. Material and Methods  This study has a one-group pretest-posttest design. Twenty-one adults with obesity and SDB were assigned to perform 8 weeks of AIT combined with RT. Subjective sleep disorder variables including the Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire, and Epworth Sleepiness Scale were defined as primary outcomes. Anthropometric variables, physical fitness components, and blood biomarkers were assigned as secondary outcomes. All outcome measurements were examined at baseline and after 8 weeks of training. Results  Daytime dysfunction of PSQI was significantly improved after 8 weeks of the exercise program ( p  < 0.05). Upper and lower chest expansion and estimated maximum oxygen consumption were significantly increased after 8 weeks of the exercise program (all p  < 0.05). None of the blood biomarkers changed after 8 weeks of training. Conclusion  This study suggests that home-based AIT combined with RT effectively alleviates daytime dysfunction and seems to be more helpful in improving global PSQI in adults with obesity. Future studies with a larger sample size, under a controlled trial are recommended to prove the benefits of the exercise program.

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Given advances in antiretroviral therapy, the mortality rate for HIV infection has dropped considerably over recent decades. However, people living with HIV (PLWH) experience longer life spans coupled with persistent immune activation despite viral suppression and potential toxicity from long-term antiretroviral therapy use. Consequently, PLWH face a cardiovascular disease (CVD) risk more than twice that of the general population, making it the leading cause of death among this group. Here, we briefly review the epidemiology of CVD in PLWH highlighting disparities at the intersections of sex and gender, age, race/ethnicity, and the contributions of social determinants of health and psychosocial stress to increased CVD risk among individuals with marginalized identities. We then overview the pathophysiology of HIV and discuss the primary factors implicated as contributors to CVD risk among PLWH on antiretroviral therapy. Subsequently, we highlight the functional evidence of premature vascular dysfunction as an early pathophysiological determinant of CVD risk among PLWH, discuss several mechanisms underlying premature vascular dysfunction in PLWH, and synthesize current research on the pathophysiological mechanisms underlying accelerated vascular aging in PLWH, focusing on immune activation, chronic inflammation, and oxidative stress. We consider understudied aspects such as HIV-related changes to the gut microbiome and psychosocial stress, which may serve as mechanisms through which exercise can abrogate accelerated vascular aging. Emphasizing the significance of exercise, we review various modalities and their impacts on vascular health, proposing a holistic approach to managing CVD risks in PLWH. The discussion extends to critical future study areas related to vascular aging, CVD, and the efficacy of exercise interventions, with a call for more inclusive research that considers the diversity of the PLWH population.