Acute and Chronic Catabolic Responses to

Clinical effects and biological mechanisms of exercise on lumbar disc herniation

Lumbar Disc Herniation (LDH) is a syndrome in which lumbar disc degeneration, rupture of the annulus fibrosus, and herniation of the nucleus pulposus irritate and compress the nerve roots and cauda equina, resulting in the main manifestations of lumbar pain and/or lower extremity pain. There is evidence in various clinical areas that exercise is effective in treating LDH, and exercise intervention for more than 2 weeks reduces disease activity in LDH. However, the mechanism of exercise's action in reducing disease activity in LDH is unclear. In this article, we first summarize and highlight the effectiveness of exercise in treating LDH and provide guideline recommendations regarding exercise type, intensity, frequency, and duration. Then, we integrate the existing evidence and propose biological mechanisms for the potential effects of exercise on neuromechanical compression, inflammatory chemical stimuli, and autoimmune responses from the perspective of LDH pathogenesis as an entry point. However, a large body of evidence was obtained from non-LDH populations. Future research needs to investigate further the proposed biological mechanisms of exercise in reducing disease activity in LDH populations. This knowledge will contribute to the basic science and strengthen the scientific basis for prescribing exercise therapy for the routine clinical treatment of LDH.

Do Men and Women Differ in Hematological Adaptations to 24 Weeks of Crossfit® Training?

Regular exercise can modulate the immune system functioning through changes in the number and function of leukocytes as well as in red blood cells and other typical blood markers. High intensity exercise promotes increases in cytotoxic activity, phagocytic capacity, chemotaxis and cell apoptosis. The aim of the study was to compare the chronic effects of a 24-week training program using CrossFit® methodology on hematological variables of men vs. women. Twenty-nine CrossFit® athletes (35.3 ± 10.4 years, 175.0 ± 9.2 cm, 79.5 ± 16.4 kg) participated in the study. The blood count, the lipid profile and glucose markers were measured every two months during the study period. The erythrocyte count and hemoglobin concentrations increased in months 4 and 6 in men and women, respectively. Hematocrit levels increased in men in months 2, 4 and 6, while in women only in month 6. Red cell distribution width increased in men in month 6 when compared to the value in month 2. Segmented neutrophils increased in men in month 6 and eosinophil levels increased in women in month 6. Differences between the two sexes were observed in monocytes levels at baseline, as well as in months 2, 4 and 6. Cross-Fit® training increased red cell count indicators in both sexes, which may be related to increased erythropoiesis. Some white blood cell counts were altered and these differed between sexes. The number of lymphocytes remained stable throughout the experiment.

Sensorimotor expertise influences perceptual weight judgments during observation of a sport-specific gesture

This study aimed to investigate the role of sensorimotor expertise in evaluating relative weight of a lifted object during the observation of a sport-specific gesture, namely the deadlift. Fifty-six participants, assigned to three groups according to their experience in weight lifting, powerlifters, CrossFit® practitioners and naïve participants (controls), performed a perceptual weight judgments task. Participants observed videos showing a powerlifter executing a deadlift at the 80%, 90% and 100% of 1 repetition maximum (1RM) and answered a question about the weight of the lifted object. Participants' response accuracy and variability were evaluated. Findings showed that powerlifters were more accurate than controls. No differences appeared between powerlifter and CrossFit® practitioners, and between CrossFit® practitioners and controls. Response variability was similar in the three groups. These findings suggest that a fine sensorimotor expertise specific for the observed gesture is crucial to detect the weight of the object displayed in the observed movement, since it might allow detecting small changes in the observed movement kinematics, which we speculate are at the basis of the object weight recognition.

Physiological effects of regular CrossFit® training and the impact of the COVID-19 pandemic—A systematic review

CrossFit® is a functional fitness training program known for its day-to-day varying “Workouts of the Day” (WOD). In accordance with the ‘CrossFit® Level 1 Training Guide’, regular CrossFit® training sessions consist of Warm-up, Mobility, Skill/Power training, WOD, and Cool-down. Despite the fast-growing and widespread popularity, data on the practical implementation of the training program based on scientific evidence are rare. Therefore, the purpose of this study is to systematically review the existing literature on the physiological effects of regular CrossFit® training in full extent instead of stand-alone WODs and to examine the impact of the COVID-19 pandemic on the training behavior of CrossFit® athletes. A systematic search was conducted following the PRISMA guidelines in April 2022 and updated in July 2022 using the following databases: PubMed, SPORTDiscus, Scopus, and Web of Science. Using the keyword “CrossFit”, 1,264 records were found. Based on the eligibility criteria, 12 studies are included and separated by topics: acute-short term physiological response (n = 8), and impact of the COVID-19 pandemic (n = 4). The results show that studies of regular training sessions were rarely conducted and contradicted the existing knowledge of the physiological demands [e.g., heart rate (HR)] of CrossFit®. In detail, included studies demonstrate that training sessions last 30–60 min and provide a progressive increase in cardiovascular load up to maximal effort activity (>90% HRmax), differing from stand-alone WODs exclusively at high-intensity. Also, scarce research exists on COVID-19-pandemic-induced effects on training behavior, and studies are of moderate to low quality. There is still a lack of comprehensive analyses on the acute physiological effects of regular training sessions and the consequences of the COVID-19 pandemic in the scientific literature. Moreover, the inconsistent terminology used in CrossFit® research complicates generalized conclusions. Therefore, future research on the training methodology of CrossFit® needs to overcome terminological inequalities and examine scientifically the implementation of the concept by considering regular training sessions under practical settings.

Acute physiological outcomes of high-intensity functional training: a scoping review

Background

Systematic reviews and meta-analyses related to high-intensity functional training (HIFT) have been conducted. However, due to a restricted pool of available research, these investigations are often limited in scope. As such, a scoping review investigating the present literature surrounding the acute physiological response to HIFT-based exercise was chosen as a more appropriate structured review.

Methodology

A scoping review was conducted following Arksey and O'Malley's framework. Three large scale databases were searched to reveal any article pertaining to HIFT and related exercise terminology.

Results

A total of 2,241 articles were found during the initial search. Following this, titles, then abstracts, and full-texts were reviewed to determine inclusion eligibility. A total of 60 articles which investigated a combined total of 35 unique HIFT workouts were included within this review.

Conclusions

A variety of physiological parameters and HIFT workouts have been examined. Markers of intensity (e.g., blood lactate concentrations, heart rate) have been most consistently assessed across all studies, and these support the idea that HIFT workouts are typically performed at high-intensity. In contrast, the inclusion of most other measures (e.g., hormonal, markers of inflammation and damage, energy expenditure, performance) has been inconsistent and has thus, limited the possibility for making generalized conclusions. Differences in study methodologies have further impacted conclusions, as different studies have varied in sample population characteristics, workouts assessed, and time points. Though it may be impossible to comprehensively research all possible HIFT workouts, consistent adoption of population definitions and workload quantification may overcome this challenge and assist with future comparisons.

Salivary Diagnostic for Monitoring Strenuous Exercise-A Pilot Study in a Cohort of Male Ultramarathon Runners

Intense physical stress, such as that in ultramarathon running, affects the immune system. For monitoring in sports medicine, non-invasive methods, e.g., salivary analysis, are of interest. This pilot cohort study aimed to assess changes in salivary parameters in response to an ultramarathon. The results were compared to blood parameters. Male, healthy finishers (n = 9, mean age: 48 ± 8.8 years, mean height: 1.8 ± 0.1 m, mean weight: 72.5 ± 7.2 kg, mean BMI: 23.5 ± 1.9 kg/cm²) of a 160 km ultramarathon were included. Saliva and blood samples were collected at three time points: T1 (baseline), T2 (shortly after the ultramarathon) and T3 (after recovery). In saliva, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, albumin, IgA, α-amylase, aMMP-8, and neopterin were assessed via ELISA. In blood, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, blood cell counts, procalcitonin, CRP, osmolality, albumin, and α-amylase were analyzed. The statistical evaluation comprised longitudinal testing and cross-sectional testing between saliva and blood using ratios of T2 and T3 to baseline values. Various parameters in saliva and blood changed in response to the ultramarathon. Comparing blood and saliva, the longitudinal changes of testosterone (p = 0.02) and α-amylase (p = 0.03) differed significantly. Despite the limitations of the study, it underlines that saliva is an interesting option for comprehensive monitoring in sports medicine and necessitates further studies.

The Relationship between Exercise and Salivary Oxidative Stress: A Systematic Review

Salivary content has been reported as a potential biomarker for oxidative stress assessments especially in context of exercise-induced oxidative stress. This systematic review following PRISMA guidelines aimed to evaluate the effects of physical exercise and changes promoted in oxidative stress identified in saliva. Methods: Studies published up to May 2022 were searched in online databases (PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar). Risk of bias evaluation were performed using the Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Results: A total of 473 references were identified and 22 considered eligible. In this case 14 studies reported increase of antioxidant parameters in saliva while eight studies demonstrated increased lipid peroxidation after exercise. Regarding nitrite levels, two studies showed higher levels after exercise. The quality of evidence was very low due to high heterogeneity, inconsistency and indirectness among studies according Grading of Recommendations, Assessment, Development and Evaluation analysis. Conclusion: Increase of oxidative stress and antioxidant activity in saliva appears to be present after exercise, especially at moderate intensity. However, the wide variety of methods leads to divergent data. For precision in salivary assessments, new research with larger sample sizes and better participant matching are recommended.

The Effects of High-Intensity Multimodal Training in Apparently Healthy Populations: A Systematic Review

Background

High-intensity multimodal training (HIMT) is emerging as a popular training method that combines aerobic and resistance training throughout a single exercise session. The current literature is limited by a lack of terminology that broadly encompasses all styles of combined aerobic and resistance training. The magnitude of chronic or long-term (i.e.  ≥ 4 weeks) effects of HIMT participation on aerobic and muscular fitness also remains unclear. Additionally, one of many complex reasons for the growing popularity of HIMT may be attributed to the affective response to exercise, namely levels of enjoyment. However, this concept is not yet well understood across all styles of HIMT. A comprehensive systematic review is required to synthesise the available literature and attempt to provide an operational definition of HIMT to capture the breadth of combined training styles that exist.

Objective

The objective of this systematic review was to determine the chronic effects of HIMT participation on aerobic and muscular fitness and to compare HIMT to established concurrent training methods. Enjoyability and other adherence-related subjective responses were also examined in HIMT participants. This review critically assessed the level of evidence and feasibility of current HIMT guidelines.

Methods

A systematic literature search was conducted on PubMed, Web of Science and SPORTDiscus to identify studies up until March 2021.

Results

A total of 20 studies were included for review. Studies generally reported moderate to large effects on aerobic fitness and subjective responses in favour of HIMT interventions. Mixed outcomes were demonstrated in muscular fitness. These results should be treated with caution due to high risk of bias among included studies.

Conclusions

Few studies have assessed the chronic effects of HIMT participation on aerobic, and musculoskeletal adaptations and subjective responses, in particular exercise enjoyment. Research conclusions are limited by heterogeneity of experimental protocols and outcome measures. Furthermore, the inability of the literature to make adequate comparisons between various styles of HIMT and other concurrent training protocols limits understandings of the efficacy of HIMT.

Registration This systematic review was registered on the Open Science Framework (10.17605/OSF.IO/2RE4B; 26 March 2021).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00434-x.

Effects of 8 Weeks of High-Intensity Interval Training and Spirulina Supplementation on Immunoglobin Levels, Cardio-Respiratory Fitness, and Body Composition of Overweight and Obese Women

Simple Summary

Overweight and obese, like other forms of malnutrition, have been shown to affect immune function through changing immunoglobin or cardio-respiratory fitness levels and cell-mediated immune responses. Although calorie restriction and exercise are the most common therapies for obesity or overweight, it is unclear what kind of supplementation these people should take or how much exercise they should perform. Hence, in this study, we examined the effect of 8 weeks of high-intensity interval training (HIIT) with spirulina supplementation on the humoral immunity, cardio-respiratory fitness, and body composition of overweight and obese women. The results demonstrated that spirulina supplementation with HIIT not only decreased fat free mass but also boosted immunoglobin-A, which plays an important role in the immune system.

Abstract

Our study examined the effect of 8 weeks of high-intensity interval training (HIIT) and spirulina supplementation on the humoral immunity, cardio-respiratory fitness, and body composition of overweight and obese women. Thirty sedentary women (height: 161.7 ± 2.8 cm, body mass: 75.8 ± 8.4 kg, body mass index [BMI]: 28.8 ± 2.5 kg/m², age: 25.1 ± 6.7 years) were divided into three groups: placebo with HIIT group, spirulina group (SG), or combined group (CG). Exercise groups performed HIIT for 8 weeks, with three sessions per week and four to seven repetitions in each session of 30 s running and 30 s walking; the intensity was established at 90% of the maximum heart rate. Supplementation groups received 6 g of spirulina powder per day. Fasting blood samples were collected before and after 8 weeks to determine the concentrations of immunoglobulins (IgA and IgG). There was a significant group-by-time interaction for fat free mass (FFM; p = 0.001, f = 8.52, ηp² = 0.39) and IgA (p = 0.036, f = 3.86, ηp² = 0.22). The post hoc analysis revealed that CG reduced FFM significantly (p = 0.012, g = −0.55) after training. CG and SG showed significantly greater IgA concentrations after 8 weeks (p = 0.02, g = 0.70 and p = 0.001, g = 0.34, respectively). We conclude that spirulina supplementation with HIIT affects the body composition (lower FFM) but also boosts IgA, which plays an important role in the immune system.

Acute/Chronic Responses of Combined Training on Serum Pro-thermogenic/Anti-inflammatory Inducers and Its Relation With Fed and Fasting State in Overweight Type 2 Diabetic Individuals

Concentrations of pro-thermogenic/anti-inflammatory inductors are influenced by fed/fasting, sedentary/trained states, and metabolic pattern. However, there is a lack of information on the interactions of these conditions, especially in humans. Thus, the present study aimed to evaluate the chronic and acute training responses as well as the fed/fasted states of serum pro-thermogenic/anti-inflammatory inducers in overweight type 2 diabetics individuals. Fifteen individuals with type 2 diabetes [body mass index (BMI): 29.61 ± 3.60 kg/m2; age: 50.67 ± 3.97 years] participated in the study. In the pre- and post-experimental periods, baseline clinical parameters analyses were performed. Pro-thermogenic/anti-inflammatory inductors were evaluated pre/post-baseline and before, shortly after, and after 30′ and 60′ in the first and last sessions of a 16-week combined training (CT) period. These inducers were also compared for fasting and feeding before and after the training period. CT has improved baseline physical fitness, metabolic pattern, and it has also increased interleukin (IL)33 and FNDC5/irisin. In the first training session, there was a decrease in IL4, IL13, and IL33, besides an increase in FNDC5/irisin, and natriuretic peptides. In the last training session, there was an increase in natriuretic peptides and bone morphogenic protein 4 (BMP4). Differences in responses between the first and last training sessions were observed at certain post-session times for IL4, IL33, and natriuretic peptides, always with higher concentrations occurring in the last session. In evaluating the area under the curve (AUC) of the first and last training session, FNDC5/irisin, natriuretics peptides, and meteorin-like showed increased areas in the last training session. The pre-training fed state showed an increase in IL4 and IL33, while in fasting there was an increase in meteorin-like, natriuretic peptides, and FNDC5/irisin. In the post-training, IL4, IL13, and IL33 were increased in the fed state, while meteorin-like, natriuretic peptides, and FNDC5/irisin remained increased in the fast. Adaptation to physical training and a better metabolic pattern favor an improvement in the acute secretory pattern in part of pro-thermogenic and anti-inflammatory substances analyzed. The fed and fasting states also interfere differently in these substances, where fasting interferes with the increase of myokines, while the fed state induces an increase in interleukins.

Clinical Trial Registration: [http://www.ensaiosclinicos.gov.br/rg/RBR-62n5qn/], identifier [U1111-1202-1476].