Regular Exercise Improved Fatigue and Musculoskeletal Pain in Young Adult Psoriatic Patients without Psoriatic Arthritis

Fatigue and musculoskeletal pain are also frequent in patients with psoriasis (PsO) without arthritis (PsA). The current study aimed to assess the impact of an intervention program based on aerobic training to reduce fatigue and musculoskeletal pain in patients with PsO without PsA. A total of 118 male patients with PsO volunteered in the current interventional study and were randomly allocated to the experimental (n = 59) or control group (n = 59). The intervention consisted of a 16-week aerobic training program on a treadmill, three sessions per week, consisting of a warm-up, 35-50 min treadmill exercise (increasing 5 min/4 weeks) at a work intensity of 50-65% of peak heart-rate (increasing 5%/4 weeks), and cooling-down. The functional assessment of chronic illness therapy fatigue scale (FACIT-Fatigue), health assessment questionnaire disability index (HAQ-DI), and visual analog scale (VAS) were compared pre and post intervention. Nutritional intake, maximal aerobic power, lipid profile, serum markers of muscle damage, and body composition were also assessed. When compared to baseline, FACIT-Fatigue, HAQ-DI, and VAS scores were significantly improved without increasing markers of muscle damage. Fat mass percentage, lipid profile, and maximal oxygen consumption were also improved. In conclusion, a 16-week aerobic training program at moderate intensity was safe, well tolerated, and effective in psoriatic patients without PsA. Long-term follow-up studies are required to examine whether these promising results may improve clinical outcomes.

Effects of Resistance Training in Muscle Mass and Markers of Muscle Damage in Adults with Down Syndrome

Recent studies have emphasized that regular exercise should be encouraged as a key part of care and support for people with Down syndrome (DS). However, muscle hypotonia has traditionally been considered a major barrier to resistance training (RT) in people with DS. The main objective of this study was to analyze the impact of circuit RT on markers of muscle damage. The secondary objective was to assess the influence of a RT program on body composition and work task performance. Thirty-six men with DS were recruited and randomly assigned to perform a circuit RT program with six stations 3 days/week for 12 weeks (n = 18) or to a control group (n = 18). Body composition was assessed by bioelectrical impedance analysis. Serum markers of muscle damage (creatine kinase, myoglobin, and lactate dehydrogenase) were determined at baseline and at the end of training weeks 1, 6, and 12. Work task performance was assessed using the weighted pail-carry test. RT did not induce significant changes in markers of muscle damage during the intervention. Furthermore, muscle mass and work task performance were significantly improved in the exercise group. These findings suggest that circuit RT can be used safely to increase muscle mass and work task performance in young adults with DS. Muscle hypotonia should not be considered a major barrier to exercise in people with DS, provided that qualified staff design and supervise all training sessions.

Exercise reduced inflammation: but for how long after training?

BACKGROUND

Previous studies have reported that obese people with trisomy 21 suffer from low-grade systemic inflammation. A recent study has found that aerobic training reduced inflammation in obese women with Down syndrome. To the best of our knowledge, the study reported in this paper is the first to determine for how long these effects were maintained after completion of the programme.

METHODS

Twenty premenopausal obese women (18-30 years old) with Down syndrome volunteered for this study. Eleven were randomly assigned to the intervention group and performed a 10-week aerobic training programme, 3 sessions per week, consisting of warming-up followed by treadmill exercise (30-40 min) at a work intensity of 55-65% of peak heart rate and a cooling-down period. The control group included 9, age, sex and BMI matched women with Down syndrome that did not perform any training programme. Fat mass percentage and distribution were measured. Plasma level of IL-6 and high-sensitive C-reactive protein (hs-CRP) were monitored. Time-course changes for these outcomes were assessed at pre- and post-intervention. Further, they were re-evaluated at 1, 3 and 6 months after completion of the programme.

RESULTS

Three months after completion of the programme, plasma levels of IL-6 and hs-CRP were significantly increased. Up to 6 months later, both fat mass percentage and waist circumference (WC) were significantly increased. Furthermore, physical fitness was also impaired in the intervention group. No changes were observed in the control group.

CONCLUSION

A 3-month detraining period significantly impaired chronic inflammation in obese women with DS.

Aerobic training improved low-grade inflammation in obese women with intellectual disability

BACKGROUND

Obesity is a major health problem in people with intellectual disabilities. It is also widely accepted that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. Fortunately, physical activity has shown to improve inflammation in people with metabolic syndrome and type 2 diabetes. Accordingly, we assessed the influence of aerobic training on pro-inflammatory cytokines and acute phase proteins in women with Down syndrome.

METHODS

To achieve this outcome, 20 premenopausal obese young women with Down syndrome volunteered for this study. Eleven were randomly assigned to the intervention group and performed a 10-week aerobic training programme, three sessions per week, consisting of a warm-up then a 30- to 40-min treadmill exercise at a work intensity of 55-65% of peak heart rate followed by a cooling-down period. The control group included nine age-, sex- and body mass index-matched women with Down syndrome. Fat mass percentage and fat distribution were measured. Plasmatic levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and fibrinogen were assessed by commercial enzyme-linked immunosorbent assay kits. C-reactive protein (CRP) was assessed by nephelometry.

RESULTS

Plasmatic levels of TNF-α (11.7 ± 1.6 vs. 9.2 ± 1.3 pg/ml; P = 0.022), IL-6 (8.2 ± 1.1 vs. 6.1 ± 0.9 pg/ml; P = 0.014) and high sensitive CRP (0.62 ± 0.11 vs. 0.53 ± 0.09 mg/dl; P = 0.009) were significantly reduced in the intervention group. Further, significant correlations between plasmatic and anthropometric parameters were found.

CONCLUSION

A 10-week training programme reduced pro-inflammatory cytokines and acute phase proteins in obese young women with Down syndrome. Long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with trisomy 21.

Salivary testosterone and immunoglobulin A were increased by resistance training in adults with Down syndrome

This study was designed to assess the influence of resistance training on salivary immunoglobulin A (IgA) levels and hormone profile in sedentary adults with Down syndrome (DS). A total of 40 male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities. All participants had medical approval for participation in physical activity. Twenty-four adults were randomly assigned to perform resistance training in a circuit with six stations, 3 days per week for 12 weeks. Training intensity was based on functioning in the eight-repetition maximum (8RM) test for each exercise. The control group included 16 age-, gender-, and BMI-matched adults with DS. Salivary IgA, testosterone, and cortisol levels were measured by ELISA. Work task performance was assessed using the repetitive weighted-box-stacking test. Resistance training significantly increased salivary IgA concentration (P=0.0120; d=0.94) and testosterone levels (P=0.0088; d=1.57) in the exercising group. Furthermore, it also improved work task performance. No changes were seen in the controls who had not exercised. In conclusion, a short-term resistance training protocol improved mucosal immunity response as well as salivary testosterone levels in sedentary adults with DS.

Resistance circuit training reduced inflammatory cytokines in a cohort of male adults with Down syndrome

BACKGROUND

It is widely accepted that muscle strength plays a key role on functional tasks of daily living and employability in individuals with Down syndrome (DS). Recent studies have also reported resistance training may improve chronic inflammation in other clinical situations. This is the first study conducted to determine the effect of resistance circuit training on low-grade systemic inflammation in adults with DS.

MATERIAL/METHODS

A total of 40 young male adults with DS were recruited for the trial through different community support groups for people with intellectual disabilities and their families. They had medical approval for physical activity participation. Twenty-four were randomly assigned to perform resistance circuit training with 6 stations, 3 days per week for 12 weeks. Exercise intensity was based on function of the 8RM assessments. The control group included 16 age-, sex-, and BMI-matched adults with Down syndrome. Plasma levels of leptin, adiponectin, and TNF-a were assessed by commercial ELISA kits. C-reactive protein (CRP) was assessed by nephelometry. Body composition was also determined, measuring fat-free mass percentage and waist circumference (WC). This protocol was approved by our Institutional Ethics Committee.

RESULTS

Plasma levels of leptin, TNF-a, and IL-6 were significantly decreased after the completion of the training program, as were fat-free mass and WC. No sports-related injuries or withdrawals from the program were reported during the entire study period. No changes were observed in the control group.

CONCLUSIONS

Resistance circuit training improved low-grade systemic inflammation in male sedentary adults with DS.

Central obesity measurements predict metabolic syndrome in a retrospective cohort study of postmenopausal women

INTRODUCTION

The various diagnostic classifications in the literature concur as regards the important role of abdominal obesity in the onset and progression of metabolic syndrome. Accordingly, this study was aimed at clarifying whether central obesity measurements assessed by dual X-ray absorptiometry (DXA) may predict metabolic syndrome in Spanish postmenopausal women.

MATERIAL AND METHODS

This historical cohort study included a total of 1326 postmenopausal women aged > 45 years old who had routinely undergone DXA to measure their bone mineral density between January 2006 and January 2011. The regions of interest (ROI) envisaged in our study by using DXA were the lumbar regions L1-L4 and L4-L5. At the same time, they underwent a complete medical examination including personal medical history assessment, biochemical blood analysis, blood pressure measurement and anthropometrical evaluation. Metabolic syndrome was diagnosed attending to the criteria established by National Cholesterol Education Program Adult Treatment Panel III (NECP-ATP-III).

RESULTS

During the observation period, 537 women, representing 40.5% of the total studied, met the diagnostic criteria for metabolic syndrome. L1-L4 and L4-L5 abdominal fat mass determinations were associated with the development of metabolic syndrome in all regression models tested, showing an increasing gradient from the lowest to highest quintile.

CONCLUSION

Central adiposity measurements assessed by DXA, especially L1-L4 region of interest, could be considered a powerful predictor of metabolic syndrome in postmenopausal women.

Maternal fat mass may predict overweight/obesity in non-instituzionalized women with intellectual disability

INTRODUCTION

Previous studies have found a significant correlation between parents and offspring regarding overweight and obesity in general population at early life stages. However this issue has received no attention in people with intellectual disability (ID). Therefore, the present study was designed to find out potential correlations in overweight/obesity between young adult women with ID living in the family and their parents.

MATERIAL AND METHODS

In the present observational cross-sectional study, a total of thirty-four women with Down syndrome (n=34;22.6±2.1 years; 29.6±3.3 km/m2) were recruited through different community support groups for people with intellectual disabilities. Furthermore, biological mothers (n=34;59.6±4.9 years; 28.5±3.2 km/m2) and fathers (n=34; 61.5±5.3 years; 26.2±2.7 km/m2) volunteered for this study. They all underwent an anthropometric assessment to determine body mass index (BMI). This protocol was approved by an Institutional Ethics Committee.

RESULTS

In the studied population, a total of 26 (76.5%) women with ID were overweight/obese. Furthermore, there were 22 (66.6%) overweight/obese mothers and 16(53.3%) fathers. Results also showed significant correlations between participants BMI and their father (r = 0.327; p = 0.0116) and mother BMI (r = 0.412; p < 0.001). Lastly, overweight/obese women presented a stronger correlation with overweight/obese mothers (odds ratio 4.3; 95%CI 2.9-7.3) than fathers (odds ratio 3.1; 95%CI 1.6-4.4).

CONCLUSION

Parental overweight/obesity, especially maternal one, was strongly associated to overweight/obesity in young adult women with DS. Accordingly, there is an urgent necessity of incorporating parents in the intervention programs designed to the prevention and treatment of overweight and obesity in people with ID.

Low-grade systemic inflammation and leptin levels were improved by arm cranking exercise in adults with chronic spinal cord injury

OBJECTIVE

To ascertain the effect of arm cranking exercise on improving plasma levels of inflammatory cytokines and adipokines in untrained adults with chronic spinal cord injury (SCI).

DESIGN

Longitudinal study.

SETTING

Community-based supervised intervention.

PARTICIPANTS

Men (N=17) with complete SCI at or below T5 volunteered for this study. Participants were randomly allocated to the intervention (n=9) or control group (n=8) using a concealed method.

INTERVENTION

A 12-week arm cranking exercise program of 3 sessions per week consisted of warm-up (10-15min), arm crank (20-30min; increasing 2min and 30s every 3wk) at a moderate work intensity of 50% to 65% of heart rate reserve (starting at 50% and increasing 5% every 3wk), and cool-down (5-10min).

MAIN OUTCOME MEASURES

Plasma levels of leptin, adiponectin, plasminogen activator inhibitor-1, tumor necrosis factor-alpha, and interleukin-6 were determined. Furthermore, physical fitness (maximum oxygen consumption [V˙O2max]) and body composition (anthropometric index, waist circumference, and body mass index) were also assessed.

RESULTS

Plasma levels of leptin, tumor necrosis factor-alpha, and interleukin-6 were significantly decreased after the completion of the training program. Similarly, the anthropometric index and waist circumference were diminished too. A moderate correlation was found between leptin and the anthropometric index. Finally, V˙O2max was significantly increased, suggesting an improvement of physical fitness in the intervention group. No changes were found in the control group.

CONCLUSIONS

Arm cranking exercise improved low-grade systemic inflammation by decreasing plasma levels of inflammatory cytokines. Furthermore, it also reduced plasma leptin levels. Long-term, well-conducted studies are still required to determine whether these changes may improve clinical outcomes of adults with chronic SCI.

[A short-term training program reduced acute phase proteins in premenopausal women with metabolic syndrome]

INTRODUCTION

It is accepted low grade systemic inflammation plays a key role in metabolic syndrome. Further, several studies have reported it may be considered a therapeutic target. Accordingly, this study was conducted to ascertain the impact of a short-term aerobic training program on acute phase proteins in women with metabolic syndrome.

MATERIAL AND METHODS

A total of 135 adult women (38.4 ± 3.3 years) with metabolic syndrome volunteered for this study. Participants assigned to the intervention group underwent a 12-week aerobic training program, 3 sessions/week. The main part of each exercise sessions was performed in a treadmill at moderate intensity (60- 75%HRmax; increasing 5% each 3 weeks) for 25-40 minutes (increasing 5 minutes each 3 weeks). Physical fitness was determined by a continuous maximal incremental test. Further, fat mass percentage and indices of obesity were assessed. Plasmatic levels of C reactive protein (CRP-us) and fibrinogen were determined by nephelometry and HPLC respectively. This protocol was approved by an Institutional Ethics Committee.

RESULTS

Aerobic training improved physical fitness and reduced both fat mass percentage and indices of obesity. Compared with baseline, it also reduced significantly plasmatic levels of CRP-us (4.90 ± 0.7 vs. 3.77 ± 0.4 mg/l; p = 0.017) and fibrinogen (3.88 ± 0.4 vs. 3.36 ± 0.2 g/l; p = 0.025). Further, a moderate correlation was found between CRP-us and waist circumference (r = 0.66; p = 0.008). No significant changes were found in controls.

CONCLUSION

A short-term, aerobic training program reduced acute phase proteins in young women with metabolic syndrome. Further, long-term, well-conducted studies are still required to determine whether correction of this low-grade inflammation improves clinical outcomes of women with metabolic syndrome.

Arm-cranking exercise reduced oxidative damage in adults with chronic spinal cord injury

OBJECTIVE

To assess the effect of a 12-week arm-cranking exercise program on reducing oxidative damage in untrained adults with chronic spinal cord injury (SCI).

DESIGN

Randomized controlled trial.

SETTING

Community-based supervised intervention.

PARTICIPANTS

Male adults with complete SCI at or below the fifth thoracic level (T5) (N=17) volunteered for this study. Participants were randomly allocated to the intervention (n=9) or control (n=8) group using a concealed method.

INTERVENTION

A 12-week arm-cranking exercise program, 3 sessions/wk, consisting of warming-up (10-15min) followed by a main part in arm-crank (20-30min [increasing 2min and 30s every 3wk]) at a moderate work intensity of 50% to 65% of the heart rate reserve (starting at 50% and increasing 5% every 3 weeks) and by a cooling-down period (5-10min).

MAIN OUTCOME MEASURES

Plasmatic levels of total antioxidant status as well as erythrocyte glutathione peroxidase activity were measured. Lipid and protein oxidation were determined as malondialdehyde and carbonyl group levels, respectively. Furthermore, physical fitness and body composition were assessed.

RESULTS

When compared with baseline results, maximum oxygen consumption was significantly increased (P=.031), suggesting an improvement in physical fitness in the intervention group. Regarding the antioxidant defense system, it was found that both total antioxidant status (P=.014) and erythrocyte glutathione peroxidase activity (P=.027) were significantly increased at the end of the training program. As a consequence, plasmatic levels of malondialdehyde (P=.008) and carbonyl groups (P=.022) were significantly reduced.

CONCLUSION

A 12-week arm-cranking exercise program improved the antioxidant defense system in adults with chronic SCI, which may finally attenuate both lipid and protein oxidation in this population.

Correlation between glutathione peroxidase activity and anthropometrical parameters in adolescents with Down syndrome

Since we have recently found that regular exercise increased erythrocyte antioxidant enzyme activities such as glutathione peroxidase (GPX) in adolescents with Down syndrome, these programs may be recommended. This study was designed to assess the role of anthropometrical parameters as easy, economic and non-invasive biomarkers of GPX. Thirty-one adolescents with Down syndrome performed a 12-week training program. Three days after its ending, GPX activity and anthropometrical parameters were assessed. Pearson's correlation coefficient showed negative but significant association (r=0.49, p=0.022) between GPX activity and waist circumference (WC). Body mass index (BMI) and waist-to-hip ratio (WHR) were not significant. We may conclude that anthropometrical parameters such as WC are easy to perform but not strongly associated to GPX activity. Further studies concerning other variables are needed.

Glucose-6-phosphatedehydrogenase is also increased in erythrocytes from adolescents with Down syndrome

For some time it has been claimed that trisomic cells are more sensitive to oxidative stress since there is an imbalance in hydrogen peroxide metabolism due to an increase in superoxide dismutase (SOD) catalytic activity. We designed the present study to assess activity levels of antioxidant enzymes [superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and glucose-6-phosphate-dehydrogenase (G6PDH)] in erythrocytes in 31 male adolescents with Down syndrome (mean age 16.3 +/- 1.1). An increase of 35.2%, 15.3% and 14.9% in the catalytic activity of SOD, GPx and G6PDH respectively was observed in male adolescents with Down syndrome compared to age-matched controls. For CAT, a slight increase of 6.0% was also found. It is concluded that our data are consistent with previous evidence of the existence of oxidative stress in individuals with Down syndrome as revealed by significantly enhanced activities of SOD and GPx. The most striking feature was that G6PDH, in contrast to CAT, presented a similar behaviour. Further studies are required to identify other antioxidant enzymes in red blood cells as well as in white blood cells in order to increase the range of potential bioindicators of oxidative stress.

8-weeks training program attenuates mitochondrial oxidative stress in the liver of emotionally stressed rats

In recent years it has been shown that emotional stress induced by immobilization may change the balance between pro-oxidant and antioxidant factors inducing oxidative damage. On the other hand, contradictory views exist concerning the role of physical activity on redox metabolism. Consequently, the present work was designed to assess the influence of an 8-week moderate swimming training program in emotionally stressed rats. Sixty 1-month-old male albino Wistar rats weighing 125-135 g were used in this experimental study. They were divided into three groups, as Control (lot A; n=20), Stressed (lot B; n=20) and Stressed & Exercised (lot C; n=20). Rats were stressed by placing the animals in a 25 x 7 cm plastic bottle 1 h/day, 5 days a week for 8 weeks. Protein carbonyl content values in liver homogenates were significantly increased in stressed animals (0.58+/-0.02 vs 0.86+/-0.03; p=0.018) which clearly indicated that emotional stress was associated with oxidative stress. Ultrastructural alterations, predominantly mitochondrial swelling and the decrease of cristae number observed by electron microscopy represented direct evidence of membrane injury. The most striking feature of our study was that we also found differences between stressed rats and stressed rats that performed our 8 week training program. Consequently our results highlight the potential benefit of a moderate training program to reduce oxidative damage induced by emotional stress since it attenuated protein oxidation and mitochondrial alterations.

Time course variations of antioxidant enzyme activities and histopathology of gilthead seabream gills exposed to malathion

In a widely distributed and commercially important fish, gilthead seabream Sparus aurata L., we have studied sublethal effects of malathion in order to identify early warning bioindicators of exposure before irreversible damage occurs. To achieve this goal, groups of 10 juvenile specimens were exposed for 24, 48, 72 and 96 h to a sublethal concentration of malathion (0.4 mg/l). Another group was used as control. The activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase) and histopathological features from exposed gills were assessed. It should also be mentioned that no mortality was observed during the whole experience. The activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) were altered significantly from 24 h onward (p<0.05). It is of interest to note that catalase activity was decreased after exposure instead of increasing as other antioxidant enzymes assessed. On the other hand, histopathological alterations of the gills were observed as early as at 48 h-exposure, but the most severe damage occurred at 96 h exposure. The evidence presented here, together with other data from the literature, unequivocally established oxidative-stress-inducing effects of malathion in gilthead seabream Sparus aurata. It is also concluded antioxidants employed (SOD, CAT and GPX) changed significantly a long time before histopathological alterations of gills became evident. Consequently, these antioxidant enzymes may be highly recommended as early-warning bioindicators of environmental pollution by malathion in the areas where it is proposed to be used in pest control activities.