The aim of this study was to investigate the effects of two consecutive extreme conditioning program training sessions (24 h apart) designed to enhance work-capacity that involved both cardiovascular and muscular exercises on cytokines, muscle power, blood lactate and glucose. Nine male members of the extreme conditioning community (age 26.7 ± 6.6 years; body mass 78.8 ± 13.2 kg; body fat 13.5 ± 6.2%; training experience 2.5 ± 1.2 years) completed two experimental protocols (24 h apart): (1) strength and power exercises, (2) gymnastic movements, and (3) metabolic conditioning as follows: 10 min of as many rounds as possible (AMRAP) of 30 double-unders and 15 power snatches (34 kg). The same sequence as repeated on session 2 with the following metabolic conditioning: 12 min AMRAP of: row 250 m and 25 target burpees. Serum interleukin-6 (IL-6), IL-10, and osteoprotegerin were measured before, immediately post and 24 h after workout of the day (WOD) 1, immediately post, 24 and 48 h after WOD 2. Peak and mean power were obtained for each repetition (back squat with 50% of 1 repetition maximum) using a linear position transducer measured before, immediately post and 24 h after WOD 1, immediately post and 24 h after WOD 2. Blood lactate and glucose were measured pre and immediately post WOD 1 and 2. Although both sessions of exercise elicited an significant increase in blood lactate (1.20 ± 0.41 to 11.84 ± 1.34 vs. 0.94 ± 0.34 to 9.05 ± 2.56 mmol/l) and glucose concentration (81.59 ± 10.27 to 114.99 ± 12.52 vs. 69.47 ± 6.97 to 89.95 ± 19.26 mg/dL), WOD 1 induced a significantly greater increase than WOD 2 (p ≤ 0.05). The training sessions elicited significant changes (p ≤ 0.05) in IL-6, IL-10 and osteoprotegerin concentration over time. IL-6 displayed an increase immediately after training WOD 1 [197 ± 109%] (p = 0.009) and 2 [99 ± 58%] (p = 0.045). IL-10 displayed an increase immediately after only WOD 1 [44 ± 52%] (p = 0.046), and decreased 24 and 48 h following WOD 2 (~40%; p = 0.018) as compared to pre-exercise values. Osteoprotegerin displayed a decrease 48 h following WOD 2 (~25%; p = 0.018) as compared with pre intervention. In conclusion, two consecutive extreme conditioning training sessions increase pro/anti-inflammatory cytokines with no interference on muscle performance in the recovery period.

Background and Purpose: The feasibility, safety, and efficacy of a high-intensity multimodal exercise program (aerobic, strengthening, and balance training) have not been well vetted in persons with Parkinson disease (PD). Thus, the primary aim was to determine whether a high-intensity multimodal exercise boot camp (HIBC) was both feasible and safe in persons with PD. The secondary aim was to determine whether the program would produce greater benefit than a usual care, low-intensity exercise program (UC). An exploratory aim was to determine whether these programs affected putative disease-modifying mechanisms. Methods: Twenty-seven participants (19 men and 8 women) were randomized into 8 weeks of either the HIBC or UC supervised by physical therapists. For feasibility, participation, and meeting, Centers for Disease Control and Prevention (CDC) exercise guidelines were assessed. For safety, adverse events were monitored. For efficacy, the following outcome domains were assessed before and after participation: balance, motor activity, endurance and fatigue, strength, mental health, and quality of life. For disease-modifying mechanisms, circulating brain-derived neurotrophic factor (BDNF) and its genotype, superoxide dismutase, and cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-10) were monitored. Results: The HIBC was better at attaining CDC guidelines (P = 0.013) and spent more minutes in higher-intensity exercise per week (P < 0.001). There were no differences in adverse events (P = 0.419). The HIBC experienced significant improvements in 7/31 outcomes versus 3/31 in the UC arm. BDNF improved significantly for both groups from pre- to posttests (Ps ≤ 0.041) and an improved anti-inflammatory was observed for both groups. Discussion and Conclusions: A high-intensity multimodal exercise boot camp was feasible and safe in persons with PD. Compared with usual care, there were no differences in adverse events. Moreover, the high-intensity multimodal exercise program produced more improvement across more domains than usual care. Our results also suggest a possible link between improvement in outcomes and an improved anti-inflammatory milieu. Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A244).

Because lymphocyte apoptosis is significantly elevated immediately following high-intensity exercise in humans, it seems intuitive that the cell death process must be initiated at some point during the task. This study was designed to determine whether exercise-induced lymphocyte apoptosis occurs at a threshold level of intensity, or exists only following maximal or near-maximal exercise intensities. Fourteen untrained subjects completed a discontinuous, incremental treadmill test to exhaustion (.VO(2max)). Blood for films was sampled before the test, immediately after each work stage, and for 1-h postexercise. Blood smears were stained with May-Grünwald Giemsa and lymphocytes were evaluated for characteristic features of apoptosis. The apoptotic index (AI) during exercise at 38 % .VO(2max) was similar to pre-exercise but significantly elevated at an intensity approximating 61 % .VO(2max) (p < 0.0001). Significant increases in apoptosis were noted with additional elevations in exercise intensity (i.e., 76 %, 89 %, and 100 %, p < 0.0001). Following 20 min of recovery, AI was significantly lower than values obtained immediately postexercise (p < 0.0001). Forty minutes of recovery resulted in a further significant decrease (p < 0.0001), and by 1-h postexercise, AI was similar to pre-exercise values. Results indicate that the exercise intensity threshold for inducing an increase in lymphocyte apoptosis occurs between 40 and 60 % .VO(2max). In addition, since values return to baseline within 1 h following exhaustive exercise, it is unlikely that factors responsible for the apoptotic response in lymphocytes maintain a prolonged presence once exercise has been terminated.

This study was designed to compare the effects of linear periodization (LP) and undulating periodization (UP) on functional capacity, neuromuscular function, body composition, and cytokines in elderly sedentary women. We also aimed to identify the presence of high responders (HR), medium responders (MR), and low responders (LR) for irisin, interleukin-1 beta (IL-1β), toll-like receptor-4 (TLR-4), and brainderived neurotrophic factor (BDNF) to resistance training (RT). Forty-nine elderly women were assigned to a control group, LP, and UP scheme. Functional capacity, body composition, maximal strength, irisin, TLR-4, BDNF, and IL-1β were evaluated. Both periodization models were effective in improving 45°leg press 1RM, chair-stand, arm curl, and time-up and go tests, with no significant differences in body composition and cytokines. Furthermore, HR, MR, and LR were identified for irisin, IL-1β, TLR-4, and BDNF, with differences between groups and moments. This study provides evidence that both periodization models were effective in improving functional capacity and neuromuscular function, with no effect on body composition and cytokines (probably as a consequence of the different responsiveness). Furthermore, for the first time, HR, MR, and LR were identified for irisin, IL1-β, TLR-4, and BDNF in response to RT.

Purpose This study aimed to verify the effect of 6 months of periodized resistance training (RT) with and without blood flow restriction (BFR) in patients with stage 2 chronic kidney disease (CKD) on glomerular filtration rate (GFR), uremic parameters, cytokines, and klotho–fibroblast growth factor 23 (FGF23) axis. Methods A total of 105 subjects were randomized in three groups of 35 each: control (CTL), RT, and RT + BFR. A first visit was required for an anamnesis to evaluate the number of medications and anthropometric measurements (body weight, height, and body mass index). Muscle strength (one-repetition maximum) was assessed. Venous blood samples were collected at baseline and after 6 months of training in all patients for the analysis of markers of renal function and integrity, as well as for the determination of the inflammatory profile. Statistical significances were adopted with P < 0.05. Results Both training therapies attenuated the decline of GFR (P < 0.05). The majority of CTL patients declined to stage 3 CKD (88.5%), whereas fewer incidents were noted with RT (25.7%) and RT + BFR (17.1%). Improved uremic parameters as well as inflammation (IL-6, IL-10, IL-15, IL-17a, IL-18, and TNF-α) and klotho–FGF23 axis in RT and RT + BFR (P < 0.05) were observed. Monocyte chemoattractant protein 1 was not changed (P > 0.05) but presented a large effect size (Cohen’s d), demonstrating a propensity for improvement. Conclusion Six months of periodized RT with and without BFR in patients with stage 2 CKD attenuated the progression of the disease by maintaining GFR, improving uremic parameters, cytokine profile regulation, and klotho–FGF23 axis.

This investigation was designed to evaluate responses of blood pressure (BP) following an acute resistance exercise (RE) session. Middle-aged women (N=13) who were classified as overweight (N=8) or obese (N=5) according to body mass index (BMI) participated in the investigation. Participants were randomly submitted to a control session (30-min seated rest) and a exercise session (3 sets, 10 repetitions at 60% 1RM of exercises for the upper and lower body) with systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) obtained at rest and 10, 20, 30, 40, 50, and 60-min following exercise, and through 24 h. Acute RE decreased SBP at 10, 30, and 40-min compared with pre-exercise and control (P<0.05). DBP decreased at 10 and 40-min post-exercise compared with the control trial (P<0.05). Both SBP and DBP decreased in the nighttime period (-4.2 mmHg and -4.1 mmHg, respectively) and in the overall 24 h period (-3.6 mmHg and -4.5 mmHg, respectively) following the acute RE session when compared with the control trial. These findings indicate important benefits of acute RE on BP circadian rhythm, particularly at night as well as in the morning, which are critical periods associated with increased risk for cardiovascular events.

Footpod monitors are wearable devices attaching to the shoe with the ability to sense oscillations in leg movement; however, few studies provide reliability. The purpose was to provide reliability data for outdoor tasks as measured by the Stryd Power Meter, which is a footpod monitor. Young healthy individuals (N=20, male n=12, female n=8) completed two 5-min self-paced walks along a trail, and two 5-min trail runs. Reliability of the tasks was determined using Coefficient of Variation (CV), Intraclass Correlation (ICC), and 95% confidence intervals (CI). Measures during trail running that returned a CV less than 10%, met the ICC threshold of 0.70, and displayed good to excellent 95% CI included pace, average elapsed power, average elapsed form power, average elapsed leg spring, and vertical oscillation. The only variable during walking to meet these criteria was maximal power (CV=4.02%, ICC=0.968, CI=0.902, 0.989). Running tasks completed on a trail generally return more consistent measures for variables that can be obtained from the Stryd footpod device than walking tasks.

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