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Special Issue "Exercise Medicine in Health and Disease"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (15 January 2021) | Viewed by 43219

Special Issue Editor

Prof. Dr. Dae Yun Seo
E-Mail Website
Chief Guest Editor
National Research Laboratory for Mitochondrial Signaling, Department of Physiology, BK21 Plus Project Team, College of Medicine, Smart Marine Therapeutics Center, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Korea
Interests: exercise medicine; cellular and molecular control of skeletal muscle metabolism; mitochondrial bioenergetics; nutrition metabolism for enhancement of physical activity

Special Issue Information

Dear Colleagues,

There is a growing body of literature that recognizes the importance of the beneficial effect of regular exercise based on advances in research at the molecular, cellular, and whole-body levels. Exercise is one of the very prospective therapeutics for disease, contributing to the inhibition of epidemic and pathogenic diseases, including hypertension, diabetes, cancer, aging, brain disorder, cardiovascular disease, and hepatic-related diseases, around the world. However, physical inactivity and unbalanced dietary patterns result in increased exposure to a variety of diseases and weaknesses in exercise capacity, ultimately resulting in mortality. To prevent diseases and promote healthy lifestyle conditions, the World Health Organization recommends increased physical activity level, aerobic exercise, and/or resistance exercise, and a combination of aerobic exercise and resistance exercise, in the 21st century. Therefore, the aim of this Special Issue is to collect novel findings in the field of exercise medicine in health and disease.

The Special Issue cordially invites scientist involved in basic research as well as in translational studies to submit their original researches.

Prof. Dae Yun Seo
Guest Editor

Manuscript Submission Information

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Keywords

  • exercise
  • health care
  • aging
  • metabolic dysfunction
  • cancer
  • sarcopenia
  • exercise rehabilitation
  • psychology
  • obesity
  • cardiovascular disease

Published Papers (21 papers)

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Article
A Feasibility Study of Kinematic Characteristics on the Upper Body According to the Shooting of Elite Disabled Archery Athletes
Int. J. Environ. Res. Public Health 2021, 18(6), 2962; https://doi.org/10.3390/ijerph18062962 - 14 Mar 2021
Cited by 1 | Viewed by 1266
Abstract
The purpose of this study is to compare and analyze the kinematic characteristics of the upper limb segments during the archery shooting of Paralympic Wheelchair Class archers (ARW2—second wheelchair class—paraplegia or comparable disability) and Paralympic Standing Class archers (ARST—standing archery class—loss of 25 [...] Read more.
The purpose of this study is to compare and analyze the kinematic characteristics of the upper limb segments during the archery shooting of Paralympic Wheelchair Class archers (ARW2—second wheelchair class—paraplegia or comparable disability) and Paralympic Standing Class archers (ARST—standing archery class—loss of 25 points in the upper limbs or lower limbs), where archers are classified according to their disability grade among elite disabled archers. The participants of this study were selected as seven elite athletes with disabilities by the ARW2 (n = 4) and ARST (n = 3). The analysis variables were (1) the time required for each phase, (2) the angle of inclination of the body center, (3) the change of trajectory of body center, and (4) the change of the movement trajectory of the bow center by phase when performing six shots in total. The ARW2 group (drawing phase; M = 2.228 s, p < 0.05, holding phase; M = 4.414 s, p < 0.05) showed a longer time than the ARST group (drawing phase; M = 0.985 s, holding phase; M = 3.042 s), and the angle of the body did not show a significant difference between the two groups. Additionally, in the direction of the anteroposterior axis in the drawing phase, the change in the movement trajectory of the body center showed a more significant amount of change in the ARW2 group than in the ARST group, and the change in the movement trajectory of the bow center did not show a significant difference between the two groups. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Effects of Exercise Intervention on Mitochondrial Stress Biomarkers in Metabolic Syndrome Patients: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2021, 18(5), 2242; https://doi.org/10.3390/ijerph18052242 - 24 Feb 2021
Cited by 4 | Viewed by 1730
Abstract
Metabolic syndrome (MetS) pathogenesis involves oxidative stress associated with mitochondrial dysfunction, which triggers integrated stress responses via various compensatory metabolic modulators like mitokines and hepatokines. However, the regulatory mechanisms underlying the exercise-derived benefits with respect to mitokines and hepatokines (potential MetS biomarkers) are [...] Read more.
Metabolic syndrome (MetS) pathogenesis involves oxidative stress associated with mitochondrial dysfunction, which triggers integrated stress responses via various compensatory metabolic modulators like mitokines and hepatokines. However, the regulatory mechanisms underlying the exercise-derived benefits with respect to mitokines and hepatokines (potential MetS biomarkers) are unknown. Thus, we investigated the effects of exercise training on MetS biomarkers and their associations with clinical parameters. In this single-center trial, 30 women with MetS were randomly assigned to 12-week supervised exercise or control groups (1:1) and compared with 12 age-matched healthy volunteers. All participants completed the study except one subject in the control group. Expectedly, serum levels of the mitokines, fibroblast growth factor-21 (FGF21), growth differentiation factor-15 (GDF15), and the hepatokine, angiopoietin-like 6 (ANGPTL6), were higher in MetS patients than in healthy volunteers. Moreover, their levels were markedly attenuated in the exercise group. Further, exercise-mediated changes in serum FGF21 and GDF15 correlated with changes in the homeostasis model of assessment of insulin resistance (HOMA-IR) and appendicular lean mass (ALM), respectively. Additionally, changes in serum triglycerides and ANGPTL6 were correlated with changes in leptin. Aberrant mitokine and hepatokine levels can be rectified by relieving metabolic stress burden. Therefore, exercise training may reduce the need for the compensatory upregulation of MetS metabolic modulators by improving gluco-lipid metabolism. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Immediate Effects of a Telerehabilitation Program Based on Aerobic Exercise in Women with Fibromyalgia
Int. J. Environ. Res. Public Health 2021, 18(4), 2075; https://doi.org/10.3390/ijerph18042075 - 20 Feb 2021
Cited by 9 | Viewed by 3252
Abstract
Background: We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in Spain due to the COVID-19 pandemic. Methods: A single-blind randomized controlled trial was designed. Thirty-four women with [...] Read more.
Background: We analyzed the immediate effects of a Telerehabilitation Program (TP) based on aerobic exercise in women with fibromyalgia (FM) syndrome during the lockdown declared in Spain due to the COVID-19 pandemic. Methods: A single-blind randomized controlled trial was designed. Thirty-four women with FM were randomized into two groups: TP group and Control group. The intervention lasted 15 weeks, with 2 sessions per week. The TP based on aerobic exercise was guided by video and the intensity of each session was monitored using the Borg scale. Pain intensity (Visual Analogue Scale), mechanical pain sensitivity (algometer), number of tender points, FM impact (Revised Fibromyalgia Impact Questionnaire), pain catastrophizing (Pain Catastrophizing Scale), physiological distress (Hospital Anxiety and Depression Scale), upper (Arm Curl Test) and lower-limb physical function (6-min Walk Test) were measured at baseline and after the intervention. Results: The TP group improved pain intensity (p = 0.022), mechanical pain sensitivity (p < 0.05), and psychological distress (p = 0.005), compared to the Control group. The Control group showed no statistically significant changes in any variable (p > 0.05). Conclusions: A TP based on aerobic exercise achieved improvements on pain intensity, mechanical pain sensitivity, and psychological distress compared to a Control group during the lockdown declared in Spain due to COVID-19 pandemic. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Relationships between Socioeconomic Status, Handgrip Strength, and Non-Alcoholic Fatty Liver Disease in Middle-Aged Adults
Int. J. Environ. Res. Public Health 2021, 18(4), 1892; https://doi.org/10.3390/ijerph18041892 - 16 Feb 2021
Cited by 10 | Viewed by 1311
Abstract
Although low socioeconomic status (SES) and decreased muscle strength have been found to be associated with the risk factors of non-alcoholic fatty liver disease (NAFLD), including insulin resistance, obesity, and metabolic syndrome, the associations among SES, muscle strength, and NAFLD are still unclear. [...] Read more.
Although low socioeconomic status (SES) and decreased muscle strength have been found to be associated with the risk factors of non-alcoholic fatty liver disease (NAFLD), including insulin resistance, obesity, and metabolic syndrome, the associations among SES, muscle strength, and NAFLD are still unclear. We aimed to investigate the combined effect of SES and relative handgrip strength (HGS) on the risk of NAFLD in middle-aged adults. Data from 5272 middle-aged adults who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014–2018 were analyzed. NAFLD was defined using the hepatic steatosis index (HSI) > 36 and the comprehensive NAFLD score (CNS) ≥ 40 in the absence of other causes of liver disease. SES was based on a self-reported questionnaire. Overall, individuals with low SES (odds ratio (OR) = 1.703, 95% confidence interval (CI): 1.424–2.037, p < 0.001) or low HGS (OR = 12.161, 95% CI: 9.548–15.488, p < 0.001) had a significantly higher risk of NAFLD. The joint association analysis showed that a low SES combined with a low HGS (OR = 2.479, 95% CI: 1.351–4.549, p = 0.003) further significantly increased the risk of NAFLD when adjusted for all the covariates, compared with individuals with a high SES and a high HGS (OR = 1). The current findings suggest that both low SES and low HGS were independently and synergistically associated with an increased risk of NAFLD in middle-aged Korean adults. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
12-Week Exercise Training of Knee Joint and Squat Movement Improves Gait Ability in Older Women
Int. J. Environ. Res. Public Health 2021, 18(4), 1515; https://doi.org/10.3390/ijerph18041515 - 05 Feb 2021
Cited by 3 | Viewed by 1084
Abstract
This study analyzed the effects of an exercise training program consisting of a knee joint complex exercise device (leg-link system) with digitally controlled active motion function and squat movement on physical fitness and gait ability of elderly women aged 70 or above. Fifty [...] Read more.
This study analyzed the effects of an exercise training program consisting of a knee joint complex exercise device (leg-link system) with digitally controlled active motion function and squat movement on physical fitness and gait ability of elderly women aged 70 or above. Fifty four (54) elderly women aged 70 or above were divided into three groups as control group (n = 18), aerobic training group (n = 18), and combined training group with resistance and aerobic exercise (n = 18). Health-related physical fitness, gait ability-related physical fitness, and the temporal and spatial parameters of gait ability were compared. The health-related physical fitness after the 12-week training was not significantly altered in control group, whereas combined training group showed significant increase in all factors (p < 0.05) and aerobic training group showed significant increase (p < 0.05) only in the physical efficiency index. The gait ability-related physical fitness and all items of the temporal and spatial parameters of gait were found to have significantly increased (p < 0.05) in combined training group after the 12-week exercise training; however, in aerobic training group, only the factors related to muscular endurance and balance showed significant increase (p < 0.05). This study suggested that the exercise training consisting of knee joint complex exercise with digitally controlled active motion function and squat exercise for strengthening lower extremities and core muscles had positive effects on enhancing the ambulatory competence in elderly women. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Effects of Acute Visual Stimulation Exercise on Attention Processes: An ERP Study
Int. J. Environ. Res. Public Health 2021, 18(3), 1107; https://doi.org/10.3390/ijerph18031107 - 27 Jan 2021
Cited by 1 | Viewed by 1246
Abstract
Backgrounds: It remains to be determined whether visual stimuli during exercise differentially influence the attention process. The purpose of the present study was to examine if different color stimuli during aerobic exercise are associated with different attention processes. Methods: 22 college students completed [...] Read more.
Backgrounds: It remains to be determined whether visual stimuli during exercise differentially influence the attention process. The purpose of the present study was to examine if different color stimuli during aerobic exercise are associated with different attention processes. Methods: 22 college students completed a four 30-min running session during the presentation of different color stimuli (blue, green, red, and yellow) and without color stimulus on separate visits. The Kanizsa triangle task was administrated before and immediately after exercise to assess the attention process. Behavioral performance (accuracy and response time (RT)) and event-related potential (P2, N2b and P3a) were recorded during the test. Results: Valid/invalid cue RT during the Kaniza test performance was significantly faster following the presentation of color stimuli during treadmill exercise compared to the seated rest. During exercise, these changes were larger after green and yellow stimuli than red in invalid cue RT. P2, N2b and P3a amplitudes of green were significantly larger than the other colors for both valid and invalid cues. Red color showed the lowest P2 and P3a amplitudes for both valid and invalid cues among colors. Conclusion: The distinctive neurocognitive changes during aerobic exercise suggest different effects of color stimuli on visual search attention, attention capture, attentional orienting and processing speed. This study will be a first step to understand the optimal environmental setting during exercise for subsequent improvements in the attention process. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
A Case Study on Curling Stone and Sweeping Effect According to Sweeping Conditions
Int. J. Environ. Res. Public Health 2021, 18(2), 833; https://doi.org/10.3390/ijerph18020833 - 19 Jan 2021
Cited by 1 | Viewed by 1321
Abstract
The purpose of this study was to use the same ice temperature and air temperature as the Pyeongchang Curling Stadium by using an Ice Chamber. Then, launch the stone at the same speed, and move according to the sweeping conditions (perpendicular to the [...] Read more.
The purpose of this study was to use the same ice temperature and air temperature as the Pyeongchang Curling Stadium by using an Ice Chamber. Then, launch the stone at the same speed, and move according to the sweeping conditions (perpendicular to the axis of motion, along the axis of motion) of male and female elite curlers. The aim is to provide sports science information required for curling athletes by analyzing the distance of the stone, the change in the speed of a moved stone, the change in broom acceleration, and athletes’ muscle activity. The results of experiments conducted on four male and four elite female curlers are as follows. Under gender, the stone’s movement distance was long after the sweeping of male athletes, and the speed of the stone was not different according to the conditions. The broom’s acceleration did not show a difference in both the sweeping condition and the athlete’s gender condition, and the muscle activity did not show a significant difference in both the sweeping condition and the gender condition. In summary, it is thought that male athletes moved the stone farther by raising the ice surface temperature by vertical load than female athletes. Also, there was no statistically significant difference in muscle activity results, but it was found that there was a specific pattern of muscle activity in the pushing and pulling motions during the sweeping of male and female athletes. It is expected to be used as primary data. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Exercise Behavior and Mood during the COVID-19 Pandemic in Taiwan: Lessons for the Future
Int. J. Environ. Res. Public Health 2020, 17(19), 7092; https://doi.org/10.3390/ijerph17197092 - 28 Sep 2020
Cited by 18 | Viewed by 3371
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic and its associated governmental recommendations and restrictions have influenced many aspects of human life, including exercise and mental health. This study aims to explore the influence of COVID-19 on exercise behavior and its impact on mood states, [...] Read more.
The Coronavirus disease 2019 (COVID-19) pandemic and its associated governmental recommendations and restrictions have influenced many aspects of human life, including exercise and mental health. This study aims to explore the influence of COVID-19 on exercise behavior and its impact on mood states, as well as predict changes in exercise behavior during a similar future pandemic in Taiwan. A cross-sectional online survey was conducted between 7 April and 13 May 2020 (n = 1114). Data on exercise behavior pre and during the pandemic and mood states were collected. A cumulative link model was used to predict changes in exercise frequency during a similar future pandemic by exercise frequency during the pandemic. A linear model was used to predict the influence of exercise frequency before and during the pandemic on mood states during the pandemic. A total of 71.2%, 67.3%, and 58.3% of respondents maintained their exercise intensity, frequency, and duration, respectively, during the pandemic. Frequent exercisers are more likely to maintain their exercise frequency during a similar pandemic (p < 0.001). Higher exercise frequencies during the pandemic were associated with better mood states (p < 0.05). Moreover, the effects of prepandemic exercise frequency on mood states are moderated by changes in exercise frequency during the pandemic (p < 0.05). Additionally, maintenance of exercise frequency during a pandemic specifically for frequent exercisers are recommended to preserve mood states. These results may provide evidence for health policies on exercise promotion and mental health before and during a future pandemic. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
The Relationship between Muscular Strength and Depression in Older Adults with Chronic Disease Comorbidity
Int. J. Environ. Res. Public Health 2020, 17(18), 6830; https://doi.org/10.3390/ijerph17186830 - 18 Sep 2020
Cited by 2 | Viewed by 1026
Abstract
Older adults with disease and disability are particularly vulnerable to experiencing more severe consequences of depression. The purpose of the present study is to investigate the relationship between disease comorbidities (number of disease: ND0, 1 disease: ND1 and 2 or more diseases: ND [...] Read more.
Older adults with disease and disability are particularly vulnerable to experiencing more severe consequences of depression. The purpose of the present study is to investigate the relationship between disease comorbidities (number of disease: ND0, 1 disease: ND1 and 2 or more diseases: ND ≥ 2), hand grip strength (low HGS and high HGS), and the prevalence of depression in Korean older adults. Data from the living profiles of older people survey that was conducted by the ministry of health and welfare in Korea were utilized. Data for 6107 females and 4347 males were appropriate for statistical tests. The results demonstrated that depression was more prevalent as ND increased (p < 0.01). In addition, HGS appeared lower as ND increased in both male (p < 0.01) and female subjects (p < 0.01). Furthermore, relative to ND0 and low HGS, ND0 and high HGS showed a ~65% reduction in the prevalence of depression (p < 0.01). After adjusting for age, the prevalence of depression was reduced by ~60% in the subgroup with ND0 and high HGS relative to ND0 and low HGS (p < 0.01). These data demonstrate that muscular strength indices such as HGS may be useful when assessing depression in older adults. Further research in this area is warranted. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
Article
Effect of Passive Stretching of Respiratory Muscles on Chest Expansion and 6-Minute Walk Distance in COPD Patients
Int. J. Environ. Res. Public Health 2020, 17(18), 6480; https://doi.org/10.3390/ijerph17186480 - 06 Sep 2020
Cited by 2 | Viewed by 1693
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Hyperinflation of the lungs leads to a remodeling of the inspiratory muscles that causes postural deformities and more labored breathing. Postural changes include elevated, protracted, or abducted scapulae [...] Read more.
Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Hyperinflation of the lungs leads to a remodeling of the inspiratory muscles that causes postural deformities and more labored breathing. Postural changes include elevated, protracted, or abducted scapulae with medially rotated humerus, and kyphosis that leads to further tightening of respiratory muscles. As the severity of the disease progresses, use of the upper limbs for functional tasks becomes difficult due to muscle stiffness. There are various studies that suggest different rehabilitation programs for COPD patients; however, to the best of our knowledge none recommends passive stretching techniques. The aim of this study was to assess the effect of respiratory muscle passive stretching on chest expansion and 6-min walk distance (6MWD) in patients with moderate to severe COPD. Methods: Thirty patients were divided into two groups, experimental (n = 15) and control (n = 15). The experimental group received a hot pack followed by stretching of the respiratory muscles and relaxed passive movements of the shoulder joints. The control group received a hot pack followed by relaxed passive movements of the shoulder joints. Results: In the control group, there was no difference in chest expansion at the levels of both the axilla and the xiphisternum or in 6MWD between baseline and post treatment (p > 0.05). In the experimental group, chest expansion at the level of the axilla (p < 0.05) and 6MWD (p < 0.001) were significantly higher post treatment, while there was no difference in chest expansion at the level of the xiphisternum (p > 0.05). A comparison between control and experimental groups showed that chest expansion at the level of the axilla (p < 0.05) and 6MWD (p < 0.01) were significantly higher in the experimental group, while there was no difference in chest expansion at the level of the xiphisternum (p > 0.05). Conclusions: Although COPD is an irreversible disease, results of this study indicate that passive stretching of respiratory muscles can clinically improve the condition of such patients, especially in terms of chest expansion and 6MWD. Given the good effects of muscle stretching and the fact that such an exercise is harmless, clinicians and physiotherapists should consider including passive stretching of respiratory muscles in the rehabilitation plan of COPD patients. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
Article
Can Active Aerobic Exercise Reduce the Risk of Cardiovascular Disease in Prehypertensive Elderly Women by Improving HDL Cholesterol and Inflammatory Markers?
Int. J. Environ. Res. Public Health 2020, 17(16), 5910; https://doi.org/10.3390/ijerph17165910 - 14 Aug 2020
Cited by 6 | Viewed by 1517
Abstract
This study aims to verify the efficacy of exercise programs designed to prevent and treat hypertension-induced cardiovascular disease (CVD) by analyzing the effects of a 6-month active aerobic exercise program, administered to prehypertensive elderly women, on reducing the risk of developing CVD by [...] Read more.
This study aims to verify the efficacy of exercise programs designed to prevent and treat hypertension-induced cardiovascular disease (CVD) by analyzing the effects of a 6-month active aerobic exercise program, administered to prehypertensive elderly women, on reducing the risk of developing CVD by enhancing their physical fitness level and improving the detailed markers of high-density lipoprotein cholesterol (HDL-C) and inflammatory markers. We assigned the elderly women (≥65 years) recruited into normal blood pressure (120–129/80–84; NBP, n = 18) and high-normal blood pressure (130–139/85–89; HNBP, n = 12) groups according to the European guidelines for the management of arterial hypertension. The exercise program was made up of combined workouts of elastic band resistance exercise and aerobics with dance music. The program took place three times a week for six months, with each session lasting 60 min. We measured pre- and post-intervention body composition, blood pressure, physical fitness level, blood lipids profile, HDL-C, SAA, TNF-α, IL-6, IL-4, IL-15, CRP, and HSP70 and calculated the Framingham risk scores for comparison. A significant post-intervention reduction in the mean systolic blood pressure (SBP) was observed in the HNBP group (p < 0.001), with significant increase in HDL-C (p < 0.01) and significant decrease in serum amyloid A (SAA) concentration (p < 0.01). A significant improvement in physical fitness factors such as physical efficiency index (PEI) was also observed in the HNBP group (p < 0.05). The post-intervention TNF-α, IL-6, and SAA concentrations were more significantly lower in the HNBP than in the NBP group (p < 0.05). Compared to the baseline values, a significant decrease in SAA concentration (p < 0.01) and significant increase in HSP70 concentration (p < 0.001) were observed in the HNBP group. The HNBP group’s 10-year CVD risk was also significantly reduced (p < 0.05). The pre–post differences in SBP and DBP were significantly correlated with those in the anti-inflammatory markers IL-4 and IL-15 (p < 0.01). In conclusion, the 6-month active aerobic exercise program of moderate intensity administered to prehypertensive elderly women (≥65 years) had the effect of reducing the 10-year CVD risk through a substantial reduction in SBP, overall physical fitness improvement, increase in HDL-C, decrease in SAA concentration, and substantial decrease in inflammatory biomarkers. It was also confirmed that an increase in anti-inflammatory markers, which showed a small range of increase with respect to the decrease in blood pressure, may have a major effect. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Low-Intensity Exercise Training Additionally Increases Mitochondrial Dynamics Caused by High-Fat Diet (HFD) but Has No Additional Effect on Mitochondrial Biogenesis in Fast-Twitch Muscle by HFD
Int. J. Environ. Res. Public Health 2020, 17(15), 5461; https://doi.org/10.3390/ijerph17155461 - 29 Jul 2020
Cited by 4 | Viewed by 1081
Abstract
This study examines how the high-fat diet (HFD) affects mitochondrial dynamics and biogenesis, and also whether combining it with low-intensity endurance exercise adds to these effects. Six 8-week-old male Sprague–Dawley (SD) rats were put on control (CON; standard chow diet), HF (HFD intake), [...] Read more.
This study examines how the high-fat diet (HFD) affects mitochondrial dynamics and biogenesis, and also whether combining it with low-intensity endurance exercise adds to these effects. Six 8-week-old male Sprague–Dawley (SD) rats were put on control (CON; standard chow diet), HF (HFD intake), and HFEx (HFD + low-intensity treadmill exercise) for 6 weeks. As a result, no change in body weight was observed among the groups. However, epididymal fat mass increased significantly in the two groups that had been given HFD. Blood free fatty acid (FFA) also increased significantly in the HF group. While HFD increased insulin resistance (IR), this was improved significantly in the HFEx group. HFD also significantly increased mitochondrial biogenesis-related factors (PPARδ, PGC-1α, and mtTFA) and mitochondrial electron transport chain proteins; however, no additional effect from exercise was observed. Mitochondrial dynamic-related factors were also affected: Mfn2 increased significantly in the HFEx group, while Drp1 and Fis-1 increased significantly in both the HF and HFEx groups. The number of mitochondria in the subsarcolemmal region, and their size in the subsarcolemmal and intermyofibrillar regions, also increased significantly in the HFEx group. Taken overall, these results show that HFD in combination with low-intensity endurance exercise has no additive effect on mitochondrial biogenesis, although it does have such an effect on mitochondrial dynamics by improving IR. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Exercise-Induced Circulating Irisin Level Is Correlated with Improved Cardiac Function in Rats
Int. J. Environ. Res. Public Health 2020, 17(11), 3863; https://doi.org/10.3390/ijerph17113863 - 29 May 2020
Cited by 9 | Viewed by 1499
Abstract
Irisin, a recently identified myokine, plays an important physiological role in modulating energy homeostasis. However, the role of irisin in cardiac function during exercise has not been evaluated. In this study, we investigated the effect of exercise on irisin, pro-inflammatory cytokines, and cardiac [...] Read more.
Irisin, a recently identified myokine, plays an important physiological role in modulating energy homeostasis. However, the role of irisin in cardiac function during exercise has not been evaluated. In this study, we investigated the effect of exercise on irisin, pro-inflammatory cytokines, and cardiac function during 12 weeks of exercise in rats. Eight-week-old Sprague-Dawley male rats were randomly divided into two groups (n = 9 per group): sedentary control (CON) and exercise (EXE) groups. The EXE group was trained on a motorized treadmill at 20 m/min, for 60 min/day, five times/week for 12 weeks. The EXE group showed a decrease in abdominal visceral fat (p < 0.05), epididymal fat (p < 0.01), and total cholesterol (TC) (p < 0.05) and an increase in irisin levels (p < 0.01). Irisin negatively correlated with abdominal visceral (p < 0.05) and epididymal fat (p < 0.05) and positively correlated with the ejection fraction (p < 0.05), fractional shortening (p < 0.05), and cardiac output (p < 0.05). In conclusion, exercise decreases the abdominal visceral and epididymal fat and TC levels, possibly caused by elevated irisin levels, thus improving the cardiac function. This suggests that exercise-induced circulating irisin levels correlate with improved cardiac function in rats. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Effects of Long-Term Endurance Exercise and Lithium Treatment on Neuroprotective Factors in Hippocampus of Obese Rats
Int. J. Environ. Res. Public Health 2020, 17(9), 3317; https://doi.org/10.3390/ijerph17093317 - 10 May 2020
Cited by 3 | Viewed by 1577
Abstract
To investigate the effects of long-term lithium treatment and low intensity endurance exercise on brain-derived neurotrophic factor (BDNF) expression and glycogen synthase kinase 3 beta (GSK3β) activity in the hippocampus of obese rats. Fifty 10-week-old male Sprague-Dawley rats were selected. There was a [...] Read more.
To investigate the effects of long-term lithium treatment and low intensity endurance exercise on brain-derived neurotrophic factor (BDNF) expression and glycogen synthase kinase 3 beta (GSK3β) activity in the hippocampus of obese rats. Fifty 10-week-old male Sprague-Dawley rats were selected. There was a control group of 10 rats (chow control group) while the other forty rats were fed on a high-fat diet for eight weeks to induce obesity. Rats were then assigned into four random groups. The rats were given 10 mg/kg lithium chloride (LiCl) dissolved in 1 mL sterile distilled water once a day, 5 times a week. The rats did 20 min of treadmill walking with an exercise intensity of 40% maximal oxygen uptake (VO2 max) (12 m/min, slope 0%). This was performed for 20 min a day, 3 days a week. Twelve weeks of lithium treatment or endurance exercise significantly reduced body weight and body fat mass in obese rats, without showing additive effects when the treatments were given in parallel or significant toxic responses in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in blood and kidney and liver tissues. BDNF expression in the hippocampus was significantly increased both in exercise and lithium groups with synergistic effects found in the group where both exercise and lithium treatments were given in parallel. On the other hand, the decrease in GSK3β activity was shown only in the lithium treatment group, without showing additive effects when the treatments were given in parallel. Lithium and low-intensity endurance exercise for 12 weeks increased the expression of BDNF, a neuroprotective factor in the hippocampus of obese mice. Lithium treatment alone inhibited the activity of GSK3β. This can be interpreted as a positive indication of applicability of the two factors in the prevention of neurodegenerative diseases. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Feasibility and Tolerability of a Culture-Based Virtual Reality (VR) Training Program in Patients with Mild Cognitive Impairment: A Randomized Controlled Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(9), 3030; https://doi.org/10.3390/ijerph17093030 - 27 Apr 2020
Cited by 18 | Viewed by 2158
Abstract
The present study examined whether a culture-based virtual reality (VR) training program is feasible and tolerable for patients with amnestic mild cognitive impairment (aMCI), and whether it could improve cognitive function in these patients. Twenty-one outpatients with aMCI were randomized to either the [...] Read more.
The present study examined whether a culture-based virtual reality (VR) training program is feasible and tolerable for patients with amnestic mild cognitive impairment (aMCI), and whether it could improve cognitive function in these patients. Twenty-one outpatients with aMCI were randomized to either the VR-based training group or the control group in a 1:1 ratio. The VR-based training group participated in training for 30 min/day, two days/week, for three months (24 times). The VR-based program was designed based on Korean traditional culture and used attention, processing speed, executive function and memory conditions to stimulate cognitive function. The adherence to the culture-based VR training program was 91.55% ± 6.41% in the VR group. The only adverse events observed in the VR group were dizziness (4.2%) and fatigue (8.3%). Analysis revealed that the VR-based training group exhibited no significant differences following the three-month VR program in Korean Mini-Mental State Examination (K-MMSE) scores, working memory functions such as performance on the digit span test, or in Stroop test performance and word fluency. We conclude that although the 12-week culture-based VR training program did not improve cognitive function, our findings revealed that the culture-based VR training program was feasible and tolerable for participants with aMCI. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Communication
Effects of Aerobic and Resistance Exercise on Myokines in High Fat Diet-Induced Middle-Aged Obese Rats
Int. J. Environ. Res. Public Health 2020, 17(8), 2685; https://doi.org/10.3390/ijerph17082685 - 14 Apr 2020
Cited by 11 | Viewed by 1570
Abstract
The objective of this study was to analyze the effects of aerobic and resistance exercise on myokines expression in the skeletal muscle of middle-aged rats with high fat diet-induced obesity, to investigate the feasibility of using exercise training to reduce inflammation. Male 50-week-old [...] Read more.
The objective of this study was to analyze the effects of aerobic and resistance exercise on myokines expression in the skeletal muscle of middle-aged rats with high fat diet-induced obesity, to investigate the feasibility of using exercise training to reduce inflammation. Male 50-week-old Sprague Dawley rats were divided into normal diet, normal diet + exercise, high fat diet, and high fat diet + exercise groups. After six weeks on a high fat diet to induce obesity, a 12-week exercise program was implemented, which combined aerobic exercise (treadmill running) and resistance exercise (ladder climbing) three times a week for 75 min per session. We analyzed the protein levels of interleukins (IL) 6, 7, and 8, C-X-C motif chemokine receptor 2, and vascular endothelial growth factor in skeletal muscles by western blotting. Body weight decreased significantly during the 12-week exercise program in the exercise groups compared to the non-exercise groups (p < 0.05). The levels of all myokines analyzed were significantly lower in the skeletal muscle of the high fat diet group compared to the normal diet group (p < 0.05). After completing the 12-week exercise program, IL-7, IL-8, C-X-C motif chemokine receptor 2, and vascular endothelial growth factor expressions were significantly higher in the high fat diet + exercise group compared to the high fat diet group (p < 0.05). However, while IL-6 expression was significantly lower in the high fat diet and high fat diet + exercise groups compared to the normal diet group (p < 0.05), it was not significantly affected by exercise. In conclusion, high fat diet-induced obesity resulted in decreased myokines in the skeletal muscles, but combined exercise training of aerobic and resistance exercise increased myokines secretion in the skeletal muscle of obese rats, and is thought to help reduce inflammation. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Effect of Schisandra chinensis Extract Supplementation on Quadriceps Muscle Strength and Fatigue in Adult Women: A Randomized, Double-Blind, Placebo-Controlled Trial
Int. J. Environ. Res. Public Health 2020, 17(7), 2475; https://doi.org/10.3390/ijerph17072475 - 04 Apr 2020
Cited by 9 | Viewed by 2291
Abstract
The fruit of Schisandra chinensis (SC) is a well-known traditional herb used for pharmacological purposes in Asian countries (e.g., Korea, China, and Japan). In animal studies, SC extract supplementation had beneficial effects on muscle strength and lactate level. However, the effect of SC [...] Read more.
The fruit of Schisandra chinensis (SC) is a well-known traditional herb used for pharmacological purposes in Asian countries (e.g., Korea, China, and Japan). In animal studies, SC extract supplementation had beneficial effects on muscle strength and lactate level. However, the effect of SC extract supplementation on skeletal muscle strength and lactate at rest in humans remains unclear. The purpose of this study was to evaluate the effect of SC extract supplementation on quadriceps muscle strength (QMS) and lactate at rest in adult women. Forty five healthy post-menopausal middle-aged women (61.9 ± 8.4 years) were randomly divided into the SC (n = 24) or the placebo group (n = 21). The SC group consumed 1000 mg of SC extract per day, whereas the placebo group consumed 1000 mg of starch per day for 12 weeks. The difference in muscle mass, physical function, and biomarkers and the relative changes between baseline and 12 weeks were evaluated. We used two-factor repeated measures analysis of variance (ANOVA) to determine interaction (group × time) effects for variables. Statistical significance was accepted at p < 0.05. In ANOVA results, QMS (p = 0.001) and lactate level (p = 0.038) showed significant interactions. With paired t-tests, QMS was significantly increased (p < 0.001) and lactate level at rest was significantly decreased (p < 0.05) after 12 weeks in the SC group. However, no interactions were found between the other variables. Supplementation of SC extract may help to improve QMS as well as decrease lactate level at rest in adult women. We believe that SC extract is a health supplement that can support healthy life in this population. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Article
Interval Hypoxic Training Enhances Athletic Performance and Does Not Adversely Affect Immune Function in Middle- and Long-Distance Runners
Int. J. Environ. Res. Public Health 2020, 17(6), 1934; https://doi.org/10.3390/ijerph17061934 - 16 Mar 2020
Cited by 9 | Viewed by 1776
Abstract
This study evaluated the effects of intermittent interval training in hypoxic conditions for six weeks compared with normoxic conditions, on hemodynamic function, autonomic nervous system (ANS) function, immune function, and athletic performance in middle- and long-distance runners. Twenty athletes were divided into normoxic [...] Read more.
This study evaluated the effects of intermittent interval training in hypoxic conditions for six weeks compared with normoxic conditions, on hemodynamic function, autonomic nervous system (ANS) function, immune function, and athletic performance in middle- and long-distance runners. Twenty athletes were divided into normoxic training (normoxic training group (NTG); n = 10; residing and training at sea level) and hypoxic training (hypoxic training group (HTG); n = 10; residing at sea level but training in 526-mmHg hypobaric hypoxia) groups. All dependent variables were measured before, and after, training. The training frequency was 90 min, 3 d per week for six weeks. Body composition showed no significant difference between the two groups. However, the HTG showed more significantly improved athletic performance (e.g., maximal oxygen uptake). The hemodynamic function (e.g., oxygen uptake, oxygen pulse, and cardiac output) during submaximal exercise and ANS function (e.g., standard deviation and root mean square of successive differences, high frequency, and low/high frequency) improved more in the HTG. Immune function parameters were stable within the normal range before and after training in both groups. Therefore, hypoxic training was more effective in enhancing athletic performance, and improving hemodynamic and ANS function; further, it did not adversely affect immune function in competitive runners. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Review

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Review
Physical Exercise as a Multimodal Tool for COVID-19: Could It Be Used as a Preventive Strategy?
Int. J. Environ. Res. Public Health 2020, 17(22), 8496; https://doi.org/10.3390/ijerph17228496 - 17 Nov 2020
Cited by 25 | Viewed by 4705
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) is a novel coronavirus not previously recognized in humans until late 2019. On 31 December 2019, a cluster of cases of pneumonia of unspecified etiology was reported to the World [...] Read more.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) is a novel coronavirus not previously recognized in humans until late 2019. On 31 December 2019, a cluster of cases of pneumonia of unspecified etiology was reported to the World Health Organization in China. The availability of adequate SARS-CoV-2 drugs is also limited, and the efficacy and safety of these drugs for COVID-2019 pneumonia patients need to be assessed by further clinical trials. For these reasons, there is a need for other strategies against COVID-19 that are capable of prevention and treatment. Physical exercise has proven to be an effective therapy for most chronic diseases and microbial infections with preventive/therapeutic benefits, considering that exercise involves primary immunological mediators and/or anti-inflammatory properties. This review aimed to provide an insight into how the implementation of a physical exercise program against COVID-19 may be a useful complementary tool for prevention, which can also enhance recovery, improve quality of life, and provide immune protection against SARS-CoV-2 virus infection in the long term. In summary, physical exercise training exerts immunomodulatory effects, controls the viral gateway, modulates inflammation, stimulates nitric oxide synthesis pathways, and establishes control over oxidative stress. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
Review
Benefits of Exercise on Influenza or Pneumonia in Older Adults: A Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(8), 2655; https://doi.org/10.3390/ijerph17082655 - 13 Apr 2020
Cited by 29 | Viewed by 5013
Abstract
A coronavirus pandemic has recently become one of the greatest threats the world is facing. Older adults are under a high risk of infection because of weaker immune systems. Therefore, the purpose of this review is to summarize the recent scientific evidence that [...] Read more.
A coronavirus pandemic has recently become one of the greatest threats the world is facing. Older adults are under a high risk of infection because of weaker immune systems. Therefore, the purpose of this review is to summarize the recent scientific evidence that outlines the effects of exercise on influenza or pneumonia in older adults. An electronic literature search was conducted using the WEB OF SCIENCE, SCIENCEDIRECT and GOOGLE SCHOLAR databases using the following keywords, “Exercise,” “Older adult,” “Influenza,” and “Pneumonia.” Any randomized control trials, cross-sectional and observational studies that related to this topic were all included. Twenty studies met the eligibility criteria for this review. Thirteen randomized control trials investigated the effects of exercise on the immune responses to influenza or pneumonia vaccination: seven trials employed moderate aerobic exercise, three employed resistance exercise, and the remaining three used Asian martial arts or special home-based exercises. Five cross-sectional and two observational studies examined the associations between exercise/physical condition and influenza/pneumonia. Most of the current studies suggested that prolonged moderate aerobic exercise may help to reduce the risk of influenza-related infection and improve the immune responses to influenza or pneumonia vaccination in older adults. In addition, training in traditional Asian martial arts was also found to be beneficial. Future research should focus on the different effects of moderate and vigorous exercise on influenza-related diseases. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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Other

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Case Report
Effects of 2-Week Exercise Training in Hypobaric Hypoxic Conditions on Exercise Performance and Immune Function in Korean National Cycling Athletes with Disabilities: A Case Report
Int. J. Environ. Res. Public Health 2020, 17(3), 861; https://doi.org/10.3390/ijerph17030861 - 30 Jan 2020
Cited by 5 | Viewed by 1756
Abstract
We aimed to evaluate the effects of a 2-week exercise training program in hypobaric hypoxic conditions on exercise performance and immune function in Korean national cycling athletes with disabilities. Six Korean national cycling athletes with disabilities participated in exercise training consisting of continuous [...] Read more.
We aimed to evaluate the effects of a 2-week exercise training program in hypobaric hypoxic conditions on exercise performance and immune function in Korean national cycling athletes with disabilities. Six Korean national cycling athletes with disabilities participated in exercise training consisting of continuous aerobic exercise and anaerobic interval exercise in hypobaric hypoxic conditions. The exercise training frequency was 60 min (5 days per week for 2 weeks). Before and after the exercise training, exercise performance and immune function were measured in all athletes. Regarding the exercise performance parameters, the 3-km time trial significantly decreased and blood lactate levels after the 3-km time trial test significantly increased by exercise training in hypobaric hypoxic conditions. Regarding the oxygen-transporting capacity, significant differences were not observed. Regarding immune function, the number of leukocytes and natural killer cells significantly decreased and that of eosinophils, B cells, and T cells significantly increased. These results indicated that our 2-week hypoxic training showed the potential to improve exercise performance in Korean national disabled athletes. However, the effects of our hypoxic training method on immune function remained unclear. Full article
(This article belongs to the Special Issue Exercise Medicine in Health and Disease)
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