Elastic tubes: the ideal equipment for telehealth exercise medicine in the management of prostate cancer?

Prostate cancer (PCa) affects 1 in 8 men, but exercise therapy has been shown to be a very effective intervention not only to induce physiological benefits but to also reduce the side effects of cancer treatments typically administered during PCa. The COVID19 pandemic has restricted access to exercise clinics, a problem which always existed for people living in rural and remote areas. This caused many exercise physiologists and researchers to transition their clinic-based exercise to online, home-based exercise. We would like to propose that researchers and exercise physiologists should consider the use of elastic tubes in both research and the clinical management of PCa, when exercise programs are administered remotely, as their characteristics make them an ideal exercise equipment. In this article, the characteristics, considerations, and information on quantifying exercise dosage when using elastic tubes in remote exercise delivery are discussed

Delayed onset muscle soreness at one day after one-leg eccentric cycling in relation to decreases in muscle function immediately post-exercise

This study investigated the relationship between muscle function decrease at immediately post-exercise and DOMS at 24h after eccentric cycling..

Pathological mechanisms and therapeutic outlooks for arthrofibrosis

Arthrofibrosis is a fibrotic joint disorder that begins with an inflammatory reaction to insults such as injury, surgery and infection. Excessive extracellular matrix and adhesions contract pouches, bursae and tendons, cause pain and prevent a normal range of joint motion, with devastating consequences for patient quality of life. Arthrofibrosis affects people of all ages, with published rates varying. The risk factors and best management strategies are largely unknown due to a poor understanding of the pathology and lack of diagnostic biomarkers. However, current research into the pathogenesis of fibrosis in organs now informs the understanding of arthrofibrosis. The process begins when stress signals stimulate immune cells. The resulting cascade of cytokines and mediators drives fibroblasts to differentiate into myofibroblasts, which secrete fibrillar collagens and transforming growth factor-β (TGF-β). Positive feedback networks then dysregulate processes that normally terminate healing processes. We propose two subtypes of arthrofibrosis occur: active arthrofibrosis and residual arthrofibrosis. In the latter the fibrogenic processes have resolved but the joint remains stiff. The best therapeutic approach for each subtype may differ significantly. Treatment typically involves surgery, however, a pharmacological approach to correct dysregulated cell signalling could be more effective. Recent research shows that myofibroblasts are capable of reversing differentiation, and understanding the mechanisms of pathogenesis and resolution will be essential for the development of cell-based treatments. Therapies with significant promise are currently available, with more in development, including those that inhibit TGF-β signalling and epigenetic modifications. This review focuses on pathogenesis of sterile arthrofibrosis and therapeutic treatments

Exercise medicine for cancer cachexia: targeted exercise to counteract mechanisms and treatment side effects

Purpose Cancer-induced muscle wasting (i.e., cancer cachexia, CC) is a common and devastating syndrome that results in the death of more than 1 in 5 patients. Although primarily a result of elevated inflammation, there are multiple mechanisms that complement and amplify one another. Research on the use of exercise to manage CC is still limited, while exercise for CC management has been recently discouraged. Moreover, there is a lack of understanding that exercise is not a single medicine, but mode, type, dosage, and timing (exercise prescription) have distinct health outcomes. The purpose of this review was to examine the effects of these modes and subtypes to identify the most optimal form and dosage of exercise therapy specific to each underlying mechanism of CC. Methods The relevant literatures from MEDLINE and Scopus databases were examined. Results Exercise can counteract the most prominent mechanisms and signs of CC including muscle wasting, increased protein turnover, systemic inflammation, reduced appetite and anorexia, increased energy expenditure and fat wasting, insulin resistance, metabolic dysregulation, gut dysbiosis, hypogonadism, impaired oxidative capacity, mitochondrial dysfunction, and cancer treatments side-effects. There are different modes of exercise, and each mode has different sub-types that induce vastly diverse changes when performed over multiple sessions. Choosing suboptimal exercise modes, types, or dosages can be counterproductive and could further contribute to the mechanisms of CC without impacting muscle growth. Conclusion Available evidence shows that patients with CC can safely undertake higher-intensity resistance exercise programs, and benefit from increases in body mass and muscle mass

The effects of home-based exercise therapy for breast cancer-related fatigue induced by radical radiotherapy

Background Radiotherapy (RT) can lead to cancer-related fatigue (CRF) and decreased health-related quality of life (HRQoL) in breast cancer patients. The purpose of this trial was to examine the feasibility and efficacy of a home-based resistance and aerobic exercise intervention for reducing CRF and improving HRQoL in breast cancer patients during RT. Methods Women with breast cancer (N = 106) commencing RT were randomized to 12 weeks of home-based resistance and aerobic exercise (EX) or usual care/control (CON). The primary endpoint was CRF, with secondary endpoints of HRQoL, sleep duration and quality, and physical activity. Measurements were undertaken prior to RT, at completion of RT (~ 6 weeks), at completion of the intervention (12 weeks), and 6 and 12 months after RT completion, while CRF was also measured weekly during RT. Results Eighty-nine women completed the study (EX = 43, CON = 46). Over the 12-week intervention, EX completed 1–2 resistance training sessions and accumulated 30–40 min of aerobic exercise weekly. For CRF, EX had a quicker recovery both during and post-RT compared to CON (p < 0.05). Moreover, there was a significant difference in HRQoL between groups at RT completion, with HRQoL unchanged in CON and higher in EX (p < 0.05). There was no change in sleep duration or quality for either group and there were no exercise-related adverse effects. Conclusions Home-based resistance and aerobic exercise during RT is safe, feasible, and effective in accelerating CRF recovery and improving HRQoL. Improvements in CRF and HRQoL for these patients can be achieved with smaller exercise dosages than stated in the generic recommendations for breast cancer

The effect of a handball game on stretch shortening cycle of lower limb up to 72H through recovery

Handball characterized by high intensity activities such sprints, reactions, strength and sort periods of assumption. Basic content of handball movement patterns is the stretch shortening cycle (SSC), which may be produce muscle damage with consequence deterioration of performance for several hours following a handball game. The purpose of the present study was to investigate the effect of a handball game on selected indices of performance during 3 day recovery period. Twenty four male handball player separated in two groups the experimental (E: age 19.8±1.2 yrs, weight 80.2±7.6 kg, height 178.5±7.3 cm, body fat: 14.4±5 VO2max 45±6 ml kg‐1 min‐1 ) which participated in a handball game and control (C age: 22.6±2.2 yrs, weight 85.2±6.5 kg, height 184.3±3.2 cm, body fat: 14.2±3.1, VO2max 47.6±3.2 ml kg‐1 min‐1 ) didn’t participate in a handball game. Squat jump (SJ), counter movement jump (CMJ), drop jump (DJ), fast SSC and sort SSC (Newtest, Oulu, Finland) were the independed variables. Differences were evaluated with ANOVA repeated measures. The highest percentage deterioration in SJ was detected at 24 h, in CMJ at 72 h, in DJ at 48 h. The fast SSC shown the highest percentage deterioration at 24 h and the sort SSC at 48 h. In conclusion basketball game produced, a transient reduction of performance for at least 24 hours. The results indicate the necessity of enough recovery time after a handball game, at least 48 hours and therefore participate in trainings with high intensity

Changes in muscle activation during 72 hours following an acute plyometric bout

Introduction Plyometric training (PT) has been used widely in sport training to improve characteristics such as power, strength and to induce beneficial neuromuscular improvements. Previous evidence has demonstrated a significant impact of this training method on muscle activation patterns during training, however there is a lack in research literature of studies examining its follow up effects in the recovery period. The purpose of this study was to examine any possible changes in the muscle activation of the lower extremities up to 72 hours after high intensity PT. Methods An experimental study design with repeated measures was used. Twelve (n=12) male subjects (mean age 24.33 ± 2.6) executed a high intensity PT protocol for the lower extremities. Countermovement jump test (CMJ) was performed pre, immediately post, 24, 48 and 72 hours after the PT. Surface electromyography (sEMG) evaluation examined the activation of Gluteus Maximus (GM), Vastus Lateralis (VL), Biceps Femoris (BF) and Gastrocnemius (GAS) during the CMJ in all the time points of the recovery. A one way ANOVA with repeated measures was used to analyze differences between the five time points (p≤0.05). Results The results indicated a statistical significant decrease in CMJ performance at 24 and 48 hours, compared with the baseline, that peaked at 24 hours (-7.16%), and recovered at 72 hours. Muscle activation levels for GM, VL and BF followed the same pattern, decreasing significantly post training compared to the baseline, recovering at 72 hours post. Muscle activation decrease peaked immediately post training for GM (-21.8%), VL (-14.04%) and BF (-19.82%). Muscle activation for GAS decreased significantly post training (-6.77%), recovering faster than the other muscle groups, at 48 hours. Discussion CMJ jump performance impairment was in accordance with previous research, peaking at 24-48 hours and recovering at 72 hours after the bout (Chatzinikolaou et al., 2010). The impairment pattern observed in the sEMG values peaked immediately post training, recovering at 72 hours; however the magnitude of the decrease was not as extended as observed after eccentric training (Hortobágyi et al, 1998). GAS activation recovered 24 hours faster than the rest of the tested muscle groups probably due to the higher percentage of slow twitch fibers which are less susceptible to muscle damage than fast twitch. In conclusion PT significantly decreases muscle activation and jump performance up to 72 hours after the bout in GM, VL and BF, while GAS recovered in 48 hours

The influence of heat acclimation and hypohydration on Post-Weight-Loss exercise performance

Purpose: To examine the influence of fluid intake on heat acclimation and the subsequent effects on exercise performance following acute hypohydration. Methods: Participants were randomly assigned to 1 of 2 groups, either able to consume water ad libitum (n = 10; age 23 [3] y, height 1.81 [0.09] m, body mass 87 [13] kg; HAW) or not allowed fluid (n = 10; age 26 [5] y, height 1.76 [0.05] m, body mass 79 [10] kg; HANW) throughout 12 × 1.5-h passive heat-acclimation sessions. Experimental trials were completed on 2 occasions before (2 baseline trials) and 1 following the heat-acclimation sessions. These sessions involved 3 h of passive heating (45°C, 38% relative humidity) to induce hypohydration followed by 3 h of ad libitum food and fluid intake after which participants performed a repeat sled-push test to assess physical performance. Urine and blood samples were collected before, immediately, and 3 h following hypohydration to assess hydration status. Mood was also assessed at the same time points. Results: No meaningful differences in physiological or performance variables were observed between HANW and HAW at any time point. Using pooled data, mean sprint speed was significantly (P < .001) faster following heat acclimation (4.6 [0.7] s compared with 5.1 [0.8] s). Furthermore, heat acclimation appeared to improve mood following hypohydration. Conclusions: Results suggest that passive heat-acclimation protocols may be effective at improving short-duration repeat-effort performance following acute hypohydration

Increases in Integrin–ILK–RICTOR–Akt Proteins, muscle mass, and strength after eccentric cycling training

Purpose Recently, it has been suggested that a cellular pathway composed of integrin, integrin-linked kinase (ILK), rapamycin-insensitive companion of mTOR (RICTOR), and Akt may facilitate long-term structural and functional adaptations associated with exercise, independent of the mTORC1 pathway. Therefore, we examined changes in integrin–ILK–RICTOR–Akt protein in vastus lateralis (VL) before and after 8 wk of eccentric cycling training (ECC), which was expected to increase muscle function and VL cross-sectional area (CSA). Methods Eleven men (23 ± 4 yr) completed 24 sessions of ECC with progressive increases in intensity and duration, resulting in a twofold increase in work from the first three (75.4 ± 14.1 kJ) to the last three sessions (150.7 ± 28.4 kJ). Outcome measures included lower limb lean mass, VL CSA, static strength, and peak and average cycling power output. These measures and VL samples were taken before and 4–5 d after the last training session. Results Significant (P < 0.05) increases in integrin-β1 (1.64-fold) and RICTOR (2.99-fold) protein as well as the phosphorylated-to-total ILK ratio (1.70-fold) were found, but integrin-α7 and Akt did not change. Increases in lower limb, thigh, and trunk lean mass (2.8%–5.3%, P < 0.05) and CSA (13.3% ± 9.0%, P < 0.001) were observed. Static strength (18.1% ± 10.8%) and both peak (8.6% ± 10.5%) and average power output (7.4% ± 8.3%) also increased (P < 0.05). However, no significant correlations were found between the magnitude of increases in protein and the magnitude of increases in CSA, static strength, or power output. Conclusions In addition to increased muscle mass, strength, and power, we demonstrate that ECC increases integrin-β1 and RICTOR total protein and p-ILK/t-ILK, which may play a role in protection against muscle damage as well as anabolic signaling to induce muscle adaptations