Earticle

Hyperglycemic diabetes is a chronic metabolic disorder characterized by high level of plasma glucose. Numerous studies have shown that hy-perglycemic diabetes leads to brain dysfunction including cognitive im-pairment and emotional disorders. This study evaluated the impact of exercise on brain dysfunction, hippocampal neurogenesis, and cogni-tive impairment in hyperglycemic diabetes. The present study suggests that exercise improves hyperglycemic control and prevents decline of cognition through increasing hippocampal neurogenesis. Understanding the mechanism of exercise for hippocampal neurogenesis can lead to the development of therapeutic strategies for metabolic disorders.

Maternal separation during early life causes psychiatric and neurologi-cal disorders such as anxiety and depression. Depression or anxiety is closely associated with memory impairment. The purpose of this study was to investigate the effect of treadmill exercise on activity, short-term memory, vascular dysfunction using maternal separation-induced de-pression model. Maternal separation started on 15-day-old rats. The rats in the maternal separation and fluoxetine injection group received intraperitoneal injection of 5 mg/kg of fluoxetine one time daily for 15 days from 21 to 35 days. The rats performed treadmill exercise once a day during 15 days from 21 to 35 days. There was low activity and short-term memory was decreased in the maternal separation rats. Treadmill exercise and fluoxetine injection increased activity and ameliorated memory impairment. The number of rat endothelial cells antigen-1 (RECA-1) of microvessels was decreased in the maternal separation rats. The number of RECA-1was increased by treadmill exercise and fluoxetine injection. Expression of matrix metalloproteinase-9 (MMP-9) was increased and expressions of zonula occludens-2 (ZO-2) and oc-cludin were decreased in the maternal separation rats. Treadmill exer-cise and fluoxetine injection suppressed MMP-9 expression and en-hanced ZO-2 and occludin expressions in the maternal separation rats. The present study shows treadmill exercise and antidepressant treat-ment ameliorates depressive symptom and short-term memory impair-ment by protecting from blood-brain barrier damage.

We wanted to find the intensity of exercise that could increase brainderived neurotrophic factor (BDNF) expression and improve spatial learning and memory without dietary control. C57BL/6 mice were fed a 60% high-fat diet (HFD) for 6 weeks to induce obesity. Obesity-induced mice were exercised on a treadmill for 8 weeks at various exercise intensities: HFD-control (n= 7), HFD-low-intensity exercise (HFD-LIE, n= 7, 12 m/min for 75 min), HFD-middle intensity exercise (HFD-MIE, n= 7, 15 m/min for 60 min) and HFD-high-intensity exercise (HFD-HIE, n= 7, 18 m/min for 50 min). One week before sacrificing mice, the Morris water maze test was performed, and the hippocampus was immediately removed after sacrifice. The expression levels of BDNF (encoded by the gene Bdnf) and tropomyosin receptor kinase B (TrkB) in the hippocampus were analyzed by quantitative real-time reverse transcriptionpolymerase chain reaction and western blot. In the last probe test of the Morris water maze test, occupancy in the target quadrant was significantly higher in the HFD-HIE group (P< 0.05) than in the other groups. In addition, mRNA expression from the Bdnf promoter region was found to be significantly higher in the HFD-HIE group than in the other groups (P< 0.001). Although there were some differences in the levels of significance, the expression levels of both BDNF and TrkB were significantly higher in the HFD-HIE group than in the other groups. Therefore, relatively high-intensity aerobic exercise can resist the adverse effects of a high-fat diet on the brain without dietary control.

Social isolation during adolescence is associated with anxiety, depres-sion, and memory impairment. Exercise has been reported as a positive effect on brain function, especially hippocampus. The present study ex-amined the effect of swimming exercise on apoptosis, cell proliferation, and serotonin expression in social isolation rats during adolescence stage. Social isolation started at postnatal day 21 and continued for 6 weeks. The rats in the swimming group were forced to swim for 60 min once daily during 6 days per week for 6 consecutive weeks. The rats in the social isolation during adolescence showed anxiety, depression, short-term memory impairment. Social isolation facilitated apoptosis and inhibited cell proliferation and differentiation. Social isolation sup-pressed expression of serotonin, brain-derived neurotrophic factor, and tyrosine kinase B. Swimming exercise alleviated anxiety, depression, short-term impairment. Swimming exercise suppressed apoptosis, en-hanced neurogenesis, and increased serotonin expression. In our study, swimming exercise ameliorates mood disorder and memory impairment by enhancing neurogenesis and serotonin expression and inhibiting apoptosis in social isolation.

The purpose of this study was to investigate the effect of treadmill exer-cise on activating transcription factors such as activating transcription factor 3 (ATF3) and extracellular signal-regulated kinase (ERK1/2) sig-naling pathway to facilitate axonal regrowth after sciatic nerve injury (SNI). The experimental rats divided into the normal control (n=10), sedentary groups for 7 (n=10) and 14 days (n=10) post crush, exercise group for 7 (n=10) and 14 days (n=10) post crush (dpc). The rats in ex-ercise groups run on treadmill device at a speed of 8 m/min for 20 min once a day according to exercise duration. In order to evaluate specific regeneration markers and axonal elongation in injured sciatic nerve, we applied immunofluorescence staining and western blot techniques. Treadmill exercise further increased growth-associated protein (GAP-43) expression and axonal regrowth at 7 and 14 dpc than those in sed-entary group. Among mitogen-activated protein kinase downstream molecules, phospho-ERK1/2 (p-ERK1/2) was enhanced by treadmill ex-ercise at only 7 dpc and decreased to basal level 14 days later. But c-Jun N-terminal kinase, c-Jun, and phospho-cyclic adenosine mono-phosphate response element-binding protein showed a tendency to in-crease continuously until 14 dpc by exercise. ATF3 expression in exer-cise group was upregulated at both 7 and 14 dpc compared to the sed-entary group. These results indicate that treadmill exercise had benefi-cial effect on expression of regeneration-related proteins after SNI, suggesting that exercise might be one of various therapeutic strategies for sciatic nerve regeneration.

With the increasing number of aged individuals, research pertaining to their cognitive functions and physical-motor has become exponentially imperative. The purpose of the study was to investigate the effect com-bined aquatic and cognitive training on quality of life (QoL), fall self-effi-cacy and motor performance (static and dynamic balance) in aged with varying cognitive status levels. Thirty participants were assigned to a high cognitive status group (n=10), low cognitive status group (n=10), or nonintervention control group (n=10). Participants completed a 6-week motor-cognitive training regime with increasing intensity. QoL, fall self-efficacy, static balance, and dynamic balance were assessed. Preliminary results suggest proof-of-concept significant (P<0.05) im-provements were found in both the high and low cognitive status groups for static and dynamic balance and fall self-efficacy. However, QoL was only found to be significantly improved in the low cognitive status group. Aqua training along with cognitive training can effectively be used to prevent falls in the elderly and to improve their physical-motor perfor-mance. However, when attempting to improve QoL, the cognitive status of the individual should be considered.

This study was to analyze bullying experiences, physical fitness, and stress and social support in young students who have taken part in a soccer program for approximately 3 years. Fifty-two participants who were divided into two groups: a control group that had not experienced alienation (NAG; n=45, 86.5%) and an experimental group that had ex-perienced alienation (AG; n=7, 13.5%). The frequency of alienation in AG was ‘1–2 times’ or ‘a few times’ per week. NAG believed their in-volvement in the soccer program helped them improve their relation-ships with friends, cope with alienation, and overcome bullying. Muscle mass and basal metabolic rate of NAG showed higher levels than those of AG. Strength of NAG was significantly higher than that of AG. Stress levels of NAG were significantly lower than those of AG. Although so-cial support was not significantly different between groups, there was a higher tendency in NAG to have stronger social support compared to AG. In conclusion, this study suggests that physical fitness and stress levels can be improved by playing soccer. In particular, participating in a soccer program for an extended period of time can benefit individuals who are socially alienated.

The present study aimed to investigate the fear of falling and its associ-ated factors among patients with vestibular hypofunction. We conduct-ed a cross-sectional survey using structured questionnaires to evaluate fear of falling and activities of daily living among participants. Vestibular function was assessed via a rotary chair test. This study was conduct-ed from January through March 2018. The subjects were 167 individuals older than 20 years who agreed to participate in this study. Data were analyzed using SPSS ver. 22.0. The significant variables associated with fear of falling were gender (P=0.012), age (P<0.001), marital status (P=0.006), living alone (P=0.020), having a job (P<0.001), frequency of dizziness (P=0.007), use of antivertigo medication (P<0.001), and histo-ry of falling (P<0.001). Fear of falling showed statistically significant positive correlations with activities of daily living (r=0.82, P<0.001) and dizziness (r=0.61, P<0.001). In the multiple regression analysis, age, gender, history of falling, and severity of dizziness explained 53.4% of the variance in fear of falling. The results of this study demonstrate that thoroughly assessing predictors making an impact on fear of falling in the initial assessment and the level of fear of falling needs to be ad-dressed early to prevent sedentary behavior.

Increased use of smartphones can cause abnormal alignment of head and neck, resulting in forward head posture (FHP). This can lead to change in the structures and function of the cervical vertebrae. The purpose of this study was to determine the impact on deep neck flexor muscles, proprioception, vestibular function, and balance of subjects with induced FHP by using smartphone. Twenty-two healthy persons were randomly divided into two groups. The FHP group maintained a craniovertebral angle (CVA) of <49° and a normal head posture group maintained a CVA of >50° watching the smartphone for 40 min. We measured the area of the longus colli and longus capitis muscles, cervi-cal joint position sense, Romberg test, subjective visual vertical test, and subjective visual horizontal test. There was no significant differ-ence in the deep neck flexor muscles, vestibular function, and static balance between the groups. However, there was a significant differ-ence in the cervical proprioception (P<0.05). Proprioception may be considered to be the most influential factor in induced FHP by smart-phone viewing.

This study aimed to analyze if the ratio standard or the allometry is the best scaling methods of handgrip strength (HGS) for body mass (BM) in judo athletes and nonathletes, and to verify if the HGS mean values are higher in judo athletes than nonathletes when the BM effect is removed. One hundred forty-two individuals, being 88 judo athletes and 54 non-athletes participated in this study. The maximal isometric HGS was measured in judo athletes and nonathletes in the preferred hand. Only the allometry method was able to remove the BM effect of HGS. The al-lometric exponents found for athletes was b=0.68 and b=0.563 for non-athletes. A common allometric exponent was identified as (b=0.64) for comparing judo athletes and nonathletes. However, neither was able to allow for the comparison between groups due to a distortion of (bias; P<0.01). Thus, an index (HGSINDEX) was proposed to allow within-group (judo athletes and nonathletes) and between-group (judo athletes vs. nonathletes) comparison, removing the effect of BM. In summary, the allometric exponent based on the theory of geometric similarity (b=0.67) was able to remove the BM effect of HGS in judo athletes. An index (HGSINDEX) is suggested for classification (or rank) of the judoka in rela-tion to the expected average of HGS.

This study was performed to identify the factors affecting the develop-ment of metabolic syndrome by comparing the numbers of risk factors of the syndrome and by identifying the factors influencing the develop-ment of metabolic syndrome. Two hundred forty-eight health screening of examinee were used for the study (101 males, 147 females). Diagnos-tic basis ratio of metabolic syndrome risk factors showed that 35.1% of the subjects had abdominal obesity, 32.7% for high blood pressure, 66.1% for high insulin blood sugar, 43.1% for high triglyceride lipidemia, and 7.3% for low high-density lipoprotein lipidemia. No significant differ-ence of the incidence of metabolic syndrome was found between gen-der. The diagnostic number for male was the highest with 1 risk factor (31.7%) while the highest with 2 factors (30.6%) in female. Significant differences were found in age and body mass index (BMI) between normal group with no risk factor and metabolic syndrome group. There was significant difference in BMI between the syndrome group with 1 risk factor and 3 risk factors. BMI was significantly higher (5.282 times) compared to their counterpart (P<0.001). Significant difference was found in BMI between 2 risk factors and the syndrome group with more than 3 risk factors and the incidence was higher (4.094 times) in the overweight group than their counterpart (P<0.001).

Chest wall expansion determines lung volume and functional capacity. Factors determining chest wall expansion include respiratory muscle strength. Accordingly, there may be association among respiratory muscle strength, chest wall expansion, and functional capacity. Thusly, this cross-sectional study identified the relationship between respirato-ry muscle strength, chest wall expansion, and functional capacity. Sev-enty-six healthy male and female participants aged between 20 to 59 years exhibiting a body mass index of 18.5 to 22.9 kg/m2 were enrolled. Inspiratory and expiratory muscle strength were evaluated via maxi-mum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), respectively. Chest wall expansion was measured through tho-racic circumferences at three different levels; upper, middle, and lower levels with diaphragmatic movement also measured utilizing the cir-cumference of the lower edge of the 10th rib. Functional capacity was evaluated through distance obtained from a 6-min walk test. Results showed that both MIP and MEP were significantly correlated with chest wall expansion at the middle (P=0.005 and P=0.006) and lower (P=0.012 and P=0.020) thoracic levels as well as diaphragmatic move-ment (both P<0.001). Moreover, both MIP and MEP were significantly related amid the 6-min walk distance (P=0.025 and P<0.001). In conclu-sion, respiratory muscle strength is positively associated with chest wall expansion, diaphragmatic movement, and functional capacity in healthy participants.

Vestibular rehabilitation (VR) improves dizziness and vertigo, postural control, and quality of life. It is a beneficial and safe intervention for pa-tients with peripheral vestibular disease. Physical therapists play an im-portant role in treating them, but Korean physical therapists have little experience in VR or treating peripheral vestibular disease. Furthermore, there are few studies on the current status of Korean physical thera-pists regarding VR. Therefore, we aimed to identify the awareness and current status of Korean physical therapists regarding VR and to dis-cuss the necessity of VR education. The data were obtained from an online survey conducted among 483 licensed physical therapists. In to-tal, 393 questionnaires were analyzed, after excluding 90 questionnaires (18.6%) with poor answers. Most physical therapists had no VR educa-tion (75.6%) and had a high positive response for the necessity of VR education (68.2%) and intention to receive VR education (63.9%). There was a significant difference in clinical experience and intention to re-ceive VR education (P<0.05) with respect to presence or absence of VR education. For the necessity of VR education, there was a statisti-cally significant difference in academic background, institutional type, and intention to receive VR education (P<0.05). In conclusion, many physical therapists in Korea are very interested in VR education, and various factors have highlighted the need for VR education. Therefore, professional education for VR and the cooperation and attention of re-lated medical staff are urgently required.