Earticle

As blood flow is proportional to the fourth power of the vascular radius small changes in the diameter of resistance arteries/arterioles following an increase in intraluminal pressure would be expected to substantially increase blood flow. However, arteriolar myocytes display an intrinsic ability to locally regulate blood flow according to metabolic demands by tuning the diameter of small arteries in response to local changes in he-modynamics. Critical to this, observations were made more than 100 years ago that mechanosensitive small arteries exhibit the “myogenic response” or pressure-induced vasoconstriction or vasodilation in re-sponse to increased or decreased intravascular pressure, respectively. Although cellular mechanisms underlying the myogenic response have now been studied extensively, the precise cellular mechanisms under-lying this intriguing phenomenon still remain uncertain. In particular, the biological machinery that senses changes in intravascular pressure in vascular smooth muscle cells have not been unquestionably identified and remain a significant issue in vascular biology to be fully elucidated. As such, this brief review focuses on putative mechanosensors that have been proposed to contribute to myogenic vasoreactivity. Specific attention is paid to the roles of integrins, G protein-coupled receptors, and cadherins.

Scapular stabilization approaches have been a mainstay of therapeutic training programs in the recent past for patients with subacromial impingement syndrome, whereas its contributions solely in the clinical outcome of reducing shoulder pain and disability are largely unclear. This systematic review aims to evaluate and summarize the best evidence regarding the role of scapular stabilization interventions in alleviating shoulder dysfunction among subjects with subacromial impingement syndrome. Six reviewers involved in this systematic review. Literature was retrieved systematically through searching 5 electronic databases (PubMed, MEDLINE, CINAHL, Cochrane, and Google Scholar). Articles published from the year 2010 up to and including 2019 were included. The literature search included clinical trials those intervened subjects with scapular exercises or scapular stabilization exercises or scapular rehabilitation, as an intervention for subacromial impingement syndrome. Seven studies, totaling 228 participants were included in this systematic review. Articles included in this review were graded according to Lloyd-Smith hierarchy of evidence scale and critically appraised with a tool developed by National, Heart, Lung and Blood Institute (United States), named as quality assessment of controlled intervention studies tool. There was a significant effect on the scapular stabilization exercise program on improving pain and disability among subjects with subacromial impingement syndrome. This systematic review provides sufficient evidence to suggest that scapular stabilization exercises offers effectiveness in reducing pain and disability among subjects with subacromial impingement syndrome. However, more trials with larger sample are needed to provide a more definitive evidence on the clinical outcomes of scapular stabilization exercises among patients with impingement.

The effect of treadmill exercise on the social isolation-induced memory impairment in relation with the silent information regulator-1 (SIRT-1) was investigated. The rats in the control groups lived four in the stan-dard cages for 8 weeks. The rats in the social isolation groups lived alone in the small cages for 8 weeks. The rats in the treadmill exercise groups were subjected to run on a treadmill for 30 min once a day for 8 weeks. We used step-through avoidance test for short-term memory and Morris water maze task for spatial working memory. Immunohisto-chemistry for SIRT-1 and western blot analysis for Bax, Bcl-2, cleaved caspase-3, brain-derived neurotrophic factor (BDNF), and tropomyosin receptor kinase B (TrkB) were performed. The rats in the social isolation group showed a decrease in short-term memory and spatial working memory. Treadmill exercise alleviated short-term memory and spatial working memory in the social isolation rats. SIRT-1 expression in the hippocampus was decreased in the rats of social isolation group. Treadmill exercise increased SIRT-1 expression in the social isolation rats. Bax expression was increased, Bcl-2 expression was decreased, and cleaved caspase-3 expression in the hippocampus was increased in the rats of social isolation group. Treadmill exercise decreased Bax expression, increased Bcl-2 expression, and decreased cleaved caspase-3 expression in the social isolation rats. Hippocampal BDNF and TrkB expression was decreased in the rats of social isolation group. Treadmill exercise increased BDNF and TrkB expression in the social isolation rats.

Effect of swimming exercise on serotonin (5-hydroxytryptamine, 5-HT) expression and apoptosis in social isolation rats during old age was in-vestigated. Rats in the old social isolation groups were housed alone per cage for 4 weeks. Rats in the swimming exercise groups were al-lowed to swim for 30 min once daily for 4 weeks. Morris water maze task determined spatial working memory and elevated plus maze test determined anxiety. Immunohistochemistry for tryptophan hydroxylase (TPH) and 5-HT in the dorsal raphe and for doublecortin (DCX) in the hippocampal dentate gyrus was conducted. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining in the hippocampal dentate gyrus was performed. Western blot analysis for Bax, Bcl-2, and cytochrome c in the hippocampus was conducted. So-cial isolation in rats of old age reduced spatial working memory and in-creased anxiety level. Swimming exercise enhanced spatial working memory and suppressed anxiety level. Social isolation in rats of old age inhibited TPH and 5-HT expression in dorsal rape. Swimming exercise increased TPH and 5-HT expression. Social isolation in rats of old age inhibited DCX-positive cells in the hippocampal dente gyrus. Swimming exercise increased DCX-positive cells. Social isolation in rats of old age increased TUNEL-positive cells, Bax and cytochrome c expression, and decreased Bcl-2 expression, which promoted apoptosis. Swimming ex-ercise suppressed TUNEL-positive cells, Bax and cytochrome c expres-sion, and increased Bcl-2 expression, which inhibited apoptosis. Swim-ming exercise improved 5-HT expression and suppressed apoptosis to alleviate anxiety and memory impairment during old age.

The purpose of this study was to investigate the interactive effect of cognitive function and intervention on walking independence of stroke patients. Stroke patients (n=405) who admitted to convalescent reha-bilitation ward, were classified as being walking independent or depen-dent. To examine the interaction between cognitive function and inter-vention, high cognitive function (functional independence measure score ≥20) and physical therapy and occupational therapy intervention delivered in 1 day (lasting >2 hr) were defined as cognition-intervention interaction and included as independent variables. The incidence of walking independence was calculated using Kaplan–Meier curves. In-tergroup differences were estimated using log-rank test. Cox propor-tional hazards analysis was used to extract the predictors of walking in-dependence. Survival analyses using Kaplan–Meier log-rank test showed that the probability of incidence of walking independence was significantly higher in the presence of a cognition-intervention interac-tion. The results of Cox proportional hazards analysis showed that age, left versus right cerebral damage, and cognition-intervention interac-tion significantly influenced walking independence at discharge from the hospital. The hazard ratios were 0.971 per year of age, 0.544 for left versus right cerebral damage, and 1.794 for cognition-intervention inter-action. Walking independence was more likely to be achieved by stroke patients with high cognitive function who received therapy. In other words, the conditions that increase the likelihood of an effect of therapy intervention on walking independence were identified in this study.

This study evaluated the effects of whole-body vibration (WBV) com-bined with action observation on gross motor function, balance, and gait in children with spastic cerebral palsy. The participants were ran-domized into the WBV combined with action observation (WBVAO) group (n=7) and the WBV group (n=7). The WBVAO group received WBV combined with action observation training, and the WBV group received WBV training for 4 weeks. Both groups received 30 min of training a day, 3 times a week. All participants completed the 5 times sit to stand (FTSTS) test, Timed Up and Go (TUG) test, pediatric reach test, 10-m walk test, 6-min walk test (6MWT), and timed up and down stair (TUDS) test before and after the training intervention. Moreover, the participant’s Gross Motor Function Measure (GMFM) and Pediatric Balance Scale (PBS) scores were assessed. Both the WBVAO and WBV groups demonstrated significant increases in the scores of FTSTS test, GMFM (D and E dimensions), PBS, TUG test, 6MWT, and TUDS test. The WBVAO group improved more significantly compared to the WBV group based on the scores of the FTSTS test, GMFM (D dimen-sion), PBS, 6MWT, and TUDS test. WBV combined with action observa-tion improved lower extremity functional strength, gross motor function, and balance and gait in children with cerebral palsy. These results sug-gest that WBV combined with action observation is both feasible and suitable for individuals with cerebral palsy.

This study aimed at providing an exercise program for each type of dis-ability after analyzing the exercise program performed by adults with intellectual disability (ID) or autistic spectrum disorder (ASD). Twenty- nine male adults voluntarily took part in this study, whose age ranged from 19 to 28 years and with an average body mass index of 23.98± 4.02 kg/m2. The sample was divided into two groups as follows: ASD group (ASDG; n=15) and ID group (IDG, n=14). The selected tests used to measure gross motor function (GMF, locomotion and object control skills) and health fitness (body composition, flexibility, strength, muscle endurance, and cardiopulmonary endurance) were also used in previ-ous studies. The GMF and health fitness between ASDG and IDG showed no significant differences. This study indicates that exercise programs could provide similar effects, even with other disorder types having similar symptoms.

Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism, components of metabolic syn-drome, constitute risk factors for cardiovascular disease in women. Iri-sin and fibroblast growth factor-21 (FGF-21), which regulate browning, and high molecular weight (HMW) adiponectin have emerged benefi-cial for metabolic health. The purpose of the study was to examine the effect of endurance aerobic exercise on circulating browning factor and HMW-adiponectin level in postmenopausal women. Twenty-five postmenopausal women were included in this study. The aerobic exer-cise program consisted of 60 min of walking exercise at 50%–60% max-imum oxygen uptake, and conducted 3 times per week for 6 weeks. Body composition, blood pressure, lipid profiles, physical fitness, and concentration of plasma irisin, FGF-21, HMW-adiponectin were ana-lyzed before and after exercise. Waist circumference, systolic blood pressure, and triglyceride levels decreased, and levels of high-density lipoprotein cholesterol, irisin increased after exercise. However, there were no significant changes in FGF-21 and HMW-adiponectin. Balance and flexibility among physical fitness indices improved after exercise. These results suggested that moderate intensity walking could be the ideal type of exercise in menopausal women to induce a positive change in metabolic health markers, including an increase in irisin levels. Fur-ther studies are needed to determine the effects of exercise on brown adipose tissue browning factor.

Electrotherapy modalities are one of the increasing ways of muscle strength and endurance. However, it is not clear which electrotherapy modalities are more effective. The purpose of this study is to compare the effect of Russian current (RC) and high voltage pulsed current (HVPC) on the strength and endurance of the quadriceps muscle. The study was performed on 10 volleyball athletes. The participants’ extrem-ities were divided into two groups as RC and HVPC. Muscle strength and endurance levels were assessed by an isokinetic device. Isokinetic training and 20-min electrotherapy were given in each treatment ses-sion. This training program consisted of a total of 12 sessions, sched-uled twice a week for 6 weeks. After training, knee extensor peak torque values and endurance ratios have increased in both groups, but it was determined that this increase was only significant in terms of the endurance ratio (P<0.05). There was no significant difference between the muscle strength and the endurance ratio of the RC and HVPC groups (P>0.05). RC or HVPC have no advantages over each other, and therefore it has been determined that both currents can be used in or-der to strengthen muscles and increase muscular endurance. Addition-al studies whose longer-term effects will investigate are needed.

This study aimed to provide fundamental data of core balance training (CBT) on Cobb angle and isokinetic torque and balance in unilateral exercised athletes. Forty-eight subjects were divided by control group (CON; n=16), non-CBT exercised group in unilateral handed athletes (NEG, n=16), and CBT exercised group in unilateral handed athletes (EG, n=16), respectively. Although the group by time interaction in the Cobb angle and in the isokinetic torque were not significantly changed in the EG, the balance of the EG showed significantly improved. As con-clusions, these results informed that the 16-week CBT would provide a positive effect on the balance except for the Cobb angle and the isoki-netic torque.

The purpose of this study was to analyze the mood states, recovery, displacement patterns, and rating of perceived exertion of elite junior soccer players during a national competition, considering substitutions in the matches. Before the games, the mood states and total quality re-covery (TQR) were evaluated. During the games, the total distance (TD), low-speed distance (LSD), and high-speed distance were monitored. At the end of the matches, the rating of perceived exertion scale was used. The average and standard deviation were used to compare the match stages, soccer positions and influence of the substitutions. The significance level adopted was 5%. In relation to the mood states, fa-tigue presented higher values (P<0.05) for entire match and substitute players, and in the TQR, substitute players presented better recovery (P<0.05) than entire match and replaced players. In the TD, shorter dis-tances covered were observed (P<0.05) in the first half, and the aver-age of the midfielders was longer (P<0.05) than that of the defenders. In the LSD, the midfielders covered longer distances (P<0.05) than the strikers and defenders. It is possible to conclude that the substitutions have an impact on the player positions, match stages and maintenance of the intensity of the players.

The use of real-time ultrasound imaging (RUSI) as biofeedback to en-hance the performance of spinal stabilization exercise and recovery from low back pain has been a recent trend in musculoskeletal rehabili-tation. The aim of this pilot study was to evaluate whether it would be feasible to conduct a randomized controlled trial investigating the ef-fects of spinal stabilization exercise with RUSI biofeedback in individu-als with chronic nonspecific low back pain. This was a single-group pretest-posttest quasi-experimental study. Ten consecutive patients with chronic nonspecific low back pain met the study criteria. They re-ceived spinal stabilization exercise with the RUSI biofeedback focusing on lumbar multifidus muscle activation. The intervention was provided twice weekly for 6 weeks. Outcome measures were lumbar multifidus muscle cross-sectional area, pain, disability and quality of life assessed at baseline and after intervention. A paired t-test was applied and effect size (Cohen d) was computed. The recruitment and retention rates were 75% and 83% respectively. No adverse events were reported during the study. Compared with the baseline, the participants demonstrated sta-tistically significant improvement in lumbar multifidus muscle cross- sectional area (P<0.05, d=1.03), pain (P<0.001, d=2.56) and disability (P<0.05, d=1.43) with large effect size after the intervention. However, no statistically significant differences were observed for physical and mental health (P>0.05) after the intervention. It was concluded that spi-nal stabilization exercise with RUSI biofeedback is effective in improv-ing lumbar multifidus muscle cross-sectional area, pain and disability in individuals with chronic nonspecific low back pain. The results demon-strated the feasibility of conducting a future, larger-scale powered ran-domized controlled trial to confirm these preliminary findings.