Earticle

People with disabilities (PWD) suffer from chronic diseases and other problems due to their low physical activity compared to people without disabilities. Physical activity and exercise can prevent chronic diseases and improve health management. However, PWD do not receive proper rehabilitation exercise and sports services immediately after dicharge from hospitals. An effective model of rehabilitation exercise and sports service delivery system has not been established in Korea. This study aimed to present such a model for health promotion, which enables PWD to participate in exercise regularly in local communities. The model is presented by dividing it into sides of consumers and suppliers by analyzing domestic and foreign rehabilitation and sports service systems and expert meetings. The system presented in this study can help promote returning to normal social life and transition into sports in daily life for PWD. In addition, it is expected to positively affect local communities through training instructors in rehabilitation exercise and sports; it can serve as a bridge between rehabilitation in medical institutes and sports in daily life.

The purpose of this study was to investigate the time-dependent alter-ation in whether concurrent aerobic exercise and bone marrow stromal cell (BMSC) engraftment could regulate myogenic differentiation-relat-ed signaling pathway in the soleus up to 35 days after sciatic nerve inju-ry (SNI). The rats were divided as follows: the normal control (CON, n=5), sedentary group (SED, n=20), treadmill exercise group (TEX, n=20), BMSC transplantation group (BMSC, n=20), TEX+BMSC transplanta-tion group (TEX+BMSC, n=20) 7, 14, 21, and 35 days after SNI. SNI was applied into the thigh and treadmill exercise was comprised of walking at a speed of 4 to 8 m/min for 30 min once a day. Harvested BMSC at a density of 5×106 in 50-μL phosphate-buff-ered saline was injected into the injury site. Phosphorylated (p) extracellular signal-regulated kinase 1/2 expression was dramatically upregulated in BMSC and BMSC+EX groups from 21 days after SNI compared to those in the SED group. P-ribosomal s6 kinase (RSK) was sharply increased 14 days later, and then rapidly downregulated from day 21, whereas TEX, BMSC and TEX+ BMSC groups significantly kept up expression levels of p-RSK until 35 days post injury than SED group. TEX+BMSC group significantly in-creased activation of protein kinase B-mammalian target of rapamycin in the soleus from day 14 and myoblast determination protein 1-myogen-in pathways was activated in TEX+BMSC group from day 21. Present findings provide information that combined intervention of aerobic ex-ercise and BMSC transplantation might be a reliable therapeutic strate-gy for overcoming the morphological and functional problems in dener-vated soleus muscle.

The purpose of this study was to determine whether combined inter-vention of treadmill exercise and bone marrow stromal cell (BMSC) transplantation would affect the expression of neurotrophic factors in the sciatic nerve injury (SNI) and neuropathic pain-related cascades in ipsilateral lumbar 4-5 dorsal root ganglion (DRG) during the early or late stage of sciatic nerve regeneration. The rats were randomly divided into the normal control group (CONT, n=6), sedentary group (SS, n=24), exercise group (SE, n=24), BMSC transplantation group (SB, n=24), BMSC transplantation+exercise group (SBE, n=24) 1, 2, 3, and 5 weeks after SNI. Single dose of 5×106 harvested BMSC was injected into the injury area sing by a 30 gauge needle. Treadmill exercise was performed at a speed of 8 m/min for 30 min once a day. Tropomyosin-receptor ki-nase B, brain-derived neurotrophic factor and ciliary neurotrophic fac-tor were significantly upregulated in the SE and SBE groups at 1- and 2-week postinjury than those in the CONT and SS groups, and SB and SBE groups continuously kept up proinflammatory cytokines until the late stage of regeneration. Nuclear factor kappa-light-chain-enhancer of activated B cells, interleukin and tumor necrosis factor alpha in ipsi-lateral DRG were progressively decreased by exercise alone application and/or BMSC transplantation at early and late stage of regeneration. Present results provide reliable information that combined intervention of treadmill exercise and BMSC transplantation might be one of the ef-fective treatment strategies for recovering sciatic nerve injury-induced neuropathic pain over time.

The purpose of this study is to verify the effects of participation in 12-week multimodal cognitive exercise program on cognitive function, bone mineral density, blood lipids, senior functional fitness, and depres-sion of the old women with mild cognitive impairment and osteopenia. As a result, the exercise group showed significant effects in cognitive function, depression, bone mineral density, blood lipid, lower extremity flexibility, upper extremity flexibility, dynamic balance, and body endur-ance. Such results prove that multimodal cognitive exercise program is an effective interventional exercise program for improving cognitive function in the old women with mild cognitive impairment.

The aim of this study was to explore and describe the exercise be-haviours and barriers in people with Charcot-Marie-Tooth disease (CMT), with a particular focus on resistance training (RT). Ninety-four Australian adults with a diagnosis of CMT completed an online survey. Fifty-seven percent of respondents reported performing some form of RT each week. Those performing RT engaged in more aerobic activity (P≤0.01) and were involved in longer periods of structured exercise (P<0.01) compared to those not performing RT. The RT group was more likely to perceive their exercise levels as acceptable (P<0.01), that fol-lowing a program was important (P=0.02), and that exercise is benefi-cial (P=0.04). The RT group were more likely to have been advised to exercise (P=0.02). Common barriers to exercise were fatigue (64.9%), pain (57.4%), motivation (51.1%), and time (46.8%). RT status did not in-fluence the type of barriers experienced. Weekly RT time was positively associated with exercise satisfaction (r=0.43, P<0.01) and walking dis-tance prior to resting (r=0.29, P=0.04). The findings suggest that posi-tive exercise experiences, advice, assistance from a trainer, and poten-tially greater resources may influence participation in RT for people with CMT

This study aimed to examine whether compared with a program without walking, intervention programs with three types of walking can improve the muscle property and immunocytes in elderly women. Thirty- two subjects were randomly assigned to control group (CON), slow walking group (SWG), moderate walking group (MWG), and fast walking group (FWG). Three types of walking on treadmill were 30 min a day, 5 days/wk for 12 weeks. Muscle contraction time (Tc), maximum displacement (Dm), and immunocytes were tested by tensiomyography and flow cytometry. After the intervention, FWG had an increasing tendency in the muscle mass compared with other three groups. Tc of biceps femoris (BF) decreased in CON and SWG, while Tc of BF in MWG and FWG (30.58%± 23.71%) increased. It was similar in the rectus femoris (RF). Although Dm of BF and RF increased in CON and SWG, those decreased in MWG and FWG. Leucocytes of CON and SWG had a decreasing tendency, those of MWG (9.65%± 13.01%) and FWG (13.01%± 13.58%) increased. In the neutrophil, only CON decreased, whereas the three groups showed an increasing tendency. Helper T cell was increased only in FWG (19.61%± 19.94%), showing significant differences between groups (P= 0.009, η²= 0.378). Natural killer cell was improved in SWG and MWG but showed a clear increase in FWG (75.76%± 63.57%). It might be confirmed that walking for elderly increases the muscle property of the lower legs as they walk faster, which might be expected to improve the immunocytes function.

This study aimed to compare the effects of 8 weeks of foot plus hip ex-ercise to foot exercise alone on medial longitudinal arch (MLA) param-eters; navicular drop (ND), arch height index (AHI), plantar pressure, static balance, and dynamic balance were measured at baseline, 4 weeks, and 8 weeks. A total of 52 healthy participants with bilateral flatfoot were randomly assigned into foot exercise (n=26) and foot plus hip exercise (n=26) group. At 4 weeks, the foot plus hip exercise group showed significantly less ND (P=0.002), plantar pressure at the medial forefoot (P=0.002), and mediolateral displacement (P=0.001) while showing a greater AHI (P=0.019) than the foot exercise group. At 8 weeks, there was also significantly less plantar pressure at the medial hindfoot (P=0.017) and less anteroposterior displacement (P=0.002) in the foot plus hip exercise group than in the foot exercise group. No sig-nificant differences between groups were found in dynamic balance. The addition of gluteus medius muscle strengthening exercise to foot exercise was more effective in supporting the MLA than performing foot exercise alone.

CrossFit is a high-intensity training related to physical fitness and respi-ratory capacity that can promote changes in lung function. This cross- sectional study was aimed at evaluating respiratory muscle strength, electromyographic (EMG) activity, and lung capacity in CrossFit ath-letes. Thirty subjects aged between 25 and 35 years were divided into groups: CrossFit athletes (n=15) and sedentary individuals without co-morbidities (n=15). Respiratory muscle strength was evaluated using maximal inspiratory and expiratory pressures, lung capacity, and EMG of the sternocleidomastoid, serratus anterior, external intercostal, and diaphragm muscles at respiratory rest, maximal inspiration and expira-tion, and respiratory cycle. Data were tabulated and subjected to statis-tical analyses (t-test and Spearman test, P<0.05). Respiratory muscle strength on EMG of the sternocleidomastoid, serratus, external inter-costal, and diaphragm muscles at the respiratory cycle and maximal forced inspiration and expiration were higher in the CrossFit athletes group than in the sedentary group without comorbidities. CrossFit ath-lete group showed significantly strong positive correlation between maximal inspiratory and expiratory muscle strengths (Spearman rho= 0.903, P=0.000), with increasing muscle strength during inspiration fa-voring an increase in strength during expiration. The forced vital capac-ity (FVC) and forced expiratory volume in 1 sec (FEV1) also showed a significantly high positive correlation (Spearman rho=0.912, P=0.000) in the CrossFit athletes group, showing that higher FVC favors higher FEV1. The results of this study suggest that improved fitness is based on in-creased respiratory muscle strength on EMG in CrossFit athletes.

Oxidative stress has been suggested to play a role in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study aimed to investigate a link between malondialdehyde (MDA) levels, pulmonary function, and cardiac autonomic control in patients with COPD. Plasma levels of MDA, heart rate variability, and pulmonary function were mea-sured in 50 clinically stable COPD patients and 50 normal male controls. COPD patients exhibited lower means of the standard deviations of all normal to normal (NN) intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), and high frequency (HF). Nevertheless, they presented great-er low frequency (LF) and low frequency/high frequency ratio (LF/HF ra-tio) in supine and head-up tilt positions than controls (P<0.001). More-over, a negative correlation between MDA levels with SDNN (P<0.001) and a positive correlation with LF (P<0.01) and LF/HF ratio (P<0.05) were observed in both positions. In COPD patients, plasma MDA levels were 2.3 times greater than controls (4.33±2.03 μM vs. 1.89±0.39 μM, P<0.001), and they were inversely correlated with forced vital capacity, forced expiratory volume in 1 sec, midexpiratory flow, and peak expira-tory flow (P<0.001). Our findings suggest a potential role for oxidative stress in impaired cardiac autonomic control and clinical relevance of plasma MDA levels as a predictor of severity of COPD in COPD patients.

The purpose of this study was to verify classification performance and the difference analysis between gender using optimal warping paths of dynamic time warping (DTW) and to examine the usefulness of root mean square error (RMSE) represented by the perpendicular distance from the optimal warping path to the diagonal. A 3-dimensional motion analysis experiment was performed with 24 healthy adults (male=12, female=12) in their 20s of age without gait-related diseases or injuries for the past 6 months to collect gait data. This study performed a DTW 132 times in total (male=62, female=62) for the flexion angle of the right leg’s hip, knee, and ankle joints. Then, the global cost and the RMSE of the optimal warping paths were calculated and normalized. The differ-ence analysis was performed by independent t-test. Machine learning was performed to test the classification performance using the neural network, support vector machine, and logistic regression model among the supervised models. Results analyzed using global cost and RMSE for hip, knee, and ankle joints showed a statistically significant differ-ence between genders in global cost and RMSE for hip and knee joints but not for ankle joints using RMSE. Considering both area under the receiver operating characteristic curve and F1-score, the logistic re-gression model has been evaluated as the most suitable for gender classification using the global cost or RMSE. This study demonstrated that optimal warping paths could be used for statistical difference anal-ysis and classification analysis.