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Free radicals in exhaustive physical exercise: mechanism of production, and protection by antioxidants.

Moderate exercise is a healthy practice. However, exhaustive exercise generates free radicals. This can be evidenced by increases in lipid peroxidation, glutathione oxidation, and oxidative protein damage. It is well known that activity of cytosolic enzymes in blood plasma is increased after exhaustive exercise. This may be taken as a sign of damage to muscle cells. The degree of oxidative stress and of muscle damage does not depend on the absolute intensity of exercise but on the degree of exhaustion of the person who performs exercise. Training partially prevents free radical-formation in exhaustive exercise. Treatment with antioxidants such as vitamins C or E protects in part against free radical-mediated damage in exercise. Xanthine oxidase is involved in free-radical formation in exercise in humans and inhibition of this enzyme with allopurinol decreases oxidative stress and muscle damage associated with exhaustive exercise. Knowledge of the mechanism of free-radical formation in exercise is important because it will be useful to prevent oxidative stress and damage associated with exhaustive physical activity.

Allopurinol↗

Effect of physical exercise on the pharmacokinetics of digoxin during maintenance treatment.

Blood samples were taken repeatedly and urine was collected for digoxin assays on two occasions from 12 healthy male volunteers after an oral maintenance dose of digoxin. On one occasion the subjects exercised intermittently on a bicycle ergometer for 8 h after the dose. On the other occasion they rested in the supine position during the study period. Thirty and 45 min after the intake of digoxin, the serum digoxin concentration was significantly higher during exercise compared with rest, indicating increased absorption rate during exercise. Two and 4 h after the intake of digoxin, the serum digoxin concentration was significantly lower during exercise than during rest. Furthermore, the intermittent bicycle exercise decreased the renal excretion of digoxin during the study period. It also increased the steady state digoxin concentration measured after a terminating standardized period of rest. The most probable reason for these changes in the pharmacokinetics is a previously described increased binding of digoxin to exercising muscles. According to the results, there is reason to believe that the daily physical activity performed by digoxin-treated patients will determine to some extent the body content of digoxin. Changes in activity from day to day may therefore cause variations in the effect of the drug.

Adult↗

[Evaluation of cardiac function in patients with ischemic heart disease in the early stages of controlled physical exercise].

Fifty-nine coronary patients and 20 clinically normal subjects were investigated. Coronarography was performed in 21 patients. Everybody was referred to one of the three functional classes. Central hemodynamic parameters were measured using tetrapolar chest rheography. Venous levels of lactic and pyruvic acids were also measured. The measurements were taken in resting conditions and under threefold increase in systemic oxygen consumption following bicycle ergometry in supine position. Three types of response were identified: normal, compensated and decompensated ones. On the basis of these, functional reserves of the heart can be evaluated at earlier stages of rationed exercise, this being particularly important for coronary patients not to be exposed to maximum and submaximum physical stress.

Coronary Disease↗

[The effect of physical exercise on the response to exertion in the elderly].

BACKGROUND: A decrease in adaptation to exertion has been observed as age progresses. Although this decline may also be affected by factors such as health conditions and age, physical inactivity related to sedentary behaviour plays a dominant role. METHODS: In order to evaluate the influence of physical activity on cardiovascular response to exertion in the elderly, 4 groups of 22 subjects each were submitted to maximal electrocardiographic exercise test on a cycloergometer (multistage program with 30 Watts x 3 min. steps). All subjects were male. The composition of the groups was as follows: 1) veteran long distance runners (mean age: 71 +/- 5.4); 2) sedentary veterans (mean age: 69.8 +/- 3.9); 3) young long distance runners (mean age: 25.4 +/- 4.3); 4) sedentary young adults (mean age: 25.8 +/- 3.9). The endurance athletes, well fitted to competition, had been practicing sport activity for at least 3 years. RESULTS: Heart rate, arterial systolic and diastolic blood pressure were recorded; mean blood pressure and double product were calculated at baseline and at the climax of the stress test; furthermore, total and maximal watts were recorded. For each of the parameters, Student's t test for non-paired observations were used to evaluate statistical differences amongst the four groups. The most interesting result arises in the comparison between veteran long distance runners and sedentary young adults: between the two groups no statistically significant differences in workload, expressed as total watts (1649.55 +/- 296.32 vs 1650.00 +/- 446.32; p = NS) and maximal watts (175.91 +/- 19.19 vs 173.18 +/- 24.38; p = N.S.), were observed. On the contrary, highly significant differences in both total (p < 0.01) and maximal (p < 0.01) watts were noticed by comparing long distance runners and sedentary subjects of the same age. CONCLUSIONS: These data support the hypothesis that the progressive reduction in physical activity, which is usually observed in aging, is the major determinant of exercise deconditioning in the elderly.

Adolescent↗

[The history of the development of sports medicine and therapeutic physical exercise in Ukraine].

The article focuses on stages of the history of development of sports medicine and remedial gymnastics in Ukraine. Shown in the article is a high level development of physical culture and its medical maintenance in Ukraine in the beginning of the 20th century. A valuable contribution to the development of remedial gymnastics and sports medicine was made, among others, by Professors O. V. Pocharovska, V. T. Stovbun, I. P. Kalistov, Yu. A. Chiyak, H. L. Apanasenko, S. A. Dushanin, V. V. Klapchuk, V. F. Shapovalova. The role sports medicine has in enhancement of capacity for work and maintenance of health of sportsmen is shown.

Exercise Therapy↗

Blood pressure response to physical exercise in healthy adolescents and adolescents with insulin-dependent diabetes mellitus.

1. Reference values for systolic blood pressure during exercise are provided for 88 healthy adolescents (12-22 years of age) of both sexes. Data were related to oxygen uptake, heart rate, blood lactate concentration, rate of perceived exertion, age, sex, body size and physical fitness. 2. The same variables were measured in 55 adolescents of both sexes with insulin-dependent diabetes mellitus of about 12 years duration and were analysed with respect to the healthy control group, to degree of metabolic control and to late diabetic complications. 3. In healthy adolescents the pressure response was not related to sex or age. When compared with control subjects diabetic patients had a higher diastolic blood pressure at rest and a more marked blood pressure increase, 23 versus 19 mmHg W-1 kg-1 body weight, during exercise with no sex difference. The blood pressure rise was not related to metabolic control, glomerular hyperfiltration or physical fitness. 4. Prolonged exercise tests were no more informative regarding the blood pressure response to exercise than the stepwise increased load test. Analysing the blood pressure increase versus relative work load (W/kg body weight) during exercise reveals blood pressure differences otherwise not noted. A diabetic patient with blood pressure above the 97.5% confidence limit during exercise seems to have a higher risk of developing incipient nephropathy 5 years later.

Adolescent↗

[Physical exercise for preventing obesity, promoting weight loss and maintaining weight management].

Obesity is a multifactorial disease making difficult the determination of the precise role of one specific factor such as physical activity or sedentary. Nevertheless, numerous arguments, derived from epidemiological observational studies or from randomized controlled interventional trials, support a favourable role of regular physical activity in the control of body weight. Physical activity contributes to prevent the occurrence of weight excess, especially in children or adolescents, to obtain a satisfactory weight loss, in general in combination with reduced-energy diets, and to maintain long-term weight loss. In addition, physical activity improves both the metabolic profile and health of obese subjects.

Clinical Trials as Topic↗

[Physical exercise in secondary prevention of coronary heart disease].

Addition of life style intervention to pharmacological therapy has been shown to be essential for secondary prevention of cardiovascular diseases. The American Heart Association and American College of Sports Medicine propose physical activity of moderate intensity using dynamic exercise not causing myocardial ischemia and recommend four to five training sessions (30-40 min each) per week. Such activity has been shown to improve prognosis in coronary heart disease. This can be explained by exercise induced improvements of cardiovascular risk factors e.g. dyslipoproteinemia, insulin resistance and inflammation, normalization of endothelial function and retardation of atherosclerosis. Because of the strong evidence of the benefit of exercise in cardiovascular prevention and rehabilitation, this approach should be included in the complex therapy of cardiovascular patients.

Angioplasty, Balloon, Coronary↗

Physical exercise for patients with cystic fibrosis: a review.

Cystic fibrosis (CF) is an inherited, chronic disease which mainly affects the lungs and the nutrition. Intensive treatment has gradually improved the outcome for the patients. Exercise therapy has been increasingly advocated to be included in the CF regimen. Our own studies indicate that both short-term and long-term training ameliorate the physical conditions for CF patients, that there is no danger for well-trained CF patients--both boys and girls--to take part even in vigorous, prolonged exercises, and that CF patients might have a positive attitude toward physical activities. Of course, all physical activities have to be individually designed. A review of the literature is also given: The specific ventilatory factors in CF, the limitations of exercise, the problem with exercise-induced asthma, the training effect on lung drainage, on lung function, on infections, on biochemical and hormonal variables, on nutrition and the gastrointestinal tract, on the musculoskeletal apparatus, and on the mind. Nearly all these reports are favorable for a carefully monitored, high activity in CF patients. Practical considerations for activities are given.

Biomechanical Phenomena↗

The heart and physical exercise.

Cardiac hypertrophy and extreme bradycardia occur in the highly trained endurance athlete, but not in those with lesser degrees of training. Several longevity studies in athletes fail to show any beneficial effects of athletic training confined to the college years. The invaluable British studies relating physical activity of various occupations to coronary disease show that while exercise does not prevent coronary atherosclerosis, it may reduce the incidence of large and fatal infarctions and of complete coronary obstructions. Various American studies have not confirmed this beneficial effect of exercise. To be of any value in the prevention of coronary disease, exercise must be continued on into middle age. The sedentary life characteristic of western civilization is probably not a major factor in the high incidence of coronary disease.

Cardiomegaly↗

Effects of acute exhaustive physical exercise upon glutamine metabolism of lymphocytes from trained rats.

Transitory immunosupression is reported after intense exercise, especially after an increase in training overload and in overtraining. The influence of intense exercise on plasma hormones and glutamine concentration may contribute to this effect. However, the effect of such exercise-induced changes upon lymphocyte and glutamine metabolism is not known. We compared glutamine metabolism in lymphocytes in sedentary (SED) and trained rats. Rats from the moderate group (MOD) swam for 6 weeks, 1 h/day, in water at 32+/-1 degrees C, with a load of 5.5% body weight attached to the tail. Animals from the exhaustive group (EXT) trained like MOD, with training increasing to 3 times 1 h a day during the last week, with 150 min rest between each bout. Animals were killed immediately after the last training bout. We observed reduced concentrations of plasma glucose (p<0.05), glutamine (p<0.05), glutamate (p<0.05) in EXT compared to SED. In MOD, decreases in glutamine (p<0.05) were observed. Analyzing lymphocyte metabolism, we observed an increase in lactate production and glutamine consumption (p<0.05) in MOD (p<0.05) compared to SED and a decrease in glutamine consumption (p<0.05) and aspartate production in EXT. An increase in the proliferative response of lymphocytes in MOD and EXT was also observed when stimulated by ConA and LPS similarly to SED. Acute exercise promoted decreased glutamine plasma concentration and changes in glutamine metabolism that did not impair lymphocyte proliferation in exhaustive trained rats.

Ammonia↗

Attentional style in ratings of perceived exertion during physical exercise.

This study assessed the effects of associative and dissociative psychological strategies of attention on heart rate and self-report ratings of perceived exertion (RPE) during cycling performance. Seven trained cyclists performed a control ride, a dissociation ride, and an association ride on a bicycle ergometer at a work rate corresponding to 75% of their maximal heart rate. For the dissociation ride, subjects watched a videotape unrelated to cycling and responded to a key word each time it occurred on tape. For the association ride, subjects focused attention on heart-rate feedback available throughout the ride. During the control ride, attentional focus was not intentionally manipulated. Analysis indicated that the deliberate application of an attentional strategy did not significantly affect heart rate or RPE scores; however, the dissociation condition yielded somewhat higher RPE scores. From a postexperimental interview, four subjects responded that the association ride was the easier to complete, while three subjects responded the control ride was the easier one, matching a possible trend in the data.

Adolescent↗

[The improvement in physical exercise capacity in dilated cardiomyopathy during short-term treatment with L-thyroxine].

Reduced left ventricular function and other factors, such as vascular resistances, redistribution of cardiac output and impaired muscular metabolism, limit exercise performance in chronic heart failure. Thyroid hormones have a positive cardiac inotropic effect, stimulate protein synthesis (particularly at muscular level) and reduce peripheral vascular resistances with consequent increase of cardiac output. Therefore, it is possible that thyroid hormones can improve exercise performance in chronic heart failure. We have administered L-thyroxin (100 mcg/die) for 1 week to 9 patients affected by primary dilated cardiomyopathy. All the patients were euthyroid (T3 = 1.06 +/- 0.1 mcg/ml, T4 = 8.5 +/- 1.9 mcg/dl, TSH = 1.32 +/- 0.7 mU/ml) and in II-III NYHA functional class. Before starting the treatment and at the end of it, we performed the cardiopulmonary exercise test and the echocardiogram. We also evaluated the resting hemodynamic parameters through catheterization and the plasmatic values of thyroid hormones and noradrenaline. At the end of the treatment all patients were euthyroid, despite a significant (p less than 0.05) increase of T4 (10.5 +/- 3.2 mcg/dl) and a decrease of TSH (1.1 +/- 0.1 mU/ml). Mean values of effort parameters changed as follows: peak oxygen consumption from 19.6 +/- 1.6 to 20.6 +/- 1.3 ml/min/kg, tolerance time from 460 +/- 61 to 481 +/- 60 s. These variations were not associated with changes in resting hemodynamic parameters and noradrenaline. Left ventricular ejection fraction, calculated by echocardiography, increased from 26 +/- 6 to 28.9 +/- 8% (p less than 0.05). We conclude that in dilated cardiomyopathy short term treatment with L-thyroxin significantly improves patient's response to cardiopulmonary exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Effects of physical exercise on the parameters of carbohydrate metabolism in patients with type 2 diabetes mellitus during rehabilitative treatment].

The evidence obtained by the authors supports literature data on a beneficial effect of muscular exercise on carbohydrate metabolism in diabetics. It is thought necessary to control sharp fluctuations of glycemia. Provided these are mild and associated with lowered insulinemia, patients with non-insulin-dependent diabetes mellitus could be recommended to continue training.

Adult↗