Reshaping the Brain

Physical Activity and Diabetes.

6. Fibromyalgia: The learning of an illness and its PNI correlates

Effects of aerobic exercise on executive function of healthy middle-aged and older adults: A systematic review and meta-analysis

BackgroundThis study aimed to assess the different impacts of aerobic and resistance exercise intervention on pre-diabetes and its possible influencing factor (obesity) to identify which exercise intervention mode was better for pre-diabetes to control their blood glucose levels.MethodsSingle-blind randomized controlled trial. Participants were recruited from Southwest Hospital between February 2016 and May 2017 and randomly divided into three groups using stratified randomization: aerobic exercise (A), resistance exercise (R), and control (C). The effects of each group were analyzed, and the relationship with obesity was investigated following a 12-week intervention.ResultsEighty participants were enrolled (9 were lost, and 1 was excluded). Finally, 26 participants were included in group A, 23 in group R, and 21 in group C. In groups A and R, FPG, OGTT 2-h PG, and HOMA2-IR decreased by 6.17% (P = 0.001) and 4.81% (P = 0.019), 20.39% (P < 0.001) and 16.50% (P < 0.001), and 8.34% (P = 0.026) and 18.31% (P = 0.001, superior to that in group A), respectively (all P < 0.001 compared with group C, with no significant differences between groups A and R). The ratio of reversal to euglycemia was 69.2% (P = 0.003 compared with group C) in group A and 43.5% (P = 0.213 compared with group C) in group R. The decreased ratio of GSP in group R was greater (65.2%, P = 0.008 compared with group C) compared with group A (38.5%, P = 0.355 compared with group C). Decreases in the parameters BMI (3.1 ± 3.2% P < 0.001, moderately positive correlation with the decreased FPG level, r = 0.498, P = 0.010, two-tailed) and waist circumference (3.1 ± 2.7% P < 0.001) were noted in group A, but no significant correlations were noted between other indicators in group R.ConclusionsBoth resistance and aerobic exercise can control and reverse IGR. Compared with aerobic exercise, resistance exercise may be superior in terms of GSP and IR improvement. Aerobic exercise decreases blood glucose levels through weight loss. However, the effect of resistance exercise might not be mediated via weight loss and obesity control.Trial registrationChinese Clinical Trial Registry ChiCTR2000038304. Registered on September 17, 2020.

Physical activity is frequently touted as beneficial for mental health. This article, based on a 2023 ACSM colloquium, highlights key strengths and limitations of the evidence regarding physical activity and mental health from three perspectives: epidemiological studies, randomized controlled trial experiments, and investigations that explicitly consider the potential role that contextual factors, such as the social climate in which physical activity is completed, can play in physical activity-mental health interactions. A large body of epidemiological evidence supports that regular leisure time physical activity is associated with less depression and anxiety. Higher amounts of physical activity are often associated with fewer depressive symptoms, but there may be a dose-response point where for some people more is not better but can plateau or even worsen. Epidemiological evidence is emerging but currently inadequate to support associations between mental health and occupational, transportation/active commuting, or domestic/household physical activity types. A large body of randomized controlled trials, typically small, short duration and conducted with samples biased toward middle-to-higher socioeconomic status Whites, supports that the adoption of regular exercise improves aspects of mental health; however, the mechanisms are unclear and for those without mental disorders the mean effects are small. Mental health benefits of exercise may be partially a placebo response or result from contextual factors surrounding exercise programs. A small body of evidence supports that contextual elements, such as the program implementation quality and social environment, can influence the mental health outcomes associated with physical activity programs, but the evidence is currently inadequate to identify which contextual variables have consistent moderate or larger effects. Greater progress will be made in this area when research designs are expanded to include consideration of the potential influence of contextual factors on relationships between physical activity and mental health.

The health benefits of regular physical activity and aerobic exercise are undisputed in the literature. The present series of pilot studies had two major objectives: (a) examine mental health, well-being, and regular physical activity of university students and (b) explore the potential health benefits of short-term aerobic exercise on university students in an online and a laboratory study. Mental health and well-being were measured before (Time 1, T1) and after (Time 2, T2) a 6 week (online study) and 2 week (laboratory study) low- to moderate-intensity aerobic exercise intervention. Mental health and well-being were assessed using standardized self-report measures of depression, anxiety, positive and negative affect, perceived stress and coping strategies, body dissatisfaction, and quality of life. The effects of the aerobic exercise were compared to a cognitive non-exercise control condition (online study), motor coordination exercise (laboratory study), and a waiting list (online and laboratory). A total of 185 university students were recruited from German universities at T1. Further, 74 (women: n = 67) students completed the 6-week intervention. Similarly, 32 (women: n = 30) participants completed the 2 week intervention (laboratory study). At T1, 36.6% of the students (women and men) reported experiencing depressive symptoms. 41.83% of them (women and men) had high levels of state anxiety. All the students reported experiencing stress (e.g., due to uncertainty related to factors such as their finances, job, and social relationships). At T1, regular physical activity was negatively correlated with self-reported depression, anxiety, and perceived psychosomatic stress and positively correlated with quality of life and positive affect. Among women, cardiovascular fitness (operationalized as resting heart rate variability) was negatively correlated with self-reported anxiety (state) and depression at T1 (laboratory study). The 6 week aerobic exercise intervention resulted in significant improvements in self-reported depression, overall perceived stress, and perceived stress due to uncertainty. The present results confirm that there is a relationship between regular physical activity, cardiovascular fitness, mental health, and well-being among university students. They support the hypothesis that short-term aerobic exercise interventions can act as buffer against depression and perceived stress in university students after 6 weeks of aerobic exercise of low to moderate intensity.

Lack of knowledge about the causes of fatigue often leads to ignoring this symptom in rheumatoid arthritis (RA). The severity of fatigue in patients with RA can be significantly reduced by actively using non-pharmacological treatment strategies. Aim. To evaluate the effectiveness of aerobic exercise (walking) to reduce fatigue in RA patients during long-term follow-up. Material and methods. The study involved 102 patients with RA (women 100%; average age 54.38 ± 11.3 years; disease duration 9.5[5;15] years; DAS28-ESR activity 2.85[2.32;3.06] points; fatigue on the VAS scale ≥50), who completed the stage of sanatorium treatment in full (21 days) and provided data on aerobic physical activity (steps quantity per day) and fatigue scores on the British Rheumatoid Arthritis Fatigue Scale – Numerical Rating Scale (BRAF-NRS V2). RA patients were divided into two groups according to their level of physical activity: group I (n=53) with a sedentary lifestyle (less than 5–6 thousand steps/day) and group II (n=49) with a recommended (mobile) lifestyle (more than 7–8 thousand steps/day). Assessment of RA patients’ adherence to physical activity was carried out 2 months after return from the sanatorium, and the dynamics of BRAF-NRS fatigue indexes were recorded. Results and discussion. Seventy-six people (74.5%) agreed to participate in the final survey: 32 patients from a group I and 44 patients from a group II. Commitment to daily aerobic activity (more than 5,000 steps per day) was maintained by 34% of participants in the group I and 59% in the group II (p=0.033). The majority of respondents (51.3%) decreased the physical activity level and significantly reduced the time for aerobic exercise after returning from the sanatorium, citing a lack of incentives and time. 47% of the group I patients (15/32) felt able to devote more attention to physical activity, but only 25% confirmed a strong belief that they would dedicate at least 30 minutes to aerobic exercise 5 times a week over the next three months. In the group II, 48% of patients (p=0.044) reported maintaining or even increasing the corresponding physical activity level, confirming the effectiveness of individual physical activity programs formed during the sanatorium treatment and then integrated into daily life. Two months after returning from the sanatorium, group II patients showed lower fatigue scores on all BRAF-NRS scales: NRS-severity (p=0.04), NRS-effect (p=0.005), and NRS-overcoming (p=0.034). The analysis of variance revealed a decrease in the level of fatigue in the medium term (up to 2 months) regardless of the level of physical activity of the patients, but in RA patients committed to an active lifestyle and regular aerobic physical activity (group II), the positive changes were most pronounced (p&lt;0.001). Conclusion. The positive effect of aerobic exercise (walking) on reducing fatigue is significantly negated even in the med-term, if patients do not continue to lead an active lifestyle. After completion of the sanatorium stage of treatment (with selection of optimal dose and frequency of physical activity), RA patients should be further encouraged to do daily aerobic exercises and be supported to continue rehabilitation programs in the community in order to achieve a better effect in the long term.

Mild cognitive impairment (MCI) in older adults is often accompanied by poor sleep quality and mood disturbances, which can exacerbate cognitive decline.1 Regular physical activity and exercise have been identified as potential interventions to improve these conditions.2 With the ageing population rapidly increasing, the prevalence of MCI has become a significant public health concern. Mild cognitive impairment often leads to cognitive decline and is associated with symptoms such as sleep disturbances and mood disorders. These symptoms not only reduce the quality of life but also accelerate cognitive deterioration. Regular physical activity and exercise have been shown to mitigate these effects by improving physiological and psychological health outcomes. In particular, South Korea, with its rapidly growing population of older adults, needs to better understand and address the relationship between physical activity, sleep quality and mood in older adults with MCI. Sleep disturbances are common in individuals with MCI, often manifesting as difficulties in falling asleep, frequent awakenings and reduced sleep efficiency.3 Regular physical activity, particularly aerobic and resistance training, has been shown to regulate circadian rhythms and improve sleep architecture. Such activity promotes the release of melatonin and reduces sleep latency, leading to better restorative sleep.4 Improved sleep quality is essential for memory consolidation, emotional regulation and overall brain function, all of which are critical for managing MCI. Mood disorders, including depression and anxiety, are common among older adults with MCI. These conditions can significantly affect motivation, cognitive performance and social interactions.5 Regular physical activity, through its ability to induce endorphin release and reduce cortisol levels, has been associated with improved mood and reduced stress.6 It provides a non-pharmacological and accessible approach to enhancing emotional well-being and fostering greater autonomy in daily living. Public health interventions should prioritise the development and integration of exercise programs tailored to the needs of older adults with MCI. Engaging in at least 150 min of moderate-intensity activity or 75 min of vigorous-intensity activity per week has been shown to be effective in promoting physical and mental health.7 However, uncertainty remains regarding the specific types of physical activities or exercise that are most beneficial, leaving the question of optimal exercise regimens open. Community-based programs and caregiver involvement can play a crucial role in enhancing adherence and sustaining long-term benefits. Further research should focus on identifying optimal exercise protocols, including the appropriate intensity, frequency and duration, to maximise benefits for this population. Regular exercise holds significant promise in addressing the sleep and mood disturbances experienced by older adults with MCI. By improving sleep quality and emotional regulation, physical activity can enhance cognitive health, delay cognitive decline and improve the overall quality of life. Implementing exercise-based interventions should be a cornerstone of preventive health-care strategies for ageing populations. As a non-pharmacological treatment, exercise is very effective in improving sleep quality in older people. No conflicts of interest declared.

Background:Regular exercise performed during pregnancy has been shown to reduce the risk of developing perinatal gestational hypertensive conditions. Further evidence on the exact parameters of exercise needed to explain these beneficial responses is required, within both uncomplicated and at-risk pregnancies.Objective:The aim of this systematic review and meta-analysis was to investigate the effects of aerobic and resistance exercise on blood pressure during pregnancy.Design:Systematic review and meta-analysis.Data Sources and Methods:An online search of six search engines was conducted up to February 2023. Randomized controlled trials, quasi-experimental, cohort, and longitudinal studies were included. Studies included an acute exercise bout or intervention of land-based aerobic and/or resistance exercise during any trimester in uncomplicated and at-risk pregnancies. Outcomes included mean arterial pressure (MAP), or systolic blood pressure (SBP) and diastolic blood pressure (DBP).Results:Following the removal of duplicates, 1538 articles were screened with 59 studies meeting the inclusion criteria for the review (randomized controlled trials (RCTs) n = 34, clinical trials n = 19, cohort n = 5 and cross-sectional n = 2), and 21 studies included in the meta-analysis. A random effects model was used with mean difference calculated in mmHg. Overall, there were no statistically significant effects of exercise on resting blood pressure (BP) outcomes in pregnant women with normal blood pressure compared to control/usual care populations following intervention (SBP mean diff -1.54 mmHg (favours intervention), p = 0.38; DBP mean diff -2.25 mmHg (favours intervention), p = 0.1; MAP mean diff -1.75 mmHg (favours intervention), p = 0.31). In at-risk pregnant women, both aerobic and combination exercise significantly reduced BP outcomes compared to control (SBP mean diff -3.91 mmHg, p < 0.01; DBP mean diff -2.9 mmHg, p = 0.01; MAP mean diff -2.38 mmHg, p = 0.01). Twenty-seven studies reported an acute increase in SBP and DBP during aerobic exercise, with no difference found between uncomplicated and at-risk pregnancies.Conclusions:Compared to usual care, aerobic and/or resistance exercise performed throughout uncomplicated pregnancy had no influence on blood pressure. Pregnant women with no diagnosed complications should be encouraged to exercise regularly due to the multitude of known benefits. In women who are at risk of, or diagnosed, with gestational hypertensive conditions during pregnancy, moderate to vigorous exercise during pregnancy improves blood pressure outcomes. Higher risk pregnancies may reduce their risk of future cardiovascular complications through regular exercise training during pregnancy.Registration:CRD42020159998.

To Editor, Regular exercise and/or physical activity have long been recognised for their numerous benefits on physical health, but their impact on mental health and mood, particularly in older people experiencing cognitive decline, is equally profound. Cognitive decline, which may manifest as mild cognitive impairment (MCI) or progress to conditions like Alzheimer's disease, is often accompanied by mood disturbances such as depression, anxiety and irritability (Ismail et al. 2018). Engaging in consistent physical activity has been shown to mitigate these issues, offering both physiological and psychological benefits that enhance overall quality of life (Kim and Lim 2022). Depression and anxiety are common symptoms in older people with cognitive decline. These mood disorders can worsen cognitive symptoms, creating a vicious cycle of poor mental and emotional health, and chronic stress is a significant risk factor for both cognitive decline and mental health in older people. Regular exercise and/or physical activity act as a natural stress reliever by lowering levels of cortisol, the body's main stress hormone, and physical activity also helps manage emotional issues associated with cognitive impairment by providing a constructive outlet for tension and frustration (Smyth et al. 2020; Quinn et al. 2016). The effectiveness of regular exercise and/or physical activity in improving mood and mental health depends on its consistency and suitability for the individual. Older people with cognitive decline may have physical limitations or comorbid conditions that require tailored exercise programmes. Consistency is crucial for reaping the mental health benefits of exercise and/or physical activity. Even moderate physical activity—as little as five 30-min bouts of moderate intensity or three 25-min bouts of vigorous intensity per week—can lead to noticeable improvements in mood and cognitive function. Regular exercise and/or physical activity are powerful tools for improving mood and mental health in older people experiencing cognitive decline. Through physiological mechanisms such as increased neuroplasticity and reduced inflammation, as well as psychological benefits such as stress reduction and enhanced social connections, exercise addresses multiple dimensions of mental well-being (Lee et al. 2021). By incorporating consistent and individualised physical activity into their lives, older people with cognitive decline can experience significant improvements in mood, resilience and overall quality of life. This underscores the importance of promoting exercise as a key component of holistic care for this vulnerable population. This study was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2022S1A5B5A16055088). The authors declare no conflicts of interest. Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Background/Purpose: The role of exercise interventions in the treatment of psychiatric disorders is receiving increased attention, and the positive protective effect of aerobic exercise on anxiety symptoms has now been extensively demonstrated. This study aimed to investigate the systematic evaluation of the effects of different aerobic exercise interventions on anxiety symptoms in college students. Method: Using keywords such as “physical activity,” “anxiety,” and “college students” screened Randomized controlled trials (RCT) published until February 2024 in three databases: PubMed, Web of Science, and Scopus. A total of 5073 studies were retrieved after systematically searching individual databases. After removing duplicate literature, 4112 studies remained. Following the screening of titles and abstracts, 72 studies were read in their entirety for refinement. We used the PICOS principle to define the inclusion criteria for the articles. The analysis was performed using RevMan 5.4 and Stata 16.0 software. Results: A total of 6 RCTs comprising 253 college student participants (exercise n=125; control n=128) were included. The analysis revealed that aerobic exercise had a statistically significant reduction in anxiety symptoms compared to the control group in anxious college students (standardized mean difference=-0.79, 95% CI (-1.10, -0.47); I²=31%). Mind-body exercise had the most significant effect on anxiety symptoms, followed by conventional aerobic exercise, and multicomponent aerobic exercise. Furthermore, experiments of less than 8 weeks and more than 8 weeks showed significant improvement in anxiety symptoms (SMD=-0.74, 95% CI (-1.13, -0.35), P &lt; 0.01; SMD=-0.81, 95% CI (-1.45, -0.17), P = 0.01). Additionally, ≤60 min of exercise had a significant effect (SMD=-0.59, 95% CI (-0.99, -0.20), P &lt; 0.01), and ≥60 min of exercise was more effective (SMD=-0.94, 95% CI (-1.40, -0.47), P &lt; 0.01). The study also found a significant improvement in anxiety among low exercise intensity, moderate exercise intensity, and high exercise intensity (SMD=-0.69, 95% CI (-1.13, -0.24), P &lt; 0.01); SMD=-0.91, 95% CI (-1.58, -0.25), P &lt; 0.01; SMD=-0.41, 95% CI (-0.91, -0.08), P = 0.1). Conclusion/Discussion: Exercise significantly improved anxiety symptoms in college students, with multicomponent aerobic exercise having the most significant effect. A moderate-intensity exercise program lasting more than 60 minutes, over 8 weeks, had a greater impact on college students. Future research is still needed to explore the factors that modulate the effects of exercise interventions.

The present study aimed to differentiate the acute effects of aerobic, resistance and concurrent exercises, and 40-meter maximal shuttle run test (MSRT) on coagulation and fibrinolysis in non-athletic healthy young men. Fifty participants (aged 20-30 years old) were randomly divided into a control and four exercise groups: aerobic, resistance, concurrent, and MSRT (N.=10 each). A single session of exercise was performed: the aerobic group used a cycle ergometer (60% heart rate maximum) for 40 minutes, the resistance group performed 3 movements for the upper extremities and 3 movements for the lower extremities with 60% of 1-repetition maximum (each movement in 2 sets of 8-10 repetitions), the concurrent group followed by a combination of aerobic and resistance protocols, and the MSRT group performed four trials of the 40-meter MSRT. The duration for aerobic, resistance and concurrent exercises was 60 minutes, while it was only 30 minutes for MSRT. Before and 30 minutes after exercise, blood samples were collected to evaluate fibrinogen (mg/dL), D-dimer (mg/dL), prothrombin time (PT), partial thromboplastin time (PTT) and platelet count (×103/µL). There was a significant reduction in fibrinogen in all exercise groups compared to before exercise (P<0.01) and to the control group (P<0.05). D-dimer, as the index of fibrinolysis, was significantly increased in all exercise groups compared to before exercise (P<0.01) and to the control group (P<0.05). Aerobic exercise and MSRT also increased the PT and PTT (P<0.001). Finally, the number of platelets had a significant reduction following resistance and concurrent exercise protocols (P<0.001, P<0.01). Based on our findings, both coagulation and fibrinolytic activity are strongly affected by single a session of different exercise protocols.

Introduction: Oxidative stress plays important roles in pathophysiology of atherosclerotic disease. However, little is known about the effects of aerobic exercise and resistance exercise on the oxidant offense and antioxidant defense systems in cardiovascular disease (CVD). Hypothesis: We hypothesized that combined aerobic and resistance exercise training decrease oxidative stress in patient with CVD. Methods: Thirty-two patients with CVD refer to in-hospital cardiac rehabilitation were divided to aerobic exercise (AE) group (n=15) and combined aerobic and resistance exercise (AE+RE) group (n=17). AE sessions consisted of 50 minutes of exercise (anaerobic threshold level), 5 days/week during training period (mean 27 days). Resistance exercise (30% of 1-repetition maximum) was performed 3 days/week before AE sessions. Serum reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) were measured using the FRAS4 (Diacron International, Italy) before and after training period. BAP/d-ROMs ratio was used as an indicator of oxidative stress. Results: No significant differences in baseline values of age, body mass index, exercise tolerance and BAP/d-ROMs ratio were observed between the AE+RE group and the AE group. After training period, exercise tolerance (the AE group: 5.1 ± 1.0 to 5.6 ± 1.0 METs, p&lt;0.01, the AE+RE group: 5.1 ± 1.1 to 5.7 ± 1.0 METs, p&lt;0.01) were significantly increased in both groups. In the AE+RE group, d-ROMs decreased and BAP significantly increased (2173 ± 268 to 2338 ± 182, p&lt;0.05). Consequently BAP/d-ROMs ratio significantly increased (7.3 ± 1.5 to 8.9 ± 3.1, p&lt;0.05) after training period. In the AE group, d-ROMs significantly decreased (374 ± 61 to 347 ± 61, p&lt;0.05), and BAP trends to decreased (2389 ± 201 to 2279 ± 189, p&lt;0.1). Consequently BAP/d-ROMs ratio did not significantly change after training period. BAP/d-ROMs ratio in the AE+RE group were significantly higher than those in the AE group (8.9 ± 3.1 vs 6.8 ± 1.3, p&lt;0.05) after training period. Conclusions: The present findings suggest that combined aerobic and resistance exercise training decrease oxidative stress by augmenting antioxidant potential in patients with CVD.

Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be Preserved and Enhanced?

Primary dysmenorrhea is a prevalent gynecological condition that significantly impacts women’s physical and emotional well-being. This study investigates the correlation between regular physical activity and the occurrence and severity of primary dysmenorrhea. A cross-sectional design was used, involving 401 menstruating females aged 16 to 50 years, who completed an online questionnaire assessing menstrual symptoms and physical activity habits.The results indicate a trend toward a lower prevalence of dysmenorrhea among individuals who engage in regular, long-term, and higher-intensity physical activity. Although statistical significance was not reached in most comparisons, women who exercised daily or had more than five years of experience with physical activity reported less frequent and less severe menstrual pain. These findings support the growing evidence that physical activity may serve as a non-pharmacological strategy for managing primary dysmenorrhea. The study underscores the importance of promoting active lifestyles among women as part of broader public health efforts to enhance menstrual health and reduce reliance on medication. Further longitudinal and intervention-based research is recommended to confirm causality and develop targeted exercise guidelines.