Nigel T. Cable

Physical activity and older adults: a review of health benefits and the effectiveness of interventions

The purpose of this multidisciplinary review paper is to critically review evidence from descriptive, efficacy and effectiveness studies concerned with physical activity and older people. Both levels of fitness (aerobic power, strength, flexibility and functional capability) and measures of physical activity involvement decline with age, and the extent to which this is due to a biological ageing processes or disuse (physical inactivity) is critically examined. The review will consider the evidence for a causal relationship between sedentary behaviour/physical activity programmes and cardiovascular, musculoskeletal and psycho-social health, independent living and health-related quality of life into old age. The review also considers the effectiveness of different physical activity interventions for older people and issues relating to cost-effectiveness. The implications for future policy in terms of research, health care services, and education and training are briefly discussed.

Impact of inactivity and exercise on the vasculature in humans

The effects of inactivity and exercise training on established and novel cardiovascular risk factors are relatively modest and do not account for the impact of inactivity and exercise on vascular risk. We examine evidence that inactivity and exercise have direct effects on both vasculature function and structure in humans. Physical deconditioning is associated with enhanced vasoconstrictor tone and has profound and rapid effects on arterial remodelling in both large and smaller arteries. Evidence for an effect of deconditioning on vasodilator function is less consistent. Studies of the impact of exercise training suggest that both functional and structural remodelling adaptations occur and that the magnitude and time-course of these changes depends upon training duration and intensity and the vessel beds involved. Inactivity and exercise have direct “vascular deconditioning and conditioning” effects which likely modify cardiovascular risk.

Physiological responses to laboratory-based soccer-specific intermittent and continuous exercise

The aim of this study was to devise a laboratory-based protocol for a motorized treadmill that was representative of work rates observed during soccer match-play. Selected physiological responses to this soccer-specific intermittent exercise protocol were then compared with steady-rate exercise performed at the same average speed. Seven male university soccer players (mean - s : age 24 - 2 years, height 1.78 - 0.1 m, mass 72.2 - 5.0 kg, VO 2max 57.8 - 4 ml·kg -1 ·min -1 ) completed a 45-min soccer-specific intermittent exercise protocol on a motorized treadmill. They also completed a continuous steady-rate exercise session for an identical period at the same average speed. The physiological responses to the laboratory-based soccer-specific protocol were similar to values previously observed for soccer match-play (oxygen consumption approximately 68% of maximum, heart rate 168 - 10 beats·min -1 ). No significant differences were observed in oxygen consumption, heart rate, rectal temperature or sweat production rate between the two conditions. Average minute ventilation was greater ( P ≪ 0.05) in intermittent exercise (81.3 - 0.2l·min -1 ) than steady-rate exercise (72.4 - 11.4l·min -1 ). The rating of perceived exertion for the session as a whole was 15 - 2 during soccer-specific intermittent exercise and 12 - 1 for continuous exercise ( P ≪ 0.05). The physiological strain associated with the laboratory-based soccer-specific intermittent protocol was similar to that associated with 45 min of soccer match-play, based on the variables measured, indicating the relevance of the simulation as a model of match-play work rates. Soccer-specific intermittent exercise did not increase the demands placed on the aerobic energy systems compared to continuous exercise performed at the same average speed, although the results indicate that anaerobic energy provision is more important during intermittent than during continuous exercise at the same average speed.

Exercise and cardiovascular risk reduction: Time to update the rationale for exercise?

although it is generally accepted that the promotion of exercise accords with clinical best practice, the anecdotal experience of many primary care physicians, cardiologists, and exercise physiologists is that, even when exercise prescriptions are adhered to, risk factors often fail to demonstrate

Brachial Artery Blood Flow Responses to Different Modalities of Lower Limb Exercise

INTRODUCTION/PURPOSE Cycling is associated with a reproducible systolic anterograde and diastolic retrograde flow pattern in the brachial artery (BA) of the inactive upper limb, which results in endothelial nitric oxide (NO) release. The purpose of this study was to examine the impact of different types and intensities of lower limb exercise on the BA flow pattern. METHODS We examined BA blood flow and shear rate patterns during cycling, leg kicking, and walking exercise in 12 young subjects (24 +/- 3 yr). BA diameter, blood flow, and shear rate were assessed at baseline (1 min) and at three incremental intensity levels of cycling (60, 80, and 120 W), bilateral leg kicking (5, 7.5, and 10 kg), and walking (3, 4, and 5 km x h(-1)), performed for 3 min each. Edge detection and wall tracking of high-resolution B-mode arterial ultrasound images, combined with synchronized Doppler waveform envelope analysis, were used to calculate conduit artery diameter and anterograde/retrograde blood flow and shear rate continuously across the cardiac cycle. RESULTS BA mean blood flow and shear rate increased significantly throughout each exercise protocol (P < 0.001), and BA anterograde blood flow and shear rate showed comparable increases throughout each protocol (P < 0.001). Retrograde blood flow and shear rate, however, demonstrated a significant increase during cycling and walking (P < 0.001) but not during leg kicking. CONCLUSION Rhythmic lower limb exercise (cycling and walking) results in an increase in BA systolic anterograde blood flow and shear rate, directly followed by a large retrograde flow and shear rate. This typical pattern, previously linked with endothelial NO release, is not present during a different type of exercise such as leg kicking.

Investigation of the effects of the pre-cooling on the physiological responses to soccer-specific intermittent exercise

Abstract Whole-body cooling prior to activity has the potential to reduce thermal strain and fatigue during subsequent endurance exercise. Intermittent activity is associated with greater increases in rectal temperature compared with continuous exercise. Thus, the effect of pre-cooling on thermoregulatory responses was examined during an intermittent test under “normal” environmental conditions. Six male university soccer players [mean (SD) age 27 (2) years; height 1.77 (0.3) m; mass 72.2 (1.5) kg; maximal oxygen consumption 58.9 (3.5) ml · kg−1 · min−1] completed a 90-minute soccer-specific intermittent exercise protocol on a non-motorised treadmill. The run was completed with and without pre-cooling under normal laboratory conditions (20°C) and without pre-cooling in a heated laboratory (26°C). The pre-cooling strategy involved exposure to a cold shower (26°C) for 60 min. The pre-cooling manipulation lowered rectal temperature prior to exercise [−0.6 (0.6)°C, range −1.5°C; P < 0.05]. The rectal temperature response to exercise was significantly lower following pre-cooling than in the heated condition [pre-cooled 38.1 (0.6)°C, heated 38.6 (0.3)°C]. The increase in rectal temperature during the second half of the protocol following pre-cooling was significantly greater than the increase observed under normal or heated conditions (P < 0.05). No significant differences were observed between the three conditions for oxygen consumption, heart rate, minute ventilation, rating of perceived exertion and plasma lactate, glucose or free fatty acid concentrations. Based on the current investigation, it can be concluded that there is no evidence for the beneficial effects of pre-cooling on the physiological responses to soccer-specific intermittent exercise under normal environmental conditions.

Proteomic investigation of changes in human vastus lateralis muscle in response to interval-exercise training.

No previous study has used proteomics to investigate the effects of exercise training on human skeletal muscle. Five recreationally active men completed a 6‐wk training programme involving three sessions per week, utilising six 1‐min bouts at maximum oxygen uptake (V̇ O2max) interspersed with 4 min at 50% V̇ O2max. Vastus lateralis was biopsied at standardised times before and after the training intervention. Protein expression profiling was performed using differential analysis of 2‐DE gels; complemented with quantitative analysis (iTRAQ) of tryptic peptides from 1‐DE gel lane‐segments using LC‐MALDI MS/MS. Interval training increased average V̇ O2max (7%; p<0.001) and was associated with greater expression of mitochondrial components, including succinate dehydrogenase, trifunctional protein‐α and ATP synthase α‐ and β‐chains. 2‐DE resolved 256 spots, and paired t‐tests identified 20 significant differences in expression (false discovery rate <10%). Each differentially expressed gene product was present as multiple isoelectric species. Therefore, the differences in spot expression represent changes in post‐transcriptional or post‐translational processing. In particular, modulation of muscle creatine kinase and troponin T were prominent. Pro‐Q Diamond staining revealed these changes in expression were associated with phosphorylated protein species, which provides novel information regarding muscle adaptation to interval training.

Maximal physiological responses to deep and shallow water running.

The maximal physiological responses to treadmill running (TMR), shallow water running (SWR) and deep water running (DWR) while wearing a buoyancy vest were compared in 15 trained male runners. Measurements included oxygen consumption (VO2 max), respiratory exchange ratio (RER) and heart rate (HR). Treadmill running elicited VO2 max and HRmax, which were higher than the peaks attained in both water tests (p < 0.01). VO2 peak averaged 83.7 and 75.3% of VO2 max for SWR and DWR respectively. Peak HR for SWR and DWR were 94.1 and 87.2% of the HRmax reached in the TMR. RER responses were similar between the three modalities. The observations suggest that the training stimulus provided by water is still adequate for supplementary training. While SWR is potentially an efficient method of maintaining cardiovascular fitness, it needs to be investigated further to establish if it is a viable technique for the injured athlete to employ.

The effects of intermittent hypoxic training on aerobic and anaerobic performance

The aim of the present study was to determine whether short-term intermittent hypoxic training would enhance sea level aerobic and anaerobic performance over and above that occurring with equivalent sea level training. Over a 4-week period, two groups of eight moderately trained team sports players performed 30 min of cycling exercise three times per week. One group trained in normobaric hypoxia at a simulated altitude of 2750 m (FIO2= 0.15), the other group trained in a laboratory under sea level conditions. Each training session consisted of ten 1-min bouts at 80% maximum workload maintained for 2 min (Wmax) during the incremental exercise test at sea level separated by 2-min active recovery at 50% Wmax. Training intensities were increased by 5% after six training sessions and by a further 5% (of original Wmax) after nine sessions. Pre-training assessments of VO2max, power output at onset of 4 mM blood lactate accumulation (OBLA), Wmax and Wingate anaerobic performance were performed on a cycle ergometer at sea level and repeated 4–7 d following the training intervention. Following training there were significant increases (p < 0.01) in VO2max (7.2 vs. 8.0%), Wmax (15.5 vs. 17.8%), OBLA (11.1 vs. 11.9%), mean power (8.0 vs. 6.5%) and peak power (2.9 vs. 9.3%) in both the hypoxic and normoxic groups respectively. There were no significant differences between the increases in any of the above-mentioned performance parameters in either training environment (p>0.05). In addition, neither haemoglobin concentration nor haematocrit were significantly changed in either group (p>0.05). It is concluded that acute exposure of moderately trained subjects to normobaric hypoxia during a short-term training programme consisting of moderate- to high-intensity intermittent exercise has no enhanced effect on the degree of improvement in either aerobic or anaerobic performance. These data suggest that if there are any advantages to training in hypoxia for sea level performance, they would not arise from the short-term protocol employed in the present study.

Trained Men Display Increased Basal Heat Shock Protein Content of Skeletal Muscle

PURPOSE 1) To compare the baseline levels of heat shock and antioxidant protein content in the skeletal muscle of trained and untrained humans and 2) to characterize the exercise-induced stress response of aerobically trained human skeletal muscle to an acute exercise challenge. METHODS Resting muscle biopsies were obtained from the vastus lateralis muscle of six untrained and six aerobically trained young males. To characterize the stress response of a trained population, the trained subjects also performed a 45-min nondamaging running exercise protocol at an intensity corresponding to 75% of V O2max. Muscle biopsies were obtained from the vastus lateralis muscle at 48 h and 7 d after exercise. RESULTS Trained subjects displayed significantly higher (P<0.05) resting levels of heat shock protein 60 (HSP60, 25%), alphaB-crystallin (43%), and manganese superoxide (MnSOD, 45%) protein content compared with untrained subjects. Trained subjects also exhibited no significant change (P > 0.05) in resting levels of HSP70 (16%), HSC70 (13%), and total superoxide dismutase (SOD) activity (46%) compared with untrained subjects. Resting HSP27 levels were unaffected by exercise training (P > 0.05). In the trained subjects, exercise failed to induce significant increases (P>0.05)in muscle content of HSP70, HSC70, HSP60, HSP27, alphaB-crystallin, and MnSOD protein content or in the activity of SOD at any time point after exercise. CONCLUSION This study demonstrates for the first time that trained men display a selective up-regulation of basal heat shock and antioxidant protein content and do not exhibit a stress response to customary running exercise. It is suggested that an increase in these protective systems functions to maintain homeostasis during the stress of exercise by protecting against disruptions to the cytoskeleton/contractile machinery, by maintaining redox balance, and by facilitating mitochondrial biogenesis.