MOTOmed下肢智能运动训练联合运动想象疗法对脑卒中偏瘫患者下肢功能、步行能力和躯干屈伸肌群肌力的影响

摘要 目的：探讨MOTOmed下肢智能运动训练联合运动想象疗法对脑卒中偏瘫患者下肢功能、步行能力和躯干屈伸肌群肌力的影响。方法：148例脑卒中偏瘫患者来源于我院2019年5月~2021年5月期间我院接收的患者,根据随机数字表法分为对照组（n=74,常规康复训练的基础上结合MOTOmed下肢智能运动训练）和研究组（n=74,对照组的基础上结合运动想象疗法）。两组均干预12周。对比两组下肢功能、步行能力和躯干屈伸肌群肌力变化。结果：两组干预12周后Fugl-Meyer运动功能量表（FMA）、Barthel指数（BI）、功能性步行能力分级量表（FAC）评分升高,且研究组高于对照组（P<0.05）。两组干预12周后步频、步速、跨步长比率升高,且研究组高于对照组（P<0.05）。两组干预12周后健侧腹直肌、竖脊肌表面肌电信号的均方根值未见明显变化,且组间同时点对比无差异（P>0.05）。两组干预12周后患侧腹直肌、竖脊肌表面肌电信号的均方根值升高,且研究组高于对照组（P<0.05）。结论：脑卒中偏瘫患者在MOTOmed下肢智能运动训练的基础上进行运动想象疗法,可促进下肢功能改善,提高步行能力,同时还可改善患侧躯干屈伸肌群肌力。     

间歇性θ脉冲刺激联合有氧运动训练对老年2型糖尿病合并轻度认知功能障碍患者糖脂代谢、认知功能和听觉诱发电位P300的影响

摘要 目的：探讨间歇性θ脉冲刺激（iTBS）联合有氧运动训练对老年2型糖尿病（T2DM）合并轻度认知功能障碍（MCI）患者糖脂代谢、认知功能和听觉诱发电位P300的影响。方法：选取2020年3月~2021年11月期间来我院接受治疗的老年T2DM合并MCI患者117例。按照随机数字表法分为对照组（有氧运动训练,58例）和观察组（iTBS联合有氧运动训练,59例）。观察两组干预前后糖脂代谢、认知功能和听觉诱发电位P300的变化情况。结果：观察组干预后空腹血糖（FBG）、糖化血红蛋白（HbA1c）低于对照组（P<0.05）。两组干预后总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）组间对比,统计学无差异（P>0.05）。观察组干预后蒙特利尔量表（MoCA）各维度及总分高于对照组（P<0.05）。观察组干预后中央区（Cz）潜伏期、组顶区（Pz）潜伏期短于对照组,Cz波幅、Pz波幅高于对照组（P<0.05）。结论：iTBS联合有氧运动训练用于老年T2DM合并MCI患者,可有效降低血糖,改善机体认知功能和听觉诱发电位P300。     

Cheetah do not abandon hunts because they overheat

Hunting cheetah reportedly store metabolic heat during the chase and abandon chases because they overheat. Using biologging to remotely measure the body temperature (every minute) and locomotor activity (every 5 min) of four free-living cheetah, hunting spontaneously, we found that cheetah abandoned hunts, but not because they overheated. Body temperature averaged 38.4°C when the chase was terminated. Storage of metabolic heat did not compromise hunts. The increase in body temperature following a successful hunt was double that of an unsuccessful hunt (1.3°C ± 0.2°C versus 0.5°C ± 0.1°C), even though the level of activity during the hunts was similar. We propose that the increase in body temperature following a successful hunt is a stress hyperthermia, rather than an exercise-induced hyperthermia.     

Exercise induces autophagy in peripheral tissues and in the brain

We recently identified physical exercise as a newly defined inducer of autophagy in vivo. Exercise induced autophagy in multiple organs involved in metabolic regulation, such as muscle, liver, pancreas and adipose tissue. To study the physiological role of exercise-induced autophagy, we generated mice with a knock-in nonphosphorylatable mutation in BCL2 (Thr69Ala, Ser70Ala and Ser84Ala) (BCL2 AAA) that are defective in exercise- and starvation-induced autophagy but not in basal autophagy. We found that BCL2 AAA mice could not run on a treadmill as long as wild-type mice, and did not undergo exercise-mediated increases in skeletal glucose muscle uptake. Unlike wild-type mice, the BCL2 AAA mice failed to reverse high-fat diet-induced glucose intolerance after 8 weeks of exercise training, possibly due to defects in signaling pathways that regulate muscle glucose uptake and metabolism during exercise. Together, these findings suggested a hitherto unknown important role of autophagy in mediating exercise-induced metabolic benefits. In the present addendum, we show that treadmill exercise also induces autophagy in the cerebral cortex of adult mice. This observation raises the intriguing question of whether autophagy may in part mediate the beneficial effects of exercise in neurodegeneration, adult neurogenesis and improved cognitive function.     

Exercise‐Induced Reduction in Obesity and Insulin Resistance in Women: a Randomized Controlled Trial

Objectives : To determine the effects of equivalent diet‐ or exercise‐induced weight loss and exercise without weight loss on subcutaneous fat, visceral fat, and insulin sensitivity in obese women. Research Methods and Procedures : Fifty‐four premenopausal women with abdominal obesity [waist circumference 110.1 ± 5.8 cm (mean ± SD)] (BMI 31.3 ± 2.0 kg/m²) were randomly assigned to one of four groups: diet weight loss (n = 15), exercise weight loss (n = 17), exercise without weight loss (n = 12), and a weight‐stable control group (n = 10). All groups underwent a 14‐week intervention. Results : Body weight decreased by ～6.5% within both weight loss groups and was unchanged in the exercise without weight loss and control groups. In comparison with controls, cardiorespiratory fitness improved within the exercise groups only (p < 0.01). Reduction in total, abdominal, and abdominal subcutaneous fat within the exercise weight loss group was greater (p < 0.001) than within all other groups. The reduction in total and abdominal fat within the diet weight loss and exercise without weight loss groups was greater than within controls (p < 0.001) but not different from each other (p > 0.05). Visceral fat decreased within all treatment groups (p < 0.008), and these changes were not different from each other. In comparison with the control group, insulin sensitivity improved within the exercise weight loss group alone (p < 0.001). Discussion : Daily exercise without caloric restriction was associated with substantial reductions in total fat, abdominal fat, visceral fat, and insulin resistance in women. Exercise without weight loss was also associated with a substantial reduction in total and abdominal obesity.     

Cognitive Change in Obese Adolescents Losing Weight

Objectives: To investigate how obese adolescents think about themselves in terms of exercise, eating, and appearance and whether these cognitions change over the course of a residential weight loss camp. Research Methods and Procedures: Obese adolescents [N = 61; age, 14.1 (±0.2) years; BMI, 33.9 (±0.7) kg/m²] completed assessments of body weight and height and self‐esteem and a sentence‐completion test eliciting thoughts and beliefs about exercise, eating, and appearance at the start and end of the camp (mean stay, 26 days). They were compared with a single assessment of 20 normal‐weight adolescents [age, 15.4 (±0.2) years; BMI, 21.8 (±0.5) kg/m²]. Results: The obese adolescents lost 5.7 kg and reduced their BMI SD score by 0.25. Camp residence was associated with a significant reduction in the number of negative automatic thoughts and an increase in positive thoughts, especially related to exercise and appearance. There was no change in conditional beliefs, either functional or dysfunctional. Including BMI SD score change as a covariate took away all the main and interaction effects of time, showing that cognitive change was largely accounted for by the reduction in weight. Despite this improvement, campers remained cognitively more negative and dysfunctional than the normal‐weight comparison adolescents. Discussion: Obese adolescents not only lost weight, but they improved their self‐representation, specifically in terms of automatic thoughts about exercise and appearance. Although these are short‐term cognitive changes, they reflect positively on the camp experience and show the value of psychological improvement in assessing obesity‐treatment outcomes.     

The Effect of CYP19 and COMT Polymorphisms on Exercise‐Induced Fat Loss in Postmenopausal Women

Objective:To examine whether genetic polymorphisms in CYP19 [intron 4 (TTTA)_n; n = 7 to 13 and a 3‐base pair deletion, which is in strong linkage disequilibrium with the seven repeat] and COMT (Val^108/158Met) modified the change in BMI, total and percentage body fat, or subcutaneous and intra‐abdominal fat during a year‐long exercise intervention trial. These genes metabolize estrogens and androgens, which are important in body fat regulation. Research Methods and Procedures: A randomized intervention trial was used, with an intervention goal of 225 min/wk of moderate‐intensity exercise for one year. Participants (n = 173) were postmenopausal, 50 to 75 years old, sedentary, overweight or obese, and not taking hormone therapy at baseline. Results: Exercisers with two vs. no CYP19 11‐repeat alleles had a larger decrease in total fat (?3.1 kg vs. ?0.5 kg, respectively, p = 0.01) and percentage body fat (?2.4% vs. ?0.6%, respectively, p = 0.001). Exercisers with the COMT Met/Met vs. Val/Val genotype had a smaller decrease in percentage fat (?0.7% vs. ?1.9%, respectively, p = 0.05). Among exercisers, women with the COMT Val/Val genotype and at least one copy of the CYP19 11‐repeat allele vs. those with neither genotype/allele had a significantly larger decrease in BMI (?1.0 vs. +0.1 kg/m², respectively, p = 0.009), total fat (?2.9 vs. ?0.5 kg, respectively, p = 0.004), and percentage body fat (?2.6% vs. ?0.4%, respectively, p < 0.001). Discussion: Genetic polymorphisms in CYP19 and COMT may be important for body fat regulation and possibly modify the effect of exercise on fat loss in postmenopausal women.     

4周中等强度有氧运动诱导大鼠心房肌蛋白质组差异表达的研究

目的：探讨中等强度有氧运动对大鼠心房肌蛋白质组及其基因差异表达的影响,为运动心脏重塑和慢性心血管疾病康复研究提供研究依据。方法：20只雄性SD大鼠按照体重随机配对分为对照组、实验组（n=10）,实验组大鼠每次按照速度24 m·min^-1、持续训练40 min （负荷强度相当于60%~70% VO_2max）,每周训练6 d,持续训练4周中等强度有氧运动。应用双向凝胶电泳技术（2-DE）分离心房肌蛋白质点,串联飞行时间质谱仪技术鉴定电泳结果中表达量上调≥5倍以上,下调至1/5以下的13个备选目标蛋白质点。并对其中6个目标蛋白质用逆转录-聚合酶链式反应（RT-PCR）技术检测其mRNA。结果：通过软件分析,实验组与对照组比较,其中表达量下调至20%以下的点8个,上调5倍及以上点有5个,质谱鉴定分析其中的13个蛋白质点,最终鉴定出8种蛋白质和一个分子量为54 KDa的未知蛋白,包括：丙酮酸脱氢酶E1α1、线粒体乌头酸水合酶、蛋白质二硫键异构酶A3、甲基丙二酸半醛脱氢酶、线粒体二氢硫辛酸脱氢酶、异戊酰辅酶A脱氢酶、谷胱甘肽合成酶、丝裂素活化蛋白激酶3等。RT-PCR检测结果表明,与对照组相比,4周中等强度有氧运动后,大鼠心房肌中甲基丙二酸半醛脱氢酶的mRNA表达量降低（P﹤0.05）,线粒体二氢硫辛酸脱氢酶、蛋白质二硫键异构酶A3、线粒体乌头酸水合酶、谷胱甘肽合成酶的mRNA表达量降低（P>0.05）;异戊烯辅酶A脱氢酶的mRNA表达量增高（P>0.05）,表明mRNA表达水平与质谱鉴定结果的变化不完全一致。结论：4周的中等强度有氧运动诱导大鼠心房肌蛋白质组发生显著变化,有13个明显变化的目标蛋白,多数为能量物质代谢酶,这些目标蛋白质的变化与其mRNA表达量的变化并不完全一致,表明中等强度运动可能影响这些目标蛋白质上游基因转录的调控,也可影响下游翻译﹑修饰等的调控,导致表达的差异变化。     

运动对肥胖大鼠胰岛素抵抗的影响

目的：探讨急、慢性游泳运动对胰岛素抵抗大鼠半乳凝素-3（galectin-3）表达的影响。方法：100只大鼠随机分为：普通膳食对照组（CON组,n=10）;高脂膳食组（HFD组,n=90）。分别喂养8周后,从高脂膳食组筛选出肥胖（即体重位于上游）大鼠30只用于后续实验。将肥胖大鼠随机分为3组（n=10）：①HFD-SED组：高脂膳食安静组;②HFD-CE组：高脂膳食慢性运动组,进行慢性游泳运动;③HFD-AE组：高脂膳食急性运动组,进行急性游泳运动。肥胖大鼠继续高脂膳食喂养8周,并进行运动干预;CON组大鼠继续普通饲料喂养8周。运动干预结束后,各组进行口服糖耐量和胰岛素释放实验,计算葡萄糖-胰岛素指数;测定体重;以ELISA分析大鼠血液中Gal-3含量。结果：HFD-SED组葡萄糖-胰岛素指数明显大于CON组（P<0.01）,HFD-CE组和HFD-AE组葡萄糖-胰岛素指数明显小于HFD-SED组（P<0.01）;HFD-SED组血液Gal-3含量明显高于CON组（P<0.01）,HFD-CE和HFD-AE组血液Gal-3含量明显小于HFD-SED组（P<0.01）。运动干预结束后,HFD-SED组和HFD-AE组大鼠体重明显高于CON组（P<0.01）;HFD-CE组大鼠体重明显低于HFD-SED组（P<0.01）,而与CON组无统计学差异。结论：急、慢性游泳运动均能改善胰岛素抵抗状态、降低胰岛素抵抗大鼠的Gal-3表达,但慢性游泳运动能明显改善机体超重状态。建议临床上采用长期、规律的慢性有氧运动对肥胖、胰岛素抵抗等代谢疾病进行干预。