Physiology international最新文献

Background: Chronic obstructive pulmonary disease (COPD) and post-COVID syndrome cause persistent dyspnea and exercise intolerance. Traditional pulmonary rehabilitation (PR) improves outcomes. Virtual reality (VR)-based PR has been proposed as an engaging alternative. We systematically reviewed randomized trials of VR-based PR programs to evaluate its efficacy and feasibility.

Methods: Following PRISMA guidelines, we searched PubMed, Web of Science, CENTRAL and Google Scholar (2014-Feb 2025) for RCTs comparing VR-assisted PR versus standard PR in patients with COPD or post-COVID conditions. Based on the selection criteria nine trials (primary search total n = 552; 488 COPD and 64 post-COVID patients) were included. Six domains were considered: lung function, exercise capacity (6MWT, STST), dyspnea, quality of life, mental health, and cognitive function.

Results: Across nine RCTs (n = 552), VR-based pulmonary rehabilitation resulted improvements in exercise capacity in all studies, with several reporting greater gains in VR groups. A long-duration trial showed meaningful FEV1 improvement with VR, while shorter trials showed limited changes. Dyspnea and functional scores improved in both groups without consistent between-group differences. VR tended to yield greater reductions in anxiety and depression scores, and one trial showed better cognitive function in post-intervention. Quality-of-life outcomes improved in both groups.

Conclusion: VR-based PR was feasible and produced functional gains at least equal to those of traditional PR. VR's capacity for remote supervised training and gamification holds promise to improve access and adherence. However, evidence is limited by small, short-term trials. Larger, longer RCTs are needed to confirm these benefits, optimize VR protocols, and evaluate cost-effectiveness.

Purpose: To test whether ultrasound-triggered pre-landing quadriceps focal vibration acutely improves knee mechanics and coordination during single-leg drop landings under fresh vs combined cognitive-physical fatigue.

Methods: Twenty-four healthy males (25.4 ± 2.1 years; 175.0 ± 3.1 cm; 73.2 ± 4.9 kg) performed randomized-crossover single-leg forward drop landings. Quadriceps vibration was off or ultrasonically triggered. Landings were tested pre- and post-combined fatigue (15 min dual-task cognitive +90 s burpees).

Results: In the pre-fatigued state, vibration increased peak knee flexion angle by 2.67% (P = 0.001) and knee flexion range of motion by 1.36% (P = 0.008), reduced knee flexion work by 1.69% (P = 0.024), peak vertical ground reaction forces loading rate by 6.67% (P < 0.001), peak patellar tendon force by 5.92% (P < 0.05), time to stabilization by 3.88% (P = 0.003), and maximal diagonal line length by 2.32% (P = 0.008). Post-fatigue, vibration increased determinism (P = 0.023), Shannon entropy (P = 0.041), and dynamic time warping distance (P = 0.045) without significant kinematic or energetic changes.

Conclusions: Pre-landing quadriceps vibration acutely enhances sagittal-plane landing biomechanics, increasing knee flexion, reducing eccentric work and impact loading, and improving adaptive coordination in fresh conditions, with no significant effects under combined fatigue.

Background: Cervicogenic headache (CGH) is frequently associated with altered cervical sensorimotor control, reduced range of motion and impaired postural stability. Prior work has shown that proprioceptive retraining with gaze direction recognition (GDR) can reduce pain and improve postural stability in CGH and chronic neck pain.

Purpose: To examine whether adding a GDR-based proprioceptive training to standard physiotherapy reduces headache frequency and duration and improves postural balance (COP path length) in CGH patients.

Methods: Thirty-eight participants with CGH (aged 35-49 years) were randomly assigned to receive either standard physiotherapy (Control, n = 19) or physiotherapy plus GDR proprioceptive training (Treatment, n = 19) for 8 weeks (3 sessions/week). Outcomes measured pre- and post-intervention included headache frequency (attacks/month), headache duration (hours/attack), and center-of-pressure (COP) path length during quiet standing.

Results: Multivariate analyses revealed significant effects of time and group × time interaction (Wilks' Λ = 0.142, F (3,30) = 60.55, P < 0.001; Wilks' Λ = 0.193, F (3,30) = 41.77, P < 0.001), indicating greater improvements in the treatment group. Follow-up ANOVAs showed significant time and interaction effects for COP path length (F (1,32) = 186.0, P < 0.001; F (1,32) = 130.0, P < 0.001), headache duration (F (1,32) = 16.0, P = 0.00035; F (1,32) = 7.43, P = 0.010), and headache frequency (F (1,32) = 11.7, P = 0.002; F (1,32) = 7.61, P = 0.010). Groups did not differ at baseline.

Conclusion: Adding GDR-based proprioceptive training to standard physiotherapy produced greater improvements in headache burden and markedly improved postural balance compared with standard physiotherapy alone.

Obesity has become one of the main risk factors threatening human health, and it is the core cause of various major chronic diseases. Although the efficacy of exercise intervention on obesity remains controversial, it has long been considered one of the most effective and safest approach for managing obesity and providing benefits to patients with obesity. Metabolic flexibility, especially skeletal muscle metabolic flexibility, has a profound impact on exercise weight loss due to its association with muscle fiber types. To understand the effect of exercise intervention on obese individuals with different muscle types, this review emphasizes high calorie diet induced obesity, investigates the interrelationships among obesity, exercise, and metabolic flexibility, and identifies potential molecular targets within this framework to inform future combined therapeutic strategies targeting metabolic inflexibility.

Abstract: Takotsubo syndrome (also known as stress-induced cardiomyopathy or takotsubo cardiomyopathy) is an acute, reversible left ventricular dysfunction typically triggered by emotional or physical stress. TS is a rare but dangerous disease. In-hospital mortality in patients with TS is identical to mortality of patients with ST-segment elevation myocardial infarction. There is no obstructive coronary plaque or thrombosis in patients with TS, but there is injury of both cardiomyocytes and endothelial cells. The main manifestations of TS are apical akinesia and apical ballooning. The main cause of death in patients with TS is cardiogenic shock. The excessive release of endogenous catecholamines is a trigger of TS. There is evidence that TS is a consequence of β1-adrenergic receptor (β1-AR) overstimulation by catecholamines. The protein kinase A inhibitor H-89 partially reversed stress-induced cardiac injury in rats with TS model (TSM). The β2-AR antagonist ICI-118,551 exacerbated cardiac injury in TSM. The β2-AR agonist formoterol partially reversed cardiac injury in TSM. The β3-AR antagonist L-748337 had no effect on TSM. These findings indicate that the activation of β1-AR plays a key role in the pathogenesis of cardiac injury in TSM. In contrast, β2-AR stimulation protects the heart against stress-induced damage. However, there is evidence that β2-AR overstimulation can cause a negative inotropic effect. It remains unclear why β1-AR antagonists protect the heart against cardiac injury in TSM, but β1-AR antagonists do not demonstrate a significant clinical effect in patients with TS. Administration of isoproterenol and immobilization stress can be used for TSM, because both impacts induce apical akinesia, but only immobilization causes apical ballooning. There is indirect evidence on the involvement of progesterone in cardiac injury in TSM.

Objective: To develop and validate a predictive nomogram for oocyte retrieval and embryo quality based on personalized growth hormone (GH) pretreatment in women undergoing assisted reproductive techniques (ART) with diminished ovarian reserve (DOR).

Methods: 2,000 women ≤40 years, diagnosed with DOR, were non-randomly assigned to one of four groups based upon hormonal and metabolic markers: G1 (1-month GH pretreatment followed by ART), G2 (2-month GH pretreatment), G3 (GH given only during ovarian stimulation), and G4 (standard ART without GH). 2 IU/day of GH was given to women from G1-G3, hormonal profile was repeated and dynamic stratification was done.

Results: The G2 group showed significantly higher estradiol levels, more oocytes retrieved, and a higher proportion of good-quality embryos compared to G1, G3, and G4 (P < 0.001). HOMA-IR levels were elevated in the G2 group, indicating increased insulin resistance with prolonged GH exposure. Multivariate regression identified GH dose (β = 0.48, P < 0.0001) and AMH (β = 0.35, P = 0.0013) as strong positive predictors, while HOMA-IR (β = -0.22, P = 0.012) and testosterone (β = -0.29, P = 0.028) negatively impacted outcomes. The nomogram modelled through multivariate regression provides a clinically effective tool for personalization of GH pretreatment.

Conclusions: The study demonstrates that GH pretreatment significantly enhances oocyte retrieval and embryo quality. A nomogram-based predictive model stratifies patients, supports the personalization of GH treatment duration, and offers a clinically useful tool toward precision reproductive medicine.

Purpose: Ligustilide, an active ingredient from Rhizoma Chuanxiong, exhibits anti-inflammatory, antioxidant, and neuroprotective effects. We aim to evaluate the protective effects of ligustilide against cuprizone-induced sciatic nerve injury in rats by assessing autophagy, fibrosis and apoptosis.

Methods: Cuprizone-induced sciatic nerve injury was investigated in rats. The severity of injury was evaluated using the open field test, the rotarod test, the wire grip test, and nerve conduction velocity measurements. Additionally, sections of the sciatic nerve were stained with Masson trichrome and immune-stained using an anti-mTOR antibody. Samples from the sciatic nerve were utilized to analyze gene expression and protein levels of mTOR, ATG5, beclin-1, TGF-β, β-catenin, and AMPK. The enzyme activities of caspases 3, 8, and 9 were assessed.

Results: Ligustilide significantly improved performance in the open field test, extended grip endurance, and yielded enhanced results in the rotarod test among rats. Additionally, it increased nerve conduction velocity and restored the structural integrity of the sciatic nerves. Furthermore, ligustilide reduced the expression levels of mTOR, TGF-β, β-catenin, and AMPK, which are associated with the overexpression of ATG5 and beclin-1. Finally, ligustilide reduced the enzyme activities of caspases 3, 8, and 9.

Conclusion: Ligustilide has demonstrated significant therapeutic effects in rat models of sciatic nerve injury. It enhances autophagy and inhibits fibrosis and apoptosis.

Purpose: To examine muscle oxygenation during running with and without blood flow restriction (BFR).

Methods: Fifteen aerobically trained males randomly completed four, three-minute running bouts at 70%BFR, 80%BFR, and 90%BFR of their top speed with BFR and 100%NOBFR of their top speed without BFR. Oxygenated hemoglobin (O2Hb), deoxygenated Hb (HHb), total Hb (tHb), Hb difference (HbDiff) and muscle tissue oxygenation (StO2) were assessed continuously throughout the running bouts. Separate two-way, 4 (Intensity [70%BFR, 80%BFR, 90%BFR, 100%NOBFR]) × 3 (Time [120, 150, and 180 s]), repeated-measure ANOVA models were constructed to examine O2Hb, HHb, tHb, HbDiff, and StO2 responses.

Results: O2Hb decreased (120- [65.25 ± 6.58%] > 150-s [63.72 ± 6.75%]), while HHb increased (120- [14.4 ± 12.55%] < 150- [16.91 ± 12.6%] < 180-s [18.26 ± 12.87%]) (P < 0.001). tHb was similar across time (P = 0.159) and between intensities (P = 0.454). HbDiff decreased (120- [73.56 ± 6.54%] > 150- [71.66 ± 6.61%] > 180-s [70.98 ± 6.93%]). StO2 decreased and then plateaued (120- > 150- and 180-s) during the 70%BFR (51.87 ± 5.09% > 51.20 ± 5.37% and 51.02 ± 5.21%) (P = 0.004), 80%BFR (52.2 ± 3.93% > 51.34 ± 4.17% and 51.01 ± 4.09%) (P = 0.008), and 100%NOBFR (51.69 ± 4.6% > 50.84 ± 4.87% and 50.62 ± 4.89%) (P < 0.001) bouts, while there were no differences for 90%BFR (P > 0.05).

Conclusions: Submaximal running with BFR induced similar responses as maximal running without, despite large differences (i.e., ≤30%) in running speed.

Background: Ketogenic diet (KD) is increasingly recognized as a strategy to combat obesity. However, its effects on cognition in sedentary healthy young adults remain underexplored.

Methods: In a quasi-experimental design, 186 participants were screened, 78 excluded based on predefined criteria, leaving 108 healthy adults (age 25-45 years, BMI 18-29.9 kg m-2, sedentary <5,000 steps/day) assigned to either KD group (<5% carbohydrates, 20-25% protein, 70-75% fat; n = 54) or control group (regular diet ∼50-65% carbohydrates; n = 54). Participants underwent a 4 weeks' dietary intervention. Cognitive domains were assessed at baseline and post intervention using validated computer-based test battery. Pre, mid and post weight, BMI, blood ketones and fasting glucose were also measured. Forty-three participants in the KD group and 38 in the control group completed the trial.

Results: Four weeks of non-energy restricted KD improved processing speed, semantic memory, working memory, episodic memory, fluid cognition, crystallized cognition and overall cognitive composite scores (all P ≤ 0.001) versus controls. Attention and inhibitory control (P = 0.46) and cognitive flexibility (P = 0.21) showed no significant differences. Blood ketones increased (0.12-1.32 mmol L-1, P < 0.001) in KD participants versus controls (0.118-0.105 mmol L-1, P = 0.94). KD reduced weight (P < 0.001), BMI (P < 0.001) and fasting glucose (P < 0.001). Post intervention ketones predicted cognitive gain in most cognitive domains except attention & inhibitory control and cognitive flexibility.

Conclusion: Short term KD intervention enhances memory, processing speed, fluid, crystallized and overall cognitive function composite scores in sedentary healthy adults.

To compare the mitigating effects of different interventions-low-concentration oxygen-enriched air and exercise-on mental fatigue. Researchers recruited 25 healthy male subjects and had them perform a Stroop task to induce cerebral fatigue, then different interventions (meditation, placebo, low-concentration oxygen-enriched air, exercise, and low-concentration oxygen-enriched air plus exercise) were used to provide recovery interventions to subjects, and recovery from cerebral fatigue was assessed by measuring psychometric scales, galvanic skin activity, heart rate variability, and cognitive executive tasks. The results showed that low-concentration oxygen-enriched air and exercise were effective in relieving cerebral fatigue and improving cognitive executive function, and the combined intervention was particularly effective, showing the most comprehensive benefits.