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Essential hypertension is associated with blunted smooth muscle cell vasodilator responsiveness and is reversed by 10-20-30 training in men.
Gunnarsson, TP, Ehlers, TS, Fiorenza, M, Nyberg, M, Bangsbo, J
American journal of physiology. Cell physiology. 2020;(6):C1252-C1263
Abstract
Essential hypertension is associated with impairments in vascular function and sympathetic nerve hyperactivity; however, the extent to which the lower limbs are affected remains unclear. We examined the leg vascular responsiveness to infusion of acetylcholine (ACh), sodium nitroprusside (SNP), and phenylephrine (PEP) in 10 hypertensive men [HYP: age 59.5 ± 9.7 (means ± SD) yr; clinical and nighttime blood pressure: 142 ± 10/86 ± 10 and 141 ± 11/83 ± 6 mmHg, respectively; and body mass index (BMI): 29.2 ± 4.0 kg/m2] and 8 age-matched normotensive counterparts (NORM: age 57.9 ± 10.8 yr; clinical and nighttime blood pressure: 128 ± 9/78 ± 7 and 116 ± 3/69 ± 3 mmHg, respectively; and BMI: 26.3 ± 3.1 kg/m2). The vascular responsiveness was evaluated before and after 6 wk of 10-20-30 training, consisting of 3 × 5 × 10-s sprint followed by 30 and 20 s of low- to moderate-intensity cycling, respectively, interspersed by 3 min of rest. Before training, the vascular responsiveness to infusion of SNP was lower (P < 0.05) in HYP compared with NORM, with no difference in the responsiveness to infusion of ACh and PEP. The vascular responsiveness to infusion of SNP and ACh improved (P < 0.05) with training in HYP, with no change in NORM. With training, intra-arterial systolic blood pressure decreased (P < 0.05) by 9 mmHg in both HYP and NORM whereas diastolic blood pressure decreased (5 mmHg; P < 0.05) in HYP only. We provide here the first line of evidence in humans that smooth muscle cell vasodilator responsiveness is blunted in the lower limbs of hypertensive men. This impairment can be reversed by 10-20-30 training, which is an effective intervention to improve the responsiveness of smooth muscle cells in men with essential hypertension.
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The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage.
Oakley, ET, Pardeiro, RB, Powell, JW, Millar, AL
Journal of strength and conditioning research. 2013;(10):2743-51
Abstract
There is inconclusive evidence for the effectiveness of cryotherapy for the treatment of exercised-induced muscle damage (EIMD). Small sample sizes and treatment applications that did not correspond to evidence-based practice are limitations in previous studies that may have contributed to these equivocal findings. The purpose of this study was to examine the effectiveness of daily multiple applications of ice on EIMD throughout the 72-hour recovery period, an icing protocol that more closely resembles current clinical practice. Thirty-three subjects were assigned to either the cryotherapy group (n = 23) or control group (n = 10). The EIMD was induced through repeated isokinetic eccentric contractions of the right hamstring muscle group. The experimental group received ice immediately after induction of EIMD and continued to ice thrice a day for 20 minutes throughout the 72 hours; the control group received no intervention. Isometric torque, hamstring length, pain, and biochemical markers (creatine kinase [CK], alanine aminotransferase, and aspartate aminotransferase [AST]) were assessed at baseline, 24, 48, and 72 hours. Both groups demonstrated a significant change (p < 0.05) in all dependent variables compared with that at baseline, but there was no difference between groups except for pain. The cryotherapy group had significantly (p = 0.048) less pain (3.0 ± 2.1 cm) compared with the control (5.35 ± 2.5 cm) at 48 hours. Although not statistically significant, the cryotherapy group had a greater range of motion and lower CK and AST means at 72 hours compared with that of the control group. Repeated applications of ice can decrease the pain associated with EIMD significantly at 48 hours post EIMD. Although the results may not be unique, the methodology in this study was distinctive in that we used a larger sample size and an icing protocol similar to current recommended treatment practice.
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[Effect of Chinese drugs for benefiting-qi, activating-blood, dissolving-phlegm and removing-toxin combined with conventional treatment in preventing and treating post-operative vascular restenosis in patients with diabetic lower extremity arterial disease underwent percutaneous transluminal angioplasty].
Ju, S, Yang, BH, Cui, YL
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine. 2010;(9):901-4
Abstract
OBJECTIVE To verify the clinical efficacy of Chinese drugs for benefiting-qi, activating-blood, dissolving phlegm and removing-toxin (CDs) Combined with Conventional Treatment on post-operative vascular restenosis in patients with diabetic lower extremity arterial disease (DLEAD) underwent percutaneous transluminal angioplasty (PTA). METHODS Fifty-six DLEAD patients underwent PTA of below-knee artery were assigned to the treatment group (32 patients) treated by basic therapy combined with CDs and the control group (24 patients) treated by basic therapy only. The changes in symptoms and signs, ankle/brachial index (ABI) and transcutaneous oxygen pressure (TCPO2) of affected limb, and blood flow (BF) in operated vessels checked with color Doppler examination were monitored and analyzed with SPSS software 16. 0. RESULTS Overall effectiveness, including symptom score, ABI, TCPO2 and BF in patients after operation were all better in both groups significantly (P < 0.05), the improvements began to reveal in 3-6 months, and be stabilized in the treatment group, but declined gradually in the control group after then. So, the effective rate in the treatment group became significantly higher than that in the control group (75.00% vs. 41.67%, P < 0.01) at the end of the 6th month, meanwhile levels of ABI (0.65 +/- 0.12), TCPO2 (68.00 +/- 4.21 mm Hg), and BF (35.00 +/- 2.11 cm/s) in the former were better than those in the control group, respectively (0.44 +/- 0.12, 41.00 +/- 2.02 mm Hg and 21.00 +/- 1.85 cm/s, P < 0.05). CONCLUSION CDs shows definite effect in post-PTA prevention of vascular restenosis in DLEAD patients.
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Effect of aqua exercise on recovery of lower limb muscles after downhill running.
Takahashi, J, Ishihara, K, Aoki, J
Journal of sports sciences. 2006;(8):835-42
Abstract
The aim of the present study was to examine how the recovery of physiological functioning of the leg muscles after high-intensity eccentric exercise such as downhill running could be promoted by aqua exercise for a period until the damaged muscle had recovered almost completely. Ten male long-distance runners were divided equally into an aqua exercise group and a control group. From the first day (Day 0) to the fourth day (Day 3), the participants completed a questionnaire on muscle soreness, and serum creatine kinase activity, muscle power, flexibility, whole-body reaction time and muscle stiffness were measured. After measurements on Day 0, the participants performed downhill running (three 5 min runs with a 5 min rest interval at -10%, 335.7 +/- 6.1 m . min-1). The aqua exercise group performed walking, jogging and jumping in water on three successive days following the downhill running on Day 0 for 30 min each day. Muscle power was reduced on Day 1 in the control group (P < 0.05). Muscle soreness in the calf on Day 3 was greater in the control group than that in the aqua exercise group (P < 0.05). In the aqua exercise group, muscle stiffness in the calf was less than that in the control group over 4 days (time main effect: P < 0.05; group x time interaction: P < 0.05). We conclude that aqua exercise promoted physiological functioning of the muscles in the legs after high-intensity downhill running for a period until the damaged muscles had recovered almost completely.
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Biomechanical characteristics of adults walking in shallow water and on land.
Barela, AM, Stolf, SF, Duarte, M
Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2006;(3):250-6
Abstract
Although water environment has been employed for different physical activities, there is little available information regarding the biomechanical characteristics of walking in shallow water. In the present study, we investigated the kinematics, ground reaction forces (GRF), and electromyographic (EMG) activation patterns of eight selected muscles of adults walking in shallow water and on land. Ten healthy adults were videotaped while walking at self-selected comfortable speeds on land and in water (at the Xiphoid process level). In both conditions there was a force plate embedded in the middle of each walkway to register the GRF components. Reflective markers were placed over main anatomical landmarks and they were digitalized later to obtain stride characteristics and joint angle information. In general, walking in water was different to walking on land in many aspects and these differences were attributed to the drag force, the apparent body weight reduction, and the lower comfortable speed during walking in shallow water. The joint range of motions (ROM) were not different, the segment ROM, magnitudes of GRF components, impact force, and impulse were different between the two conditions. The present results will contribute to a better understanding of this activity in the context of training and rehabilitation.
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Functional roles of lower-limb joint moments while walking in water.
Miyoshi, T, Shirota, T, Yamamoto, S, Nakazawa, K, Akai, M
Clinical biomechanics (Bristol, Avon). 2005;(2):194-201
Abstract
OBJECTIVE To clarify the functional roles of lower-limb joint moments and their contribution to support and propulsion tasks while walking in water compared with that on land. DESIGN Sixteen healthy, young subjects walked on land and in water at several different speeds with and without additional loads. BACKGROUND Walking in water is a major rehabilitation therapy for patients with orthopedic disorders. However, the functional role of lower-limb joint moments while walking in water is still unclear. METHODS Kinematics, electromyographic activities in biceps femoris and gluteus maximums, and ground reaction forces were measured under the following conditions: walking on land and in water at a self-determined pace, slow walking on land, and fast walking in water with or without additional loads (8 kg). The hip, knee, and ankle joint moments were calculated by inverse dynamics. RESULTS The contribution of the walking speed increased the hip extension moment, and the additional weight increased the ankle plantar flexion and knee extension moment. CONCLUSIONS The major functional role was different in each lower-limb joint muscle. That of the muscle group in the ankle is to support the body against gravity, and that of the muscle group involved in hip extension is to contribute to propulsion. In addition, walking in water not only reduced the joint moments but also completely changed the inter-joint coordination. RELEVANCE It is of value for clinicians to be aware that the greater the viscosity of water produces a greater load on the hip joint when fast walking in water.
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Controlled reperfusion using a simplified perfusion system preserves function after acute and persistent limb ischemia: a preliminary study.
Wilhelm, MP, Schlensak, C, Hoh, A, Knipping, L, Mangold, G, Dallmeier Rojas, D, Beyersdorf, F
Journal of vascular surgery. 2005;(4):690-4
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Abstract
OBJECTIVE Reperfusion of the limb after acute and persistent ischemia is associated with high rates of morbidity and mortality despite complete revascularization. Although reperfusion is a prerequisite for maintaining limb function, it may in itself cause further injury. There is experimental evidence that modification of the initial reperfusion modalities can minimize this reperfusion injury. We hypothesized that controlled reperfusion using a simple blood bag perfusion system reduces reperfusion injury and facilitates the return of normal function. METHODS Fifteen consecutive patients (mean age, 80.5 +/- 5.0 years) with severe, acute lower-limb ischemia were allocated to two treatment arms in this prospective, controlled observational study. Group I (n = 8) underwent surgical embolectomy alone, and group II (n = 7) underwent surgical embolectomy plus controlled reperfusion using a simplified perfusion system. Indication for controlled reperfusion was made by the responsible surgeon. Controlled reperfusion consisted of a 30-minute infusion of a crystalloid reperfusion solution that was mixed with oxygenated blood (the blood:reperfusion solution ratio was 6:1) distal to the occlusion. Duration of ischemia, postoperative amputation rate, motor function of the ischemic limb, and pre- and postoperative serum creatine kinase levels were assessed. RESULTS The duration of ischemia was 10.7 +/- 1.1 hours in group I and 19 +/- 5.2 hours in group II (P < .05). The site of the arterial occlusion was the iliac artery in nine patients and the common femoral artery in six patients. Full recovery was achieved in six of seven patients in group II and in only two of eight patients in group I (P < .05). There were three in-hospital deaths in group I, and two patients underwent major amputations. No in-hospital deaths or major amputations occurred in group II. CONCLUSION The results from this preliminary study strongly suggest the hypothesis that the results of conventional embolectomy for acute, severe lower-limb ischemia can be improved by controlled reperfusion. To prove our preliminary findings, a large randomized, prospective, controlled, multicenter trial, the Controlled Reperfusion of the Acutely Ischemic Limb trial (CRAIL-Trial) is currently being conducted to prove our preliminary findings.