Inflammatory Cytokines Response to Isometric Handgrip Exercise and the Effects of Duration and Intensity of the Isometric Effort in Prehypertensive Subjects

BACKGROUND Chronic low grade systemic inflammation has been identified as a major risk factor for chronic diseases. The potential for physical exercise to induce anti-inflammatory effect is now increasingly being explored but there is paucity of data regarding the effects isometric exercise on inflammatory cytokines. The objective of this study was to investigate the responses of selected inflammatory cytokines to isometric handgrip exercise and identify possible effects of intensity and duration of the isometric effort on these variables. CASE PRESENTATION: A total of one hundred and ninety two (N=192) sedentary pre-hypertensive subjects, aged between 30-50years were recruited into the study and randomly distributed into three groups of 64 subjects each. The subjects performed a 24 consecutive day’s isometric hand grip exercise at 30% Maximum Voluntary Contraction. At the end of the 24 days, the group one (GP1) discontinued with the exercise protocol while the group two (GP2) continued the exercise protocol for another 24 consecutive days and the group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50%MVC. The parameters used to assess for the inflammatory cytokine variables included interleukin 10, interleukin 6 and tumor necrotic factor. At the end of the study, there was an increase in the resting values of interleukin 10 across the three groups while the resting values of interleukin 6 and tumor necrotic factor reduced significantly across groups. CONCLUSIONS: The reductions noted in the pro-inflammatory cytokines and increase in the anti-inflammatory cytokines could have a positive impact in the management of chronic diseases. It was also found that increase in intensity and/or duration produced more proportionate effect.

Physical Fitness as a Prognostic Marker for Infectious Events in Kidney Transplant Recipients

<b><i>Introduction:</i></b> Infectious events are one of the leading causes of death in kidney transplant recipients (KTRs). KTRs have reduced cardiorespiratory fitness (CRF), a predictor for infections in other populations. The aim of this study was to investigate whether CRF and muscle strength are prognostic markers for infectious events in KTRs. <b><i>Methods:</i></b> In this retrospective cohort study, 155 KTRs underwent an incremental, maximal cardiopulmonary exercise test (CPET) 3 months after transplantation. CRF was analyzed with peak oxygen consumption (VO₂ peak) while muscle strength with isometric handgrip (HG) test. Laboratory blood samples and drug therapy were collected. The median follow-up period was 54 (interquartile range 38–62) months. Cox regression analyses were performed to evaluate predictors of infectious events adjusting for potential confounders. <b><i>Results:</i></b> During this study, severe infectious events occurred in 41 subjects (26.5%). 15.5% (<i>n</i> = 24) of patients had a severely reduced CRF, defined as a VO₂ peak below the 5th percentile of the reference values reported for a matched healthy population. The hazard ratio for infectious events in this subgroup was 2.389 (95% CI = 1.188–4.801, <i>p</i> = 0.014), independently of gender, age, BMI, time on dialysis, hemoglobin concentration, eGFR, diabetes, and immunosuppressive regimen. On the contrary, no significant association of HG strength and infections was found. <b><i>Conclusion:</i></b> Therefore, low CRF may be considered as a modifiable predictor of severe infectious events in KTRs. A CPET should thus be recommended for cardiovascular screening, evaluation of CRF, and tailored exercise prescription to reduce the risk of infections and potentially improve long-term outcomes of transplantation.

Penerapan Isometric Handgrip Exercisedan Slow Deep Breathing Exercise Untuk Menurunkan Tekanan Darah

Hypertension is an increase in blood pressure with systolic above 140 mmHg and diastolic above 90 mmHg. One of the non-pharmacological methods to lower blood pressure is to do isometric handgrip exercise and slow deep breathing exercise. The purpose of this case study is to evaluate blood pressure by implementing isometric handgrip exercise and slow deep breathing exercise toward hypertensive patients within five day of training (twice per day). There were two hipertensive patients involvid in this study. The results of this case study showed that the blood pressure of both patients dropped to normal. The firt patients blood pressure dropped to normal from 160/100 mmHg to 130/80 mmHg after the intervention. Similarly, the second patients blood pressure reduced from 170/100 mmHg to 120/80 mmHg. This study conclusion that the isometric handgrip exercise and slow deep breathing exercise can lower blood pressure.Keywords: Hypertension; Isometric Handgrip; Slow Deep Breathing AbstrakHipertensi adalah peningkatan tekanan darah dengan sistolik diatas 140 mmHg dan diastolik diatas 90 mmHg.salah satu tindakan nonfarmakologi yang dapat menurunkan tekanan darah adalah dengan melakukan latihan isometric handgrip exercise dan slow deep breathing exercise. Tujuan dilakukannya penerapan studi kasus ini adalah untuk menurunkan tekanan darah dengan menggunakan latihan isometric handgrip exercise dan slow deep breathing exercise pada keluarga dengan hipertensi. Metode yang digunakan adalah dengan penerapan latihan isometric handgrip exercise dan slow deep breathing exercise. Hasil dari studi kasus ini menunjukkan adanya penurunan tekanan darah pada klien I dan II yang disertai dengan penurunan rasa nyeri, klien I dengan tekanan darah 160/100 mmHg turun menjadi 130/80 mmHg dan klien II dengan tekanan darah 170/100 mmHg turun menjadi 120/80 mmHg. Kesimpulan dari penerapan isometric handgrip exercise dan slow deep breathing exercise adalah bahwa penerapan latihan isometric handgrip exercise dan slow deep breathing exercise dapat menurunkan tekanan darah selama 5 hari latihan dengan 2 kali pertemuan setiap harinya.Kata kunci: Hipertensi; Isometric Handgrip; Slow Deep Breathing

The effect of extracellular hyperosmolality on sweat rate during metaboreflex activation in passively heated young men

Metaboreflex activation augments sweating during mild-to-moderate hyperthermia in euhydrated (isosmotic isovolemic) individuals. Recent work indicates that extracellular hyperosmolality may augment metaboreflex-mediated elevations in sympathetic nervous activity. Our primary objective was therefore to test the hypothesis that extracellular hyperosmolality would exacerbate metaboreflex-mediated increases in sweat rate. On two separate occasions, 12 young men (mean (SD): 25 (5) years) received a 90-min intravenous infusion of either 0.9% saline (isosmotic condition, ISO) or 3.0% saline (hyperosmotic condition, HYP), resulting in a post-infusion serum osmolality of 290 (3) and 301 (7) mOsm/kg, respectively. A whole-body water perfusion suit was then used to increase esophageal temperature by 0.8°C above resting. Participants then performed a metaboreflex activation protocol consisting of 90 s isometric handgrip exercise (40% of their pre-determined maximum voluntary contraction), followed by 150 s of brachial occlusion (trapping produced metabolites within the limb). Metaboreflex-induced sweating was quantified as the change in global sweat rate (from pre-isometric handgrip exercise to brachial occlusion), estimated as the surface area-weighted average of local sweat rate on the abdomen, axilla, chest, bicep, quadriceps, and calf, measured using ventilated capsules (3.8 cm2). We also explored whether this response differed between body regions. The change in global sweat rate due to metaboreflex activation was significantly greater in HYP compared to ISO (0.03 mg/min/cm2 [95% confidence interval: 0.00, 0.06]; p=0.047), but was not modulated by body region (site*condition interaction: p=0.679). These findings indicate that extracellular hyperosmolality augments metaboreflex-induced increases in global sweat rate, with no evidence for region-specific differences.

Getting the best GRIP on blood pressure control: Investigating a cost-effective isometric handgrip alternative

Objectives The World Health Organization emphasises the need for cost-effective alternative methods to lower blood pressure (BP). Endorsed nationally in HTN guidelines, isometric handgrip (IHG) training is an alternative method of BP control. The purpose of this study was to compare the BP, heart rate (HR) and rates of perceived exertion (RPE) responses between a bout of IHG training performed using the traditional computerized device and a more affordable, inflatable stress ball. Methods Twenty healthy adults performed one bout (4, 2-min isometric contractions, with 1-min rests between each contraction at 30% maximal voluntary contraction) of IHG training using the traditional computerized device, and one bout with the inflatable stress ball. BP, HR, and RPE were recorded. Results No statistically significant differences between devices were observed with HR, BP, and RPE ( p < 0.05). However, average RPE for both devices ranged between 5 and 6 indicating that participants were rating 30% of their MVC, consistent with previous work. Discussion The similar cardiovascular and psychophysical responses provide support for the potential use of this low individual- and provider-burden, cost-efficient IHG device, and lay the foundation for a future training study to test the hypothesis of benefit.