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Exercise and Life Style Modification in Health and Disease: Focus on the Immunology, Frailty, and Cardiovascular Function

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 44249

Special Issue Editors


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Chief Guest Editor
Department of Physical Education, University of Dong-Eui, 995 Eomgwangno, Busanjin-gu, Busan 471, Republic of Korea
Interests: exercise physiology; immunology; obesity; exercise; nutrition; physical allergy; metabolic syndrome; dance-intervention
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
School of Health and Kinesiology, University of Nebraska-Omaha, 6001 Dodge St, Omaha, NE 68182, USA
Interests: cardiovascular physiology; aging; exercise; endothelial function; hypertension
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Health & Kinesiology - Vascular Research Lab, University of Nebraska at Omaha | UN Omaha, 6001 Dodge St, Omaha, NE 68182, USA
Interests: cardiovascular physiology; chronic ischemia; exercise; endothelial function; mitochondrial dysfunction
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Cardiovascular and immunological disease has been classified as the number-one killer of both men and women worldwide. Over several decades, a greater understanding has been obtained of abilities of exercise, dance intervention, and lifestyle factors to positively influence risk factors for cardiovascular disease, such as immune function, inflammation, oxidative stress, and vascular dysfunction. However, the mechanisms underlying these exercise and lifestyle modification-mediated beneficial effects on these specified risk factors have not been well elucidated, and therefore, mechanistic studies are in urgent need to examine how dietary and lifestyle changes, independently or in combination with each other, influence these processes. Additionally, the mechanisms behind the beneficial effects of physical activity and nutritional intervention on human health, considering aging-associated frailty, immunity and dynapenia (loss of muscle strength) have not been well documented yet. Therefore, this Special Issue examines the health effects of exercise and life style modification on exercise immunology, cardiovascular risks, and skeletal muscular dysfunction and performance. Further insight into these mechanisms will be beneficial for researchers and clinicians alike to develop novel interventions to help to reduce risks for cardiovascular disease, thereby potentially reducing overall disease risk worldwide.

Dr. Yi-Sub Kwak
Dr. Song-Young Park
Dr. Elizabeth Pekas
Guest Editors

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Keywords

  • exercise
  • life style modification
  • aging
  • cardiovascular health
  • immunology
  • frailty
  • arterial stiffness

Published Papers (13 papers)

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Research

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10 pages, 567 KiB  
Article
Multi-Component Intervention Program on Habitual Physical Activity Parameters and Cognitive Function in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial
by Min-Ki Jeong, Kyung-Won Park, Je-Kwang Ryu, Gwon-Min Kim, Hyun-Hun Jung and Hyuntae Park
Int. J. Environ. Res. Public Health 2021, 18(12), 6240; https://doi.org/10.3390/ijerph18126240 - 9 Jun 2021
Cited by 19 | Viewed by 4609
Abstract
Age-related dementia refers to a state in which someone experiences multiple cognitive function impairment due to degenerative brain disease, and which causes difficulties in their daily life or social life. Dementia is the most common and serious obstacle in later life. Early intervention [...] Read more.
Age-related dementia refers to a state in which someone experiences multiple cognitive function impairment due to degenerative brain disease, and which causes difficulties in their daily life or social life. Dementia is the most common and serious obstacle in later life. Early intervention in the case of patients who are in the mild cognitive impairment (MCI) stage among the high-risk group can maintain and improve their cognitive function. The purpose of the current trial is aimed at investigating the association between a multi-component (exercise with cognitive) intervention program and habitual physical activity parameters on cognitive functions in MCI patients. Neuropsychological cognitive and depression assessments were performed by neuropsychologists according to normalized methods, including the Korean mini-mental State examination (K-MMSE) and modified Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog) and cognitive assessment tool (attention, processing speed), and the Korean version of the geriatric depression scale (SGDS-K), both at baseline and at a 12 weeks follow-up. The 12-week multi-component intervention improved cognitive function and habitual physical activity parameters in patients with MCI relative to controls. A multi-component intervention program for patients with MCI is considered to be an effective method of dementia prevention by improving global (ADAS-Cog) and frontal (trail-making test, digit symbol substitution test) cognition and habitual physical activity parameters such as moderate to vigorous physical activity and step count. In addition, it is important to encourage habitual physical activities to ensure that exercise intervention strategies are carried out at the duration and intensity required for improving physical and cognitive wellbeing and obtaining health benefits. Full article
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14 pages, 596 KiB  
Article
Effects of Regular Taekwondo Intervention on Health-Related Physical Fitness, Cardiovascular Disease Risk Factors and Epicardial Adipose Tissue in Elderly Women with Hypertension
by Yun Hwan Kim, Min Ki Jeong, Hyuntae Park and Sang Kab Park
Int. J. Environ. Res. Public Health 2021, 18(6), 2935; https://doi.org/10.3390/ijerph18062935 - 12 Mar 2021
Cited by 16 | Viewed by 3401
Abstract
Regular exercise has been proven to prevent hypertension and to help in the management of hypertension. There is a lack of studies examining changes in these issues as a result of Taekwondo training intervention. The aim of the current trial is to identify [...] Read more.
Regular exercise has been proven to prevent hypertension and to help in the management of hypertension. There is a lack of studies examining changes in these issues as a result of Taekwondo training intervention. The aim of the current trial is to identify the effects of a regular Taekwondo (TKD) training program on health-related physical fitness (HRPF), cardiovascular disease (CVD) risk factors, inflammatory factors, and epicardial adipose tissue (EAT) in elderly women with hypertension. To accomplish this, 20 participants, who were older women with hypertension, were divided into a TKD group (n = 10) and a control group (n = 10). The TKD program was conducted in program for 90 min, three times a week, for 12 weeks. Outcomes, including body composition, blood pressure (BP), HRPF, cardiovascular risk factor and EAT, were measured before and after the Taekwondo program. The 12-week TKD program improved body composition, BP, HRPF, CVD risk factor, and EAT in elderly women with hypertension relative to controls. Meanwhile, EAT and interukin-1β (r = 0.530, p < 0.05), monocyte chemotactic protein-1 (r = 0.524, p < 0.05), triglyceride (r = 0.493, p < 0.05) and sedentary behavior (r = 0.459, p < 0.05) presented a positive correlation, while EAT and lean body mass (r = −0.453, p < 0.05) showed a negative correlation. The 12-week regular TKD training intervention was found to be effective in reducing the thickness of EAT measured by multi-detector computed tomography and can also enhance health-related physical fitness and risk factors of CVD in older individuals with hypertension. Full article
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9 pages, 1075 KiB  
Article
An Association between Lower Extremity Function and Cognitive Frailty: A Sample Population from the KFACS Study
by Gwon-Min Kim, Bo-Kun Kim, Du-Ri Kim, Yung Liao, Jong-Hwan Park and Hyuntae Park
Int. J. Environ. Res. Public Health 2021, 18(3), 1007; https://doi.org/10.3390/ijerph18031007 - 23 Jan 2021
Cited by 10 | Viewed by 2792
Abstract
The present study aimed to define the physical function and lipid profile for physical and cognitive frailty in community-dwelling Korean older adults. A total of 229 participants (age = 76.76 ± 3.72 years; body mass index = 24.83 ± 3.15) were classified into [...] Read more.
The present study aimed to define the physical function and lipid profile for physical and cognitive frailty in community-dwelling Korean older adults. A total of 229 participants (age = 76.76 ± 3.72 years; body mass index = 24.83 ± 3.15) were classified into four groups: robust, pre-frailty, cognitive decline, and cognitive frailty. An analysis on the four groups was performed to measure their physical and cognitive function, as well as blood biomarkers. The area under (AUC) the receiver operating characteristic curve (ROC) indicated that the 6-min Walk Test (6MWT), Timed Up and Go test (TUG), and Five Times Sit-to-Stand test (FTSS) had the potential to distinguish the capacity of an old adult to predict cognitive frailty. The 6MWT had a higher sensitivity and the TUG and FTSS tests had greater specificity. With cognitive frailty as a categorical variable, cognitive frailty status was a significant predictor of the TUG (odds ratio (OR) 2.897; 95% confidence interval (CI), 1.283–6.541), FTSS (OR 3.337; 95% CI 1.451–7.673), and 6MWT (OR 0.204; 95% CI 0.070–0.591) tests. Our findings indicate that the 6MWT, TUG, and FTSS tests are closely related to cognitive frailty and can provide potential prognostic cutoff points. Full article
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17 pages, 5639 KiB  
Article
In Vitro and In Vivo Effects of Fermented Oyster-Derived Lactate on Exercise Endurance Indicators in Mice
by Storm N. S. Reid, Joung-Hyun Park, Yunsook Kim, Yi Sub Kwak and Byeong Hwan Jeon
Int. J. Environ. Res. Public Health 2020, 17(23), 8811; https://doi.org/10.3390/ijerph17238811 - 27 Nov 2020
Cited by 8 | Viewed by 2369
Abstract
Exogenous lactate administration has more recently been investigated for its various prophylactic effects. Lactate derived from potential functional foods, such as fermented oyster extract (FO), may emerge as a practical and effective method of consuming exogenous lactate. The current study endeavored to ascertain [...] Read more.
Exogenous lactate administration has more recently been investigated for its various prophylactic effects. Lactate derived from potential functional foods, such as fermented oyster extract (FO), may emerge as a practical and effective method of consuming exogenous lactate. The current study endeavored to ascertain whether the lactate derived from FO may act on muscle cell biology, and to what extent this may translate into physical fitness improvements. We examined the effects of FO in vitro and in vivo, on mouse C2C12 cells and exercise performance indicators in mice, respectively. In vitro, biochemical analysis was carried out to determine the effects of FO on lactate content and muscle cell energy metabolism, including adenosine triphosphate (ATP) activity. Western blot analysis was also utilized to measure the protein expression of total adenosine monophosphate-activated protein kinase (AMPK), p-AMPK (Thr172), lactate dehydrogenase (LDH), succinate dehydrogenase (SDHA) and peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in response to FO administration. Three experimental groups were formed: a positive control (PC) treated with 1% horse serum, FO10 treated with 10 μg/mL and FO50 treated with 50 μg/mL. In vivo, the effects of FO supplementation on exercise endurance were measured using the Rota-rod test, and Western blot analysis measured myosin heavy-chain 2 (MYH2) to assess skeletal muscle growth, alongside p-AMPK, total-AMPK, PGC-1α, cytochrome C and UCP3 protein expression. Biochemical analysis was also performed on muscle tissue to measure the changes in concentration of liver lactate, lactate dehydrogenase (LDH), glycogen and citrate. Five groups (n = 10/per group) consisted of a control group (CON), exercise group (Ex), positive control treated with Ex and 500 mg/kg Taurine (Ex-Tau), Ex and 100 mg/kg FO supplementation (Ex-FO100) and Ex and 200 mg/kg FO supplementation (Ex-FO200) orally administered over the 4-week experimental period.FO50 significantly increased PGC-1α expression (p < 0.001), whereas both FO10 and FO50 increased the expression of p-AMPK (p < 0.001), in C2C12 muscle cells, showing increased signaling important for mitochondrial metabolism and biogenesis. Muscle lactate levels were also significantly increased following FO10 (p < 0.05) and FO50 (p < 0.001). In vivo, muscle protein expression of p-AMPK (p < 0.05) and PGC-1α were increased, corroborating our in vitro results. Cytochrome C also significantly increased following FO200 intake. These results suggest that the effects of FO supplementation may manifest in a dose-response manner. FO administration, in vitro, and supplementation, in vivo, both demonstrate a potential for improvements in mitochondrial metabolism and biogenesis, and even for potentiating the adaptive effects of endurance exercise. Mechanistically, lactate may be an important molecule in explaining the aforementioned positive effects of FO. Full article
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9 pages, 1384 KiB  
Article
Resistance Exercise Regulates Hepatic Lipolytic Factors as Effective as Aerobic Exercise in Obese Mice
by Ju Yong Bae
Int. J. Environ. Res. Public Health 2020, 17(22), 8307; https://doi.org/10.3390/ijerph17228307 - 10 Nov 2020
Cited by 10 | Viewed by 2295
Abstract
Non-alcoholic fatty liver disease (NAFLD) is associated with obesity. The effect of resistance exercise without dietary restriction on the regulation of hepatic lipolytic factors is unclear. This study aimed to analyze the effects of aerobic and resistance exercise on hepatic lipolytic factors of [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) is associated with obesity. The effect of resistance exercise without dietary restriction on the regulation of hepatic lipolytic factors is unclear. This study aimed to analyze the effects of aerobic and resistance exercise on hepatic lipolytic factors of obese mice. High-fat diet (HFD)-induced obese mice were divided into HFD + sedentary (HF), HFD + aerobic exercise, and HFD + resistance exercise groups. Exercise group mice were subjected to treadmill or ladder climbing exercise for 8 weeks. Fat mass and liver triglycerides were significantly decreased in both aerobic and resistance training groups. In the results of protein levels related to hepatic steatosis, HFD significantly increased liver cannabinoid receptor 1 and sterol-regulatory element binding protein 1 (SREBP-1). Both aerobic and resistance training significantly (p < 0.05) increased liver carnitine palmitoyltransferase-1, phosphor-AMP-activated protein kinase (p-AMPK), and p-AMPK/AMPK and decreased liver SREBP-1. However, the type of exercise did not exert any significant effects on these protein levels. Thus, resistance exercise, similarly to aerobic exercise, effectively regulated hepatic lipolytic factors of obese mice. Therefore, a sustainable type of exercise selected based on the fitness level, disease type, musculoskeletal disorder status, and preference of the patients is the best exercise intervention for alleviating NAFLD. Full article
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11 pages, 541 KiB  
Article
The Relationship between Flourishing and Depression in Children in the U.S. Using a Socioecological Perspective
by Chang-Yong Jang, Eun-Hyung Cho, Yi-Sub Kwak and TaeEung Kim
Int. J. Environ. Res. Public Health 2020, 17(21), 8246; https://doi.org/10.3390/ijerph17218246 - 8 Nov 2020
Cited by 7 | Viewed by 2808
Abstract
Children’s flourishing is likely to be associated with achieving a positive mental and physical quality of life, which is considered as an important factor for helping children to overcome psychological adversity during the critical stage of emotional development. This study examined the relationships [...] Read more.
Children’s flourishing is likely to be associated with achieving a positive mental and physical quality of life, which is considered as an important factor for helping children to overcome psychological adversity during the critical stage of emotional development. This study examined the relationships between children’s flourishing and childhood depression. This was a cross-sectional study using the 2011–2012 National Children’s Health Survey in the U.S. The conceptual framework that guided this study was a modified ecological system theory model. Multiple regressions were performed to investigate the associations between flourishing and pediatric depression, controlling for demographics, physical activity-related behaviors, family and environmental conditions. A total of 45,309 children (representing 33,293,823 children at the population level) were identified in this study (mean age: 13.63 years; female: 48.7%). Children’s childhood depression was highly related to direct parenting functions, individual needs and environmental availabilities and accessibilities from a socioecological perspective. This study revealed multiple dimensions of how sociological factors influence children’s flourishing and mental health. Parents’ involvement in children’s physical activities and family and social support are crucial for children’s flourishing and mental health status. More attention needs to be paid to provide children with family and social support to help them to overcome and reduce childhood depression. Full article
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13 pages, 578 KiB  
Article
Correlation of Pre-Hypertension with Carotid Artery Damage in Middle-Aged and Older Adults
by Jinkee Park, Yongseong Na, Yunjung Jang, Song-Young Park and Hyuntae Park
Int. J. Environ. Res. Public Health 2020, 17(20), 7686; https://doi.org/10.3390/ijerph17207686 - 21 Oct 2020
Cited by 2 | Viewed by 2344
Abstract
The intima–media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between [...] Read more.
The intima–media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and β-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults. Full article
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13 pages, 980 KiB  
Article
Short-Term ONX-0914 Administration: Performance and Muscle Phenotype in Mdx Mice
by Dongmin Kwak, Guoxian Wei, LaDora V. Thompson and Jong-Hee Kim
Int. J. Environ. Res. Public Health 2020, 17(14), 5211; https://doi.org/10.3390/ijerph17145211 - 19 Jul 2020
Cited by 1 | Viewed by 2330
Abstract
Duchenne muscular dystrophy (DMD) is a severe muscle-wasting disease. Although the lack of dystrophin protein is the primary defect responsible for the development of DMD, secondary disease complications such as persistent inflammation contribute greatly to the pathogenesis and the time-dependent progression of muscle [...] Read more.
Duchenne muscular dystrophy (DMD) is a severe muscle-wasting disease. Although the lack of dystrophin protein is the primary defect responsible for the development of DMD, secondary disease complications such as persistent inflammation contribute greatly to the pathogenesis and the time-dependent progression of muscle destruction. The immunoproteasome is a potential therapeutic target for conditions or diseases mechanistically linked to inflammation. In this study, we explored the possible effects of ONX-0914 administration, an inhibitor specific for the immunoproteasome subunit LMP7 (ß5i), on motor performance, muscular pathology and protein degradation in 7-week old MDX mice, an age when the dystrophic muscles show extensive degeneration and regeneration. ONX-0914 (10 mg/kg) was injected subcutaneously on Day 2, 4, and 6. The mice were evaluated for physical performance (walking speed and strength) on Day 1 and 8. We show that this short-term treatment of ONX-0914 in MDX mice did not alter strength nor walking speed. The physical performance findings were consistent with no change in muscle inflammatory infiltration, percentage of central nuclei and proteasome content. Taken together, muscle structure and function in the young adult MDX mouse model are not altered with ONX-0914 treatment, indicating the administration of ONX-0914 during this critical time period does not exhibit any detrimental effects and may be an effective treatment of secondary complications of muscular dystrophy after further investigations. Full article
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14 pages, 515 KiB  
Article
Comparisons between Manual Lymph Drainage, Abdominal Massage, and Electrical Stimulation on Functional Constipation Outcomes: A Randomized, Controlled Trial
by Jacqueline S. Drouin, Lucinda Pfalzer, Jung Myo Shim and Seong Jung Kim
Int. J. Environ. Res. Public Health 2020, 17(11), 3924; https://doi.org/10.3390/ijerph17113924 - 1 Jun 2020
Cited by 7 | Viewed by 6268
Abstract
Background: Evidence supports abdominal massage (AM) or electrical stimulation (ES) as effective in treating functional constipation (FC). Manual lymph drainage (MLD) may also be beneficial, however, it was not previously investigated or compared to ES and AM. Methods: Sixteen college-aged males and 36 [...] Read more.
Background: Evidence supports abdominal massage (AM) or electrical stimulation (ES) as effective in treating functional constipation (FC). Manual lymph drainage (MLD) may also be beneficial, however, it was not previously investigated or compared to ES and AM. Methods: Sixteen college-aged males and 36 females were recruited. Participants were randomly assigned to MLD, AM or ES. Heart rate variability (HRV) measures for total power (TP), high frequency (HF), low frequency and LF/HF ratio assessed ANS outcomes. state-trait anxiety inventory (STAI) and stress response inventory (SRI) assessed psychological factors and bowel movement frequency (BMF) and duration (BMD) were recorded daily. Results: MLD significantly improved all ANS measures ( p 0.01 ); AM significantly improved LF, HF and LF/HF ratios (p = 0.04); and ES significantly improved LF (p = 0.1). STAI measures improved, but not significantly in all groups. SRI improved significantly from MLD (p < 0.01), AM (p = 0.04) and ES (p < 0.01), but changes were not significant between groups. BMD improved significantly in all groups ( p 0.02). BMF improved significantly only following MLD and AM (p < 0.1), but differences between groups were not significant (p = 0.39). Conclusions: MLD significantly reduced FC symptoms and MLD had greater improvements than AM or ES. Full article
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15 pages, 2096 KiB  
Article
Habitual Combined Exercise Protects against Age-Associated Decline in Vascular Function and Lipid Profiles in Elderly Postmenopausal Women
by Elizabeth J. Pekas, John Shin, Won-Mok Son, Ronald J. Headid III and Song-Young Park
Int. J. Environ. Res. Public Health 2020, 17(11), 3893; https://doi.org/10.3390/ijerph17113893 - 30 May 2020
Cited by 14 | Viewed by 3616
Abstract
Postmenopausal status is associated with increased risks for cardiovascular diseases (CVD). This study investigated differences in vascular function, lipids, body composition, and physical fitness in elderly postmenopausal women active in combined resistance and aerobic exercise (CRAE) training for 1 year versus a sedentary [...] Read more.
Postmenopausal status is associated with increased risks for cardiovascular diseases (CVD). This study investigated differences in vascular function, lipids, body composition, and physical fitness in elderly postmenopausal women active in combined resistance and aerobic exercise (CRAE) training for 1 year versus a sedentary cohort of similar-in-age counterparts. Elderly postmenopausal women performing habitual CRAE training for 1 year (age ~75 year; CRAE, n = 57) and elderly sedentary postmenopausal women (age ~78 year; SED, n = 44) were recruited. Arterial stiffness (brachial-to-ankle pulse-wave velocity, baPWV), blood pressure, blood lipids, anthropometrics, 2-min walking distance, and muscular strength were assessed for both groups. There were significant differences for baPWV, systolic blood pressure, low-density lipoprotein, and body fat percentage, which were significantly lower (p < 0.05) in CRAE vs. SED, and both 2 min walking distance and muscular strength were significantly greater (p < 0.05) in CRAE vs. SED. These results indicate that elderly postmenopausal women participating in habitual CRAE training may have better protection against risks for CVD and have better physical fitness compared to SED counterparts. Full article
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10 pages, 615 KiB  
Article
The Relationship between Chronotype, Physical Activity and the Estimated Risk of Dementia in Community-Dwelling Older Adults
by Ngeemasara Thapa, Boram Kim, Ja-Gyeong Yang, Hye-Jin Park, Minwoo Jang, Ha-Eun Son, Gwon-Min Kim and Hyuntae Park
Int. J. Environ. Res. Public Health 2020, 17(10), 3701; https://doi.org/10.3390/ijerph17103701 - 24 May 2020
Cited by 20 | Viewed by 3800
Abstract
Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. [...] Read more.
Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to measure the estimated risk of dementia. The evening chronotype, low daily physical activity, and dementia were positively associated with each other. The participants with low physical activity alongside evening preference had 3.05 to 3.67 times higher estimated risk of developing dementia, and participants with low physical activity and morning preference had 1.95 to 2.26 times higher estimated risk than those with high physical activity and morning preference. Our study design does not infer causation. Nevertheless, our findings suggest that chronotype and daily physical activity are predictors of the risk of having dementia in older adults aged 70 years and above. Full article
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11 pages, 422 KiB  
Article
The Psychometric Characteristic of the Taekwondo Electronic Protector Cognition Scale: The Application of the Rasch Model
by Eun-Hyung Cho, Chang-Yong Jang, Yi-Sub Kwak and Eung-Joon Kim
Int. J. Environ. Res. Public Health 2020, 17(10), 3684; https://doi.org/10.3390/ijerph17103684 - 23 May 2020
Cited by 3 | Viewed by 2356
Abstract
This research was to investigate the psychometric characteristics of the electronic protector cognition scale by the infit and outfit of taekwondo athletes. Participants were 216 athletes (male = 109; female = 117) from 19 countries competed at the 19th Taekwondo World Championships. The [...] Read more.
This research was to investigate the psychometric characteristics of the electronic protector cognition scale by the infit and outfit of taekwondo athletes. Participants were 216 athletes (male = 109; female = 117) from 19 countries competed at the 19th Taekwondo World Championships. The electronic protector cognition scale consisting of 24-item with four subscales was utilized. The electronic protector cognition scale used a five-point Likert grading with 1 (not at all) to 5 (very likely). Analysis using IBM SPSS STATISTICS version 23 (IBM SPSS, Inc., Chicago, IL, USA) was conducted for the 226 data sets collected. WINSTEPS 3.74 (Linacre, 2015) was used for calculating subject reliability, item goodness-of-fit, scale propriety, and item level of difficulty, in order to apply the item response theory to the psychometric characteristics of electronic protectors. The research results showed that it was suitable for subject infit/outfit in taekwondo electronic protector cognition scale as 1.00~1.01 and the input/output of taekwondo electronic protector cognition scale as 1.00~1.01. Secondly, five-point scales were reviewed to be suitable for scale propriety, resulting from stage index judgment. Thirdly, 8 items showed problems in item goodness-of-fit. Finally, scale propriety was reported to be suitable considering the ability distribution of taekwondo players and the level of scale difficulty. Full article
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Review

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15 pages, 6110 KiB  
Review
Microvascular Dysfunction in Peripheral Artery Disease: Is Heat Therapy a Viable Treatment?
by Cody P. Anderson, Elizabeth J. Pekas and Song-Young Park
Int. J. Environ. Res. Public Health 2021, 18(5), 2384; https://doi.org/10.3390/ijerph18052384 - 1 Mar 2021
Cited by 13 | Viewed by 3930
Abstract
Peripheral artery disease (PAD) is characterized by the development of atherosclerotic plaques in the lower-body conduit arteries. PAD is commonly accompanied by microvascular disease, which may result in poor wound healing, plantar ulcer development, and subsequent limb amputation. Understanding the mechanisms underlying the [...] Read more.
Peripheral artery disease (PAD) is characterized by the development of atherosclerotic plaques in the lower-body conduit arteries. PAD is commonly accompanied by microvascular disease, which may result in poor wound healing, plantar ulcer development, and subsequent limb amputation. Understanding the mechanisms underlying the development of plantar ulcers is a critical step in the development of adequate treatment options for patients with PAD. Skin is classified into two major components: glabrous and non-glabrous. These skin types have unique microcirculation characteristics, making it important to differentiate between the two when investigating mechanisms for plantar ulcer development in PAD. There is evidence for a microcirculation compensatory mechanism in PAD. This is evident by the maintenance of basal microcirculation perfusion and capillary filling pressure despite a reduced pressure differential beyond an occlusion in non-critical limb ischemia PAD. The major mechanism for this compensatory system seems to be progressive vasodilation of the arterial network below an occlusion. Recently, heat therapies have emerged as novel treatment options for attenuating the progression of PAD. Heat therapies are capable of stimulating the cardiovascular system, which may lead to beneficial adaptations that may ultimately reduce fatigue during walking in PAD. Early work in this area has shown that full-body heating is capable of generating an acute cardiovascular response, similar to exercise, which has been suggested as the most efficient treatment modality and may generate adaptations with chronic exposure. Heat therapies may emerge as a conservative treatment option capable of attenuating the progression of PAD and ultimately impeding the development of plantar ulcers. Full article
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